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"Mysterious Illness" Plagues Sugar Cane Workers

By Libby Leyden-Sussler

The world is smitten with one of the world’s biggest commodities, sugar. We use it to add flavor to our coffee in the morning, to satisfy our “sweet tooth,” and consume it in all types of food at levels far greater than ever before. But where does our sugar come from? And what are the costs of producing it?

Nicaragua, one of the poorest Central American countries, exports 40 percent of all its sugar to the U.S., forced to work in slave-like working conditions, the men who harvest sugar cane only live on average of 49 years. And these workers are dying at alarming rates. At the root of these early deaths is an epidemic that has been swept under the rug— fatal Chronic Kidney Disease (CKD).

The painful disease that affects the kidneys has killed at least 20,000 people over the past decade throughout Central America. From 2005-2009, 815 workers in Nicaragua alone died from CKD. Nicaragua’s sugar cane heartland Chichigalpa has been hit especially hard by the disease. Home to the country’s largest sugar mill, the town is called the “Island of Widows.” There, one in three men are in the end-stage of renal failure.

The cause of CKD is still a mystery to scientists and epidemiologists. The list of possible factors include: heat stress, chronic dehydration, exposure to toxic chemicals, overuse of painkillers, sugar consumption, and exposure to volcanic ash. The Nicaraguan government, the country’s sugar mills, and even the World Bank (which has poured tens of millions of dollars into the sugar industry there) all state that until the question of the disease is solved, there is little they can do to prevent it. To the citizens of Nicaragua, this answer is nearly impossible to grapple with.  

“The International Finance Corporation [IFC] (the private sector lending arm of the World Bank) didn’t do their diligence, or they were aware that the client’s employees were dying and didn’t look into whether there was a connection between the disease and the working conditions,” says Kristen Genovese, senior researcher at the Center for Research on Multinational Corporation as well as a lawyer who helped sick former workers file a complaint against the IFC in 2008 for lending $55 million to the sugar mill, San Antonio.

“Either way, the IFC failed to uphold its policies and failed in its responsibility to the very people it is meant to benefit," said Genovese.

Given the U.S.’s extremely high demand for sugar, the fact that most of the research on the issue is being conducted by the Centers for Disease Control and Prevention only adds to the distrust. “I don’t think anybody has clean hands,” says Genovese. “We should expect more from the Nicaraguan government and the World Bank Group, which after all, is led by a world-renowned public health expert and physician, President Jim Yong Kim.”

Mario Amador, general manager of Nicaragua’s National Committee of Sugar Producers (one of the groups financing the C.D.C. studies) said in an interview with The New York Times that the sugar cane business in Nicaragua has quadrupled in just 10 years into a $500-million-a-year industry, supplying companies like Coca-Cola to rum makers like Flor de Cana.

The mill in Chichigalpa says it pays the government every year so that workers can receive pensions and health insurance. But workers argue their wages are so low, they don’t have money to buy basic foods. Some sugar cane workers are so desperate for an answer to CDK that they  hang hammocks carrying their dying coworkers outside plantation headquarters. But without decisive scientific answers on the disease, industry officials question why they should be held responsible.

Map provided by Globalization.com 

Associate professor of epidemiology at Boston University, Daniel Brooks, is leading a team in charge of the three C.D.C. Foundation studies, which he believes could have an impact far beyond Nicaragua. He argues that there is a universal basis for serious interest in stopping the disease. Brooks discussed how CDK is a human tragedy, affecting not only individuals who die of the disease but also their families and communities. The fact that the people primarily affected are poor and the young men intensifies the impact. Second, Brooks pointed out that CDK is a global health issue.

There are at least two other areas that have been identified with epidemics that appear very similar: Sri Lanka and the northeastern coast of India. Lastly, Brooks argued that finding the causes, when identified, are not likely to be limited to exposures that occur only in Central America. 

It will take more than research to draw attention to the issue plaguing Nicaragua and the rest of Central America, but these studies are a step in the right direction. It is in the best interest of the the United States, as well as other wealthy nations and international development agencies, to investigate the “mysterious” disease. If not for the ethical reasons, the U.S. and other actors should investigate CDK given the importance Central America has in the export of raw sugar.

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Libby Leyden-Sussler is an editorial assistant at World Policy Journal.

[Photos courtesy of Lon&Queta and Jeff Lee and Wikimedia]

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