Policy Aspects in Addressing Chronic Kidney Disease of an unknown/uncertain Etiology (CKDu)

Abstract

The issues associated with the prevalence of CKDu points to the need for re-visiting social policies, which are concerned with the several dimensions of the problem. It is necessary to examine whether policy priorities are sufficient to respond, not just to the health consequences of CKDu, but also to the psycho-social and cultural dimensions of the problem. The focus of this paper is to explain the ways in which CKDu impact on everyday life of people who live in affected communities and their discourse with regards to etiology and the origin of CKDu in their locality, and to revisit relevant social policies and assess their competency and limitations in responding effectively to the burning issues related to CKDu.12 Health hazards can occur in circumstances that may create extreme emergencies and life-threatening conditions. Chronic Kidney Disease of an unknown/ uncertain etiology (CKDu) has emerged as a health hazard in the North Western, North Central and Uva Provinces in Sri Lanka since late 1980s, and has now reached catastrophic proportions leading to the deterioration of health conditions, low productivity of livelihoods, and psycho-social problems in affected communities. Initially, CKDu was identified as a health hazard by local healthcare providers after investigating a considerable number of patients who visited them seeking treatment for symptoms such as continuing fever, back pain, swollen legs, headache, body-ache, kidney stones, urine infections and loss of appetite etc. While investigating patients with the above symptoms, the local healthcare providers were able to diagnose the disease as CKD but the etiology is yet to be determined as it goes beyond existing knowledge and a biomedical explanatory model with regard to renal failure. The local healthcare providers have also noticed that a number of patients visiting them with the above symptoms have been gradually increasing and therefore they conducted a series of screening programs