A cane cutter, covered in the soot and ashes of charred sugar cane, works in a field that was burned the night before, in Chichigalpa, Nicaragua on May 1, 2014.
A worker slices through the burnt stalks of sugar cane.
Cane cutters take a break from working in the field to sharpen their blades and recuperate from the intense heat.
Sugar cane workers return from a day of work in the fields.
A worker closes the hydration tent on the plantation of Ingenio San Antonio in Chichigalpa.
Workers for Ingenio San Antonio, the sugar company which controls the town, line up for their food stipends. The company supplies most of the workers who are sick with Chronic Kidney Disease of unknown origin (CKDu), and the families of those who are deceased with a food stipend.
A woman carries out her family's monthly food provisions.
Sugar cane workers and their families hold a meeting in a park in Chichigalpa. The rally is to discuss strategies for getting their companies to improve their labor, health and employment policies in light of the chronic kidney disease epidemic effecting their community.
Sugar cane workers collect their pay and relax after a long day in the fields.
Women affected by the CKDu epidemic, attend a meeting at the Cultural Center in Chichigalpa. Sugar cane workers and their families gather to discuss how best to address the CKDu epidemic that is sickening and killing so many of their people.
A woman, 31, looks at photographs of deceased loved ones in her home. She has lost a total of seven relatives, including her father, to CKDu, and now works in the sugar cane fields to support her two small children.
Four women, all cousins, take a break from working in the cane fields to care for their families. These women work in the sugar cane fields to because either their husbands or brothers have died or gotten sick from CKDu.
A former sugar cane worker, 57, receives help with dialysis at home from his daughter at their family compound in Chichigalpa. He suffers from end stage kidney disease after working in the sugar fields for decades. His son, 24, who worked in the sugar fields for 5 years, is now suffering from kidney disease as well.
A former sugar cane worker, 57, sits by his son and daughter outside his home in Chinandega. He now suffers from end stage kidney disease after decades of working in the sugar fields.
Siblings play together at their home in Chichigalpa. The children's father worked in the cane fields for ten years. After he was diagnosed with CKDu, the Ingenio San Antonio Company fired him and then rehired him as an electrician. When he got sicker, the company fired him again, with 3.5 months severance. He nows lives on subsistence farming with his wife and 3 children. His father, who worked in the fields for decades, died from CKDu.
Family and friends attend the the funeral of a sugar cane cutter who died of CKDu at 49 years old, leaving behind four children.
A former sugar cane worker, 57, spends the morning at his family compound. After working in the sugar fields for decades, he now suffers from end stage kidney disease.
The family of a CKDu-diagnosed former sugar cane worker, 32, spends an evening together at home.
Family members gather for the wake of a former cane worker, 29, who died of CKDu in Chichigalpa. The deceased had worked in the sugar cane fields for 5 years before contracting CKDu in 2004. The youngest of six, three of his brothers are also sick with this kidney disease.
A former cane worker, 29, who has just passed away after long battle with CKDu, is laid to rest.
Locals gather at a cemetery for the funerals of two men who have died of CKDu.
Family and friends gather for the funeral procession and burial of a former sugar cane worker, 36, who fell victim to the epidemic after working in the sugar cane fields for 12 years. He is part of a steady procession of deaths among the cane workers in Chichigalpa, Nicaragua.
The community turns out to attend the funeral procession and burial of a former cane worker, 36.
Family and friends grieve over the body of a former sugar cane worker, 36, who died of CKDu.
Family and friends mourn the loss of a former sugar cane worker, 36, who died of CKDu.