La Isla Foundation Addressing the Chronic Kidney Disease ... · | [email protected]...

www.laislafoundation.org | [email protected]

Addressing the

Chronic Kidney Disease

epidemic in Central America

La Isla Foundation


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 | [email protected] 3

Partners

• PAHO

• SALTRA & CISTA

• Solidaridad

• FairFood

• Innovation Protocol

• A Growing List of Universities

• Mayor’s Office of Chichigalpa

• MINSAL and MINSA


What is an epidemic?

• Examples – Black Death

– SARS

– Haiti cholera outbreak

– Malaria

– AIDS

– Polio

– Influenza


Environmental and Social

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Percentage of total sugar production in Nicaragua for

2008-2009


Bigger Than Nicargua

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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)


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

http://www.kidney.org/professionals/kls/images/KLSarrow_v2_sm.gif


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

http://www.kidney.org/professionals/kls/images/KLSarrow_v2_sm.gif


Where is the CKD epidemic?

• Every day 1.2 people in Nicaragua die of CKD

Sources: Nationmaster World Health Organization

http://www.nationmaster.com/graph/mor_chr_ren_fai_percap-chronic-renal-failure-per-capita


Who gets CKD?

Sources: Third National Health and Nutrition Examination Survey Nicaraguan Ministry of Health


Who has CKD?

Sources: Third National Health and Nutrition Examination Survey Nicaraguan Ministry of Health


WORLD

LA ISLA

NICA

USA


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


What happens to the community?

Due to this cycle of death the La Isla community is known as

The Island of Widows


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


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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Sources: National Kidney Foundation



Conditions at Work

Sources: La Isla Prevalence Study w/ CISTA



• Sugar process – Planting – Burning – Cutting – Collection – Processing

• Work conditions – Temperature – Severe dehydration – Work hours – Environmental exposure


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

http://www.nicaraguasugar.com/es/

http://www.elnuevodiario.com.ni/departamentales/101672_ingenio-san-antonio-certifica-la-calidad-de-sus-productos


Why is this a global issue?

Nicaragua is #9 globally

in sugar exports per capita

Sources: USDA – Foreign Agriculture Service

..%5CSugar%20Facts%5Csugar%20production.xlsx


How does this relate to you?

• You use these products

• Sugar exports to the US/CAN

• Ethanol purchased by BP in EU


La Isla Foundation

La Isla Foundation is addressing the epidemic of Chronic Kidney Disease

among sugar cane workers in Central America.


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


Our projects

• English/Computer classes

• Sewing cooperative

• Sanitation (Latrines)

• Clean water

• Studies and interventions

• Community organization

• Clinic and school repair


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


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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Any questions?

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La Isla Foundation Addressing the Chronic Kidney Disease ... · | [email protected]...

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