Sri Lanka’s Indigenous people and Chronic Kidney Disease

The Wanniyala-Aetto, and CKD 

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(Island)

By Amarasiri de Silva (Professor Emeritus, University of Peradeniya)

While I was collecting field data on Chronic Kidney Disease of Unknown Aetiology (CKDu) in Medawachchiya in 2013, I wondered why healthcare providers believed that the Veddas were less affected by the deadly disease. I knew that urinary tract infections had been reported among Vedda people in Hennanigala and Dambana in the Mahaweli areas through a study conducted by Premakumara de Silva and Asitha G. Punchihewa on a Socio-Anthropological Research Project on the Vedda Community in Sri Lanka, but there were no reports of the Veddas in Medawachchiya and Wilachchiya in Anuradhapura District suffering from urinary tract infections or CKDu.

Some believe that the Veddas, particularly those in the Anuradhapura District, are immune to CKDu. As Wiveca Stegeborn has carried out extensive anthropological research since 1977 and has lived among the Veddas as a participant observer, speaking both their language and Sinhalese (Wiveca prefers the term, Singhalese, which is phonetically correct), I contacted her through LinkedIn to get her views on CKDu and the Veddas. Although she had sporadically visited the Anuradhapura Veddas, she acknowledged that she had never conducted fieldwork among them. Her focus was on Veddas in Dambana, Hennanigala, Pollebedda and Ratugala areas in the Ampara and Badulla districts in the East. The facts she has produced are relevant for the Veddas who live east of the Central Mountain massif.  

I exchanged several emails with Wiveca, and she has willingly responded to my queries amidst editing conference presentations, articles and a contribution to an encyclopedia. I present in this article some of her reflections on the Vedda people and CKDu among them in the form of direct quotations from emails. The early part of this article, though not directly related to CKDu, are presented as they provide valuable information on the Veddas, their names etc. I asked her whether she had come across any CKDu patients among the Veddas that she had been working with. Her first reaction to my question was that the reality of CKDu among Veddas was not publicly known, meaning that the Veddas who suffer from the disease are not in the national statistics.

This picture was added by TW from internet Image result for veddha cartoons

Wiveca Stegeborn is a Cultural Anthropologist from Sweden with an MA in Anthropology from Washington State University. She completed her PhD course work at Syracuse University, New York and taught Cultural Anthropology and conducted research at Michigan State University in the USA. At the time we were exchanging emails, she was finalising her dissertation work on Wanniyala-Aetto or Veddas (pronounced Wanniyala-Ätto; Wiveca prefers ‘Wanniyala-Aetto’ to ‘Vedda’. In this article both terms are used) to defend her contribution at the University of Tromsø, Norway. Wiveca has worked with Veddas for many years and her extensive publications on the Veddas’ traditional subsistence economy and society include contributions to the Cambridge Encyclopedia of Hunters and Gatherers and the Berg Encyclopedia. She is currently compiling an article for Brill’s Encyclopaedia about the Wanniyala-Aetto’s religion. She is a human rights defender who has organised human rights work among the Vedda people since 1977.

Wiveca explained to me the meaning of Wanniyala-Aetto. Wanni, a Sinhalese word, refers to a small jungle, particularly in the dry zone districts in Sri Lanka. Ätto or Aetto is both an animate noun and a way of addressing a person respectfully. Due to the derogatory nature of the term, the Wanniyala-Aetto do not like to call themselves Veddas. The Wanniyala-Aetto have been living in Sri Lanka long before the country was populated by the Sinhalese (believed to have migrated from Bengal) and Tamil people. As Gananath Obeyesekere, Emeritus Professor of Anthropology at Princeton University puts it, Vedda people then lived in virtually every part of the island. After the Sinhalese had occupied many parts of Sri Lanka, the Wanniyala-Aetto were confined to the Vedi rata or Maha Vedi rata, the area that extends from the Hunnasgiriya hills and lowlands to the east coast. The fact that they live between the Tamil-speaking people on one side and the Sinhalese on the other has given rise to the notion of a buffer zone. While they are distinct from present-day Tamils and Sinhalese, they speak the majority language in the areas where they reside. Vedda villages in Anuradhapura District comprise about sixty communities, practising agriculture, just like their Sinhalese neighbours. The Vedda population in Anuradhapura, Wilachchiya, Muthur and Panama was assessed by Premakumara and Punchihewa at approximately 7,350–7,500 in 2012.

Wiveca told me that ‘Wanniyala-Aetto parents sometimes name their sons Wanniya. The suffix “–a” denotes masculine gender. The Wanniya or Uru Warige Wanniya, I referred to in my text is the son of late Uru Warige Tissahamy and Uru Warige Heenmenika. Tissahamy was a well-known spokesperson for the Wanniyala-Aetto in their area and even more so, his son Wanniya.’ Wiveca explains, ‘We formed a great team of Wanniyala-Aetto comprising about 2,000 persons of all ages and settlements and collected ethnographic information and knowledge on Human Rights. We concentrated for many years on their, and other indigenous people’s struggle to survive. After Tissahamy’s death, my work continued with Wanniya, and now he is bringing up his son, Punchi Banda, who has shown interest in taking over the yoke.’

