Abstract:
Increased incidence of Chronic Kidney Disease of Un-known Etiology (CKDUe)
since late 1990s in the dry zone agriculture regions like the North Central Province in
Sri Lanka has become a national issue. The social, cultural and environmental
changes occurred due to various developmcnt activitics in the region since 1980s
may have contributed significantly to change the livelihood of people ineluding their
food habits, lifestyle and directly or indirectly have influenced the emergence of
CKDUe as the main mortality factor. So far no detailed studies have been done to
document, behavioral and psychological changes of the residents in areas where the
prevalence of CKDUe is very high (in Anuradhapura District). Hence with the help
of a structured survcy questionnaire, a detailed study was carried out among 200
individuals in Padaviya Area to detenninc thc level of stress, marginalization and
depression of CKDUe a!lected fanners; fanner-families with CKDUe patients,
relations, neighbours and farmer-families assuming that they have a potential for
CKDUe. The survey revealed that 33.5% of the respondents are suffering from
CKDUe. In addition, 36% respondents reported that their neighbors have family
members with CKDUe and 30.5% reported that they arc among the risk group with a
potential tor CKDUe infection. The survcy also revealed that CKDUe has influenced
negatively on the occupation of the fanners in that area. The driving force,
satisfaction, happiness and enthusiasm for fanning have been influenced negatively
not only on those who are suffering from CKDUe but also on those fanners whose
neighbors, relations and those who assume that they have a potential for CKDUe
infection. The relationship between depression and fimning activity (Job
Involvement) of respondents indicated that tanning activity dccreases in parallel to
their increased depression levels. This outcome reflects that the pleasure and
ii
satisfaction gained in farming has declined within the community which is residing
in CKDUe affected area. The survey revealed a significant strong negative
relationship between the stress level of the respondents and their involvement in
farming. It indicated a negative relationship between the marginalization level and
respondents involvement in fanning and fanners have become helpless when they
understood that they have infected with CKDUe. The effect of CKDUe on
psychology and behavior of the community as shown by the indicators like - stress,
depression and marginalization - very clearly indicates a disquieting situation. As it
is emphasized that farming has been a way oflives of the Sri Lankans over centuries;
the influence of CKDUe on the farming community nccds to be taken very scriously
in government development agcndas. A holistic approach is an urgent and national
requiremcnt to re-establish the limning communities in the CKDUe affected areas in
the North Central Province, Sri Lanka. Remedial measures to improve the living
standard should include - not only upgrading the environment qualities, health
facilities and financial benelits to upgrade the lives but also counseling to heal the
behavioral and psychological trauma of CKDUc.