ED KASHI

In Nicaragua, the average lifespan of men who harvest sugarcane is 49 years. At the root of these early deaths is an epidemic known as Chronic Kidney Disease of unknown origin (CKDu). In the town of Chichigalpa, often called the “Island of Widows,” 1-in-3 men, mostly cane workers, have end-stage renal failure from this fatal occupational disease that is both a public health crisis and a social injustice. In Central America alone, over 20,000 sugarcane workers have died from CKDu in the past ten years.

Research on the subject of CKDu indicates that repeated dehydration, severe heat, and environmental toxins might play a huge part in the rising death toll among sugarcane workers. These clues need further investigation and increased media coverage to find solutions to this critical problem that exists in Nicaragua, elsewhere in Central America, and globally. From southern Mexico to Ecuador, Sri Lanka, India and other tropical/subtropical countries, battling CKDu is of global concern.

Cane cutters work in a field that was burned the night before, covered in the black soot and ashes of the charred sugar cane in Chichigalpa, Nicaragua on May 1, 2014.

Cane cutters work in a field that was burned the night before, covered in the black soot and ashes of the charred sugar cane in Chichigalpa, Nicaragua on May 1, 2014.

 A cane worker slices through the burnt stalks of sugar cane in a field in Chichigalpa, Nicaragua on May 1, 2014. He is covered in ash and soot from the field that was burned the night before.

A cane worker slices through the burnt stalks of sugar cane in a field in Chichigalpa, Nicaragua on May 1, 2014.

A young sugar cane worker, 27, is photographed at home in Chichigalpa, Nicaragua on March 6, 2011. This man is a former sugar cane worker who suffers from Chronic Kidney Disease of unknown cause (CKDu).

A young sugar cane worker, 27, is photographed at home in Chichigalpa, Nicaragua on March 6, 2011. This man is a former sugar cane worker who suffers from Chronic Kidney Disease of unknown cause (CKDu).

A father mourns the loss of his son, 29, who died of CKDu in Chichigalpa, Nicaragua on April 30, 2014. He had worked in the sugar cane fields for five years before contracting CKDu in 2004. The youngest of six, three of his brothers are also sick with this kidney disease.

A father mourns the loss of his son, 29, who died of CKDu in Chichigalpa, Nicaragua on April 30, 2014. He had worked in the sugar cane fields for five years before contracting CKDu in 2004. The youngest of six, three of his brothers are also sick with this kidney disease.

A deceased cane worker, 29, who has just passed away after long battle with CKDu, is laid to rest in Chichigalpa, Nicaragua on April 30, 2014.

A deceased cane worker, 29, who has just passed away after long battle with CKDu, is laid to rest in Chichigalpa, Nicaragua on April 30, 2014.

A worker closes the hydration tent on the plantation of Ingenio San Antonio in Chichigalpa, Nicaragua on May 2, 2014.

A worker closes the hydration tent on the plantation of Ingenio San Antonio in Chichigalpa, Nicaragua on May 2, 2014.

Siblings play together at home in Chichigalpa, Nicaragua on Jan. 6, 2013. Their father worked in the cane fields for ten years before being fired by the Ingenio San Antonio Company upon contracting CKDu. The family now lives on subsistence farming.

Siblings play together at home in Chichigalpa, Nicaragua on Jan. 6, 2013. Their father worked in the cane fields for ten years before being fired by the Ingenio San Antonio Company upon contracting CKDu. The family now lives on subsistence farming.

Sugar cane workers collect their pay and relax after a long day in the fields in Chichigalpa, Nicaragua on April 27, 2014.

Sugar cane workers collect their pay and relax after a long day in the fields in Chichigalpa, Nicaragua on April 27, 2014.

Four women pose for a portrait in the cane fields of Chichigalpa, Nicaragua on April 26, 2014. They are cousins, and all work in the sugar cane fields to support they families because their husbands or brothers have died or gotten sick from CKDu.

Four women pose for a portrait in the cane fields of Chichigalpa, Nicaragua on April 26, 2014. They are cousins, and all work in the sugar cane fields to support they families because their husbands or brothers have died or gotten sick from CKDu.

A former sugar cane worker, 31, poses for a portrait in Chichigalpa, Nicaragua on April 24, 2014. After 16 years cutting sugar cane, he is sick with kidney disease. He vows, "I'll die working," and now drives a tricycle taxi.

A former sugar cane worker, 31, poses for a portrait in Chichigalpa, Nicaragua on April 24, 2014. After 16 years cutting sugar cane, he is sick with kidney disease. He vows, “I’ll die working,” and now drives a tricycle taxi.

A cane worker, 29, and his father, 58, both sick with CKDu, enjoy the ocean at Puerto Corinto beach near Chichigalpa, Nicaragua on Jan. 9, 2013.

A cane worker, 29, and his father, 58, both sick with CKDu, enjoy the ocean at Puerto Corinto beach near Chichigalpa, Nicaragua on Jan. 9, 2013.

A woman, 50, poses for a photograph with her husband and two sons who are all former cane workers, sick with CKDu, in Chichigalpa, Nicaragua on May 2, 2014.

