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La Isla Foundation
Addressing the
Chronic Kidney Disease
epidemic in Central America
www.laislafoundation.org | [email protected]
Who Are Involved?
•
•
•
•
•
•
•
Grupo Pellas
The World Bank via the IFC
ASOCHIVIDA
CAO
Boston University
Nicaraguan Government-Local & National
La Isla Foundation & partners
2
Partners
•
•
•
•
•
•
•
•
PAHO
SALTRA & CISTA
Solidaridad
FairFood
Innovation Protocol
A Growing List of Universities
Mayor’s Office of Chichigalpa
MINSAL and MINSA
3
What is an epidemic?
• Examples
–
–
–
–
–
–
–
Black Death
SARS
Haiti cholera outbreak
Malaria
AIDS
Polio
Influenza
4
Environmental and Social
5
Percentage of total sugar production in Nicaragua for
2008-2009
6
Bigger Than Nicargua
7
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.
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
Transplant
GFR:130
90
60
30
15
0
omerular Filtration Rate (mL/min/1.73m2)
8
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
9
Treatment of CKD
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%
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
Source: National Kidney Foundation
10
Where is the CKD epidemic?
• Every day 1.2 people in Nicaragua die of CKD
Sources:
Nationmaster
World Health Organization
11
Who gets CKD?
Sources:
Third National Health and Nutrition Examination Survey
Nicaraguan Ministry of Health
12
Who has CKD?
Sources:
Third National Health and Nutrition Examination Survey
Nicaraguan Ministry of Health
13
WORLD
USA
NICA
LA ISLA
WORLD
USA
NICA
LA ISLA
Cycle of Illness and death
ISA is the only
large employer
nearby
ISA pays low
wages and
demands long
work hours in
unhealthy
conditions
Bread winner
(father)g gets fired
& eventually dies of
CKD and his
children must take
his place
Parents cannot provide
food, education or
healthcare for their
family
What happens to the community?
Due to this cycle of death the La Isla community
is known as
The Island of Widows
17
What causes the CKD epidemic?
Causes of CKD
• Diabetes
• High blood pressure
• Hereditary causes
• Dehydration
• Environmental contamination
Sources:
National Kidney Foundation
18
Causes of CKD
• Diabetes
• High blood pressure
• Hereditary causes
• Dehydration
• Environmental contamination
Until Further Studies Are
Completed We Just Don’t Know
Sources:
National Kidney Foundation
19
Conditions at Work
Sources:
La Isla Prevalence Study w/ CISTA
20
• Sugar process
–
–
–
–
–
Planting
Burning
Cutting
Collection
Processing
• Work conditions
–
–
–
–
Temperature
Severe dehydration
Work hours
Environmental exposure
21
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
22
Why is this a global issue?
Nicaragua is #9 globally
in sugar exports per capita
Sources:
USDA – Foreign Agriculture Service
23
How does this relate to you?
• You use these products
• Sugar exports to the US/CAN
• Ethanol purchased by
BP in EU
24
La Isla Foundation
La Isla Foundation is addressing the
epidemic of Chronic Kidney Disease
among sugar cane workers
in Central America.
25
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
26
Our projects
• English/Computer
classes
• Sewing cooperative
• Sanitation (Latrines)
• Clean water
• Studies and
interventions
• Community
organization
• Clinic and school
repair
27
What Can You Do?
•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
28
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.
29
Any questions?
30

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