Clean water flows from well of goodwill
Clean water flows from well of goodwill
A pledge to solve human dilemmas ‘without discrimination’ has pitched The Salvation Army against a killer disease in Sri Lanka
The farmer’s face was incandescent with happiness as he gazed up at the two-storey structure built on land he had given away so that other lives in his village might be saved, if not his own.
For Lathpana Thilakaratne, 60, had not long to live. The scourge that has the world scrambling to find its cause had him in its death-grip. It takes two lives a month in his village, Damsopura, off Polonnaruwa, Sri Lanka.
Chronic Kidney Disease (CKD) is the fastest-growing killer since HIV/AIDS and although in affluent societies it is linked to diabetes, in poorer communities the causes are unclear: the common denominators are farming, heat and poverty. Sri Lanka’s North Central Province is a global hotspot for CKDu (the “u” standing for unknown origin).
There is an emerging epidemic of death among younger adults in Sri Lanka due to CKD of unknown or mixed causes, the Global Burden of Diseases study reported last year. Diagnosis is often a death sentence because CKDu is a quiet killer.
“Once we diagnose it, it’s too late – the patients are in Stage 4 or 5,” says Dr Malin Meththasinghe, Polonnaruwa District CKD Prevention Medical Officer. “We can do nothing.”
CKD symptoms often become noticeable only by Stage 4, but by then almost three-quarters of the body’s kidney functions have closed down: the body is filling with unflushed waste, the brain cells and tissue are poisoned and the victim lives in dread as his heart beats unevenly, breathing becomes difficult and he grows lifeless. Stage 5 is the end-stage, with death coming within weeks.
Male farmers are the main victims. “The entire family has to face the problem because the breadwinner is sick,” Dr Meththasinghe says. The World Health Organisation believes more than one in 10 of the North Central Province population has CKD.
The arithmetic is hopeless: only three out of every five victims will still be alive in two years, Dr Meththasinghe says. Beyond that the picture is worse.
Sri Lanka pulled high-tech foreign resources this year into the struggle to discover the cause of CKDu,with the Australian Nuclear Science and Technology Organisation’s Synchotron and Centre for Neutron Scattering offering assistance. Until the magic bullet is found early detection is a must and safe water is key to survival.
Both factors are out of reach for many in the district’s remote villages. They live far from help, breathing a mist of arsenic, lead, cadmium and mercury from agro-chemicals used in vast quantities that have poisoned their soil and groundwater.
Enter an unlikely player: The Salvation Army in Sri Lanka. Four years ago, the organisation decided to partner with Sri Lankan bodies in the Polonnaruwa District “to meet human need without discrimination”, according to its international mission statement. That resolve was put into action after a surprise visit to its headquarters by NCP Councillor Amarakeerthi Athukorale in 2013.
“He was so concerned about the high rate of kidney disease in his area that he came to Colombo to ask us for help,” says the Army's Communications Officer in Sri Lanka, Major Peter McGuigan. He had seen the Salvation Army working effectively in past disasters.
Call it divine providence, but around this time the Canada and Bermuda Territory of The Salvation Army contacted Colombo and said it wanted to invest heavily in the welfare of Sri Lankans in need. Could funds be put to good use? Then the USA Western Territory of The Salvation Army decided it also wanted to contribute. With these funds, The Salvation Army has made a difference in the lives of thousands of people in the Polonnaruwa District in just two and a half years.
The money from Canada is being spent to build 15 “safe water” community wells with super-efficient filtration units from Aqua Technologies and ABC Trade and Investments. These two-storey structures are being built at a cost of $A16,000 each, and the eight completed so far provide safe drinking water for more than 8000 villagers. Two others are almost complete.
Dr Meththasinghe is glad. If there is one thing he would ask for to help fight the spread of CKD, he says, “Mainly pure drinking water. We think we can settle most of the problem if we have that.”
The story of how The Salvation Army is going about its work is as compelling as the work itself. It must contend with poverty, ignorance, hostility towards Christian organisations that use charity to win conversions and cynicism about city folk who come and promise lots but don’t deliver.
The ‘Salvos’ are earning trust, Major McGuigan says. Of the eight wells so far completed, three are on plots donated by local farmers, a demonstration of faith in the work.
The organisation relies heavily in Polonnaruwa on Salvation Army soldier Dinuka Rajapakshe –“a great operator”, according to Major McGuigan – and his wife, Rasangika Rajapakshe.
Mr Rajapakshe needs the villagers totally on board because each project is a self-sustaining community endeavour. With advice from the Water Board he selects a village in most need of help – in some, residents had to walk up to 5km a day to fetch drinking water – and an initial meeting is held with the local MP, Divisional Secretary, grama niladhari and the village samithiya (society).
