Local Water and Environment

River Nyamwamba water pollution triggers cancer infections in Kasese

BY INNOCENT KIIZA

Moses Kasaija, is a 15 years old Pupil from Roadbaria in Bulembia Division of Kasese Municipality. Kasaija says he has grown up fetching water from River Nyamwamba for domestic use. 

Little did Moses and his family members, however, know that the water they were using to cook food, wash clothes and drink was contaminated with metals that had bed-ridden their father, Emmanuel Kasaija, for long.

The Primary six pupil, narrates that since childhood River Nyamwamba has been a darling until the doctors told them that they should change their water source due to high levels of pollution arising from metal concentrates in the river.

Aged 60, Emmanuel Kasaija, now a victim of gastric cancer, says for the over 40 years he spent in Kilembe, Nyamwamba water has been the major water source for his family livestock and domestic consumption.

Kasaija says the disease started like ulcers in February 2017 when he was 53 years old presenting abdominal pain prompting him to start self-medication  from pharmacies around Kasese town for a long time.

In 2018, what Kasaija thought was minor ulcers turned out to be much more life threatening.He had to seek medication as he started experiencing intestinal challenges. Doctors diagnosed him with ulcers and he was swiftly put on treatment.

“But the situation later worsened until the Kilembe mine hospital referred me to Mbarara hospital for further diagnosis in  2020,” recalls the aging Emmanuel.

He narrates that from 2019, doctors couldn’t find out what was exactly eating him up until Mbarara Hospital referred him to Mulago National Referral Hospital for upper Gastrointestinal tract (GIT) Endoscopy for the examination of the abdomen. The GIT diagnosis is vague because it starts from mouth to the anus.

The diagnosis at Mulago indicated there was extrinsic bulge on a greater curvature of his stomach starting from the upper body to down to the lower body.

For surgery 

He says after diagnosing him further, including scanning of the stomach and use of biomarkers and x-ray ,came out positive of Gastric cancer, Mulago recommended him for immediate surgery, which he, however, never did because he was financially constrained.

Kasaija adds that his stomach continued swelling as the treatment costs increased such that he could not save anything for surgery as much as he tried.

Frustrated, he eventually returned home to Kilembe where he waited for any good Samaritans to support him in treatment.

Incapacitated  

 “I used to work but now I can’t any longer. Even my little savings have been depleted by medicine and taking care of my family of six people leaving me under God’s mercy,” Kasaija narrates in pain. 

Palliative therapy  

Asked if he was coping, Kasaija says he is under the management of the Medical superintendent Kilembe mines Hospital, Dr Benard Balyana,  who keeps him on constant palliative care involving blood transfusion whenever he gets complications.

According to Dr Balyana, Kasaija’s case is among many other cases that were received way back in 2018.

He, however, relates the cases to facts like smoking, poor eating lifestyle, water pollution of River Nyamwamba which was his main source of water.

Dr. Balyana narrates Kasaija’s disorder.

Research 

According to research by Kabale university  findings, many unsuspecting people in the Kilembe catchment area are at risk like Emmanuel Kasaija but unaware of the timed bomb they are swallowing.

Reports from the Uganda Cancer Institute at Mulago suggest that Kasese is among the most cancer-prone towns in Uganda followed by Kampala and Wakiso due to different facts related to industrialisation and  pollution.

Studies also show that water in R. Nyamwamba is contaminated with metals from copper tailings that keep spewing into public water sources.

According to a Ministry of Water and Environment (MWE) field assessment report 2019/2020, human activities and floods eroding the copper stock tailings and untreated discharge from Kilembe Mines underground into the river are potential sources of pollution in the river catchment including water bodies downstream.

River Nyamwamba, one of the scores of rivers in Kasese district, originate from Rwenzori Mountain ranges and meander through the Nyamwamba valley draining into the swamps of Lake George in Queen Elizabeth National Park

A recent MWE assessment field report confirmed that metal concentrates were above the World Health Organisation (WHO) rural water drinking limits of 0.05mg/l.

Statistics from the WHO show that the number of cancer patients diagnosed in 2020 reached 19.3 million and that ten million died of cancer-related ailments.

Dr Balyana says the metal concentrates include copper, nickel, zinc and cobalt that mix with public water sources and soils.

According to Dr Balyana, when consumed in large numbers, most of these metals will go and bind in the body and cause inactive cells in the whole,  causing complications related to cancer in the colon, intestinal, blood, liver and stomach.

 “The body may need these metals like zinc but not in that form” Dr Balyana says.

He adds that the metals in Nyamwamba waters are in low form and hard for the body to be absorbed, hence binding and causing cancerous cells.

Dr. Benard Balyana said consumption of metal concentrates can cause cancer to the whole colon system, including liver, blood and gastro-intestinal cancer as well as abdominal complications.

“Consuming these metals in large quantities ends up binding together and causing abnormal cell retardation in the body” he says. 

He adds that drinking water contaminated with metals such as copper, cobalt,aluminum, nickel, zinc and iron has the potential of causing human respiratory cancer.

Metals such as arsenic, nitrate, chromium and other metals are highly associated with kidney, gastric and bladder cancers.

Dr Yusuf Baseka, the Kasese District Health Officer, says  there are a lot of research studies that have been done on the public water system in Kasese and findings indicate a lot of acidic metals in River Nyamwamba, River Mubuku and River Rwimi.

“So we are telling people to desist from drinking it but to use the few safe water supply sources,” Dr Baseka says.

According to water Atlas Portal,  Kasese district has 60% water coverage ranging between 18% and 95% in twenty-one of the of the district’s forty-four administrative units.

Graph showing access to safe clean water sources in Kasese District.

Genesis 

Kasese cancer cases are related to industrialisation and copper mining of the 1950s which left copper stocks piles gazetted in the river catchment eroding into public water. 

Alex Kwatampora, a Geologist who also worked with the defunct Tibet Hima mining company, says initially, when Kilembe Mines was fully operational, the underground water used to be properly managed through a well-maintained pipe system.

He says the old stock piles from the Mines, which were initially run by Canadian copper-mining companies , Frobisher limited and ventures in july 1950 were initially covered with vegetation.

“Since the companies left in 1982, In 2013 after nearly 30 years of dormancy and after several failed attempts to privatize the mine, population has been encroaching on this area for settlement and cultivation, leading to erosion into water systems”Kwatampora said.

He adds that following the closure of the mines, the resultant breakdown of the pipe network and lack of maintenance of underground mining for a long time, water containing cupriferous pyrites has been escaping into public water sources.

He says Tibet Hima mining company, which was contracted to resume mining, also left the stock piles even more openly exposed.

Water tests 

Numerous  investigations by the  National Library of Medicin in the United States of America have revealed an association between exposure to heavy metal and gastric cancer, which people like Kasaija are suffering from.

A research by  Kabale University and the Water Ministry field assessment Report 2019 show that Nyamwamba waters are polluted with different dangerous metal concentrates that leak into downstream public water systems that sustain humans and animals

The Ministry’s Acting Principal Water Analyst, Stephen Emor, says the river quality total heavy metal load   was determined using international Standards Organization (ISO) methods and for digestion analysis Inductive Coupled Plasma (ICP).

He elaborated that traces of Manganese (Mn), copper (Cu), and cobalt (Cr0, were found to be high in the discharges from the mines and streams close to discharge points. 

Graph showing results of heavy metals concentrates from upstream to downstream Nyamwamba River.

Traces down in Lake George in the sediments were not exceeding WHO standards but the trend was worrying because of the accumulation.

“Human activities eroding the copper stock tailings and untreated discharge from Kilembe Mines underground are potential sources of pollution in River Nyamwamba and other water bodies downstream” warns the report.

James Mwiruwabo, the Kasese Municipal Health Center III in-charge, says that the frequently reported medical conditions registered at the facility are ulcers, colon and abdominal complications.

Mwiruwabo attributes them to eating lifestyles or water pollution of public water, however he advocates for more research related to relevance of respiratory cancer and metal concentrates consumption.

Investigations by National Library of Medicin in the United States of America, have revealed an association between heavy metal exposure and the incidence and mortality of gastric cancer.

While presiding over a report in Kasese in August last year at Kasese Municipal Health Centre 111, Dr Abraham Mwesigye, an Environmental Toxicologist of the College of Agriculture and Environmental sciences at Makerere University, revealed that pollution of metals in  public water are not only causing gastric cancer but also ulcers diseases, colon cancer and abdominal complications.

Dr. Benjamin Mwesige, the Head of Research at Uganda Cancer Institute, Mulago, told our reporter  that the institute is alarmed by the increasing number of cancer patients from Rwenzori and Kasese in particular annually.

He cited polluted food and water as the key cause of modes of transmission.

However he says that most of the common cancers in Kasese are prostate, colon or duo tumors of gastric with prostate or colon with prostate followed by breast and osteosarcoma among children. Most of these cancers are genetically inherited. This means that most of the patients inherited the cancer from their parents.  ‘Different people develop cancers depending on age, immune system robustness and co-morbidities,” clarifies Dr Mwesige.

Chart showing top cancer prevailing cases in Uganda.

More research needed

According to Dr. Benjamin Mwesige, Uganda needs to do more research to clearly cut out the cancer relationship with copper, cobalt and iron ores in Kasese public water.

He says that doing such studies can help to monitor heavy metals in the food chains, especially in the water sources around Kasese and Rwenzori at large, then in meat and the vegetables that are eaten.

Dr. Benard Balyana urged Kilembe Mines and government to come up with enforcement for proper waste disposal and intensify sensitisation of local people living near the disposal prone areas of Kilembe, Kitiri and Bulembia on dangers of using polluted waters sources so that they can make informed decisions.

Also, there is need to construct containment all around Kilembe copper trailing sites and land-filling to protect the soils.

There is urgent need to treat underground waters of Kilembe mines before more can be left to flow into Nyamwamba.

Prof. Ephraim Kamuntu, the minister of water and environment said that there is need to adopt corresponding water management policies to reduce the harm caused by water pollution to human health, therefore there should be focus on water quality at the point of use, with interventions to improve water quality including chlorination and safe storage and provision of treated and clean water.

Kamuntu added that in order to reduce the cancer impacts of water pollution, supervision of water quality should be strengthened, that is the purity of water sources, the scientific nature of water treatment and the effectiveness of the drinking water monitoring and community sensitization on control of source pollution from production, transportation and consumption.

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