Monthly Archives: December 2013

タンティリマレ社会調査

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課題になっている原因不明慢性腎不全(CKDu)の調査のため3週間程の社会調査を行なった。目的は、CKDu発生率の高い地域を訪れ人々の農薬使用状況や病歴を調査し、今後の農薬分析活動に必要なデータを取得することだった。興味深い相関性は見れたが結論を出すにはまだまだデータの解析が必要。。。な感じです。

タンティリマレについて

タンティリマレはアヌラーダプラ市の北西にある、お寺を中心とした小さな町。Wilapattu国立公園と面していて自然や動物がきれい。お寺も有名でスリランカ人の中では観光地となっている。

今の状況

水道省は被害地に給水車で水を送っている。膨大な時間と燃料費がかかっている。設置された黒いタンクに毎月2回水が送られ、3家族が料理用と飲料水のみに使っている。掃除、シャワー、トイレ用などの水は既存の井戸から採っている。タンクは300コ以上ある!

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給水!

歴史的には人工貯水池や井戸を使用していた。貯水池や灌漑水路の技術は1000年程前から発展していて今でも使われている。文化遺産としてスリランカ人のプライドの元でもある。今の飲料水はほとんど井戸水。雨水を集めることもある。残念ながらこの地域の井戸水のほとんどが「飲料禁止」とされている。持続的な解決策が出来るまで水道省は車で水を届け続ける。

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雨水コレクター

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井戸

干ばつ

調査中、今年の干ばつについての話が多かった。飲料水は水道省が提供しているが、生活用水(掃除、洗濯、シャワーなど)が不足しており生活が苦しくなっていた人が多かった。トイレを流す水すらない。農業にも影響があった。

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カラカラな井戸。何か、動物がいる。。。

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作物への影響。この時期(11月)のトウモロコシは大人の身長位あるはず。。。

生活

普段首都のコロンボに住んでいる自分にとっては衝撃的で新鮮な経験だった。例えば、インタービュー中、話している人がその家の人じゃなかったり。実は世帯主の奥さんの弟で、周りにいた子供達もその人の子じゃなくて姪っ子だったり、隣の子だったり。自分の子供の様に抱いて、叱って、喋ってるから見た目だけじゃわからない。コミュニティ力がすごかった。どの国でもそうだけど、やっぱり都会はそのようなナニカを不足してる気がする。

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地域の代表的な家。電気が通ってないため屋根の太陽電池を使っている。技術が進んでるような、進んでないような。。。どっちだろう???

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停電中のデータ処理。。。毎日です。

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夕食の準備

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寺仲間!

自然との暮らし。。。

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Cheeず!

問題

CKDuの有病率や「水」の疑いは新しい発想ではない。様々な組織(政府機関、NGO、国際支援団体、学術機関など)が原因を調査したが、どこも成功したと言える結果を出してない。このような団体がタンティリマレに来るのも初めてではない。保健省、WHO、PLAN Sri Lankaと言うNGOなどが訪れ、水を分析し、結論を出していった。調査中に「水の硬度が高いため使用禁止と言われた」と述べる人と多くあった。「これは誰の結果?」と聞くと答えは大体以下の1つ:

①地元の保健員

②PLAN Sri Lanka

③覚えてない

誰が、どの分析方法で、何の基準を元に「硬度が高い」と決めたのか?このデータを探しているが、とても見つけにくい。どの基準で「高い」と決めたか。。。そしてどの基準で「高くないから飲んでも大丈夫」と決めたかを知ることが重要だと思う。そして、また僕らが入って同じことを繰り返してるんじゃないかなと思う不安もある。水の硬度だけじゃなくて農薬分析を開発しているから少しは違うはずだけど、結局はどうなんだろう?まぁ、活動内容とその結果の履歴をしっかり残すことも重要かな?

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放棄されたPlan Sri Lankaのプロジェクト

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 今後の活動

社会調査の結果を元に、今後は重要なサンプリングポイントを決め定期的な水分析を始める予定。分析結果とCKDuの発病地域の関係性が見えるかどうか。。。

 詳しい報告書はこちら!

https://drive.google.com/file/d/0Bzr4rabIe0tWZy1TN3Q0bUF6NW8/edit?usp=sharing
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Thanthilimale Social Survey

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A long-term social survey in a CKDu affected area was performed to get a better understanding of the dynamics between water usage and acquisition of the disease.  The target was to see where the disease was most  prevalent, learn about how people used water and pesticides (and other possible factors) and identify water sampling locations for future study.  Information on residents’ pesticide usage habits, water sources and medical histories were acquired using a survey format.  Some interesting correlations were seen, but more analyses are needed before conclusion can be drawn.

