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This is the first in a series of articles and action suggestions on the issue of sugar workers and kidney disease. Names of workers and their families have been changed to protect them from any retribution.

My cameraman and I sit captivated, gripped by the strength of the words we’ve just heard. The layers of love, perseverance, and the now familiar pragmatism that leap out of nearly every statement made by the cane workers and their families continues to impress us.

“I try to work, to provide for my family, but she won’t let me. She tells me to rest; she says that she wants to keep me here a little longer, for her, for the children, as long as she can. She makes the ends meet so I can stay strong enough to survive.”

Jorge sits in front of me with his wife, Lena, he looks straight into me, Lena looks to him, wipes an eye and softly grasps his hand. They are direct, honest and fearless about the fate that confronts them both: Carlos will die and Lena will join the growing ranks of widows in Chichigalpa, Nicaragua.

Carlos, 35, has Chronic Kidney Disease or CKD. His creatine level, an indicator of the disease’s severity, is 9.5, anything above 1.5 signals a problem with kidney function. Due to circumstances far from his control this disease, treatable in the ‘developed’ world, will be terminal for him and for men as young as 20 who are his neighbors. CKD affects thousands, and has claimed at least 2800 lives in Chichigalpa since 2000. The disease is vicious when left to its own devices; the suffering these men endure is like nothing I’ve witnessed in a fairly full and storied life. It eliminates their endurance and leaves many listless and terribly weak stripped of the ability to provide for their families.

Our kidneys clean our blood and when they cease to function properly the body’s organs and tissues become corrupted by toxins and slowly begin to shut down. Though the exact process of this death can take many routes it is always painful, always drawn out and is apparently, according to preliminary theories, avoidable. CKD is a problem for the entirety of Central America and the direct cause for the general problem is unknown.

In the case of the sugar producing regions, Dr. Aurora Aragon, chief of epidemiology at UNAN Leon assured me that, “We are facing nothing short of an epidemic.” Male sugar cane workers in the Chinandega department, disproportionately those employed by the powerful Pellas family’s Ingenio San Antonio in Chichigalpa, experience the disease at least 13 times as frequently as the already too high national average. This figure is considered low by experts and is based on an incomplete study conducted by MINSA, the Nicaraguan Health Ministry which lacked the resources to conduct an adequate investigation. While women also experience the disease most of the victims appear to be men.

The leading theory among the epidemiologists looking into this problem is that the Ingenio’s cane cutters and irrigators are overworked in the excessive heat of the region. This alone weakens their kidneys and is compounded, as they are not provided with adequate or clean drinking water. The water they do have access to is thought to be polluted by a cocktail of heavy metals, agrichemicals and other pollutants. This causes further damage to the already weakened kidneys. Men that live in the La Isla community lack access to municipal water and drink water in their homes that is likely poisoned by a variety of man-made environmental contaminants.

La Isla is now known as “La Isla de Viudas”, The Isle of Widows. In this small community of about 500 families there are now over 75 widows due to CKD and many more of the men are sick and dying. Across town in the more urban and densely populated Candelaria community the percentages are similar but at least the workers have access to cleaner municipal water.

If you’ve ever enjoyed a cold Toña or a bottle of Flor de Caña chances are you’ll remember the graphic of a palm lined boulevard framing the San Cristobal Volcano that features prominently on these beverage’s labels. This is the view from the Ingenio San Antonio’s entrance and the Volcano, according to Mr. Mario Amador of CNPA, a group that represents the sugar industry’s interests in Nicaragua, is one of the leading factors contributing to the CKD ‘problem’.

Forget for a moment that the leading epidemiologists I work with find this absurd, or that the Ingenio tests workers every employment period and fires workers who have creatine levels above 1.5, or that the Ingenio has been known to import fresh and potable water for administrators and other higher ups but not for the cane workers, or that Carlos Pellas himself has threatened to shut down the Ingenio should they be found responsible for the CKD problem. What I find intolerable is the sexism, classism and apparent wrath against male sugar cane workers that this San Cristobal Volcano displays as it focuses its wrath on cane workers and seems to largely leave the upper levels of management and the worker’s wives outside of his murderous agenda!

A Complex Problem

The Ingenio management is clearly behaving badly or at the very least ineptly and the list of grievances mentioned here fails to scratch the surface of those perceived and experienced by the workers and their families. While I understand those whose immediate reactions in the face of such injustice may include blaming only agrichemicals, writing angry letters of protest to the Pellas Group or an effort to boycott the Pellas Group’s products, I strongly encourage a different and more effective approach.

The current situation in Chichigalpa is tense and I need the reader to trust me that the situation is far deeper and more complex than the space allotted for this article allows. Some issues that are contributing to this potential powder keg are: 1) the Ingenio is facing an inquiry as to whether it should have received a loan for ethanol production from the World Bank’s internal investigation group due to the aforementioned worker allegations; 2) many people have lost their loved ones and received nothing in return; 3) there are enormous social implications attached to this problem as children are orphaned and wives widowed; and 4) there is currently a large scale epidemiological study taking place to get to the bottom of the problem once and for all which needs the space and freedom to work unimpeded. This is not the time for rash action. It is the time for careful and considered planned action. Not to mention that a boycott of Pellas’ products would be near impossible in Nicaragua and a confrontational approach serves no one.

