The father and son pictured here both worked at Ingenio San Antonio. Both men have chronic kidney disease and lost their jobs with the company.

A guard keeps watch on the border of Ingenio San Antonio's sugarcane fields.

A woman from La Isla, Nicaragua, holds up a bag of  'suero.' In an effort to combat dehydration, the sugar company started handing out this Gatorade-type drink to cane cutters in the field. But some workers say they only receive one 300 milliliter bag a day.

Boys playing soccer in the lush rural community of La Isla ("The Island "), a Nicaraguan village. Chronic kidney disease death rates are so high that locals now refer to their community as La Isla de las Viudas  ("The Island of Widows").

A young girl in La Isla shares pictures of funerals of the many family members who have died of kidney failure.

Children gather to watch as Javier Pulido Zapata, a sugarcane worker who died of chronic kidney disease at age 35, is lowered into his grave at the cemetery in Chichigalpa, Nicaragua. 

Juan Salgado is a founding member of the Association of Chichigalpa for Life  (ASOCHIVIDA), an organization of sick sugarcane workers. He is also a founder of the La Isla Foundation, which promotes research into Nicaragua's chronic kidney disease epidemic. 

Jose Donald Cortez, president of ASOCHIVIDA, has chronic kidney disease.

Jose Donald Cortez shows his scars from dialysis treatment.

The Nefrolempa medical team, part of a new initiative to fight chronic kidney disease, makes a house call to kidney patient Jesus Sosa Mancia in Bajo Lempa, El Salvador.

On the wall of Jesus Sosa Mancia’s home hangs a picture of his son Adan, who died of chronic kidney disease at 23.

Dr. Carlos Orantes of Nefrolempa talks to health ministry employees in Bajo Lempa, El Salvador, after flooding nearly destroyed the clinic and its equipment.

People from the farming region of Bajo Lempa, El Salvador, at a clinic set up by the Ministry of Health in the town of Ciudad Romero. Residents give their family medical history to volunteers. 

A truck full of sugarcane workers leaves the Nicaraguan plantation Ingenio San Antonio at the end of a day's work.