When the samithiya questions The Salvation Army’s motives, the team displays documentation and film of previous projects. A committee of 10 villagers is chosen to explore the issue.
Next is the “don’t just believe us, ask them” moment: the committee is invited to meet a similar committee at a village that has already received a well. “After that, The Salvation Army team steps back and lets the two village committees talk together and decide whether to come back to us,” Mr Rajapakshe said.
Rapport between the two committees leads to an honest exchange of information and the new committee soon calls its village together to say the well project should go ahead.
There is often a difficulty in getting everyone together. In villages such as Damsopura most paddy and chena farmers live below the poverty line and dare not spare a day away from their plots, which have been divided so many times over generations that they are uneconomical.
The Salvation Army projects require transparency and consensus, so when Mr Rajapakshe found farmers weren’t turning up because they needed to work in their fields, he held his meetings on the one day in the month every villager had to attend a samithiya meeting.
For those who doubted the Salvos, he brought local health experts and water board officials to answer questions. For those who suspected the project was a Trojan horse for conversions to Christianity, Mr Rajapakshe says, “We say upfront The Salvation Army is a Christian organisation but most of our staff here are Buddhist and we have Tamils and Muslims. We don’t discriminate.”
Once the village has met and approved a well-water purification plant, The Salvation Army hands day-to-day control of the project to the samithiya to contract labour for the project and keep accounts.
When the well is built, water is sold at 1 Sri Lankan Rupee (about 8 cents) a litre (the neediest get it free) and the proceeds are banked and used for upkeep and employment seed funding. One samithiya has collected 200,000 rupees (about $A1600) which it is using to fund repayable micro-finance loans to needy families.The well quickly becomes a community hub where people share their lives and tell their stories.
Meanwhile, Rasangika Rajapakshe travels throughout the Polonnaruwa countryside with staff from The Salvation Army’s Mobile Medical Clinic established with the funds from the Army's USA Western Territory.
“Mobile screening for kidney disease is very important for people living in remote villages,” Dr Meththasinghe says.
The Salvation Army mobile screening unit – there are two others run by the government – has screened about 20,000 people since 2014 and found more than one in 20 have CKD.
The mobile team sees families broken by the illness. In Welikanda village, a young farmer, just 29, came to be screened. Sadly, for him it was too late.
“He had Stage 4 kidney disease,” Mrs Rajapakshe says. “Because he was too sick to earn, his wife went to work as a maid in Colombo and his eldest daughter, 13 years old, had to stop going to school to look after the two younger ones. The girls were vulnerable because they had no adult protection.
"The father died eight months later. The mother came back for her husband’s funeral but I don’t know what has happened since.”
Because farmers say they work too hard to attend clinics, in July The Salvation Army began holding night clinics. Four-hundred men came to the last one.
Poverty-alleviation programs are run in concert with the mobile clinics. In Welikanda, a family was trying to scratch a living out of the thin soil of its tiny land-holding. The mother, Irangani, fed the family mainly through making a little food to sell in town. The Salvation Army gave her bakery equipment to expand her range.
“During a follow-up visit we saw how happy they were,” the Army’s Business Co-ordinator for the Safe Water Wells Project, Dinusha Perera, says.
Irangani was selling more food and made a downpayment on a three-wheeler to take her bakery goods into town. The family rents a shop in town to sell more produce and is now saving money to set up a bakery in town.
“The family has received hope,” Ms Perera wrote to the donors whose funding reached all the way from Canada to the little family in Polonnaruwa.
Such stories of joy are why Rasangika Rajapaksha joined The Salvation Army. “Before I married Dinuka I didn’t like this kind of work,” she confesses. Then she watched him helping survivors of the 2004 tsunami.
“I saw poor people given support out of their sadness, given hope. I came to see that helping people in need gave me happiness,” she says.
In Damsopura last December, Lathpana Thilakaratne joined Mr Athukorala and other dignitaries to ceremonially declare open the safe water well built on land he, a poor farmer, had donated. “Tears were running down his face,” Major McGuigan says.
“When he heard about the wells we were building to prevent kidney disease he got up at a meeting and said he was dying but he wanted to donate land to have a common well built in Damsopura,” Mr Rajapakshe adds. “He wanted to die peacefully knowing his family and neighbours would be looked after.
“At the ceremony in December he said his last wish had been granted. We held his hand and let him declare the opening – it was very moving.
“He said, ‘There are many people who come to this village and give promises, but never like this. I am so happy’.”
First published in The Sunday Times, Sri Lanka. Republished with permission
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