"This disease eats our kidneys from inside us," Martinez said. "We don't want to die, and we feel grief because we already know that we're hopeless."
Maudiel Martinez is 19 years old and has a shy smile, a tangle of curly black hair and a lean, muscular build shaped by years of work in the sugarcane fields. For most of his adolescence, he was healthy and strong and spent his days chopping tall stalks of cane with his machete.
Now Martinez is suffering from a deadly disease that is devastating his community along with scores of others in Central America, where it has decimated the ranks of sugarcane workers. The same illness killed his father and his grandfather and affects all three of his older brothers.
Martinez' illness stands at the heart of a lethal mystery — and legacy of neglect by industry and governments, including the United States, which have resisted pleas for aggressive action to spotlight the malady and find a remedy. Wealthier nations are more focused on spurring biofuels production in the region's sugarcane industry and keeping up the heavy flow of sugar to U.S. consumers and food manufacturers than the plight of those who harvest it.
Little noticed by the rest of the world, chronic kidney disease (CKD) is cutting a swath through one of the world's poorest populations, along a stretch of Central America's Pacific Coast that spans six countries and nearly 700 miles. Its victims are manual laborers, mostly sugarcane workers.
Each year from 2005 to 2009, kidney failure killed more than 2,800 men in Central America, according to the International Consortium of Investigative Journalists' analysis of the latest World Health Organization data. In El Salvador and Nicaragua alone over the last two decades, the number of men dying from kidney disease has risen fivefold. Now more men are dying from the ailment than from HIV/AIDS, diabetes and leukemia combined.
"In the 21st Century, nobody should die of kidney disease," said Ramon Trabanino, a physician from El Salvador who has studied the epidemic for a decade.
The surge of kidney disease is overwhelming hospitals, depleting health budgets, and leaving a trail of widows and children in rural communities. In El Salvador, CKD is the second leading cause of death for men. In the province of Guanacaste, Costa Rica, the regional hospital had to start a home dialysis program because it was overwhelmed with so many CKD victims that it began running out of beds to treat patients with other ailments.
So many men have died in some parts of rural Nicaragua that Maudiel Martinez's community, called The Island, now is known as the Island of the Widows — La Isla de las Viudas.
...Deadly enigma and a handful of researchers
Some scientists suspect that exposure to an unknown toxin, potentially on the job, may trigger onset of the disease. Researchers agree that dehydration and heat stress from strenuous labor are likely contributing factors — and they may even be causing the illness. Laborers, typically paid not by the hour or day but based on the amount they harvest, often work to the point of severe dehydration or collapse, potentially harming their kidneys with each shift.
Read on "Thousands of sugar cane workers die as wealthy nations stall on solutions" By Sasha Chavkin and Ronnie Greene www.icij.org:
