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www.laislafoundation.org | laislafoundation@gmail.com
Addressing the
Chronic Kidney Disease
epidemic in Central America
La Isla Foundation
www.laislafoundation.org | laislafoundation@gmail.com
Who Are Involved?
• Grupo Pellas
• The World Bank via the IFC
• ASOCHIVIDA
• CAO
• Boston University
• Nicaraguan Government-Local & National
• La Isla Foundation & partners
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www.laislafoundation.org | laislafoundation@gmail.com 3
Partners
• PAHO
• SALTRA & CISTA
• Solidaridad
• FairFood
• Innovation Protocol
• A Growing List of Universities
• Mayor’s Office of Chichigalpa
• MINSAL and MINSA
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What is an epidemic?
• Examples – Black Death
– SARS
– Haiti cholera outbreak
– Malaria
– AIDS
– Polio
– Influenza
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Percentage of total sugar production in Nicaragua for
2008-2009
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CKD defined
• Chronic Kidney Disease (CKD), or chronic renal disease, is the
progressive loss of kidney function over months or years; it is
treatable but not curable.
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STAGE 1 Kidney damage with normal or
increased kidney function
STAGE 2 Kidney damage with mild or decreased kidney function
STAGE 3 Moderately low kidney function
STAGE 4 Severely low
kidney function
STAGE 5 Kidney failure
Activity and Diet Changes Activity and Diet Changes Transplant / Dialysis
Transplant / Dialysis
90 60 30 15 GFR:130
Transplant
Glomerular Filtration Rate (mL/min/1.73m2)
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What happens with CKD?
What happens when the kidneys shut down?
•Waste products and excess fluids build up inside body
•Unpleasant taste in mouth and urine-like odor to the breath
•Nausea
•Headache
•Swelling of hands and feet
•Frequent urge to urinate
•General fatigue
Kidney failure in Central America
Is incompatible with life.
Source: National Kidney Foundation
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Treatment of CKD
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Reality in U.S.
• Dialysis 3-4 times per week
• Costs $129,000 per year
• Covered by health insurance, Social Security/Medicaid
• 5-year survival rate for a patient undergoing chronic dialysis is approximately 35%
Source: National Kidney Foundation
Reality in Nicaragua
• Lack of access to dialysis
• Average income in La Isla is less than $1 per day
• La Isla workers do not have health insurance; healthcare is inadequate
• CKD diagnosis is a death sentence. CKD=TKD
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Where is the CKD epidemic?
• Every day 1.2 people in Nicaragua die of CKD
Sources: Nationmaster World Health Organization
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Who gets CKD?
Sources: Third National Health and Nutrition Examination Survey Nicaraguan Ministry of Health
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Who has CKD?
Sources: Third National Health and Nutrition Examination Survey Nicaraguan Ministry of Health
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ISA is the only
large employer
nearby
ISA pays low
wages and
demands long
work hours in
unhealthy
conditions
Parents cannot provide
food, education or
healthcare for their
family
Bread winner
(father)g gets fired
& eventually dies of
CKD and his
children must take
his place
Cycle of Illness and death
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What happens to the community?
Due to this cycle of death the La Isla community is known as
The Island of Widows
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Causes of CKD
• Diabetes
• High blood pressure
• Hereditary causes
• Dehydration
• Environmental contamination
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What causes the CKD epidemic?
Sources: National Kidney Foundation
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Causes of CKD • Diabetes
• High blood pressure
• Hereditary causes
• Dehydration
• Environmental contamination
Until Further Studies Are Completed We Just Don’t Know
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What causes the CKD epidemic?
Sources: National Kidney Foundation
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What causes the CKD epidemic?
Conditions at Work
Sources: La Isla Prevalence Study w/ CISTA
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What causes the CKD epidemic?
• Sugar process – Planting – Burning – Cutting – Collection – Processing
• Work conditions – Temperature – Severe dehydration – Work hours – Environmental exposure
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Corporate social responsibility?
• Pellas Group is the most powerful company in region and is based in the poorest country
• 7,000 employees at height of harvest
• 46% of Nicaragua's total sugar production
• 55% of its sugar is exported
• “Sierra Club certified,” among others
• Reforestation
• Displacement
Sources: NSEL, El Nuevo Diario
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Why is this a global issue?
Nicaragua is #9 globally
in sugar exports per capita
Sources: USDA – Foreign Agriculture Service
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How does this relate to you?
• You use these products
• Sugar exports to the US/CAN
• Ethanol purchased by BP in EU
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La Isla Foundation
La Isla Foundation is addressing the epidemic of Chronic Kidney Disease
among sugar cane workers in Central America.
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The Foundation’s goals
• Help establish the cause of the CKD epidemic
• Facilitate prevention and treatment
• Create greater financial independence and sustainability for the community
• Create a bridge between workers and consumers
• Work on Policy Change
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Our projects
• English/Computer classes
• Sewing cooperative
• Sanitation (Latrines)
• Clean water
• Studies and interventions
• Community organization
• Clinic and school repair
www.laislafoundation.org | laislafoundation@gmail.com
What Can You Do?
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•Incorporate this issue into your thesis •Donate or organize a event •Take Spanish and dance classes with us
•Volunteer w/ LIF or partners •Support a community project •Travel with us
www.laislafoundation.org | laislafoundation@gmail.com
Be part of the solution
Working with La Isla Foundation You can be part of the Solution that will end this cycle of
death and loss.
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