Presentation to Science Communication Leadership Workshop during the First General Assembly of Association of Academies and Societies of Sciences in Asia (AASSA), held in Colombo, Sri Lanka, on 17 October 2012.
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Nalaka Gunawardene - Mass Kidney Failure & Mass Media Failure in Sri Lanka - 17 Oct 2012
1. Mass Kidney Failure
& Mass Media Failure:
Insights from Sri Lanka
By Nalaka Gunawardene
Independent Science Writer & Columnist, Sri Lanka
www.nalakagunawardene.com
Presentation to
Science Communication Leadership Workshop
At First General Assembly of
Association of Academies and Societies of Sciences in Asia (AASSA)
Colombo, Sri Lanka: 17 October 2012
2. Contents: Chronic Kidney Disease of
Unknown aetiology (CKDu)
CKDu: A Mysterious Disease in Sri Lanka
Challenge to scientists & healthcare system
Policy makers’ dilemma: best response?
Mass media coverage critiqued:
Structural & professional problems
Advocacy journalism’s limits
Hazards of moderate journalism
CKDu as prism of Lankan society: reveals
issues, gaps & distortions
All are my personal views!
3. CKDu: Reported in Sri Lanka’s
Dry Zone since early 1990s…
CKDu: A Mysterious Disease
Infographic courtesy: Centre for Public Integrity, USA
4. CKDu: A Brief History…
Dry Zone: Heart of
rice farming
Mostly affected male
farmers, 30-60
Started North-
Central Prov but
since spread
Affected area: 17,000
sq km, home to 2.5m
(1/8 of Sri Lanka pop)
Map courtesy: BBC Online
6. CKDu: A National Emergency
Over 15,000+ kidney patients
needing regular dialysis (2/week)
Each dialysis session: ~USD 100
Care costs LKR 350m (~USD 2.6m)
= 4.6% of annual public health
budget
How many deaths? No reliable
figure; could be 100s/more
Vast socio-psychological impacts
7. Part of a global trend?
CKDu: Reported from Central America, India,
Sri Lanka
Is there a shared causative factor?
9. Long search for causative factors…
Genetic predisposition?
Lifestyle-related exposure?
Locally brewed liquor
Ayurveda medicinal concoctions
Environmental exposure?
Excessive Cadmium or Arsenic
High Fluoride in groundwater
Aluminium utensils + Fluoride water
Naturally occurring hard water
Cyanobacterial toxins in water
Bioaccumulation of pesticide residues
Or something else?
10. WHO & Govt of Sri Lanka:
Studying CKDu from many angles
Multidisciplinary study: started 2008
Health Ministry’s Epidemiological
Unit with WHO
10 teams: looking for curative &
preventive responses
Study report Health Min mid 2012
NOT RELEASED TO PUBLIC: WHY???
In its absence confusion,
speculation, conspiracy theories
Not good for PUBLIC TRUST in
science or govt healthcare system
11. CKDu & Agrochemicals nexus:
Suspected; on trial; or proven guilty?
Mid 2011: Hypothesis: CKDu caused
by excessive Arsenic in imported
pesticides & chemical fertilizers, when
combined with calcium in hard water.
BEFORE peer-reviewed papers or
scientific debate, info & opinions are
released to mainstream & new media
One scientist claims: Divine
Intervention helped arrive at this
hypothesis Controversy!
14. Dig Deeper & Probe Further…
But proceed with CAUTION!
Ceylon Medical Journal review article, Dec 2011:
“It is timely that the available, credible, scientific
evidence on CKDu (published in peer-reviewed
journals) is collated and analysed, and the
difficulties faced in establishing causality are
discussed.”
Cause of CKDu might be “multifactorial”.
Caution: Mere associations “should not be
considered to be of causal importance without
documented evidence of proof”
Full paper: http://tiny.cc/CKDuCMJ
15. Policy makers’ Dilemma:
What to do while scientists disagree?
“Different groups have studied some aspects and
described it without giving a holistic picture. The
matter became complicated by some so-called
scientists referring to God’s assistance to
diagnose the problem.
“Commercial interests, lack of coordination
among researchers, policy makers not willing to
disclose findings and take appropriate action –
all these have made the CKDu situation worse…”
- Dr Janaka Ratnasiri, senior physicist & public
intellectual (not involved in CKDu research)
16. CKDu: Media’s Challenges
CKDu: A powerful story for media
Mystery disease, suffering, fear, death
No scientific consensus: debate, intrigue
Activist allegations, speculation, conspiracy
theories!
CKDu: Also a difficult story to cover
Slow evolving tragedy: temporal
Impacts only humans but not landscape
No drama of a ‘contagion’
Needs effort & skill to ‘connect dots’
17. CKDu is NOT a Fleeting Story…
Unsuitable for Breaking News!
CKDu: A Mysterious Disease
18. CKDu media coverage in general:
Highlights LK media limitations…
Many journalists lack science
background to critically examine
issues or ask the right questions
Uncritically peddling info fragments
& opinions without clarity, context
or coherence
Many media outlets don’t assign
sufficient resources for indepth or
investigative coverage (lack of
priority, not funds)
19. Mass Kidney Failure +
Mass Media Failure?
