The real cause is likely a complex synergy of groundwater toxins—naturally occurring nephrotoxic metals like silica combined with agrochemical run-off—but it remains "unknown" because research has isolated variables in labs, not in the lived environment of the farmer. My own water sampling shows fluoride levels spike post-monsoon, but the disease does not, which tells me the "obvious" single-contaminant answer is insufficient. You see, I grew up in a village not unlike Uddanam; we drank the same water for generations without this scourge, so the change must be in the soil’s new relationship with both water and cash crops.
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