The inexplicable rise of kidney disease in Sri Lanka’s farming communities

Residents of several ‘hotspots’ have been afflicted by kidney failure in the past few decades – and no one knows why.

Polonnaruwa, Sri Lanka – In the sleepy, verdant village of Ambagaswewa, in the Polonnaruwa district of Sri Lanka’s North Central province, 63-year-old TMH Gamini Sunil Thennakoon’s life is peaceful for the most part. On the brink of retirement, he still spends most days out working his rice paddies but is also content spending his days playing with his grandchildren and chatting with his wife and two daughters. Since boyhood, Thennakoon has farmed rice here across 2 hectares (20,000sqm). A majority-farming nation, agriculture plays a central role in Sri Lanka’s economy and constitutes 21.7 percent of total exports.

But for more than seven years, Thennakoon has been coping with unexplained kidney problems. The symptoms of his condition – abdominal and back pain – are not bad enough to require dialysis yet, but he does take tablets to keep the pain under control.

“I’m not sure what caused the issue, because the rest of my family seems fine,” he says calmly, his granddaughter straddling his lap. She reaches over to swipe at one of the puppies roaming the front porch of their home, where we’re sitting. Ambagaswewa, proliferated by rice paddies, is otherwise a jungle – birdsong twangs through the already humid morning air, luscious vines and creepers on the verge of overtaking farmers’ homes. It’s a peaceful place.

Every month, Thennakoon makes a round trip of more than 30km to a local government hospital for a check-up; during these trips, he has to hire labourers to work in the rice paddies and cover his absence.

Thennakoon is not the only one who has been affected in this way, here.

U Subasinha, a