Wanniya is married to Morane Warige Heenmenika. She changed her warige name to the same as Wanniya when the government registered them for identity cards. Traditionally, the warige name goes from the mother to her children, but the government has changed this [practice], causing insecurity for the offspring in case the father dies.’ Wiveca’s observation is interesting as the Muslims in the east coast name their children after their mother’s kudi (a system of exogamous matrilineal clan membership shared by both men and women and transmitted through women, usually mother). Kudi among the east coast Muslims, like Warige for the Veddas, refers to the clan of the mother. This common practice between the two ethnic groups on the east coast sillustrates a culturally valid coincidence, more than an assimilation.

I asked Wiveca whether she had collected any health-related data on the Wanniyala-Aetto, and she said she had conducted various health surveys. ‘I also worked with Médecins Sans Frontières (MSF) in order to eliminate leprosy and Tuberculosis. I have many binders for health records. Since I am medically trained to some extent, I also had a small health clinic where I took care of minor ailment. My most important task was to teach where they could find natural ingredients in the forest to stay healthy. That way they did not need to buy pink, blue and yellow pills from the pharmacy’. Interestingly, she said ‘many [Veddas] used them [pills] as [beads in] necklaces and bangles instead because I told them the places they could find iron, C-vitamin, minerals, etc. I worked with the village herbalist/shaman. Also, my “mother” Morane Warige (M. W.) Sudumenica taught me a lot’.

When I asked her whether there were health problems other than CKDu among the Veddas, she said, ‘Yes, with time diabetes started to spread. It came with junk food, and with Cokes, Seven-Ups and Fantas. They also received welfare coupons for sugar and white flour among other things. The tea was no longer taken with honey or hackuru [Kithul jaggery], it was with refined sugar. This is a common ailment among all indigenous people introduced to a “western” excessive food culture. Because people were uprooted from their natural environment to become confined inside compact villages with people of other places, maybe with latent diseases unknown to the Wanniyala-Aetto, epidemics spread easily, among that tuberculosis [is prominent]. Last, but indeed not the least, we have the introduction of alcohol, not only arrack, beer and casippo [illegal brews] but also whiskey and rum. The Wanniyala-Aetto were taken to perform on stage for the government and tourists on the west coast. On those occasions they were invited, with the best of intentions, to have drinks with the tourists who wanted to share a drink with them. Also, it became an exchange of goods and services for the national park guards; they gave a bottle of alcohol, a shot deer, honey or other delicacies from the jungle.’

When I asked Wiveca, whether while she was in Sri Lanka doing her research for the first time, she had met any Wanniyala-Aetto affected by the kidney disease (CKDu), she came up with a revealing description of how the people in the areas got CKDu. ‘They lived on forest products by hunting-gathering and by cultivating small chenas. They used traditional dry rice paddy seeds that did not require artificial irrigation. After they were removed from their forest to flat irrigation land inside the Accelerated Mahaweli Development Project’s (AMDP) System B and C, they were given 2.5 acres of cultivable land on which they were instructed to conduct intensive commercial agriculture on 2 of the 2.5 acres. The remaining half acre, where the house was built, was for home use horticulture; beans, manioc, pumpkins and sweet potatoes [bathala]. They were given insecticides, fungicides, pesticides and artificial fertiliser by the AMDP’s extended agricultural agents coming from the regional towns (in our case Badulla and Girandurukotte). To usurp the soon to become Post-Hunters and Gatherers to the dominant population, the Wanniyala-Aetto were settled amongst the Sinhalese and Tamil people. Hence, the lead, mercury, arsenic and cadmium affected the three ethnic groups equally. It was not only in the areas where people were misplaced; the toxins went through, canals, streams and the groundwater to areas as far as 30-40 km. outside the contaminated AMDP land. With time the soil became sterile. No grassroots, neither good nor bad could grow.

All trees had been logged, and the forest was no more. People in the various AMDP locations or Systems were encouraged to put more “behet” (medicine) in the ground, but, for a handsome penny this time. The state distributor was part of the state-sponsored AMDP, and he made deals with seed companies that had been banned from the European market and needed to get rid of the stock with further chemicals, the soil was burned to infertility.’

She said further: ‘The ones that refused to convert to the AMDP philosophy of clustering together on small plots of land were enticed to use maize seeds (irringu) that gave more corn and larger corncobs, but they were sterile. That way they were not totally out of government control. To use those genetically modified seeds or GMOs people needed artificial fertilisers and pesticides. The first few years they were given free, but once they become used to it, they had to buy both the seeds and the chemicals from the government distributers. The sterile paddy and maize seeds replaced the old ones. Some People lived with one foot in each society. A Sinhalese farmer, for example, who had taken a Wanniyala-Aetto woman as wife could access both the kumbure [paddy land] and the chena. As she moved to his house, she adapted to the chores of the DDT-mahattmea [gentleman who came to spray DDT] who sprayed their rice fields so often. This included the water holes where women collected drinking water and cleaned their children and clothes.’

