audio, stills, text and or video: Go to zReportage.com to see more - In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. According to researchers, in these countries, the prevalence of kidney disease in affected communities is with age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. Thousands of farmers have suffered from a disease that destroys their kidneys. Their eyes can become yellow, their bodies swollen and their muscles continuously cramping as their kidneys become irreversibly damaged leading to death. In the municipality of Chichigalpa, often called the 'Isle of Widows,' the disease is responsible for almost half of male deaths in the last decade. Many sick men facilitate their deaths by continuing to work in secret to help support their families. Sadly the town is fast becoming a land of widows. The epidemic of kidney disease among young Central American agricultural workers may be the result heat stress and volume depletion, according to new research published recently in the National Kidney Foundation's American Journal of Kidney Diseases.
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September 7, 2017 - Chichigalpa, Nicaragua - A woman helps her husband, ill with CRI, to perform the hemodialysis in his house. The treatment is the only hope he has to be able to stay alive. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - A family buries the patriarch. He had fallen ill with CRI 4 years ago and his kidneys could not take it anymore. The family could not bury his body in the municipal cemetery with other relatives because it has been full since the beginning of 2003, when the deaths reached up to five a day. The mayor was forced to inaugurate a new cemetery, although it will not take long to fill it too. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - Violent demonstrators face riot police during a protest for patients of CRI due to the lack of support from the Nicaraguan government in Chichigalpa. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - A cane cutter shoots an explosive during a demonstration at the entrance of Flor de Cana company, owner of Ingenio San Antonio. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - The Chichigalpa cemetery has become crowded. There is a second cemetery which was opened 15 years ago where it is estimated that there are about 10,000 cane cutters buried there who were suffering from the disease of CRI. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - Several sick workers of IRC are organized to start a demonstration against the sugar company for the lack of support for sick workers. If they do not have a minimum number of weeks, the company does not take care of the insurance that gives them a basic basket and financial support to carry out the hemodialysis. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - A cane cutter throws a Molotov cocktail at the doors of the company that owns the Ingenio San Antonio Sugar Mill in Chichigalpa, at the end of one of the demonstrations in support of the sick of CRI. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - A young girl observes her father, who has CRF, as he performs hemodialysis in his house. With hardly any sanitary methods and in tiny conditions, it is the only hope they have to be able to stay alive.In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - A group of young people loot a gas station during a protest in favor of the patients of CRI. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - JOSE DOUGLAS TORUNO, 42, shows where his blood is being filtered. That gauze on the neck is a sign that he is one of the IRC patients. He was diagnosed with the disease in 2001, after 13 seasons cutting sugarcane. He attributes the disease to fertilizers, heat and unsafe working conditions between dirty waters infected by chemicals. He has to procure, along with other colleagues, his transfer to Managua three times a week to receive hemodialysis, which they pay for themselves. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - Several riot police are preparing to cover positions at the headquarters of Flor de Cana, a rum company in Ingenio San Antonio, where most of the inhabitants of Chichigalpa work.In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - People march in support of the chronically ill of the IRC in Chichigalpa, a town where a large part of the population has fallen ill from working in the sugar company. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - A dog walks in front of the national police during a manifestation of CRI patients in Chichigalpa. The government does not attend to the requests of the sick and harshly repels any kind of support for the sick. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - PAULINA ROSTRAN, 47, shows the photo of her husband Pedro Hernandez, who died 3 years ago at age 49. She has also been working for the sugar company for 10 years. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - JOSE ANTONIO ALTAMIRANO, 16, shows photos of his father at his home on the Isle of Widows. His father was a sugar cane cutter, who died at the age of 42 after working for the company for 22 years. His mother, Angela Guevara, also has the disease. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - A protester cools off off from the heat under a gutter during a storm at the Chichigalpa Sports Center. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - JOSE DOUGLAS TORUNO, 42, holds his wife's hand. There are days that he can barely get out of bed. He was diagnosed with the disease in 2001 after 13 seasons cutting sugarcane. He attributes the disease to fertilizers, heat and unsafe working conditions between dirty waters infected by chemicals. He has to procure, along with other colleagues, his transfer to Managua three times a week to receive hemodialysis, which they pay for themselves. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - PEDRO JOSE BONILLA, 33 years old, worked in the company since he was 20, until he was diagnosed with the IRC and was fired. He works as a taxi driver with a bicycle even though he suffers from fatigue and chronic pain. His father and his 6 brothers are also sick of CRI. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - ROBERTO JESUS OLIVA is taken care of by his mother. He is 23 years old. He has been sick since he was 17, two years after starting to work as a cane cutter. Like many other workers, Jesus does not have the minimum number of weeks listed and the insurance is not responsible for defraying the expenses for his treatment. He lives prostrate in a bed and his family performs peritonial hemodialysis. He died three weeks after this image was taken. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - ROBERTO JESUS OLIVA accompanied by his mother. He is 23 years old. He has been sick since he was 17, two years after starting to work as a cane cutter. Like many other companions, Jesus does not have the minimum number of weeks listed and the insurance is not responsible for defraying the expenses for his treatment. He lives prostrate in a bed and when his family can perform peritonial hemodialysis. He died three weeks after this image was taken. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - LUIS ALFONSO CRUZ, 58, is sitting on the bed of his house. He has been ill since 2003, 6 months after a fumigation plane unloaded the product in the place where he was working with his crew. The doctors have already given him up for lost. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - Roberto Jesus Oliva is 23 years old. He has been sick since he was 17, two years after starting to work as a cane cutter. Like many other workers, Jesus does not have the minimum number of weeks listed and the insurance is not responsible for defraying the expenses for his treatment. He lives prostrate in a bed and when his family can they perform peritonial hemodialysis. He died three weeks after this image was taken.In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - ANGELINO VELAZQUEZ in a hemodialysis room in the health center of Chichigalpa. He is a community leader of Chichigalpa. He has been in jail for demonstrating against the lack of help for people with CRI. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - ANGELINO VELAZQUEZ is a community leader from Chichigalpa. He has been in jail for demonstrating against the lack of help for people with CRI. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - BRENDA LIRA, 40 years old, active sugar worker shows her feet with discoloration due to the use of chemical agents in the plantations. The rubber boots that the company gives them do not serve to protect them from the water infected by the use of these products. She is the widow of Felix Hernandez, also a cane cutter, who died at the age of 33 due to the disease that collapsed his kidneys. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - CRISTINO OSORIO, 43 years old, complains of his pain in his home in Chichigalpa. He started working as a cane cutter at the sugar mill in 1993 and was dismissed when they discovered that he was suffering from chronic kidney failure (CRF) in the year 2000. Since then he has been on hemodialysis three days a week. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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September 7, 2017 - Chichigalpa, Nicaragua - A patient of CRI, a former cane cutter, rests in front of his house in front of the sugar cane of the company where he has fallen ill. CRI is associated with heavy work under extenuating temperatures, something very common in the working practices of sugar mills. In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. Age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. In the municipality of Chichigalpa, the disease is responsible for almost half of male deaths in the last decade.
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