Healthy kidney: filters
waste & excess water
Healthy, vibrant media:
separates fact from
fiction; provides clarity
and context
What causes mass
MEDIA failure in LKA?
Is there a cure? Where?
20. Advocacy Journalism on Health &
Environment OK – but within reason!
“Journalists -- environmental or not
-- must be rigorous in their fact-
checking and field investigations.
They must provide balanced
analysis of issues, impacts, choices
and alternatives. They must also be
committed to sticking with
unfolding and evolving stories...”
- Nalaka Gunawardene, in
SciDev.Net Editorial, 20 April 2007
Full text: http://tiny.cc/SDNCOB
22. CKDu coverage in LK Media:
Advocacy or Activist Journalism?
Advocacy Journalism Activist Journalism:
Supportive of a public Supportive of a public
interest cause
Sustained coverage (story
interest cause
is kept alive) Sporadic media coverage
Journalists ask critical Journalists become
questions, verify info ‘embedded’ & uncritical
Accommodates diverse &
Selective amplification of
dissenting views; no one
is blocked out by media info & opinions
Creates an inclusive Dissenting/divergent views
platform for debate, ignored/attacked
seeking solutions Solutions???
23. 2012 Aug controversy: “WHO says” it
found “the cause” of kidney failure
Aug 15: Activist group releases 3-page
document allegedly by WHO official (named)
BUT document is an unsigned, unverified pdf:
No logo, reference or contact details
Many mainstream newspapers rush to print:
“WHO says farm chemicals found guilty!”
WHO in Colombo & Geneva: No reaction at all
LK Ministry of Health: No comment of any kind
Silence fuels suspicions; activist media claim
case is closed (“so banish the guilty party…”)
24. Too much finger pointing,
Too little reflection!
TOO MUCH time & energy spent
looking for a ‘Villain’
TOO LITTLE media attention on:
Healthcare needs of those already
living with CKDu
Economic, social & emotional needs
of affected families
How to prevent more people falling
sick: need for safe drinking water
NOT ENOUGH questions on
overall agro policies that heavily
favour high external inputs
25. LK Chemical Fertilizer Subsidy:
How did we became so addicted?
State subsidy for chemical
fertilizer: started 1962 (Green Rev)
Continued for much of past 50 yrs
Since 2005: 90% subsidy for N,P, K My column 26 Aug 2012:
Costs ~ LKR 50b (USD 380m)/year Watch out:
Everybody Lives
2009 subsidy cost = 3% of total
Downstream!
govt budget = 0.6% of LK GDP
How Lanka became
Too political to rationalise! addicted to cheap
V. cheap fertilizer = farmers not chemical fertilizer & why
it’s hard to kick the habit
thrifty massive runoffs
Organics just can’t compete! http://tiny.cc/ELDS
26. So are agrochemicals causing CKDu?
We’re still waiting for firm evidence…
Photo courtesy: Amantha Perera, IPS
27. Public Communication of Risk:
CAUTION: Handle with care!
CKDu: Emotions run high: anxiety,
suspicion, fear, anger, distrust…
Affected & others looking for
empathy + support + solutions
Need authoritative & trustworthy
persons to give clarity, assurance
Media doesn’t have all the answers
What media can do: ask right
questions; admit to gaps in
knowledge; seek short term relief;
advocate more study
28. Lankan public’s info sources on current
topics: Heavy reliance on media
Outdoor billboards, banners, etc 27%
Educational institutions 7%
Friends, neighbors, colleagues 52%
Public exhibitions, seminars,etc 13%
Mobile phone/SMS alerts 13%
Internet 9%
TV 94%
Radio 74%
Newspapers and magazines 70%
2010 survey covering 1,000 persons from all over Sri Lanka
29. Media as a Mirror: But what KIND of
mirror do our eco-activists want?
Media as mirror of society:
show things as they are:
black, white & grey…
Media cannot be a ‘Funny
Mirror’ distorting images to
impress a few
Some SL activists seem to
expect public media to
reflect/amplify exactly &
ONLY what they want.
Or else…!!!
30. Summing up 1:
CKDu as a ‘prism’ of Lankan society
Applicability of indigenous knowledge
Need for full disclosure in public science
Lack of public TRUST in govt/official
sources
Loss of public respect for scientists &
medical profession due to public spats
Policy paralysis from single-issue activism
Too few public intellectuals
Even fewer NEUTRAL platforms for
debate
31. Summing up 2:
Headline Thoughts…
CKDu: unfolding human tragedy
Need for restraint, focus, compassion:
More than just a ‘good story’ for media
or ‘agitation point’ for activists
Journalists: reassess their role: limits of
advocacy; need for balance
Eco Activists: go beyond conspiracies,
villains & finger pointing
Both: link ‘micro’ with ‘macro’; connect
the dots; keep an open-mind
32. Advice to scientist-activists…
“Scientists should first
establish themselves as
scientists, with a solid record
of peer-reviewed
achievement, THEN speak out
in their area of expertise
--loudly, if necessary.”
- Edward O Wilson
Harvard biologist, author
33. Thank You!
Blog: www.nalakagunawardene.com
Twitter: twitter.com/NalakaG
NOTE: Opinions expressed are entirely mine. These do not
represent those of any entities I am associated with. I welcome
open & dispassionate debate in the public interest.