I was in the frenetic Nicaraguan capital of Managua. Managua is a compromise city, chosen as the capital as Leon and Granada couldn’t agree to the other’s capitalhood. It is sprawling and fastpaced, with pockets of avarice and destitution. I had been wandering through some bad neighborhoods, on my way to check out some 5,000 year old footprints encased in volcanic mud and precariously located in one of the worst neighborhoods in the capital.
On my arrival back uptown, I noticed a tent city on the side of the road.
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| From The Flor de Caña Protest (Managau) |
Curious, I walked over because it seemed a little out of place in the Metro Centro shopping district and next to the jug-like roofed Nuevo Catedral. As I passed, I saw a sign that floored me with irony and truly caught my interest.
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| From The Flor de Caña Protest (Managau) |
A “wall” of a tent structure was constructed from an advertisement for a fancy christmas dinner at the fancy Hilton Hotel. The richness of irony was profound.
I began chatting with the residents of this tent city, and snapping a few pics of the fellows sitting on tree stumps.
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| From The Flor de Caña Protest (Managau) |
As they began telling me their story, I had my eureka moment. This was my public health apotheosis and the singular most apropos moment of my journey. The tent city was a protest city, a public health protest against the Flor de Caña company by the workers of their San Antonio factory for the public health degradation that they had experienced.
I sat with the gentlemen in the warm afternoon as grey clouds shielded us from the afternoon sun. Gustavo Martinez, the vice president of ANAIRC- the organization representing the workers affected and now suffering from chronic kidney disease due to the chemicals used in the Flor de Caña distillery and factory.
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| From The Flor de Caña Protest (Managau) |
Vice President Martinez shared with me the information on the workers situation, which I will now share as well. The former workers in the Flor de Caña had left their homes in San Antonio to bring attention to the fact that Flor de Caña and its parent group Pellas had been using pesticides that had contaminated the water supply in the western region of Nicaragua. The former workers mentioned that the company had harmed the regional environment by burning vast tracks of land as well as using agrochemicals that had contributed to the poor health of thousands of former workers. Mr. Martinez also mentioned that these pollutants that had entered the water supply and had caused the deaths of nearly 3,500 people. Many former factory workers as well as those in the region were suffering from chronic kidney failure due to the chemicals in the polluted water.
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| From The Flor de Caña Protest (Managau) |
In protest, the former workers of the Flor de Caña factory had left their towns and villages and had moved to Managua to set up the protest.
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| From The Flor de Caña Protest (Managau) |
They had been living just under the shadow of the giant Flor de Caña sign in the middle of the city to bring attention to their plight and raise awareness for the ongoing difficulties faced by those in the region. The former workers had left San Antonio and had been living in the protest tent city, trying to gain a meeting with the government so they could have a hearing on the situation. They had been living in the tent city- constructed from tree branches, thick garbage bags and various signs, for more than ten months. Vice President Martinez said the group was fighting for their loved ones and their children who are now so sick from the environmental degradation. They are campaigning for a boycott against Flor de Caña and its parent company.
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| From The Flor de Caña Protest (Managau) |
The organization has a Facebook page, where those interested can get more information and offer their support for the workers’ protest.
In my support, I post my photo album of their protest in the hopes to bring more attention to their plight. This is the closest intersection of public health and public diplomacy- the use of new media platforms to make foreign publics aware of public health issues. You can be sure that their struggle will be looming large in the photos for my upcoming exhibit on the world of public health.
USC Global Health Travel Blog 
THE FLOR DE CAÑA PROTEST: THE TRUTHA group of people linked to the Nicaraguan Association of Persons Affected by Chronic Renal Insufficiency (ANAIRC) has been developing for some time a defamatory campaign against Nicaragua Sugar Estates Limited (NSEL), with the sole objective of obtaining unjustified financial compensation from the company. They have extended the campaign to Grupo Pellas and have promoted a boycott against the Flor de Caña rum brand. The afore-referenced campaign rests on the assumption that former workers of Ingenio San Antonio, owned by NSEL, developed Chronic Renal Insufficiency (CRI) while working for the company. In an attempt to draw attention, ANAIRC has even presented data on CRI patients and deaths, which has not been corroborated by any authority or public or private institution of the Nicaraguan state. What needs to be clarified first is that Flor de Caña has nothing to do with these accusations because the purported affected people are not former workers of Flor de Caña, rather they claim to be former workers of Ingenio San Antonio.Flor de Caña has been involved because the afore-referenced claimants believe that this way, given the prestige of the brand and that Flor de Caña is produced by a company that belongs to Grupo Pellas, they can pressure NSEL to satisfy their unjustified demands for compensation.Chronic Renal Insufficiency is a multi-causal disease that is prevalent throughout the world. Diabetes and hypertension are among the main causes.Diverse studies show that nearly 20 million people (one of every nine) in the United States have chronic renal insufficiency and another 20 million are at risk. In Japan, the figures are even higher, estimating that 20% of the total adult population, or 20.5 million people, have some form of the disease. In Spain, the prevalence rate of the disease has increased in recent years and affects one of every 8 Spaniards, equivalent to 12% of the population. It is estimated that the number of CRI patients in several Latin American countries and Canada exceeds 3% of the population. In the case of Nicaragua, the prevalence of the disease occurs mainly in the Pacific region (Leon, Chinandega, Managua, Masaya, Granada, Carazo and Rivas), including territories where sugarcane activities do not exist, like some municipalities of Leon (Larreynaga, La Paz Centro, Nagarote), which is the department with the highest prevalence rates.No scientific study has established a causality relationship between work practices in sugar mills and CRI, as shown by the fact that countries like Guatemala, Cuba or Brazil, where sugarcane growing is a major activity, no CRI epidemic has been reported in their sugarcane zones, while Japan, which does not grow sugarcane, has the highest prevalence rate in the world. Ingenio San Antonio (ISA), owned by Nicaragua Sugar Estates, employs the same agricultural practices that are used throughout the world and it is characterized for having an eco-friendly production system given that environmental protection is an essential aspect of the company’s social responsibility. Several examples are:• An integral biological and mechanical pest control system that eliminates the use of pesticides almost entirely and protects the environment. • The use of minimal doses of insecticides of low toxicity and only on very specific occasions and in very limited sowing areas (between 2 and 3 percent of the total area). Given these characteristics and that applications occur in areas far away from population centers, there is no polluting effect.(continues…)
