Something odd has been happening to young men in the sultry farming and fishing communities of Sri Lanka.

Since the 1990s, men in their 30s and 40s have been turning up at hospitals with late-stage kidney failure, needing dialysis or even transplants. In some communities, as many as one in five young men is affected.

Their condition has no clear cause; in fact, it is called “chronic kidney disease of unknown origin.” But experts say the illness is most likely the result of exposure to extreme heat, exacerbated in recent years by climate change, and the resulting dehydration, as well as an overuse of toxic pesticides that have seeped into the groundwater.

The trend is most striking in young men, but some women, too, seem to have the disease. And children as young as 10 already show early signs of kidney trouble.

Weighing tuna in the early morning at the Negombo fish market.
Bringing a boat onto Kudawa Beach after an overnight trip.

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