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THE FACE OF NICARAGUA’S CKDU EPIDEMIC

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    The family of a deceased sugar cane worker, 52, is photographed in the cane fields. He passed away three months ago of CKDu, leaving behind his wife and five children. He had worked in the sugar cane fields for 27 years, starting when he was 15 years old.
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    A former cane worker, 29, poses with his father, 58, in the cane fields of Chichigalpa, Nicaragua. Both men suffer from Chronic Kidney Disease of unknown origin (CKDu).
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    A sugar cane worker, 29, poses for a photograph with his wife, 37. Both are sick with CKDu after working 6 and 4 years respectively in the sugar cane fields. Coming from families that have been severely impacted by kidney disease, they both continue to work to support their ten year old daughter.
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    A former cane worker, 49, poses for a portrait with his wife, 47, and their daughter, 28, at home. He worked 16 years cutting cane, starting when he was 19 years old. In 2000 he was fired after being diagnosed with kidney disease.
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    A coffin maker, 57, poses for a portrait among the sugar cane. He is a former sugar cane field worker, who became a coffin maker when diagnosed with kidney disease. He is now a busy man due to the almost daily deaths from CKDu.
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    A young worker, 18, is engulfed by sugar cane fields of Chichigalpa. He started working in the sugar cane fields at 13 when his father died from CKDu. Both of his older brothers are also sick with CKDu, so he works to help to support his family.
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    A sick cane worker, 35, stands near the sugar crops. He began working in the cane fields at 16 years old, and developed kidney disease after 8 years. Currently on dialysis, he has no income and relies on friends and family for support for him and his three small children.
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    Four women, all cousins are photographed in the sugar cane field where they work to support they families. They have all had either their husbands or brothers get sick or die from CKDu.
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    A widow, 40, poses for a portrait with her food stipend in her home. She lost her husband to CKDu in 2009. The sugar cane company supplies her with a food stipend twice a month to keep her, and most of the workers quiet.
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    A widow, 56, is photographed in Chichigalpa. She lost her husband and two brothers to Chronic Kidney Disease of unknown cause (CKDu).
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    A female cane worker, 31, name withheld for protection, stands with her sister-in-law, 22, in the sugar cane fields. She has lost a total of 7 relatives to CKDu, and works in the sugar cane fields to support her two small children.
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    A former sugar cane worker, 31, poses for a portrait while working. After 16 years cutting sugar cane, he is sick with kidney disease. He vows, "I'll die working," and now drives a tricycle taxi.
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    A sugar cane worker poses for a photograph on the Ingenio San Antonio plantation.
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    A widow, 53, poses for a portrait. This woman, identity withheld, lost her husband and two of her sons to kidney disease between 2010-2012. She is also sick, after working in the cotton fields long ago.
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    A former sugar cane worker is photographed at the dialysis clinic of the Espana Hospital. This man suffers from CKDu.
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    A woman, 50, poses for a photograph with her husband and two sons who are all former cane workers, sick with CKDu. Her husband, 48, worked for 8 years in the fields, and her sons for 5 and 7 years respectively.
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    A former cane worker, 67, is photographed in the sugar cane fields that he worked in for 25 years. He is currently sick with CKDu and spoke out against one of the worker organizations, ASOCHIVIDA, in 2013. He has since stopped receiving his food provisions.
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    A former cane worker, 32, with CKDu, poses for a portrait at home.
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    A group of young workers sick with CKDu, pose for a photograph in the cane fields. They are all between the ages of 19-23, receive no aid or support, and are out of work.
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    A grieving family reflects on the loss of a loved one, 39, who recently passed away from kidney disease. They were intimidated by the local police to accept a $5000 payoff to keep quiet regarding the kidney disease-related death in their family.
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    A young man with CKDu, 27, is photographed at home with his family. He used to be a sugar cane worker, until he contracted the disease.
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    A coffin maker, 80, poses in his workshop in Chichigalpa. He is very busy as there is a death almost daily from the epidemic of kidney disease among the sugar cane workers.
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    A cane worker poses for a photograph amidst the charred sugar cane field that was burned the night before.
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    A cane worker, 29, that suffers from CKDu, poses in the sugar cane field.
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    A young worker, 20, poses for a portrait. He has worked in the sugar cane fields for two years after his father died from CKDu.
The Face of Nicaragua’s CKDu Epidemic

In Nicaragua, the average life span of men who harvest sugarcane is 49 years. At the root of these early deaths is an epidemic known as Chronic Kidney Disease of unknown origin (CKDu). In the town of Chichigalpa, often called the “Island of Widows,” 1-in-3 men, mostly cane workers, are in end-stage renal failure from a disease that is both a public health crisis and a social injustice. In Central America alone, more than 10,000 sugarcane workers have become sick or have died from this illness in the past twenty years.

Research on the subject of CKDu has indicated that repeated dehydration, severe heat, and environmental toxins might play a huge part in the rising death toll among sugarcane workers. Pervasive from southern Mexico to Ecuador, Sri Lanka, India, and on into other tropical or subtropical countries, CKDnT is undoubtedly of global concern. After all, nearly everyone on earth consumes sugar in some form, and the United States alone imports a large portion of Nicaragua’s sugar exports.

This portrait series shows the human side of the issue by putting faces to the epidemic. All names are withheld for the protection of the subjects.

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