Thousands of men working in the Pacific Coast sugarcane fields of El Salvador, Nicaragua, Costa Rica and neighboring countries have been dying of chronic kidney disease, an ailment that in most parts of the developed world is a manageable condition. The condition has been exacerbated by difficult working conditions and poor access to timely health care, while Central American governments and the sugar industry have done little in response.
Over the years the number of cases of CKD has grown — so much that one community near sugarcane fields in Nicaragua, called La Isla, or The Island, is now known locally as the Island of the Widows. From 2005 to 2009, CKD claimed more than 2,800 men each year in the region; in El Salvador it is now the second-leading cause of death among adult men.
This was the phenomenon — widespread illness and death among a specific group of mostly men — that journalist Sasha Chavkin saw on a number of trips to the region over the past two years. Chavkin returned to the region on behalf of the International Consortium of Investigative Journalists, a project of the Center for Public Integrity, to interview dozens of current and former sugarcane field workers and their families and physicians, as well as researchers in the region. Reporting from Washington, D.C., Ronnie Greene, a senior reporter at the Center, joined Chavkin in pursuing answers and data from government health officials in a position to push for more action on CKD, global health officials and sugar industry representatives.
The reporters wanted to know: Why does it strike mostly men who mostly work in sugarcane fields? What triggers it? Why are so many people dying? What have wealthier nations and NGOs done to help?
After five months of reporting, Chavkin and Greene wrote this account about the victims, the inaction among those who should act, and of the lingering mysteries around why CKD is so lethal among certain sugarcane workers in Central America.
More victims and government officials were interviewed by Journalist Kate Sheehy for Public Radio International’s The World. Sheehy is based in the El Salvador offices of El Faro, an investigative website edited by Carlos Dada, a member of the International Consortium of Investigative Journalists, a network of 115 journalists in 51 nations. ICIJ members Carlos Fernando Chamorro in Nicaragua and Giannia Segnini in Costa Rica also contributed reporting to this project.
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Lead reporters: Sasha Chavkin and Ronnie Greene
Sasha Chavkin is a reporter at The New York World, an online publication that conducts investigative reporting on New York City government. He previously wrote for ProPublica, where his reporting on disabled borrowers with student loans, BP oil spill damage claims and BP cleanup workers helped prompt changes in federal and private programs. He has also reported abroad from Nigeria, Bolivia and Peru.
Ronnie Greene joined the Center after serving as investigations and government editor for The Miami Herald. He also spent nine years at the paper exposing slave-like conditions in Florida’s farm fields, investigating deadly air cargo plane crashes and uncovering corruption at Miami’s airport. Greene is author of Night Fire: Big Oil, Poison Air, And Margie Richard’s Fight To Save Her Town, and his work has been honored by the Gerald Loeb Awards, National Press Club, Investigative Reporters and Editors and National Headliner Awards.
Radio reporter: Kate Sheehy (Public Radio International’s The World)
Web team: Ajani Winston, Sarah Whitmire
CPI Web editor: Christine Montgomery
CPI data editor: David Donald
The World editor: David Baron
Translator: Matías Godoy
PRI’s The World (radio)
BBC World Service (radio)
El Nuevo Herald, Miami
La Nacion, Costa Rica
El Faro, El Salvador
Al Dia, Dallas
La Opinion, Los Angeles
Project editors: Ricardo Sandoval Palos (ICIJ) and Keith Epstein (CPI)