Harvesting in the heat: listening to Sri Lanka's climate frontliners

As temperatures rise globally, the impact is being felt most by those least responsible – the farmers working long hours under the sun to feed their families and nations. In June 2025, the Planetary Health team of the SingHealth Duke-NUS Global Health Institute (SDGHI), together with collaborators from Duke University, University of Jaffna - one of SDGHI’s regional collaborating centres - and University of Ruhuna travelled across Sri Lanka to see and hear first-hand how climate change is affecting the health and livelihoods of local farming communities.

This field visit marks the beginning of a new research project: “Heat stress, kidney health, and the lived experience of communities on the climate frontlines in Sri Lanka.” The project, one of the recipients of a Research Collaboration Pilot Project grant between Duke University and Duke-NUS Medical School, aims to unpack how prolonged heat exposure impacts kidney health and how climate change is reshaping the lives of farming communities.

Chronic kidney disease of uncertain etiology (CKDu) is quietly devastating farming communities across Sri Lanka. Men in their 30s are succumbing to kidney failure, and worrying signs are now being observed in children. This poorly understood illness has been called a “quintessential climate-sensitive disease” and rising temperatures are suspected to be a major contributor. 


SDGHI Assoc. Prof. Renzo Guinto meets with collaborators in Sri Lanka

Associate Professor Renzo Guinto (SingHealth Duke-NUS Global Health Institute, Duke-NUS Medical School) meets with collaborators from Sri Lanka.

 


From salt pans to paddy fields: Hearing from farmers 

In Jaffna, the team visited three groups of farmers: paddy (rice) farmers, vegetable growers, and salt pan workers. These communities work outdoors in extreme heat with limited resources or support. The team discussed their daily routines, health concerns and coping strategies—and introduced the upcoming study. "We introduced the study to them, and their enthusiasm was overwhelming. They were honest about their struggles, but also about their hopes. These conversations were incredibly valuable—not just for our research, but for making sure we're asking the right questions," said Mengieng Ung, Co-Investigator from SDGHI.  

PHOTO-2025-06-17-09-13-19

Meeting with rice farmers

The joint Duke-NUS/Duke/Jaffna/Ruhuna study team engages in initial discussions with vegetable farmers (left) and paddy farmers (right).


The team also held meetings with the Ministry of Health Sri Lanka, the World Health Organization’s Sri Lanka office, and academic partners from the University of Jaffna and University of Ruhuna. These discussions helped lay the groundwork for participant recruitment, data collection, and long-term policy engagement. Stakeholders recognised the study’s alignment with national priorities—especially as heat-related health risks rise with climate change.

“There was strong interest from government and health leaders. They saw the urgency of our work, especially as heat-related illnesses are expected to rise,” observed Associate Professor Renzo Guinto, the project’s Co-Principal Investigator. “What’s encouraging is how the concept of planetary health—connecting human health with environmental change—is gaining traction in policy circles here.”  

 

 

Sri Lankan national news

The study team's meeting with Dr. Nalinda Jayatissa, Sri Lanka's Minister of health, featured on national television.

 

 

 

From local pilot to global possibility  

The team’s visit is just the beginning. Over the coming months, they will work with hundreds of farmers throughout the growing season, using wearable heat sensors and kidney function tests to understand how environmental conditions affect kidney health.

At the same time, in-depth interviews and community assessments will explore how families are adapting or struggling to cope with these mounting pressures. The hope is that this project generates insights that can inform local policies and create tangible improvements in public health and community resilience.

Associate Professor Guinto reflects on the project: “This initiative is not just about data. It’s about people. About listening to those who till the soil and harvest under unforgiving skies.” Dr. Ung further adds: “And it is about working together - scientists, policymakers, farmers turning lived experiences into meaningful change; for farmers, their families and future generations.”


The study team meets with WHO-Sri Lanka

The study team meets with the World Health Organization country office in Colombo, Sri Lanka.

Assoc. Prof. Renzo Guinto presents to project collaborators

Associate Professor Renzo Guinto presents the project methodology to Sri Lankan collaborators.

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