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THE FLOR DE CAÑA PROTEST: THE TRUTH(continues…) • The agrochemicals used at ISA are registered with the Ministry of Agriculture and Forestry (MAGFOR) before the toxicological and eco-toxicological approvals are issued by the Ministry of Health and the Ministry of the Environment and Natural Resources (MARENA). These products are also registered with the United States Environmental Protection Agency (EPA). Products are neutralized in the soil and are not transferred along the food chain. • The compulsory use of personal protective equipment and strict compliance of safety measures in the application and use of agrochemicals.• Periodic water quality tests performed by prestigious national and international laboratories, which show that water is suitable for human consumption• An efficient state-of-the-art irrigation system that reduces water consumption, while leading to rational use of the water-bearing aquifer. • Generation of clean energy from sugarcane bagasse and eucalyptus chips, eliminating the use of bunker in its operations and ensuring 7% of Nicaragua’s power consumption during the harvest season. It is estimated that more than 95 thousand tons of greenhouse gases are reduced per year.• Annual campaigns for reforestation with native species, such as madroño, cedar, mahogany, guanacaste and oak, originating from the nurseries of Ingenio San Antonio.This clean production system has contributed, among other things, to Nicaragua Sugar being considered as an international benchmark in the sugar industry. Nicaragua Sugar is a pioneer in social responsibility. For many years it has supported nearby communities in the execution of diverse projects, from the construction of schools, parks and bridges to sanitary infrastructure, health programs, etc. For this reason, it has been interested in helping to cope with the CRI disease, which is one of the major public health problems in the area where the company operates. In this context, Nicaragua Sugar has been participating for several months in a dialogue with the Chichigalpa Association for Life (ASOCHIVIDA), the main association of CRI patients in Nicaragua. As a result of this dialogue, Nicaragua Sugar is providing food supplies to the members of ASOCHIVIDA, as well as medicines, reagents and medical equipment to the Chichigalpa Health Center. It is also coordinating studies with ASOCHIVIDA to implement livelihood projects that benefit CRI patients and their families. These projects will be defined in the next three months.On the other hand, ASOCHIVIDA and NSEL, under the auspices of the Compliance Advisor/Ombudsman (CAO) Office of the World Bank, have decided to commission an international study to identify the causes of Chronic Renal Insufficiency in the west region of Nicaragua, which will be conducted by Boston University, a prestigious university in the United States. The terms of reference that will guide the study have already been prepared by Boston University and have been approved by NSEL and ASOCHIVIDA. Regardless of their leftist or rightist ideological position, all work unions at NSEL and Compañía Licorera, the Flor de Caña rum manufacturer, have pronounced themselves against this unfounded campaign by ANAIRC, which Mr. Paul Rockower has strangely joined through this blog, probably out of ignorance.When this type of issues are addressed, it is important to take the time and seriously investigate them and not to be swayed by what some people say, otherwise you run the risk of making unfounded statements and lending yourself to campaigns that serve specific interests which, in any case, are far from being a genuine interest in public health. For more information, please visit:www.laverdadnsel.com.www.nicaraguasugar.com.niwww.youtube.com/grupopellashttp://boicotflordecana.wordpress.com/By: Claudia Serrano
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As someone who once worked as a flak, that is a pretty pathetic flak response. I will thoroughly enjoy creating a photo exhibition about the boycott and the people whose health you have been poisoning. I would be glad to send your headquarters and PR agency a post card.Saludos!Paul
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Paul,Thank you for your response. I am convinced that out of respect to the visitors of this blog, the issue in question must be examined under the light of scientific evidence and proof.I wonder if public diplomacy shouldn’t base, at least minimally, its arguments on research. Canemotional positions be allowed?If you are interested in contributing to furthering the knowledge about this topic, and should you wish for me to share additional information with you, please don't hesitate to contact me.Best regards,Claudia
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The nicaraguan region you mention in your article, is also the same area where the american banana companies settled in the 60″s and 70's (Dole and Chiquita by the way are being sued by nicaraguan farmworkers for the use of deadly quemicals, particularly one known as DBCP). ALSO, the same area is well known for succesful cotton production back in the time when Nicaraguan listed cotton as one of their mayor exports. The use of quemicals in cotton fields was done with airplanes all over the northwest area of nicaragua. A few years ago, a study by a German non-profit organization found the water supply in the northern part of the Managua lake contaminated, it was so bad they found traces of quemicals in women's breast milk..So BE CAREFUL when you acuse the sugar growers of being responsible for the illness of thousands of nicaraguan peasants, there are many people, including past and current governments that that share in that responsability because theye are guilty of ignoring something that has been happening for decades..
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I love flor de cana. that is all.
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To Genaro-I am Jason Glaser, Director of La Isla Foundation. While we have never accused your company of direct involvement it does not mean we think the Pellas group has behaved admirably towards its work force. I would like to take your bullet point responses point by point.What truly bothers me is we have been working in the most affected community, La Isla outside of Chichigalpa and have asked for your aid in bringing potable water and your company has roundly ignored us. Thankfully the local government has been of help.I agree that science and level heads must rule the day but you MUST stop using such poor PR and focus on solving the problem. Some of your points are beyond misleading to the educated. I won't even go into your analysis of kidney failure rates throughout the world as your maiming of the numbers doesn't warrant a response. You know better as a study from CISTA at UNAN-Leon and SALTRA clearly shows far higher numbers than the date you are using. The epidemiologists that carried it out were trained at Karolinska in Sweden which is rated as a better school for epidemiology than the still respectable Boston University. So, you have highly trained and impartial local scientists whose numbers you have chosen to ignore. Let's look at these points:• An integral biological and mechanical pest control system that eliminates the use of pesticides almost entirely and protects the environment.-True and False. You do have some biological fields but it isn't the majority plantation and this hasn't always been the case. Even a college freshman knows pesticides are persistent in the environment. Sometimes for decades. This is bordering on a complete lie.• The use of minimal doses of insecticides of low toxicity and only on very specific occasions and in very limited sowing areas (between 2 and 3 percent of the total area).-This is false according to all workers I have talked to. Please give me a personal tour and prove otherwise. Show me these limited zones and your biological controls instead making these claims. Most socially minded epidemiologists don't believe in a 'safe' dose of pesticide either. Only a company quack or someone working for the private firm Exponent would make such a claim.*Given these characteristics and that applications occur in areas far away from population centers, there is no polluting effect.-False. As far as being far away from population centers we both know that your fields surround and abut several communities all of which have reported or in the case of Guanacaste/La Isla have proven higher levels of IRC.
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Genaro-Let us continue going point by point. Remember, my goal is not to point fingers but to encounter a solution and improve the situation of the communities affected by this epidemic. Pellas group must stop being so aggressive in its debunking as it is being misleading and even outright ignoring available data that does not agree with the narrative you/they are creating. Plus, we both know that pesticides are persistent so your argument of what you are doing NOW has nothing to do with what may or may not have been done by Pellas group owned/operated farms in the past. This isn't saying you are guilty, just that your current PR leaves you open to many worthwhile criticisms. One of the most misleading points you make is there is no IRC in Cuba, Guatemala or Brazil. There are a few things wrong w/ this claim. 1. Little data exists in Guatemala regarding this issue. 2. Brazil's sugar cultivation is mechanized, workers wouldn't be subjected to the level of any offending element in the environment, natural or otherwise. 3. Cuba uses organic production. This claim is so misleading. Please be more genuine. I understand that other crops could be to blame that came before but saying sugar cultivation at ISA has nothing to do w/ the problem until the facts are in is misleading to say the least. We simply do not know yet. However the prevalence study from CISTA/SALTRA does suggest a correlation and you have failed to address this.• The agrochemicals used at ISA are registered with the Ministry of Agriculture and Forestry (MAGFOR) before the toxicological and eco-toxicological approvals are issued by the Ministry of Health and the Ministry of the Environment and Natural Resources (MARENA). These products are also registered with the United States Environmental Protection Agency (EPA). Products are neutralized in the soil and are not transferred along the food chain.-True. The chemicals you claim to be currently using do meet these guidelines but the claim that they do not persist is hotly debated. Could you confirm that you use them w/ in the recommended concentrations and use them with the allowed frequency? That is worthwhile info.• The compulsory use of personal protective equipment and strict compliance of safety measures in the application and use of agrochemicals.-This is false, we have violations on tape and in interviews. Please stop saying this. It is a lie. A regulation is just words on paper if not enforced and you have failed to enforce it. Further, many studies suggest that this 'protective' gear is actually worse in some cases and almost impossible to use in the tropics due to the heat. In fact the dehydration caused by the protective gear could cause kidney damage. Write me for more info. Laislafoundation@gmail.com• Periodic water quality tests performed by prestigious national and international laboratories, which show that water is suitable for human consumption-Now this is absurd. Many tests by MINSA, CIRA and other orgs show this is absolutely not the case in the communities of Chinandega and Leon department. That water is horrific. What well were you testing? You would be wise to take this claim off immediately. • An efficient state-of-the-art irrigation system that reduces water consumption, while leading to rational use of the water-bearing aquifer.-Last week Saturday I just watched you water your field near the main entrance at high noon with what amounted to a giant sprinkler. This is the least efficient way of watering. However, I know that your company is investing on improving this situation and I look forward to monitoring its implementation.
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TO CONTINUE:• Generation of clean energy from sugarcane bagasse and eucalyptus chips, eliminating the use of bunker….-This is a great program but does not directly address mistreatment of workers.• Annual campaigns for reforestation with native species, such as madroño, cedar, mahogany, guanacaste and oak, originating from the nurseries of Ingenio San Antonio.-See Above. Great work. Thank you! No one said you were all bad or all good. Stay on point please.This clean production system has contributed, among other things….-You are not part of the Better Sugar Initiative so this is a false claim. Nicaragua Sugar is a pioneer in social responsibility. For many years it has supported nearby communities in the execution of diverse projects, from the construction of schools, parks and bridges to sanitary infrastructure,…-Please help the most affected community of Guanacaste/La Isla then. You have ignored our appeals for aid completely. You have done nothing for this community of merit. Your public health initiative through foundation Coen blame the parents for the disease. That borders on evil. Do more than paint a school or install a park or put in a well or electricity that you require for your operations. People need water and income. Their husbands and sons are fired when found to be ill by your doctors but allowed to work for you through subcontractors which both accelerates the disease AND cuts them off from social security and a pension. Explain that logic sir. I have also documented sexual and physical abuse and even murder by your security personnel that has gone unanswered. I would love to share that info with you as a responsible company would probably like to address these issues and I am willing to accept that some of these abuses have been hidden from management. You have my email. Let us talk.In this context, Nicaragua Sugar has been participating for several months in a dialogue with the Chichigalpa Association for Life (ASOCHIVIDA)…-ASOCHIVIDA does not represent all parties and many of the parties are not represented by ASOCHAVIDA because the group has been viewed as partial.As a result of this dialogue, Nicaragua Sugar is providing food supplies …-This is a very small percentage of the affected population sir. You know this. However, congrats on moving forward. I hope for the best out of this process regardless of how flawed I may personally find it.
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To Conclude:On the other hand, ASOCHIVIDA and NSEL, under the auspices of the Compliance Advisor/Ombudsman (CAO) Office of the World Bank, have decided to commission an international study to identify the causes of Chronic Renal Insufficiency in the west region of Nicaragua, which will be conducted by Boston University, a prestigious university in the United States. The terms of reference that will guide the study have already been prepared by Boston University and have been approved by NSEL and ASOCHIVIDA.-This is great news. I am in full support and we are available to help. However, I find it regrettable that part of the agreement for the study stipulates that BU may not work w/ Latin American epidemiologists in Nicaragua. This is beyond the pale. Regardless of their leftist or rightist ideological position, all work unions at NSEL and Compañía Licorera, the Flor de Caña rum manufacturer, …-Interesting. I would love to tell readers about the story of the independent Union that was attempted a few years back. The leaders were threatened to the point of great mental stress and suffering. Both the company and dirty police in Chichigalpa participated in this according to those assaulted. Finally, ISA succeeded in shutting down the union and bought off the final hold outs. One of them even has a big and beautiful house in the middle of the most distressed community. It borders on a sick joke. I have proof of this process and it is on video if you would like to see it. When this type of issues are addressed, it is important to take the time and seriously investigate them and not to be swayed by what some people say, otherwise you run the risk of making unfounded statements and lending yourself to campaigns that serve specific interests which, in any case, are far from being a genuine interest in public health.-I agree. Remember. La Isla Foundation is the only player in this dialog without a special interest. We aim to work ourselves out of job and move on to another problem somewhere else. We aim to put all the power in the hands of the community in terms of funding, mission and strategy. We want health and decency for the people we work with. We would very much like to work w/ ISA and Pellas group to bring this but they continue to ignore us. The IFC/CAO process will not address this issue alone and several important issues like many of the alleged human rights abuses, land acquisition abuses and water use issues levied against ISA have been taken off the table. Plus, I am not a huge fan of epidemiological studies funded by companies, even if they are carried out by wonderful institutions like BU and when peer review by local experts is being restricted. It ceases to be science at this point as science should have no limitations on who can participate in the vetting process. We usually ignore your PR and claims and just get to work helping the community. I am annoyed I was moved to do so as some of these were just far too misleading and I know you can do better. You're probably a well to do kid with a good education for a US University. Why don't you either try harder or just work w/ us. We aren't assigning blame, we are looking for a solution. Your former PR and 'public health efforts' blamed the workers for bad genetics and drinking too much. At least you've pulled that off the table. There is work to be done. Help us do it Genaro.
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With regard to ANAIRC’s campaign against Nicaragua Sugar and the boycott against Flor de Caña and Grupo Pellas:To this date, there is no recognized formal scientific study that establishes a relationship of causality between sugarcane cultural practices and chronic kidney disease (CKD).Nonetheless, ANAIRC persists in its defamation campaign against Nicaragua Sugar Estates Limited (NSEL) and Grupo Pellas, with the objective of demanding compensation without submitting any evidence to support its claims. All trade unions that are present in the San Antonio sugar mill, regardless of their political or ideological leanings, have rejected ANAIRC’s campaign and have made public statements and demonstrations where thousands of workers have participated.Chronic kidney disease (CKD) is a global public health problem. In Nicaragua, it affects several areas throughout the country, especially in the west region, including territories with no sugarcane production.The data on sickness and death rates that ANAIRC talks about has not been corroborated by any public or private Nicaraguan institution.In the case of the San Antonio sugar mill, former workers affected by CKD were temporary workers, who also engaged in other types of agricultural activities. Many of them only worked during some harvest seasons and stopped working for the company several years ago.In the country’s west region, CKD cases have been detected in different occupational groups, including sugarcane workers, miners, banana workers, stevedores and even school children.While ILO has not classified chronic kidney disease as an occupational disease, its recognition as such by our legislation does not mean that it is caused by sugarcane activity. Each case must be assessed by a medical committee. CKD is commonly caused by high blood pressure and diabetes, which are not linked in any way to sugarcane cultivation. ASOCHIVIDA, the organization that represents most of the renal patients, and NSEL have been holding for over a year a positive dialogue on chronic kidney disease and on the best way to help the sick. ASOCHIVIDA and NSEL agreed that an impartial and prestigious international institution would conduct a study to determine the causes of CKD in Nicaragua’s west region.After a comprehensive process involving 9 public agencies, 22 U.S. and European universities and 5 private consulting firms, Boston University was chosen to conduct the study. The final results of the study will provide important knowledge about the causes of this disease in the west region, and the best way to articulate strategies for prevention and response. In keeping with its corporate social responsibility, Nicaragua Sugar has provided support and solidarity to the people in the nearby communities who have been affected by CKD.Between 2000 and 2004, Nicaragua Sugar delivered humanitarian and economic aid totally approximately US$2 million to more than 1,400 CKD patients who worked for the company in the past. Nicaragua Sugar currently provides food aid to 1,800 families that are members of ASOCHIVIDA, as well as medical assistance to the Chichigalpa health center for CKD patients, consisting of medical drugs, equipment and supplies. ANAIRC has turned down various invitations to participate with ASOCHIVIDA, Nicaragua Sugar, NGOs and health institutions in the west region in the joint actions that are being promoted to benefit people who have been affected by this disease. It is not with misinformation and defamation campaigns that a solution is found to the problems.
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DIALOGUE BETWEEN NICARAGUA SUGAR, GRUPO PELLAS AND ASOCHIVIDA REGARDING CKD Report from the Compliance Advisor and Ombudsman (CAO) of the World Bank: Dialogue process between the San Antonio Sugar Mill and ASOCHIVIDA advances.In November 2008, Nicaragua Sugar Estates Ltd. (NSEL) and the Chichigalpa Association for Life (ASOCHIVIDA) agreed to participate in a dialogue process on chronic kidney disease (CKD), which was convened by the World Bank’s Compliance Advisor and Ombudsman (CAO) following a complaint filed by ASOCHIVIDA and other community members.In accordance with the guidelines established in the Framework Agreement for Dialogue proposed by the CAO on November 20, 2008, to which NSEL and ASOCHIVIDA acceded, the dialogue aims to identify alternative solutions to the CKD issue. Since February 2009, seven dialogue tables have been held, in which the good will of NSEL and ASOCHIVIDA has prevailed to move towards concrete solutions on two fundamental topics: (a) Identifying and addressing the causes of CKDIn the framework agreement, the parties agreed to jointly define the criteria and principles for conducting a study to identify the causes of CKD, the results of which would be transparent and trustworthy for everyone and would provide feasible solutions. As a result of the dialogue, it is expected that the parties will agree on the criteria and guiding principles of the study and will accept the results and alternative solutions to the problem.Achievements thus far are as follows:• Boston University was selected by both parties to conduct the study, as the institution that deserves the confidence of NSEL and ASOCHIVIDA. The selection process was carried out as follows:(i) Following a first meeting in which ASOCHIVIDA and NSEL discussed the criteria and guiding principles for the study, the CAO drafted the Terms of Reference for selecting the scientific team, which were widely circulated in English and Spanish;(ii) The CAO also agreed on a timetable with NSEL and ASOCHIVIDA and the deadline for submission of proposals was Friday 3 April 2009;(iii) The CAO also drafted and shared with NSEL and ASOCHIVIDA a methodology proposal for qualifying the proposals based on these criteria and a scoring system;(iv) The CAO invited 9 public agencies, 22 universities in the United States and Europe, and 5 private consulting firms to submit proposals for the study. It also published a notice on its website;(v) The CAO received nine proposals on April 3, 2009, four from prestigious universities and five from private consulting firms. As of that date, the CAO began a process to review the proposals based on the criteria and scoring matrix that had been shared with the participants of the dialogue table.(vi) The CAO held separate preparatory meetings with the participants to analyze the proposals and to reflect before a decision was made; and(vii) Finally, during a dialogue session in April 2009, the dialogue participants selected a team from the Boston University School of Public Health (BUSPH) to conduct the study.• In December 2009, BUSPH completed a preliminary study and proposed next steps for conducting a comprehensive study on the causes of CKD. To carry out this phase of the study in a serious and rigorous manner, the following activities were undertaken:(i) The BUSPH reviewed all available literature and documentation on CKD in Nicaragua and in other parts of the world;(ii) The BUSPH made a fact-finding trip to Nicaragua to interview people and organizations concerned with the problem of chronic renal failure.(iii) The BUSPH team returned to Nicaragua to present to ASOCHIVIDA and NSEL their first findings and hypotheses on the problem of the IRC and to perform an initial proposal on how should undertake the comprehensive study. On this occasion, the BUSPH heard questions, criticism and reviews of both organizations.(Continues…)