‘One example of “one foot is in each society” is the case of marriage. Occasionally, a man who takes an indigenous wife acquires the right to the use and enjoyment of her property(usufruct of land). His status and rights increase while his “wife” no longer measures to his new rank. Parallel to the Bengali Prince Vijaya, in the Mahavamsa, the Sinhalese farmer can discard his indigenous wife and children, in the same way as the alleged first boat immigrant, earlier expulsed from his kingdom in the Bay of Bengal, did. In the indigenous culture she was married, (as Kuveni also thought she was) but to him, she was a temporary conquest. It is only within the last 20 years that the Wanniyala-Aetto obtain marriage certificates from the government office in town. The only license they use to have, the Wanniyala-Aetto men joked, was for their shotguns! But now they needed one for a wife too.’

Wiveca explained how Veddas had got to know pesticides: ‘They hear the news from others, mudalalis, bus drivers, friends both Sinhalese and Tamil who read the newspapers. Hence, they know they are buying toxic “medicine.” It is verified by the number of people getting sick. Since they are not allowed to conduct their traditional subsistence strategy, and they are poor, they have to survive and hope for the best. Hence, they have to plant the sterile irringu seeds [maize] hoping there would be rain. The traditional dry rice is hard to find nowadays, and it yields less than GMO seeds. Hence, they cultivate and buy rice from the COOP with their welfare coupons. The Wanniyala-Aetto do not have the luxury to choose their staple nutrients.’

I wondered how Veddas people treated CKDu patients in their communities. Wiveca said, ‘They know the symptoms, “pita patthe riddumpoddje mandakerenova” (back pain) they have a hard time sleeping on their back, and they try to hang in there as long as possible. The interactions with hospitals were often a costly affair. Not all government doctors, but some, are available full time at the local hospital in Girandurukotte, Mahiyangana or Maha Oya, where they are supposed to work. They receive a government salary, but they also spend time either at home or in a small room beside the public hospital where they conduct private clinics. Those services are not free. If a patient has to go by ambulance, they ought to reserve it, days ahead. When I was there, there were two ambulances in Mahiyangana, but one was always broken, and if the other was sent to Kandy or Badulla there was no ambulance at all. People need to plan their emergencies ahead! CKDu is a new disease; hence, there is no traditional cure for it. They have to seek help from the dominant ethnic culture that gives them the poison.’

I asked her whether there were differences between the Wanniyala-Aetto CKDu patients and other CKDu patients primarily when they were treated in hospital. Wiveca said: ‘I cannot say since I have not compared hospital care for the Sinhalese patients. I know, however, that the Sinhalese usually have more money to give to the ward personnel such as to the head nurse, her assistants, and to the physician in charge. If they do not pay they gradually lose their belongings such as their Thermos, pocket money and soap. The patients also steal amongst themselves. The Wanniyala-Aetto do not have high-ranking government contacts; hence they can neither threaten, nor reward the personnel. It is also expensive for them to travel to the great general hospitals [maha Ispirithalaya]. Usually, they cannot go there and return the same day as they are changing buses, walking, and waiting in lines. The distance is too far, and they have to stay over. Food and accommodation are not free, and sometimes Sinhalese families do not want to receive a paying indigenous guest. They also have to bribe the gatekeeper each time they visit the hospital, or the visitor is not let inside. The day after the dialysis they have to make the same trip back home if the buses function, and there is no such heavy rain.’

I asked whether she found any female Wanniyala-Aetto people affected by CKDu, and she said ‘Wanniya’s wife has had both kidneys removed. She now has one from her daughter. The kidney problem of Wanniya’s son was diagnosed when he was about 14-15 years old. Both receive dialysis. Children that have been fed with chemicals since babyhood develop the disease as young teenagers. This is the case of those who were born after 1982 when Mahaweli had them evacuated from their jungle homes. I cannot tell how many people have died or how many suffer from CKDu now. I suppose we can compare my field notes and books of genealogies to count and interview each family to determine how many had died a decade after 1982 when the toxic donations began, and the toxins take time to get its way into the human metabolism.’

Wiveca’s description and unedited notes from her email communications as shown in his article portray the larger picture of CKDu, which is an environmentally influenced disease. Her description also helps contradict the notion that Veddas are immune to CKDu.

The Veddas, like people in other agricultural settlements in the Mahaweli and Anuradhapura, were forced into monocrop agriculture, the use of pesticides, chemical fertilisers, and genetically modified seeds, which are factors that pushed these people to the threshold of disease. It is quite difficult to go back in time and make adjustments, but lessons must be learned for future programmes of agricultural settlement.

 

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