|Chronic Kidney Disease in El Limon, Dominican Republic
Draft of March 27, 2014
El Limon is a semi-isolated farming village, population 300, located at 2000 feet elevation in the dry southwest mountains of the Dominican Republic. Thirty-five years ago its residents survived by cutting down trees and burning charcoal for sale in town. With the arrival of the Green Revolution, this has been replaced by short-cycle chemical-dependent market agriculture: primarily tomatoes, eggplant, onions, peppers, and occasional crops of beans.
Over the last few years, residents have noticed an alarming number of early deaths, most of which have been vaguely ascribed to circulatory disease. One resident, a 45 year old woman, died of kidney failure last year, after several years of dialysis and futile attempts to obtain a kidney transplant. A 25 year old youth is on dialysis, and a transplant from a family member is being investigated. Possible risk factors for the village are heavy pesticide and herbicide exposure, poor diet, inbred gene pool, and a domestic water system fed by a heavily mineralized spring.
Particular suspicion falls on the herbicide glyphosate (Roundup), heavily used in El Limon. Glyphosate was recently banned in Sri Lanka, after being implicated in an epidemic of CRI that has caused some 20,000 deaths in recent years. El Salvador has legislated a similar ban, but it has not been signed into law. Strikingly, the deaths in Sri Lanka are concentrated in areas with hard domestic water, also characteristic of El Limon. El Salvador is currently investigating similar links. Recent research in Sri Lanka indicates that the glyphosate binds to heavy metals from environmental sources. High concentrations of calcium and magnesium in the drinking water multiply the toxic effects, most likely by forming lattices of glyphosate, arsenic, and other metals. The heavy metals are deposited in the kidneys, where they eventually cause CRI. A contributing factor may be dehydration (and additional chemical exposure) among greenhouse workers... definitely typical in the DR. The disease is characteristically asymptomatic until the kidneys have failed. Both cases of CRI in El Limon involved heavy agrochemical exposure. The woman lived on a hillside below fields that were subject to unusually heavy agrochemical use. The youth was in good health until he started working in an unregulated local greenhouse.
Two questions require urgent attention, so preventive measures can be implemented in El Limon and other communities:
1) If glyphosate is the key agrochemical factor here, what are the heavy metals involved, and where are they coming from? Prime candidates are arsenic and cadmium, but there may be others. Possible sources are the spring water, and contaminants in various agrochemicals that enter the body either directly, from uncontrolled use, often within the village itself, or through the chemically grown rice that is the daily mainstay of El Limon’s diet. Help is needed analyzing samples of these materials.
2) Are there tests that could detect kidney damage before it is irreversible? One article indicates that the Sri Lanka victims had elevated urine levels of cadmium and other distinctive biochemical indicators.
The community of El Limon is seeking assistance with answering the two questions above, and with raising the $25,000 needed for a kidney transplant for the young man, before his condition deteriorates.
Contact: Jon Katz
Rural Alternatives Center of El Limon (CAREL)