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(Continues…)(iv) The BUSPH team incorporated comments from ASOCHIVIDA and NSEL in their report and sent them to other experts in the United States and Nicaragua for a peer review. Experts emphasized the importance of this study and made recommendations which were taken into account by the BUSPH team.(v) At the beginning of December, the CAO convened a new meeting in which Boston University presented the final report and made a proposal to conduct a comprehensive study.(vi) At the end of January, a new meeting adopted the terms of reference so Boston University leads the activities under the first full year.ASOCHIVIDA, NSEL, and CAO would like this process to move forward faster.However, in order for a scientific study to be considered serious, it is necessary to complete all the steps that have been detailed. The CAO will be in charge of managing the funds and looking for other possible sources of funding.(b) Options to support local communities where there is a prevalence of CKD. On the basis of good will and without entailing any legal obligation, the parties agreed to find ways to alleviate the situation of the families affected by CKD by involving local resources and state institutions.Among the main achievements, NSEL committed to provide short-term assistance to alleviate the situation of families affected by CKD as follows:• Provision of food supplies for a period of two years with an annual cost of US$ 300,000 for 1,153 households that are members of ASOCHIVIDA. This amount could be extended to US$ 500,000 per year for 1,800 households. Food supplies will be purchased at wholesale prices and NSEL can also deliver food supplies for that same amount of money through an intermediary organization. So far, four deliveries have been made. To make this possible, several activities were undertaken:(i) ASOCHIVIDA was responsible for gathering all the necessary documents so that its members may receive this benefit. This task was carried out very efficiently and within a short period of time.(ii) NSEL agreed with the American Nicaraguan Foundation (ANF) on the operating mechanisms that will be used to distribute food provisions;(iii) ASOCHIVIDA turned over all the documents to the San Antonio Sugar Mill for approval and distributed the requisite food coupons quickly and efficiently; and(iv) The dialogue table met to address the difficulties that emerged during the implementation of the food aid program in relation to several beneficiaries. Little by little, this benefit has reached 1,800 families.• Provision of backpacks for 1,545 school children less than 18 years old. The delivery began in mid-January 2010 in two phases: in the first delivery, backpacks were distributed, and in a second delivery, notebooks and pencils.• Health care assistance: NSEL committed to:(i) Purchase and deliver an ultrasound machine for the Chichigalpa health center and to support the health center by hiring a radiologist to operate the ultrasound equipment.This commitment has been already achieved and the health center has the equipment and radiologist. ASOCHIVIDA has asked to increase the frequency of care provided by the radiologist.(ii) To complement the provision of medicines and reagents in the health center. This still needs to be discussed in further detail with MINSA and INSS representatives in order to ensure that the additional provision of medicines and reagents reaches the recipients. The CAO, ASOCHIVIDA and NSEL have held several meetings with the representatives of these institutions and work is underway to find a solution.(Continues…)
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(Continues…)(iii) To provide two hemodialysis machines to the health center. This has not yet been completed and, to a large extent, will depend on the number of people who are willing to undergo this treatment. For this purpose, the CAO is trying to organize a series of workshops for ASOCHIVIDA members in relation to the disease and treatment options. In addition, ASOCHIVIDA and NSEL are talking with MINSA (Minister of Health) and INSS (Social Security Institute) to improve health services that are provided to CKD patients in the area.• Beyond this short-term assistance, NSEL has expressed its willingness to support families affected by CKD by giving them access to sources of income or employment that may be sustainable over time and that do not involve any indebtedness. NSEL is ready to begin providing this support through the San Antonio Foundation. As an example of the projects that could be implemented, NSEL has suggested establishing a textile factory in Chichigalpa that could be owned by former workers with CKD and which would provide families with work uniforms. The CAO has accepted the request of NSEL and ASOCHIVIDA to include in the process an expert in new productive enterprises to advise ASOCHIVIDA in this process. To select this expert, the CAO carried out an open bid process and the finalists were interviewed by the Board of ASOCHIVIDA, which decided to hire Rogerio Cuadra. Mr. Cuadra’s work began on January 4 and is expected that by the end of March he will design, together with ASOCHIVIDA members, several projects to be funded by the San Antonio Foundation.Finally, it is worth noting that this dialogue process has helped to gradually build a bridge of communication between ASOCHIVIDA and NSEL that is beginning to bear fruit in finding solutions to the CKD problem. It is important to note the efforts carried out by representatives of both organizations to engage in a productive and respectful dialogue. ASOCHIVIDA leaders have successfully reflected the most important needs of their members at the dialogue table and have reported back the results to the assembly. NSEL representatives have shown that the company is genuinely interested in finding out the causes of CKD and that it is willing to collaborate actively in order to alleviate the situation of the families. It is on this basis that the process is solidly moving forward.