A woman, 50, poses for a photograph with her husband and two sons who are all former cane workers, sick with CKDu, in Chichigalpa, Nicaragua on May 2, 2014.

A widow, 40, poses for a portrait with her food stipend in her home in Chichigalpa, Nicaragua on Jan. 7, 2013. She lost her husband to CKDu in 2009. The sugar cane company supplies her with a food stipend twice a month to keep her, and most of the workers quiet.

A widow, 40, poses for a portrait with her food stipend in her home in Chichigalpa, Nicaragua on Jan. 7, 2013. She lost her husband to CKDu in 2009. The sugar cane company supplies her with a food stipend twice a month to keep her, and most of the workers quiet.

The family of a former sugar cane worker sick with CKDu, 32, spends an evening at home in the family compound in Chichigalpa, Nicaragua on April 29, 2014.

The family of a former sugar cane worker sick with CKDu, 32, spends an evening at home in the family compound in Chichigalpa, Nicaragua on April 29, 2014.

A former cane worker, 67, is photographed in the sugar cane fields that he worked in for 25 years, in Chichigalpa, Nicaragua on April 25, 2014. He is currently sick with CKDu and spoke out against one of the worker organizations in 2013. He has stopped receiving his food provisions.

A former cane worker, 67, is photographed in the sugar cane fields that he worked in for 25 years, in Chichigalpa, Nicaragua on April 25, 2014. He is currently sick with CKDu and spoke out against one of the worker organizations in 2013. He has stopped receiving his food provisions.

A former cane worker, 49, poses for a portrait with his wife, 47, and their daughter, 28, at home in Chichigalpa, Nicaragua on April 24, 2014. He worked 16 years cutting cane, starting when he was 19 years old. In 2000 he was fired after being diagnosed with kidney disease.

A former cane worker, 49, poses for a portrait with his wife, 47, and their daughter, 28, at home in Chichigalpa, Nicaragua on April 24, 2014. He worked 16 years cutting cane, starting when he was 19 years old. In 2000 he was fired after being diagnosed with kidney disease.

A former cane worker, 29, poses with his father, 58, in the cane fields of Chichigalpa, Nicaragua. Both men suffer from CKDu.

A former cane worker, 29, poses with his father, 58, in the cane fields of Chichigalpa, Nicaragua. Both men suffer from CKDu.

A former cane worker suffering from end stage kidney disease receives loving care from his wife at their family compound in Chichigalpa, Nicaragua on Jan. 9, 2013.

A former cane worker suffering from end stage kidney disease receives loving care from his wife at their family compound in Chichigalpa, Nicaragua on Jan. 9, 2013.

A sick sugarcane worker, 57, receives help receiving dialysis treatment at home by his daughter at their family compound in Chichigalpa, Nicaragua on Jan. 9, 2013.

A sick sugarcane worker, 57, receives help receiving dialysis treatment at home by his daughter at their family compound in Chichigalpa, Nicaragua on Jan. 9, 2013.

A cane worker suffering from CKDu, 29, poses in the cane fields of Chichigalpa, Nicaragua on Jan. 9, 2013.

A cane worker suffering from CKDu, 29, poses in the cane fields of Chichigalpa, Nicaragua on Jan. 9, 2013.

A coffin maker, 80, poses in his workshop in Chichigalpa, Nicaragua on Jan. 7, 2013. He is a busy man as there is a death almost daily from the epidemic of kidney disease among the sugar cane workers.

A coffin maker, 80, poses in his workshop in Chichigalpa, Nicaragua on Jan. 7, 2013. He is a busy man as there is a death almost daily from the epidemic of kidney disease among the sugar cane workers.

Women look on during the funeral of a sugar cane cutter who was 49 years old, in Chichigalpa, Nicaragua on March 3, 2012. The deceased passed away from CKDu and leaves behind four children.

Women look on during the funeral of a sugar cane cutter who was 49 years old, in Chichigalpa, Nicaragua on March 3, 2012. The deceased passed away from CKDu and leaves behind four children.

The community turns out to attend the funeral procession and burial of a former sugarcane worker in Chichigalpa, Nicaragua on Jan. 7, 2013.

The community turns out to attend the funeral procession and burial of a former sugarcane worker in Chichigalpa, Nicaragua on Jan. 7, 2013.

 

Family and friends gather for the funeral procession and burial of a former sugar cane worker, 36, who died of CKDu after 12 years of work in the sugar cane fields in Chichigalpa, Nicaragua on Jan. 7, 2013.

Family and friends gather for the funeral procession and burial of a former sugar cane worker, 36, who died of CKDu after 12 years of work in the sugar cane fields in Chichigalpa, Nicaragua on Jan. 7, 2013.

A sugar cane worker poses for a photograph on the Ingenio San Antonio plantation, in Chichigalpa, Nicaragua on May 2, 2014.

A sugar cane worker poses for a photograph on the Ingenio San Antonio plantation, in Chichigalpa, Nicaragua on May 2, 2014.

This story appears in:

CNN, June 11, 2014.
Open Society Foundations, May 16, 2014.
The Verge, February 7, 2014.
New York Times Lens Blog, January 28, 2014.

Interview on the project by SocialDocumentary.net, July 22, 2014.