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The rare disease that plagues Central America
13-Dec 3:01 pm | BBC
A rare kidney disease that affects Central America became one of the leading causes of death for men. Some already talk of an epidemic and, although it has not been confirmed, it is believed that working conditions are responsible
A mysterious kidney disease is becoming a major cause of death for men in Central America. In El Salvador is the second leading cause of death and Nicaragua is killing more people than HIV and diabetes combined. There has not been confirmed the cause, but it is thought that the victims are literally killing themselves working. This is the story in the lowlands of Nicaragua, a region of vast sugar cane fields, is the small community of La Isla Their small houses form a patchwork of concrete and wood. Pieces of cloth serve as doors. Maudiel Martinez out of one of these houses to greet me. It is a pale man with protruding cheekbones. Walk like an old man leaning, but only 19 years. "The way the disease arises is that you see me now, but in a month I will be gone. You can attack suddenly "he says. Maudiel's kidneys are shutting down. They do not carry out its essential function of filtering wastes from your body. The young man is poisoned internally. When he began to be wrong two years ago knew about this disease and know how he could finish. "I thought of my father and grandfather," he says. Both died the same disorder, as did three of his brothers. They all worked in the sugar fields. Kidney disease has killed so many men that local people now not only the community called "The Island" but "The Island of Widows." The epidemic is spreading beyond Nicaragua. It is prevalent along the Pacific coast of Central America, in six countries. "It is important that renal chronic kidney disease (CKD) affects thousands of rural workers in Central America to be recognized for what it is: a large epidemic a tremendous impact on the population, "says Dr. Victor Penchaszadeh, clinical epidemiologist at Columbia University in the U.S. and adviser to the Pan American Health Organization (PAHO). The Minister of Health of El Salvador recently sought help from the international community . According to the official epidemic "is consuming our people." Excess heat in a clinic in El Salvador in the agricultural region of Bajo Lempa, Dr. Carlos Orantes recently found that 25% of men in the area suffered from the disease. In addition says, most patients showed no signs of hypertension or diabetes, the most common causes of CKD in other parts of the world. "Most of the men studied had CKD but its cause was unknown," he explains. What men in the region have in common is that they all worked in the field. So Dr. Orantes believes that one of the leading causes of kidney damage are toxic chemicals, pesticides and herbicides, which are routinely used in agriculture. "These chemicals are banned in the U.S., Europe and Canada, but used here, without protection, in large quantities, which is very worrying, "said the doctor. But do not rule out that there may be other causes. For example, overuse of analgesics can damage the kidneys, like drinking too much alcohol. Both are important issues in this region, says Dr. Orantes. In Nicaragua the disease and became a political issue. In 2006 the World Bank provided a loan to Nicaragua's largest sugar company to build an ethanol plant. The plantation workers filed a complaint saying that the working conditions of the company and the use of toxic chemicals were causing an epidemic. They claimed that the loan violated the Bank's own standards on safety and environmental practices. In response, the Bank agreed to fund a study to try to identify the cause of the epidemic. "The evidence clearly points to the hypothesis that heat stress could be the cause of this disease, "says Dr. Daniel Brooks of Boston University, USA, who is conducting the investigation. He and his team found that sugar workers are not the only ones who are falling sick. The miners and dock workers also suffer from high levels of kidney disease, and yet they are not exposed to agricultural chemicals. What these men have in common, says the researcher, is that everyone is working long hours in extreme heat. "Day after day of hard manual work in hot conditions, without adequate fluid replacement, can have effects on the kidneys that are not obvious at first but will eventually build up to a state of disease, "says Dr. Brooks. "Never has been demonstrated that this cause chronic kidney disease, so we would be talking about a new mechanism has not yet been described in scientific literature, "he says. But the scientist says that a new preliminary study supports this hypothesis. His team analyzed blood and urine sugar workers carrying out different jobs. The scientists found more evidence of kidney damage in workers performing work harder abroad. Aurora Aragon Professor National University of Nicaragua, Leon says that this explanation makes sense. have long suspected that part of the problem is how they are paid to the sugar workers: they receive more money from more cut sugar cane. "This form of work force people to do more of what they can and this is not good for your health, "he says. No alternative "Work in the field makes us feel dizzy and nauseated," says Donald Jose Cortez, who cuts cane for 18 years. "Often have fever. " Cortez now have kidney disease and directs an organization of sugar workers in Nicaragua who are ill. He is convinced that something in the sugar plantations is causing the disease. Whatever it is, say, those who are sick need dialysis treatment, which can keep them alive if they fail the kidneys. But few can get it because dialysis is extremely expensive and very little available. "If you ask the ministry of health will say they do not have the money. If you ask the company if they are responsible for sugar, they say 'no.' " Meanwhile, the sugar companies say they are not convinced that the chemicals used in their plantations are responsible for the epidemic. Still, they say, seek to protect the health of their employees. A conglomerate that owns several sugar plantations in Central America, the Pellas Group, says it has begun to give their workers a one-hour break for lunch and now employs staff to ensure that men drink water. The company also carries out routine tests on their employees kidney. The company spokesman, Ariel Granera, states that if a worker is found to have kidney disease is allowed to go, concern and for their own good, he adds. But sick workers who were dismissed claim that they receive from companies and social security is not enough to live and when they lose their jobs lose their right to receive medical treatment company . On the Island, and many other similar villages, men are often employed by contractors who do not perform analysis of kidney disease. Everyone knows that working in the sugar fields is a big risk, but no other jobs the region. "We have no alternative," says a woman who recently lost his father. "There is no other way to support the family."
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