Sugarcane workers and Chronic Kidney Disease

As part of our project in Central America, Fairfood International is working to prevent Chronic Kidney Disease of non-Traditional Causes (CKDnT). This deadly disease is affecting many workers in the region’s sugarcane industry. Chronic Kidney Disease is quite well known, but what is CKDnT? Below we will answer the most common questions about CKDnT.

Chronic Kidney Disease of non-Traditional Causes – What it is?

Chronic Kidney Disease (CKD) is a sickness marked by the gradual loss of kidney function. Unless treated, this disease results in a slow and painful death. The kidneys serve as a filter for the body and once damaged they can no longer remove waste and excess liquid from the blood. Furthermore, the kidneys are crucial for the production of blood and the regulation of blood pressure. Chronic Kidney Disease is commonly associated with welfare diseases such as hypertension, diabetes and obesity. It usually affects elderly people, both male and female

In recent years, a different form of progressive decline in kidney function has been discovered. This disease has come to be referred to as Chronic Kidney Disease of non-Traditional Causes (CKDnT) and is most common among working-age males. It is not, however, related to hypertension, diabetes or obesity. The disease also seems to affect different parts of the kidneys.

Who is affected by CKDnT?

Various research institutions have found many cases of CKDnT in sugarcane workers in Central America. The disease is hitting this region hard.

In the past decade, thousands of workers in the Central American sugarcane industry have died from CKDnT. Central American countries where the disease has been found are Costa Rica, El Salvador, Guatemala, Honduras and Nicaragua.

Recently, cases of CKDnT have also been spotted in other countries on the South American continent, as well as in Asia, most notably Sri Lanka and India. In these countries sugarcane workers also seem to be particularly affected.

Why are so many sugarcane workers affected? / What are the causes of CKDnT?

The labour conditions of sugarcane cutters in Guatemala and Nicaragua, as well as in many other sugarcane-producing nations, seem to have given rise to CKDnT. Renowned research institutions, such as Boston University (BU), Lund University, Umeå University, and the Pan American Health Organisation (PAHO), have confirmed that one or more risk factors of CKDnT are occupational. Factors that are likely to make one susceptible to the disease are: strenuous labour, long working hours in the hot sun in humid climates, few quality breaks, lack of shade and insufficient water intake – all of which could lead to dehydration and heat stress that impact heavily upon the kidneys. In addition, exposure to environmental toxins (most probably agrochemicals) is frequently associated with the development of the disease.

2-Factors linked to CKDnT_RGB(web)

Why is it so important that we do something about CKDnT?

Because of the high prevalence of CKDnT and the serious consequences the disease has for many sugarcane worker families in Central America, CKDnT has gained attention as a serious public health problem. The disease greatly burdens the families and communities of those affected, as well as national health systems that are not capable of providing adequate healthcare to those that are ill. Workers with CKDnT do not show clear symptoms at an early stage of the disease. Once the symptoms (such as nausea, breathing difficulties, swelling of extremities, muscle cramps, etc.) become evident, the disease may already be irreversible and fatal.

The progression of the disease can be slowed down with medicine and dialysis. Currently, only a transplant can cure a patient suffering from CKD. All these solutions are largely inaccessible to sugarcane workers in poor communities. We believe that it is better to focus on prevention rather than treating the disease once it has been contracted, at which point it often too late. Field research conducted by La Isla Foundation and the Central American Institute for Social Studies (ICAES) indicates that sugarcane cutters in Guatemala and Nicaragua are unnecessarily exposed to CKDnT-associated risk factors, and it is highly likely that the issues are prevalent throughout the industry. This unnecessary tragedy could be prevented by taking simple and inexpensive preventive measures (see next question for more details).

What is Fairfood doing to prevent CKDnT?

In order to ensure the prevention of new cases of CKDnT, Fairfood is:

  • documenting and exposing the deplorable working conditions of workers that have led to CKDnT and related harmful working conditions;
  • engaging with key sugarcane producing and sourcing companies to discuss how they can improve their operations;
  • engaging with government officials in Europe, and through our partners in Central America, in order to push for positive steps towards better working conditions and the monitoring thereof.stronger regulations and compliance among companies.

What should companies do to prevent CKDnT?

Companies can rule out occupational factors that can cause CKDnT in their supply chain by means of the following steps:

  • Ensure that sugarcane cutters have continuous access to potable water;
  • Ensure that sugarcane cutters have adequate breaks to recuperate;
  • Ensure that sugarcane cutters have adequate access to shade in order to avoid heat stress;
  • Ensure that sugarcane cutters work a healthy amount of hours.

All the above-mentioned measures should be adjusted to the local climatic conditions.

All these measures should not affect the workers’ wages!

What can I do to help prevent CKDnT?

Fairfood is constantly in discussion with the companies linked to sugarcane production in Central America through their supply chains, and the governments that can develop and/or reinforce regulations to stop the deadly disease from claiming new casualties. At certain points in our campaign, we will need your help to put extra pressure on the companies or governments, e.g. by signing our petitions, through joint action or sharing the stories of the affected workers, and the steps which need to be taken, with your friends and family. Sign up to our supporter mailing list in order to receive updates on our latest campaigns and events, and help us push for change.

A boycott is not the answer, as we do not want to push the workers out of employment. Instead, we are engaging in constructive dialogue with companies and governments to find lasting, meaningful solutions that enable workers to keep doing their job in a safe and healthy way.