Department of Behavioral and Community Health Sciences, University of Pittsburgh and Emeritus Professor, University of Peradeniya, Sri Lanka, Pittsburgh, Pennsylvania, USA.
Ann Nutr Metab. 2020;76 Suppl 1:37-42. doi: 10.1159/000515018. Epub 2021 Mar 26.
People's belief that polluted drinking water is the principal medium through which environmental toxins are absorbed into the bodies of CKD of unknown etiology (CKDu) patients in the CKDu-endemic areas in Sri Lanka has been the subject of extensive epidemiological and medical research. This study examines (a) the people's perception and experience that polluted drinking water is the cause of CKDu, (b) how the government responded to people's demands for potable water, and (c) the impact of the use of alternative drinking water sources on the health of CKDu patients and their families, and on the progression of the disease in CKDu patients. Data were collected in 2013 and 2019 in Anuradhapura and Polonnaruwa districts in North Central Province of Sri Lanka. People's agitation, activism, and lobbying, together with the media's work in bringing the issue of polluted water to the forefront of political discourse, have prompted the government, private sector agencies, and community organizations to supply clean water to affected communities. A massive change in drinking water behaviors has occurred following the government's decision to supply reverse osmosis (RO) water to the affected communities. Informants perceived the provision of RO water as having brought about many positive outcomes in the health and disease progression of CKDu patients.
人们认为受污染的饮用水是导致斯里兰卡 CKDu 流行地区病因不明的慢性肾脏病（CKDu）患者体内环境毒素吸收的主要途径，这一观点一直是广泛的流行病学和医学研究的主题。本研究考察了：(a) 人们认为受污染的饮用水是 CKDu 病因的看法和经验；(b) 政府如何回应人们对饮用水的需求；(c) 替代饮用水源的使用对 CKDu 患者及其家庭的健康以及 CKDu 患者疾病进展的影响。数据于 2013 年和 2019 年在斯里兰卡中北部省的阿努拉德普勒和波隆纳鲁沃地区收集。人们的鼓动、积极行动和游说，以及媒体在将水污染问题提上政治议程方面的工作，促使政府、私营部门机构和社区组织向受影响的社区提供清洁水。政府决定向受影响的社区供应反渗透（RO）水后，人们的饮用水行为发生了巨大变化。知情者认为，提供 RO 水给 CKDu 患者的健康和疾病进展带来了许多积极的结果。
