How healthy is Sri Lanka?

People in every 100 with safely managed drinking water.

• Towns69 in 100
• Countryside28 in 100
• Estates3 in 100

Source: Department of Census and Statistics, Sri Lanka, Household Survey of Drinking Water Quality – 2021, page 34 of the file.

• The water board, of its own samples that passed for germs, 202397.4 in 100
• People on piped water whose water was free of the germ at the source, tested 202155.8 in 100

The two measure different things. The water board tests samples of its own supply. The survey tested the water at people's homes, including pipes run by councils, community schemes and private schemes. Dooram shows both and has found nothing that reconciles them.

Sources: National Water Supply and Drainage Board, Sri Lanka, Annual Report 2023, pages 18 and 42 of the file. Department of Census and Statistics, Sri Lanka, Household Survey of Drinking Water Quality – 2021, page 48 of the file.

• Nothing67 in 100
• Boil it22 in 100
• Filter it9 in 100

Some households do more than one of these.

Source: Department of Census and Statistics, Sri Lanka, Household Survey of Drinking Water Quality – 2021, pages 32 and 51 of the file.

Germs from waste. In Kegalle district, 62 in 100 dug-well samples were over Sri Lanka's limit for a germ that comes from human and animal waste. So were 48 in 100 tap samples and 94 in 100 spring samples. (113 samples, from August 2009.)

Fluoride and hard water, in the dry zone. In about 1,250 samples of water from under the ground, taken since 2015, fluoride reached 6.8 milligrams in a litre, a level the authors call excessive, and much of the water was very hard. These come from the rock, so boiling does not remove them.

These are local studies, not figures for the whole country, and one is from 2009.

Sources: University of Peradeniya, Water distribution systems and diarrheal disease transmission: a case study in Kagelle district, 2011. Journal of the National Science Foundation of Sri Lanka, Geo-environmental assessment of geochemistry of groundwater and associated human health risks in the dry zone terrain of Sri Lanka, 2022.

In the farming districts where a kidney disease is common, Sri Lanka's Ministry of Health and the World Health Organization tested people, their water and the fertiliser used there.

In fertiliser: cadmium, a metal that harms the kidneys, at up to 30.8 micrograms in a gram, where the study gives 4 as the acceptable limit.

In people: more cadmium in the urine of those with the disease, and traces of farm pesticides above reference levels in about a third of them.

In drinking water: cadmium, lead and uranium “were within normal limits”.

The study concludes that cadmium is a risk factor and that “multiple agents may play a role”. It does not name one cause.

On cancer: small studies have looked for a link between fertiliser in well water and cancer. Dooram has found no health authority saying that one has been shown, so it does not say so.

Source: Ministry of Health, Sri Lanka, and World Health Organization, BMC Nephrology, Chronic kidney disease of uncertain aetiology: prevalence and causative factors in a developing country, 2013.

Safely managed means the water is on the premises, there when needed, and was free of a germ that comes from human and animal waste when tested. The testers visited 3,210 homes in all 25 districts in 2021 and tested the water where it comes from and in the glass.

At the source, 55.6 in 100 people had water with the germ in it; in the glass, 65.6 in 100. A protected well tested about the same as an unprotected one, and piped water was not clean either.

The survey itself says the germ “does not necessarily mean that the person drinking it will become sick, but it indicates that over time the household is at higher risk for waterborne diseases”. It did not test for farm chemicals. Nothing has been tested across the country since 2021.

The World Health Organization and UNICEF work the same tests out differently and reach 47 in 100. Dooram leads with Sri Lanka's own figure and uses the other only to compare countries.

Sources: Department of Census and Statistics, Sri Lanka, Household Survey of Drinking Water Quality – 2021, pages 5, 11, 15, 18 and 34 of the file. World Health Organization and UNICEF Joint Monitoring Programme, Country file for Sri Lanka, read 10 October 2026.