SUNDAY, MAY 11, 2008
Sugar Workers Dying from Kidney Failure
A mother sits with the last of her four sons to be dying from kidney failure. Photo: Jason Glaser.
By Jason Glaser
[Jason Glaser works with Catawampus Films. He can be contacted at catawampusfilms@gmail.com.]
(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 creatinine 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!
If you feel 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.
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