All photographs by Ed Kashi
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Left: Australian world champion sugarcane cutter Paul Donnelly, 70, works beside an El Salvadoran cutter as part of a program to improve cutting efficiency and worker health. This is a completely unusual scene and you'd never see a white person cutting cane here. It's part of the WE Program being implemented by Solidaridad and La Isla in cooperation with the El Angel Sugar Mill in El Salvador to improve cutting techniques for efficiency so they expend less energy. Right: A former sugarcane worker lies sick from kidney disease in Chichigalpa, Nicaragua.
All photographs by Ed Kashi

Instants: The Real Cost of Sugar

In our series Instants, the Proof staff brings you a snapshot of recent dispatches from the @natgeo Instagram feed. Follow us to experience more from National Geographic on Instagram.

What first began as an assignment for photographer Ed Kashi for La Isla Foundation morphed into a personal project and mission to raise awareness about a fatal, and likely preventable, disease in El Salvador and Nicaragua. Affecting over 20,000 mostly male lives in Central America, chronic kidney disease of unknown origin (CKDu) is considered an epidemic and spreads among sugarcane workers who endure long hours in hot fields. It’s likely the result of dehydration, heat, and fatigue and has turned into a blame game between the governments and the community—a game that takes a very measurable toll on the workers and their families.

“As I documented another wake and funeral for a cane worker too young to die (35), I looked into the tear-filled eyes of his 15-year-old daughter and then at all the young girls and women and thought about the impact on a community where most of the men get sick and die,” Kashi said after his most recent visit.

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This image was taken adjacent to the San Antonio Sugar Mill cane fields and is where cane worker families live in destitute conditions in Chichigalpa, Nicaragua.

Kashi released a short documentary on the disease, its causes, and the impact it has both on the workers and their loved ones. On his most recent return visit to Nicaragua, Kashi found that not much had changed. “People are still dying nearly every day. We are not aware of improved worker conditions, and instead of adequate water they are receiving sugar-infused liquid hydration packets, which are very detrimental,” he said.

A new water tank is part of an initiative by La Isla and Solidaridad to bring clean water to 500 residents in the cane-growing communities of Chichigalpa, Nicaragua.

During Kashi’s visit to El Salvador, conditions at one private sugar mill were markedly better due to an investment which supplied increased water access, shade and mandatory breaks.

“I am personally frustrated, perplexed, and distraught by what I have witnessed,” he said. “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.”

Here we share some Instagram photos from Nicaragua and El Salvador from Kashi’s most recent visit and watch his film, Undercane, on National Geographic News.

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Reflections during a funeral procession in Nicaragua

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This photo is a diptych. At 5 a.m., cane workers muster to be taken out to the cane fields. The day after we filmed this, the company changed location deeper into the company property so media couldn’t film.

A young boy rides his bike past the cane fields and the San Cristobal volcano in the La Isla community of Chichigalpa, Nicaragua.

Don Julio Lopez, a 35-year-old former sugarcane worker with chronic kidney disease, died today. He leaves behind a 12-year-old son and 15-year-old daughter. Seventy percent of male sugarcane workers in Chichigalpa, Nicaragua are infected by chronic kidney disease and it’s terminal, meaning they are all dying early from this epidemic. The average age of death for sugarcane workers in this region is 48. Among the causes is the increased heat from climate change.

Follow Ed Kashi on Twitter and Instagram.