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In Nicaraguan sugarcane community, workers stare death in the face

In his own words, Maximiliano Lopez describes an average day in the life of a sugarcane cutter and how he's coping with the chronic kidney disease that he expects will soon kill him.

CHICHIGALPA, Nicaragua – A journey to the heart of Nicaragua’s sugarcane industry offers a glimpse into a world beyond desperation.  

Rather, it is a land of resignation.  

In Chichigalpa’s “La Isla” district, many men know they'll die before their time and many women know that fathers, husbands or brothers will slip away in horrible pain, the final insult inflicted by the mysterious epidemic of kidney disease that is battering their community. 



Thirty-two-year-old Maximiliano Lopez sat with me in his backyard, his dog chained to a tree, his feet firmly planted on the hard-packed soil. A well-built man who spent more than a decade as a cane cutter, he's now resigned to death.

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This father of four matter-of-factly told me he would be dead in three years, four if he is lucky.  

But then again, folks here are reluctant to ask for more time on Earth when they know of the crippling pain that awaits them. 

 If our bodies are like a smooth-running city, then our kidneys are the town’s sewer treatment system, eliminating the nasty toxins and toxic substances we manufacture and ingest on a regular basis. 

 But for those suffering chronic kidney disease, or CKD, that system breaks down and poisons build up. Without proper dialysis -- a luxury to the vast majority in this part of the world -- the disease leaves its victims bed-ridden in agony. 

Sacorro Mendez-Flores, surrounded by her grandchildren, holds a family photo. The resident of Chichigalpa, Nicaragua, lost both her son and husband to chronic kidney disease.

 American medical researcher Dr. Nate Raines, here trying to determine the source of the CKD epidemic in this region, says victims endure 100 times the aches and pain associated with the flu. 

 “There's no cure,” he said. “… Until we know the cause, we can't implement the interventions we need to make to prevent these workers from dying.” 

An inexplicable epidemic in Central America, where more than 16,000 people — mostly sugarcane workers — have died from incurable chronic kidney disease. NBC's Kerry Sanders reports from Nicaragua.

 Sacorro Mendez-Flores, pictured above, just lost her son to CKD. In his final weeks of life, she says, he was in agony. 
“He said that everything hurt,” she says. “He felt like he was burning. He'd say, 'Mama, you don't feel what I feel.' It made me cry. I'd say, 'What can I do?'” 

In a ramshackle concrete-block home alongside an aging two-lane highway in Chichigalpa, another family is living through a similar horror.

In a bed placed in the family living room, 63-year-old "Juan" is near death.

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Workers in Central American sugarcane fields are dying of chronic kidney disease at an astonishing rate and experts are unable to say why.

His loved ones gather at his bedside -- some in tears, others unable to even look at his body -- as the family patriarch, who spent more than three decades in the sugarcane fields, writhes in unconscious pain, with no morphine to ease his suffering.

(Juan's family allowed us into their home if we would not reveal their last name. His wife’s fear: losing a $150 monthly pension should the sugar company find out she blames his work in the fields for his CKD.)

And the ugliest irony of all: If there is a direct link between the work in the sugarcane fields and CKD, then two of Juan's sons standing at his bedside may be witness to their own end.

They both followed their father into the sugarcane fields, says Juan’s 25-year-old son, Carlos, because "it's the only job in this area. There's no other way to make a living." 

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