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DECIPHERING THE MEDIA CAMPAIGN AGAINST NICARAGUA SUGAR ESTATES AND THE PELLAS GROUPA stone in the shoeBy Jacob ParkerIn a recent article, the most conspicuous organizer of ANAIRC´s disinformation campaign against Nicaragua Sugar and the Pellas Group (Grupo Pellas) and the boycott against Flor de Caña finally decided to make an incursion into a new territory, without completely abandoning his repetitive disparaging epithets, in an attempt to give a new appearance to ANAIRC’s claims and make them seem serious. Let’s carefully examine what this is all about. The author persists in his old affirmation that the massive use of agro-toxic chemicals by Nicaragua Sugar contaminated the water in the zone and directly affected workers and their families, except that he says for the first time “that it occurred in the past”. Beware of misleading messages! This could mean that we are witnessing a change of sign in the campaign because the promoters are probably overwhelmed by evidence showing that the San Antonio Sugar Mill, owned by Nicaragua Sugar Estates, does not use pesticides, but biological and mechanical pest control, which, among other things, has made it an international benchmark in the sugar industry. There are no grounds for sustaining this reckless affirmation that the San Antonio sugar mill (ISA) has massively applied polluting agro-toxic chemicals in the past. It is a known fact that agrochemicals used by this sugar mill in cane production are approved for use around the world, have not caused pollution, and any interested party can consult this list with the company. As we continue to read the article, we are surprised that the author states that most of the affected persons “lived in a shantytown… withstanding everything, until they were evicted in 1998 in an effort to hide the alarming increase in CRI mortality rates…” Is this true? Keeping in mind the wellbeing of the workers, Nicaragua Sugar (NSEL) determined that it was necessary to rebuild the management approach that until then had governed the population that lived in the sugar mill facilities. In that sense, it was deemed that this population needed to be relocated for the following reasons:• To provide heads of household with their own house given that they lived in a house owned by the sugar mill. Their relocation to the Candelaria neighborhood allowed them to become homeowners. • To comply with industrial security standards. • To expand the facilities as required by the factory´s growth. The relocation site is still very close to ISA’s facilities, which has allowed the relocated population to keep providing services to the Company. NSEL offered different options to these people, which were agreed with each family. It is well-known that the San Antonio sugar mill has continued to support residents in Candelaria by repairing streets, supporting immunization campaigns of the Ministry of Health, donating land for a children’s playground, transporting personnel, cleaning septic tanks, supplying trucks with potable water as needed, etc. (Continues…)
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But let´s continue with the text. The writer talks about “working conditions, lack of hydration… were other elements that contributed to a direct link between CRI and the sugar industry”. Let’s see the working conditions of cane cutters.Adequate practices of hydration and food consumption by ISA workers have been established as a policy by Nicaragua Sugar, which has adjusted its annual operating plans to promote healthy lifestyles.Each team of field workers is made up of approximately 150 to 300 workers, who arrive in buses to the different plantations in groups of 60 to 70 people. Each worker brings a 4-6 liter container from his home. Each bus carries a 55-gallon plastic barrel filled with water.On the other hand, the company provides the following benefits to the cane cutters: lunch in the field (contracted with a company and based on a balanced nutritional diet), hydrating fluids and nutritious cookies each day, medical care for each cane cutter and his family, and food supplies. A group of social and health workers supervise that cane cutters receive these benefits.As we continue to read, we find that the panegyrist affirms that “the manual irrigation of agro-toxic chemicals was another element that contributed to a direct link between CRI and the sugar industry”.Does this match reality?The San Antonio sugar mill has mandatory personal protection equipment and safety measures that are strictly enforced in the application and use of agrochemicals. This equipment consists of a work uniform, long sleeve shirt, cap, mask with filters, rubber gloves, boots and raincoat.Nicaragua Sugar periodically examines agro-chemical applicators to discard any sign of intoxication.NSEL also provides training in diverse topics, such as use and handling of agrochemicals, biological pollution, environmental management, integral solid waste management and recycling, among others. Nicaragua Sugar provides adequate facilities so that workers may bathe and change clothes. It has 15 showers that are used by agrochemical applicators before and after each workday. Showers and eye-washers are also available in the factory, laboratories and co-generation areas.In the next section, the designer of the ANAIRC campaign addresses one of his favorite topics, which is to attack pseudo or white unions in the San Antonio sugar mill and rum distillery, stressing as follows: “… unfortunately one of them is affiliated to a Sandinista union (CST), which in turn is affiliated to international union organizations…”.But what really exists?NSEL currently has five unions that are duly certified and registered at the Directorate of Union Associations of the Ministry of Labor. These unions are: Ronald Altamirano Union with 500 members, Union of Democratic Workers with 825 members, Faustino Martínez Union with 1,500 members, Teachers’ Union with 33 members and Employees’ Union with 80 members.The aforesaid unions represent the most varied political and ideological tendencies and the members of the Sandinista leftist union “Ronald Altamirano” would fall head over heels if they read that the pen-pusher of ANAIRC ranks them as a pseudo or white union. (Continues…)
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Ever since NSEL began to operate in 1890, it has never interfered with the right of the workers to form unions, as proven by the fact that unions have existed in the company from the 1960s to date. However, according to the columnist, if the unions do not think like him, they are white, if the workers’ leaders denounce ANAIRC’s absurd campaign, they are in favor of the employer, if the workers demonstrate to defend their jobs and benefits in the San Antonio sugar mill, they are forced to demonstrate, and if the unions are leftist, then he doesn’t know what saint to pray to.If we keep on reading, we will see that the writer abandons the unions and bursts into the academic world, more specifically the University of Leon, to present a study by Dr. Cecilia Torres that allows him to discourse on “the factors that cause CRI”, saying that “among the major risk factors are environmental nephrotoxins, such as heavy metals, arsenic, cadmium and lead, and agrochemicals like Aldrin, Chlorotalonil, Maneb, copper sulphate, Endrin and even DBCP (Nemagon)”.It’s okay. However, one wonders what all this has to do with Nicaragua Sugar and the San Antonio sugar mill. None of these products have been used or are being used by the company. But it doesn’t end there. If we scrutinize a little further, we see that the journalist, not satisfied with his unfortunate encounter with toxicology, goes back to his old ways, always under the protective shield of Dr. Torres, and refers to the “disastrous” working conditions of cane cutters in Nicaragua’s sugar industry.What a disappointment it must be to find out that the San Antonio sugar mill has established a progressive working system so that workers adapt to