However, there is a path that has a chance of addressing these issues effectively. Within the last two months our production company has decided that a film documenting the situation is not enough and we’ve started La Isla Foundation in order to tackle this issue in an intelligent and sustainable fashion. We are working with well organized worker and ex-worker associations like ASOCHAVIDA, regional institutions like the National Autonomous University (UNAN) in Leon, the groups SALTRA and IRET of Costa Rica, popular incoming FSLN Chichigalpa mayor Victor Sevilla, the Health Ministry and other individuals and groups including, hopefully, the Pellas Group should they choose to cooperate with us and the community in a open and direct fashion. This cooperation with local and regional groups is an effort to involve and empower the community and to make sure that with time the changes and treatments we wish to implement become solid and secure institutions in themselves. In short, we aim to work ourselves out of a job eventually. A goal I think more NGOs should earnestly aspire to!

Programs of La Isla Foundation

Some of the programs we at La Isla Foundation hope to facilitate are listed below. Those that are already moving forward are the Prevalence Study, psychological services, the website, the Watchdog Group, the film and the Community Centers.

Future funding is contingent on the prevalence study. This study will prove that in La Isla and Candelaria there is a high incidence of CKD and that our findings are unbiased. This is an incredibly important program, as it will open the door to the future programs!

There are implications of this study that are important to consider. One of them is that people who didn’t know they were sick will find out. Obviously this can be a terrible blow to a person who knows the effects of this disease. We need to work quickly and efficiently to provide the initial support structures to encourage people to continue to take part in the study and the programs we wish to put in place. We need to provide hope and direct aid.

We hope to build two community centers; one in La Isla and one in Candelaria. They must be large enough to support meetings, classes, activities and a clinic with space for the necessary lab and medical equipment. It is also my hope that these centers will eventually have Internet access and a small educational library that focuses on Agricultural Industry related issues.

We want to provide psychological counseling to encourage a society of hope and self-dependence. Education programs will cover a variety of topics from better farming practices for subsistence crops, hygiene, dietary concerns, changes in lifestyle that are needed if a person is ill, alternative pain management, communications and computer classes, and many others. These will also sometimes include fun activities for all ages such as dance, painting, photography etc.

We will take reports of any suspected human right abuses experienced in both communities be they committed by an employer or any other organization or institution, public or private. We will help the affected person or group find proper legal and support resources. Further, after we present a victim with available options, their wishes and hopes for how to proceed will be our primary concern.

The website we envision would be a data hub with connections, links, and information about sugar workers and kidney failure, related issues, topics and problems. It will keep people informed about the progress of the film and the NGO. We will provide a forum where people can discuss these issues in a locale that can provide basic research and access to the people and institutions that have provided the facts all around the world. It will also be a basic network to put like-minded individuals in touch, and perhaps even include full profiles of our partners. This is imperative in order to get our story and our vision out to the world. We face a great challenge and that is why it is deserving of the world’s attention.

The documentary film we are producing will include background material on the system of exploitation beginning with the banana republics and will educate a world audience. The film will aim for a theatrical release and after a run in theatres we will sell it to TV and disperse it on the Internet.

The micro-loan program, due to the priority of need, has a special focus on widows of CKD and women who are likely to loose their husbands soon. Later it will incorporate sick workers and other members of the community as well. The goal here is to form collectives of women with specific skills or goods to offer for sale and figure out a way to increase earning potential and income. Additionally, we will research bringing a small industry to the communities and perhaps offering a new skill set that could be more profitable.

Future Plans

With the success of the above programs, especially the prevalence study we will search for funds and begin implementing other programs including water quality testing, provision of clean water for workers at the Ingenio San Antonio by the management of the Ingenio, a nutrition program in the local schools, a bereavement program that would help provide coffins for the for the departed in cooperation with local coffin producers, and provision of medication for the sick.

This will take years and only by making sure we take all the steps necessary to ensure the success of our other programs will this become a reality. It is however our dream.

By working with experts at the above mentioned institutions and by seeking out the desires and needs of the community through existing organizations we feel that with adequate funding we will achieve these goals and continue advancing in our cause at the impressive tempo we’ve already set. I will not be shy, this is an ambitious program and it is going to be contingent on a garnering enough financial and cognitive support to make it work. In my estimation supporting La Isla Foundation is the best way to ensure a long-term solution to this problem. No one else seems to be tackling the issue. It is due to our non-confrontational manner, our relationship with the community and our willingness to seek the solutions with a fully qualified team of experts that we will succeed.

If you have any resources, expertise, advice and/or time you’d like to donate to our programs please write to Jason Glaser at laislafoundation@gmail.com. Jason Glaser works with Catawampus Films.