There is a small town in Nicaragua called Chichigalpa, Known as the “Island of Widows,” nearly 1-in-3 men have end-stage renal failure. The average lifespan is 49 years old, and as the death rate climbs, the age of the afflicted men decreases, some now getting the disease in their 20’s and early 30’s. Most of these men were sugar cane workers, laboring in fields for the one giant company on the island. No official cause has been determined, but researchers believe that the epidemic, labeled as Chronic Kidney Disease of nontraditional causes (CKDnT), is due to chronic dehydration, with the men working in the severe heat and inhaling environmental toxins. Nearly 20,000 workers have died in the last ten years from CKDnT.

[REWIND: FROG PHOTOGRAPHER AND CONSERVATIONIST TRAVELS WORLD TO FIND ‘LOST FROGS’]

***NO NAMES TO BE USED***A cane cutter, covered in 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 cane cutter, covered in soot and ashes of charred sugar cane, works in a field that was burned the night before, in Chichigalpa, Nicaragua on May 1, 2014.

Photojournalist Ed Kashi has spent the last few years working with various non-governmental organizations trying to raise awareness and share the plight of these men. In some towns, there is a funeral every day, sometimes more. After his first trip there, Kashi realized that he had more of the story to tell and completed a successful crowd-funding campaign to go back last year to make more images and film a short documentary (which you can see below).

The afflicted men have no choice but to work at the sugar cane plantation, as there are very limited jobs available for them. As one man said in the documentary, it’s either die of kidney failure or die of hunger. The sugar cane company, Ingenio San Antonio, denies that the harsh working conditions have any effect on the epidemic and that they allow shaded breaks and mandates their workers to consume water each hour. They suggest that other factors such as alcohol or drug use contributes to the death of the men. Kashi’s hope is that more media coverage and awareness can help lead researchers to the underlying causes of why so many men, from southern Mexico to Ecuador, Sri Lanka, India and other tropical/subtropical countries are afflicted.

***NO NAMES TO BE USED***Napoleon Velasquez, poses in his workshop in Chichigalpa, Nicaragua on Jan. 7, 2013. Velasquez 80, is a busy coffin maker as there is a death almost daily from the epidemic of kidney disease among the sugar cane workers.
This man used to work as a suagr cane worker and now is paid by the mayor’s office to make coffins for the men.
***NO NAMES TO BE USED***Walter Arsenio Rivera, 29, poses with his father, Antonio Arsenio Rivera, 58, in the cane fields of Chichigalpa, Nicaragua on Jan. 6, 2013. Both men suffer from chronic kidney disease. La Isla is dedicated to fighting the epidemic of kidney disease in Chichigalpa, Nicaragua. They work with health officials and researchers to provide better medical treatment for the sick and to study the causes of the epidemic.  They support and organize workers and their families through education programs, health initiatives, and economic development projects.  And we are committed to breaking the silence that shrouds this epidemic. 
Both of these men, father and son, men suffer from chronic kidney disease. La Isla is dedicated to fighting the epidemic of kidney disease in Chichigalpa, Nicaragua. They work with health officials and researchers to provide better medical treatment for the sick and to study the causes of the epidemic.  They support and organize workers and their families through education programs, health initiatives, and economic development projects.  And we are committed to breaking the silence that shrouds this epidemic.

We don’t have anyone to defend our sons and husbands… [a widow who lost her husband and is caring for her son who has the disease]

Ed Kashi and his project recently was named the 2014-2015 Photocrati Fund Fellow and plans on using the grant to continue working with NGO’s to not only raise awareness but to improve working conditions and improve available support for the families of those suffering from CKDnt.

See more of Ed Kashi’s work on his website and if you are interested in applying for next year’s Photocrati Fund, submissions will be accepted the beginning of next year.

CREDITS: Photographs by Ed Kashi are copyrighted and have been used with permission for SLR Lounge. Do not copy, modify or re-post this article or images without express permission from SLR Lounge and the artist.