environmental conditions and avoid heat stroke during the freshest hours of the day until they are able to work full days. Most workers arrive at the plantation at 6:00 a.m., start working at 7:00 a.m., and stop working between 11:00 a.m. and 12:00 noon when food is delivered at the work sites. On the other hand, as of 2005 the company set a maximum of seven tons from an average of nine tons cut by each worker, and eliminated the higher pay incentive after the sixth ton. This incentive is now distributed among the first seven tons so as to reduce work effort without affecting the income of workers. Going back to the article, we discovered a really sad situation in which the author manipulates some statements by Dr. Mario Jiménez, an epidemiologist at the Center for Research on Aquatic Resources (CIRA) of the Autonomous University of Nicaragua (UNAN-Managua).With the clear intention of depicting the sugar industry, in particular the San Antonio sugar mill, as the contaminators that caused CRI, the writer tries to illustrate this with an excerpt from Dr. Jimenez’s statements: “the studies we conducted in the country’s western zone revealed the presence of organochlorinated compounds like lindane, toxaphene, DDT and DDE in the well water for human consumption…”.To what is Dr. Jimenez referring?To the study titled “PRESENCE AND CONCENTRATION OF PESTICIDE RESIDUES AND BIOLOGICAL CONTAMINANTS IN THE WATER WELLS FOR HUMAN CONSUMPTION IN THE LOCATIONS OF THE FORMER BANANA PLANTATIONS IN THE WEST OF NICARAGUA”, which he carried out in Nicaragua’s western region, together with Dr. Salvador Montenegro Guillén, both members of Nicaragua’s Center for Research on Aquatic Resources (CIRA) at the NATIONAL AUTONOMOUS UNIVERSITY OF NICARAGUA (UNAN-Managua). The objectives of this study were 1) to identify the presence of pesticide residues and biological contaminants in the water wells for human consumption in the former banana plantations in Nicaragua’s western region and 2) to establish the potential relation between the presence of pesticide residues in the water wells and the effects on the health of the population that lives in those locations. (Continues…)
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The manipulation is more than evident because the CIRA report has nothing to do with sugarcane. It is related to findings linked to mass banana production in the zone.Chinandega was an agricultural emporium for several decades where tons of chemicals were applied to control banana and cotton pests. Years after the boom of these crops ended, many former agricultural workers began reporting serious diseases.But there’s still more.In his eagerness to find a scientific endorsement that legitimizes his statement about the alleged causality link between CRI and sugar production, the representative of ANAIRC goes back to interview Dr. Jiménez and attempts to obtain the endorsement that he yearns so much. Nevertheless, the most he could obtain as an answer was: “although CRI is clearly a multifactor disease, we cannot exclude that it is related to work in the sugar mills”. As lawyers say, the confession of the parties shifts the burden of proof. Does this have any relationship with the ANAIRC campaign where it is categorically and emphatically stated that it has already been proven so no study is needed, that CRI is unquestionably caused by sugarcane agricultural practices, particularly those of the San Antonio sugar mill, and thus the money demanded by the organization should be granted?Now then, the man does not give up and persists in going back to the research by Dr. Torres, providing some statistics contained in this study. To quote him: “the results were not homogenous at the community level and revealed a greater incidence of CRI in the mining sector with 37%, as well as agriculture and coffee with 32% and 14%, respectively…”. On the other hand, CRI has been detected in different occupational groups: cane cutters, miners, banana workers, stevedores and even preschool children. In other words, it does not affect just one specific labor group. He talks here about miners, coffee growers and agriculture in general. What does this have to do with ANAIRC´s campaign that CRI is caused by the sugarcane of the San Antonio sugar mill? Let’s look carefully. As concerns the San Antonio sugar mill, former workers affected by CRI were temporary workers who also performed other types of agricultural activities. Many of them only worked during the harvest season and stopped working for the Company many years ago.On the other hand, the statement contained in the article that Nicaragua Sugar never mentions the study of Dr. Torres, is not true either. The physicians who work for this company have mentioned it and have indicated that it is one of the research studies that must be known about this health issue. These statistics appear in the Dr. Torres’s research associated to this other: “However, the community of Isla in Chichigalpa, where the main work activity is sugarcane, the prevalence of CRI is the highest, reaching 41%…” Bingo! The intrepid publicist finally got what he wanted. Although the first statistics are irrelevant for his purpose, the second statistic is the one “that counts” because it serves him as a screen for what he needed. What the busy reporter does not say is that CRI is present in several zones of the country, including territories where sugar production does not exist and, in the west of the country, the disease rate is higher in Leon than in Chinandega. Even though Leon is not a sugar-producing department, the largest number of patients is reported in the municipality of Larreynaga, where cane cultivation does not exist. (Continues…)
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Going back to the tireless narrator, we find him leaving the academia in the following paragraph and entering the detective field like Sherlock Holmes. Let´s find out what he tells us: “According to a document in the possession of ANAIRC, signed by Marino Castrillo, Director of Human Resources at the San Antonio sugar mill, exhaustive water analyses were made in the San Antonio sugar mill, which showed that the water is heavily contaminated with agro-toxic chemicals and relating this presence to the CRI disease…” He omits to mention that the referenced document was an outright falsification, for which reason Dr. Castrillo filed a criminal complaint in the Sole Local Court of Chichigalpa in 2008. It is a powerful attention grabber that ANAIRC uses this falsification object of a criminal proceeding in its campaign against Nicaragua Sugar. But where will this modern version of Caupolican take us now? Surprise! In his obsessive thinking about the Pellas Group and NSEL, he introduces Mrs. Yanirée Alvarez, indicating that she was a member at a given time of the social movement of Leon, and quotes her as saying that Nicaragua Sugar Estates Limited tried to purchase 1,500 additional hectares of land to expand cane production “without taking into account that cane cultivation requires the extraction of large amounts of water… which is already seriously affecting water reserves of the population in the rural zones…”The purchase of land by any company engaged in agricultural production is a normal activity that nobody in his right mind can question. In the case of Nicaragua Sugar, these purchases have been made pursuant to the laws, paying market prices based on supply and demand.Insofar as that cane production would be detrimental for water availability in the zone, it is necessary to point out that the San Antonio sugar mill has abundant water sources and manages them in a sustainable manner. Water is obtained from 116 wells, 57 river and channel intakes, and 16 diversion dams along the different rivers that cross the sugar mill. Nicaragua Sugar has the necessary permits for the drilling of wells and intakes from rivers, channels and dams issued by the relevant authorities.It has been estimated that available volume in the hydrologic water basin that supplies ISA and its surroundings