CHICHIGALPA, Nicaragua — During the harvest season, when exhausted workers spend seven days a week cutting sugar cane, the signs of illness were hard to spot at first.
It was in the off-season, out on the baseball field, that some residents noticed a change. Base-stealers were lethargic. Pitchers were losing their aim. In the evening, outfielders were burning up as if standing under the scorching sun of the day.
“That’s Mosquito, now dead,” said Arnulfo Téllez Aguilera, 49, pointing to a photograph of his smiling teammates before their muscles withered, like his. “That’s my brother, Danilo, dead too.”
Across Central America, a painful disease that affects the kidneys has killed at least 20,000 people over the past decade and has become the leading cause of deaths in hospitals among men in El Salvador. But the illness, often called Chronic Kidney Disease of unknown causes, or CKDu, is so poorly understood that it still does not have a universally agreed upon name.
Theories vary drastically, citing a combination of possible factors, including heat stress, chronic dehydration, toxic chemicals, painkillers, sugar consumption and even volcanic ash.
But there is a rare point of consensus, many researchers say: Nicaragua’s sugar cane heartland — in particular Chichigalpa, the town that is home to the country’s largest sugar mill — has been one of the hardest hit places in the world. Cane-cutting fathers and sons in the same family have died, and seemingly healthy young men are quickly wasting away.
The Nicaraguan government, the country’s sugar mills, even the World Bank, which has poured tens of millions of dollars into the sugar industry here, all say that until the mystery of the disease is solved, there is little they can do to prevent it. Now, after years of inconclusive research, the Centers for Disease Control and Prevention is stepping in to help with some of the most ambitious studies of the illness yet.
But the sick former sugar cane workers here have little faith that more studies will bring improvements anytime soon. The fact that the research will be funded entirely by the sugar industry is only fueling the distrust.