About Thanthilimale

Thanthilimale is a small town northwest of Anuradhapura.  It is famous for its temple, which is located on a rocky outcrop, stone carvings and bodhi tree (supposedly one of the oldest in Sri Lanka).  Directly to the west lies Willapattu National Park and lots of wildlife overflows into the town.

Current Situation

The National Water Supply and Drainage Board delivers water to people of the affected area by tanker.  This is very time and fuel consuming.  Up to three families share a tank, which is filled twice a month, for drinking and cooking only.  There are over 300 tanks to fill!

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Water delivery by tanker.

Historically, the local population depended on human-made reservoirs and dug wells to meet their water needs.  There is a rich and advanced culture of reservoirs and irrigation that goes back 1000 years in Sri Lanka.  Many of them remain in use today for irrigation.  Drinking water demands are mostly met by wells throughout the country.  Rain water collection is also sometimes used.  Unfortunately, many of the wells in the area have been determined to be “unfit for drinking” by various organizations.  Thus, the Water Board delivers water, until a more permanent solution to the issue can be found.

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Typical rainwater collection tank

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Typical well

Drought

Many people complained about the severe drought this year.  Although drinking water is supplied by the Water Board, many had no water for washing or toilets.  And if the delivered water ran out (which many people had) they literally had no water.  This was a very serious problem on very one’s mind as I went around doing the interviews.  The lack of rain was also severely affecting local crops.

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Waterless well

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Drought affecting crops. Corn is usually head high, almost ready to harvest this time of year (November).

Daily Life

Usually living in Colombo, time in Thanthilimale was refreshing and eye-opening at the same time.  There are definitely less amenities here, making dependence on others crucial for physical and social well-being.  I would visit a house and be well into my interview before realizing that the person I was talking to did not actually live there.  He/she was actually a sister or the owner’s husband’s cousin, or just a neighbor etc.  And the children running around were not theirs but their nephews, or their nephew’s kids etc.  People lived not in houses, but in the communities in which they were rooted and shared everything (including houses and parents and grandparents!).  It is a good thing that Colombo lacks.

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Typical house. You never knew if the person you were interviewing actually lived there, or was a sister/neighbor/wife’s cousin etc. Notice the Solar Panels on the roof. Only source of power in many households.

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Data entry during the almost nightly power outages. At least I didn’t have to worry about turning off the lights before going to bed!

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Making dinner! (and breakfast and lunch…)

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Friends at the temple.

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Smile!

Current Issues

The prevalence of CKDu and suspicion of water as a cause is not new in Thanthilimale or other areas of Sri Lanka.  Many organizations (Governmental, Non-governmental, international, academic etc) have attempted to find the cause, but most have failed.  Thanthilimale has been visited before by these organizations.  Public Health inspectors, local doctors, National health departments, the WHO, and NGOs such as PLAN Sri Lanka have all visited, sampled the water, given their conclusions and left.  During the interviewing process, I found that many families were told their well water was not fit to drink due to “High Hardness.”  When asked who gave this order, the answer was usually one of three: 1) The local Public Health Inspector, 2) PLAN Sri Lanka or 3) I don’t remember.  Records of the testing and results are proving very difficult to track down.  This information is vital to determine the actual hardness levels that constituted “high hardness.”  Knowing this also allows us to know one more thing: what levels were considered “safe to drink” and therefore, people continue to drink today.  And now, we are essentially there doing the same thing, testing again and leaving bad records.  The whole thing reminds me of a XKCDcartoon.  But swear, what we are trying to do is really different this time.  We are going after pesticides in the water!  Not just hardness.

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Abandoned PLAN Sri Lanka water supply scheme

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Next Steps

With the Social Survey results in hand, the next step is to determine vital sampling points.  About a dozen or so wells will be chosen to regularly sample and test for pesticides and try to correlate the results with incidents of CKDu.

A more detailed report can be found here:

https://drive.google.com/file/d/0Bzr4rabIe0tWZy1TN3Q0bUF6NW8/edit?usp=sharing