is 309 million cubic meters. According to the irrigation use of this watershed, total annual consumption is estimated at 100 million cubic meters, of which 25% percolates through the soil and eventually returns to the aquifer as recharge and the remaining 75% is easily covered by annual precipitations in the zone between the months of May and November, averaging 70 inches per year.We have an indicator for this in the standards for well measurements performed for over 40 years at ISA, which indicators, such as static level and dynamic level, remain without great variations.In 1998 and 2000, hydrological and hydro-geological studies on water availability, extraction and safe yields were carried out in the area of the sugar mill and Chinandega-Leon-Nagarote watershed. The results of both studies show that the San Antonio sugar mill makes adequate use of water resources.Since the article seeks to be exhaustive, the audacious conjurer later refers to renewable energy and again quotes Mrs. Alvarez, saying that cane cultivation would affect the environment to benefit “only a privileged group of businessmen”, as opposed to the potentials of geothermal, wind and solar energy.How far-fetched! (Continues…)
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In the San Antonio sugar mill, sugarcane bagasse is used to generate electricity, instead of being discarded. Co-generation capacity is 60 MW per hour, which allows for eliminating the use of bunker and providing 7% of Nicaragua’s power consumption during the harvest. It is a clean and cheap energy source. Since bunker is not consumed, it is estimated that over 95 thousand tons of greenhouse gases are reduced per year. After the harvest, in the months of May through July, 17 MW of electricity are produced per hour, of which 12 MW are sold to the national interconnection system. This clean energy is generated with eucalyptus chips originating from the nursery of the San Antonio sugar mill, where 800 thousand plants are produced each year and renovated in 7,650 acres. To date, more than 6 million trees have been planted. In his relentless effort to find faults attributable to Nicaragua Sugar, the columnist in question passes to talk with a painstaking air about deforestation caused by cane production. Let’s analyze this also. Nicaragua Sugar promotes the planting of native species each year as a way of contributing to the recovery and protection of water sources, the preservation of biological wildlife corridors, forest fire protection and natural regeneration. This reforestation is carried out along the banks of different rivers in the municipalities of Chichigalpa, Quezalguaque, Posoltega, Leon and Chinandega. Some reforestation activities are carried out with students, municipal governments, civil society and government institutions, with the objective of involving all the population in the protection of the environment.The nursery at the San Antonio sugar mill produces 50,000 native tree species each year, such as kapok, strawberry tree, cedar, mahogany, guanacaste and oak, which are used for reforestation. In 2006 and 2007, for example, 53,500 different species were planted to reforest more than 356 acres of river banks. In 2008, 45,000 new trees were planted in 365 acres along the banks of diverse rivers in Leon and Chinandega.But there´s still more. The officious spokesman of ANAIRC goes back to the trite theme of Law 456 that recognizes CRI as a professional disease in Nicaragua.Any person with some knowledge about Nicaraguan legislation knows that this recognition does not establish a causality link between a specific productive activity and CRI. It is known and has been stated on numerous occasions that a medical assessment committee exists.If the spokesperson were right, ANAIRC would have solved the problem and would have obtained all the money it has persistently sought for several years.In relation to the statements of the INSS Director, which are taken out of context, the official position of the Government of Nicaragua is not known. As far as raising the percentage that farmers pay to the INSS on account of occupational risks from 1 to 5%, the idea is so preposterous that it never prospered. Unfortunately never satisfied, ANAIRC´s skilled swordsman meddles with ASOCHIVIDA, Nicaragua´s most representative organization of kidney patients, with which NSEL has maintained for more than one year a very positive dialogue on the CRI problem that affects the members of this association.ASOCHIVIDA is not at all like ANAIRC. While the first tries to find a solution to the problem, the latter, entrenched in its unjustified money demands, has self-excluded itself from being part of the solution. For that reason and that reason only, it is so isolated in Nicaragua. ASOCHIVIDA and NSEL agreed that an international, impartial and prestigious organization would conduct a study to determine the causes of CRI in the west of Nicaragua.After an exhaustive process that involved 9 public agencies, 22 U.S. and European universities and 5 private consulting firms, Boston University was chosen to conduct the study. (Continues…)
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The final results of the study will provide important knowledge on the causes of this disease in the west of Nicaragua, define potential liabilities, if any, and articulate prevention and response strategies. Nicaragua Sugar, faithful to its social responsibility tradition and as an expression of support to the community, has offered its solidarity to the people in the nearby communities who suffer chronic renal insufficiency.Between 2000 and 2004 it delivered humanitarian and economic aid in the amount of approximately two million dollars to over 1,400 people affected by CRI and currently provides nutritional support to 1,800 families that are members of ASOCHIVIDA and medical assistance to the patients consisting of medicines, equipment and inputs for the Chichigalpa Health Center.In the limits of disinformation and ready for action, the distinguished essayist moves to the financial terrain and says that Nicaragua Sugar “requested a $25 million loan from the Inter-American Development Bank (IDB) to purchase 1,500 hectares of land to expand cane cultivation…” And he then adds that “to accede to a loan from IDB, no judicial causes of action can be pending. Nicaragua Sugar Estates Limited has administrative and judicial causes of action pending…”It is really sad that he makes no effort to investigate his information. For that reason, among other things, the sponsors of ANAIRC lack credibility.Even though it is not a crime to apply for a loan, Nicaragua Sugar has never applied or plans to apply for a loan with the Inter-American Development Bank (IDB). If ANAIRC´s apologist has doubts, he can easily confirm this information with IDB.As concerns the judicial causes of action, some persons did file complaints in this regard, but all of them were dismissed by the courts of justice in separate judgments.Finally, our illustrious character and the brain behind ANAIRC´s campaign, affirms that ISA has 144 thousand manzanas of land, when any minimally informed person knows that the San Antonio sugar mill owns approximately 19,000 manzanas of land. If the detractor of Nicaragua Sugar wants to verify this through independent sources, the only thing he has to do, which is not very complicated, is to visit the respective offices of the State of Nicaragua where this information can be confirmed.According to Goebbels, the famous Nazi Minister of Propaganda, “If you tell a lie big enough and keep repeating it, people will eventually come to believe it.”Maybe this is the source of inspiration of those developing this campaign.
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Thanks for taking the time to discuss this, I feel strongly about it and love learning more on this topic. If possible, as you gain expertise, would you mind updating your blog with more information? It is extremely helpful for me. Rob
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