Beyond Nicaragua, where the average life span of men who harvest sugarcane is 49 years, the Central American country of El Salvador is also impacted by the epidemic known as Chronic Kidney Disease of undetermined causes (CKDu). According to the Center for Public Integrity, CKDu is now killing more people in Nicaragua and El Salvador – the 2 countries with the highest magnitude of mortality from the disease – than HIV/AIDS, diabetes, and leukemia combined.
With one private sugar mill in El Salvador poised to make history by becoming the site of the first ever CKDu workplace intervention in Central America, labor conditions have improved due to increased water access, shade and mandatory breaks. However, since this fatal disease is both a global public health crisis and a social injustice, more research and health solutions are essential to continue creating a positive impact in the lives of effected workers, their families, and local communities.
Using the power of photography and video to generate education, support, and community awareness, Kashi states, “My passion and commitment to being a part of positive change, while continuing the drumbeat of awareness, has only grown as I watch another child left fatherless and another family confronting an illness that can be avoided.”
A sugarcane worker, 29, suffering from Chronic Kidney Disease of undetermined causes, CKDu, poses for a portrait in Chichigalpa, Nicaragua on Jan. 7, 2015.
Family and friends assist in the burial of a deceased sugarcane worker, 35, who died from CKDu the day before, in Chichigalpa, Nicaragua on Jan. 9, 2015.
Sugarcane workers begin their morning commute to the fields before dawn in Chichigalpa.
A young boy rides his bike past a field of sugarcane.
A sugar cane field is burned in order to make harvesting more efficient in terms of labor, transportation and processing, by cutting down on extraneous material.
A ‘camouflage crew’ of cane cutters load a truck with bundles of sugarcane in a large field near the town of Viejo in Chinandega. The majority of the crew is sick with kidney disease and some are underage.
A cane worker, 43, cuts stalks of sugarcane in the fields of El Angel Sugar Mill outside of Suchitoto, El Salvador on Jan. 12, 2015. He has 4 kids and has worked as a cane cutter for two years.
Sugarcane workers begin their morning commute to the fields before dawn.
An ailing former sugarcane worker, 35, is tended to by his son, 12, as he suffers through the end stages of CKDu in Chichigalpa. He worked for 15 years in the cane fields before getting sick.
The body of a deceased sugarcane worker, 35, is on display for his wake in Chichigalpa on Jan. 8, 2015.
A former sugarcane worker, 30, who is sick with CKDu, poses for a portrait at home with his family. He now works at home with his family repairing cell phones. His wife is a local political organizer in their community of “Manhattan.”
About 500 residents now have access to clean and reliable water from a new well, piping and a water tank in a village near Chichigalpa. A family uses this resource for daily cleaning.
A former cane cutter, 64, poses for a portrait in front of his wood and plastic shack that he calls home. He started working in the sugar cane fields in 1966 and continued for 34 years before he contracted CKDu in 2000. He now receives dialysis 3 times a week through a catheter in his neck. As he says, “the treatment is a sacrifice but life is too beautiful to die.”
A former cane worker, 45, who is sick with CKDu, sits with her monthly food ration from the sugar mill, in Chichigalpa. Her husband died 3 years ago from Chronic Kidney Disease and she worked in the sugar cane fields for 7 years before getting sick. Two of her four kids also suffer from CKDu.
In the community of La Isla, residents of all ages come together to dig trenches for a fresh water project in Chichigalpa, Nicaragua on Jan. 9, 2015. The 2.5 kilometers of trenches will hold pipes that supply water from a new well to 400 people in 98 homes.
A crew of cane cutters load trucks with bundles of sugarcane in a large field near the town of Viejo in Chinandega. The majority of the crew is sick with kidney disease and some are underage.
A crew of cane cutters load a truck with bundles of sugarcane in a large field near the town of Viejo.
A batch of sugarcane is lifted from a truck at the El Angel Sugar Mill in San Salvador.
A janitor cleans the floors of the dialysis clinic in the El Salvador National Hospital, the largest in Central America.
A sugarcane worker 25, poses for a portrait while working in the fields of El Angel Sugar Mill in El Salvador. She has been working the cane fields since the age of 10 and met her husband, 29, working in the fields when she was 17. They now have 3 kids and work together.
Men ride through the streets of Chichigalpa.
Sugarcane workers line up before dawn to board buses and trucks to the fields.
Family members mourn over a deceased sugarcane worker, 35, who passed away earlier that day.
A young girl, 15, cries by the body of her father, a sugarcane worker who died of CKDu earlier that day at the age of 35.
See more photographs from this project here.
Also watch the film Under Cane here.