Roughly half the adult male population of Chichigalpa, Nicaragua, is suffering from an often deadly kidney disease that appears to be linked to their work as sugarcane cutters. Known as chronic kidney failure, the disease has cast a pall over Chichigalpa, a city of 50,000 in northwestern Nicaragua that's home to the San Antonio Sugar Mill.
Causes of the disease are still mysterious, but dehydration and heat stress, agrochemicals, antibiotics, and genetics are thought to be possible contributing factors. Chronic kidney failure is known to affect agricultural workers, primarily men, in other parts of the world.
Photographer and filmmaker Ed Kashi has been documenting what some have called an epidemic, estimated to have killed 20,000 men in Central America in the past two decades. Kashi plans to use his short film about the sugar workers as a fund-raiser for producing a feature-length documentary on the issue. (See Ed Kashi's Instagram photos from the project on our Proof blog.)
Kashi spoke with National Geographic about what motivated him to pursue this story, the difficulties he's confronted in trying to document it, and what he hopes to accomplish through his coverage.
What did you find so compelling about Central America's sugarcane cutters and the disease that's afflicting them?
The profound impact it's having on the sugarcane communities of Central America. In a place like Chichigalpa, Nicaragua, all you have to do is spend one day there, and you'll meet countless men between 21 and 65 [years old] who are sick. You witness a funeral just about every day. The evidence is point-blank in your face.
How did the story come to your attention?
In 2013, I was commissioned by La Isla Foundation to go down and do this story. What started out as a gig turned into a passion project.
What has been the response from the sugar mill owners?
The sugar mill mostly puts the blame on the workers. There's also a lot of worker intimidation. It's gotten harder to photograph and cover worker funerals. Because it's a one-company town, people will say, "If my brother dies, I don't want you to photograph his funeral, because I still work for the mill and I could lose my job." The company is really trying to avoid media attention.
What has the reaction from the Nicaraguan government been like?
What's happening is an indictment of the failure of the Sandinista revolution. It's amazing to me that a movement that tried to free its people is paying no attention to labor and human rights. And this is absolutely a human rights and labor rights issue. The people in Chichigalpa are very fatalistic. I'm amazed they're not a lot more angry.
What happens once you contract the disease? What's the treatment?
Some of these young guys stop working as soon as they get sick and try to take care of themselves. There's a point at which they'll have to go on dialysis, if they can afford it. The most extreme is going on home dialysis, which means you're basically going to die within 6 or 12 months. Just two weeks ago in Chichigalpa, we were photographing a guy doing his home dialysis treatment. Then, one of the times we went, he was dead.
Is there hope that things will change?
In El Salvador a sugarcane mill, El Angel, has just begun a three-year pilot program—started by La Isla Foundation and Solidaridad—that emphasizes water, rest, and shade for the sugarcane workers. Really simple stuff.
What would you like to accomplish with this work?
My work is about raising awareness, but raising awareness is not enough. I hope this film also encourages people to get involved and puts pressure on the government and the sugarcane companies, so they'll try to be part of this change. Nearly everyone on Earth consumes sugar, and we are complicit in this production and consumption chain.
National Geographic contributor Scott Wallace covered the wars in Nicaragua and El Salvador in the 1980s and is author of The Unconquered: In Search of the Amazon's Last Uncontacted Tribes. Follow him on Twitter.
Follow Ed Kashi on Twitter.