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Help comes to El Salvador’s sick sugarcane workers

A small organisation is working to improve the conditions of workers afflicted by a mysterious kidney disease epidemic.

The Cure - sugarcane - pls don't use
La Isla Foundation's WE Programme team gets ready for cane cutters to arrive for work at a field outside Apopa, El Salvador. The workers will take part in an early-morning data collection exercise. [Tom Laffay/Al Jazeera]
By Tom Laffay
Published On 28 Jun 2016

San Salvador, El Salvador – Cutting sugarcane manually is one of the most physically difficult jobs somebody can do. In the coastal regions of El Salvador, where temperatures regularly reach over 35C, workers chop burned cane with machetes and are paid by weight, making $2.26 a tonne and earning around $10 to $15 on a good day.

Further complicating their lives is an epidemic of chronic kidney disease of unknown origin, or CKDu, which has killed between 20,000 to 30,000 people alone in the Central American nations of Nicaragua and El Salvador since the start of the millennium. It is one of the leading causes of death among men in El Salvador, a country ravaged by gang violence.

Now, an international team of doctors, researchers, scientists and activists are collaborating with Salvadoran sugarcane mill El Angel in Apopa, on the outskirts of the capital, to study and prevent the disease among its sugarcane-cutting workforce.

The Worker Health and Efficiency Programme (WE Programme) brings water, rest and shade to the fields, where before there had been little, if any. They’ve been working with three of 43 cutting groups, moving from field to field with the workers.

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Workers who cut sugarcane for El Angel, and their families from the community of Los Almendros, are caught in the everyday reality of this disease, which seems to be as much a result of extreme poverty and economic conditions as it is related to heat stress, dehydration and extreme physical conditions. Families are locked into cycles of poverty and sickness. This occupational health programme, which strives to be a model for other companies and governments to adopt, aims to restore the health and dignity of the workers who produce the sugar that the world consumes. 

WATCH: El Salvador’s sugarcane workers and their silent killer

The Cure - El Salvador - pls don''t use
Researchers with the La Isla Foundation-led WE Programme conduct data collection. The programme aims to study sugarcane workers' kidney function as well as improve labour conditions to reduce rates of CKDu. [Tom Laffay/Al Jazeera]
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The Cure - El Salvador - pls don''t use
Ilana Weiss, who works with La Isla Foundation, leads a team of researchers with the WE Programme. [Tom Laffay/Al Jazeera]
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Emmanuel Jarquin and Sandra Perraza take the accelerometre readings of Raul, a young sugarcane worker participating in the study. For a week in late February, researchers with the WE Programme used state-of-the-art accelerometres to measure the difference in workload between the two machetes used by the cane cutters to see how hard their bodies are being worked. [Tom Laffay/Al Jazeera]
The Cure - El Salvador - pls don''t use
Juan Wright, owner of the El Angel sugar mill in Apopa, volunteered for his mill to be part of the WE Programme, which is aimed at preventing the onset and development of CKDu. This disease is ravaging the workers of sugarcane and other agricultural industries, having killed an estimated 20,000-30,000 people in El Salvador and Nicaragua alone since the start of the millennium. [Tom Laffay/Al Jazeera]
The Cure - El Salvador - pls don''t use
Near Apopa, men carry shade tents out into the sugarcane fields as part of the WE Programme for cane cutters. [Tom Laffay/Al Jazeera]
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Workers from Los Almendros hydrate in different ways while cutting sugarcane. The WE Programme's intervention of shade tents provides a cooler place for workers to rest and refill bottles or hydration backpacks. [Tom Laffay/Al Jazeera]
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Ermando de Jesus Hernandez, 39, of Los Almendros, cuts sugarcane with other men from his community. They are using a new machete, introduced by the WE Programme, which has proved to be more efficient, with some workers reporting a 40 percent increase in the amount of cane they now cut. Hernandez is sick with CKDu, which has killed his father and a brother. Another brother is currently dying from it. He continues to cut sugarcane as a means of providing for his family, earning $2.26 per tonne cut. [Tom laffay/Al Jazeera]
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Hugo Ariel, 22, of La Libertad, El Salvador, undergoes dialysis treatment for CKDu at the Rosales Hospital in San Salvador. At 15, he began working on his family's land, cultivating beans and corn. The only one in his family suffering from CKDu, he blames his exposure to chemicals used on the crops for his sickness, which he developed two years ago. He has been receiving dialysis treatment for a year. [Tom Laffay/Al Jazeera]
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Green sugarcane is burned to remove the leaves. Researchers with the WE Programme have also been studying heat stress among workers. [Tom Laffay/Al Jazeera]
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Sugarcane is offloaded from trucks at the El Angel sugar mill and shredded at the beginning of the process of extracting pure sugar from the freshly cut stalks. More than 80 percent of the mill's sugarcane is cut manually; the rest of the cutting is mechanised. [Tom Laffay/Al Jazeera]
The Cure - El Salvador - pls don''t use
Domingo Mendoza of San Jose Guayabal is a work captain for one of the groups of cane cutters which is participating in the WE Programme. He ensures workers take mandatory water and rest breaks. [Tom Laffay/Al Jazeera]
The Cure - El Salvador - pls don''t use
Maria Martinez, 40, of La Carrera, near the Bay of Juiquilisco, has worked for one year collecting the leftover scraps of sugarcane and putting them into piles to later be picked up and shipped off with the rest of the collected cane. Her 12-year-old daughter is sick with CKDu and receives treatment at a local hospital. [Tom Laffay/Al Jazeera]
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Nectalin Garay, 45, of La Carrera, worked for 11 years cutting cane and now oversees men and women as a work captain at La Carrera sugar, cacao and plantain operation. He knows five people in his community who have died of CKDu and believes the chemicals used in sugarcane production are to blame. [Tom Laffay/Al Jazeera]
The Cure - El Salvador - pls don''t use
Soldiers with the 1st Infantry of the Salvadoran army stand guard outside a field where the WE Programme researchers and workers finish the day's data collection in San Luis Talpa, El Salvador. Increased violence and extortion of landowners in the region has led to workers being killed by gangs. [Tom Laffay/Al Jazeera]