An alias for Ingenio San Antonio & Nicaragua Sugar Estates Limited responded to a blog post by Constantino Schillebeeckx - The Voices at Ingenio San Antonio & Nicaragua Sugar Estates Limited - Part I - citing a study done by the Boston University Public Health School and claiming that there is no evidence that Chronic Renal Disease (CKD / CRI) in the region has been caused by agricultural labor practices. The alias has misrepresented the study and La Isla Foundation has responded.
Please go to this blog and see the company flak and La Isla’s response to it, for those that want a better understanding of what we’re up against this should be illuminating.
Our response is as follows:
February 2, 2010
Hello ‘Gerardo’,
Jason Glaser here from La Isla Foundation,. When I refer to ‘us/we’ below I am referring to La Isla Foundation and our partners in the community we work with near Chichigalpa and Ingenio San Antonio.
Not long ago, Ingenio San Antonio (ISA), — the company that posted the blog response under the name ‘Gerardo’ — made completely unsubstantiated claims that hypertension, diabetes due to poor diet, genetics and too much drink were the causes of a IRC/CKD among their workers. When this was debunked by a professional study ISA never quoted that study or apologized for the baseless claims they made. I am, of course, referring to the highly respected prevalence study carried out by local experts working via UNAN-Leon, La Isla Foundation and the SALTRA network.
That study ruled out three of ISA’s purported causes for the epidemic as experienced by agricultural workers; hypertension, genetics and diabetes. While that study certainly states that drinking alcohol would not help the problem, it makes plain that this is not a likely cause of an epidemic that has left some communities with nearly 32% of their men experiencing terminal renal failure. It is also highly unlikely that men of 19 are getting CKD via drink. Please write laislafoundation@gmail.com for a copy of this study.
I know that if ISA was sincere in their stated wishes for better lives for their stakeholders they would spend less money on PR and more on funding treatment of the disease and investigating its cause. This could be accomplished in part through a vigorous and neutral causality study that would get to the bottom of this epidemic which has left thousands of their stakeholders dead, fatherless and widowed.
Whether or not ISA is somehow responsible is not the point and ultimately unimportant as there is nothing that can be undone in the past. They are the most powerful player in the region and have the resources and connections to end this problem. Therefore, by working with the local government, La Isla, and our partners, ISA/Grupo Pellas could act as heroes by bringing a solution to this horrific situation. That would be an excellent PR move.
What else has ISA neglected to share in this latest fine example of corporate PR? Why do they go to such great lengths to say they are not responsible for the epidemic when no one at La Isla has claimed that they are responsible?
All we want is a study to find out what is causing the epidemic so we can begin to intervene effectively on behalf of the community. The truth is no one knows the cause at this stage. However, ISA has long engaged in stating causes for it that divorce them of responsibility but are not supported by any credible data.
Back to the often quoted Boston Study:
Unfortunately, one of the problems w/ ISA’s PR response to this blog is that they have intentionally misquoted the Boston study.
While at first blush it may seem like an issue of semantics, I must remind the reader that 1. This is a scientific paper they’ve intentionally misquoted and subtle changes can change the intended take away and meaning, of important statements. This is especially true when we are talking about such a complicated issue. 2. One has to wonder why someone would use quotes when they are not directly quoting and 3. I find it offensive that they would post the links to the study they are misquoting thinking that no reader will actually take the time to read it and see how it has been manipulated by ISA PR in an attempt to divorce themselves of responsibility well before the all important causality study (A Causalitiy Study is the study that will establish the cause of epidemic, the study quoted here is a hygiene and work practices study) is even completed.
MISQUOTES-
“Based on the investigation described in this report, ‘we found no evidence to conclude that work practices and chemicals used by ISA are causing CRI in ISA workers’. ‘Establishing whether there is in fact an association will require the creation of new scientific knowledge. “p 61
That above is the actual quote, notice the difference in how the company wrote it:
“Based on the research described in this report, we did not find ‘any evidence whatsoever to conclude that the practices and chemicals used by ISA are contributing to its workers developing CRI.’ ‘To determine whether an association actually exists will require the production of new scientific knowledge’,” says the report.
Actually, as we can see above that is not what the report says at all. ISA PR has taken it upon themselves to make a statement that originally clearly states no conclusion is reached and states the need for more research and they have attempted to turn it into an absolute statement that is dismissive and questions the very existence of a link.
That is an incredible abuse and misuse of the study. BU investigators certainly would not claim that nothing at ISA is ‘contributing’ to the epidemic among its workers but are saying causality cannot, at this stage, be established and more research is needed.
In fact, Boston makes it very clear that there is a plausible connection here but it requires more research:
“We found very limited evidence that current work practices or exposure to chemicals used by ISA currently or in the past might be associated with CRI. This association is plausible but not established. “
The reason evidence is lacking is that there is a huge deficit of scientific knowledge regarding the connection between acute kidney damage caused by chemicals used at ISA and work practices that cause massive dehydration and Chronic Kidney Disease. That is to say we know that dehydration and some of these chemicals cause kidney damage but could repeated kidney damage lead to CKD? We just don’t know yet! That is why new science and investigation must take place. There is just not enough literature yet but the connection is indeed plausible and warrants further investigation. More on this below.
Another intentional misquote:
“We did not find any evidence in our review of the medical literature that heat stroke (volume depletion and muscle damage) and systemic infections (leptospirosis and hantavirus) are generally accepted causes of CRI, and we only found very limited evidence that exposure to these agents is associated to CRI”, they indicated in their conclusions.
The phrase: ‘any evidence’ does not exist in the entire report and fails to reflect the facts that more research is needed and nothing has yet been determined one way or the other conclusively. Research is ongoing. Funding is being looked for. If you know of a interested party or grant giving organization please contact Boston or La Isla Foundation.
Contrary to the intended take away in the ISA blog response here, the Boston University study plainly states that more research is needed to see if there is a connection between the well established acute kidney damage caused by massive dehydration, as experienced by ISA workers, and the eventual development of Chronic Kidney Disease (CKD).
There is no respected literature that we know of that states this is not possible, only a surprising deficit of needed research and investigation.
Sufficient literature does exist to support that exposure to some of the chemicals used presently and in the past at Ingenio San Antonio can lead to acute kidney damage. But more research is needed to understand levels, frequency and duration of exposure. To reiterate for the uninitiated: Boston University does not say that acute kidney damage is not a possible precursor to CKD. Here again BU states that more research is needed as there is an insufficient literature regarding the plausible link between acute kidney damage and Chronic Kidney Disease.
‘Establishing whether there is in fact an association will require the creation of new scientific knowledge. “p 61
Nothing has been taken off the table here, least of all the issue surrounding dehydration and the associated risks it carries for workers:
‘…we have strong evidence from our field observations and available reports that current work practices at ISA could be associated with heat stress and volume depletion, and strong evidence from our review of the medical literature that volume depletion and muscle damage are associated with acute kidney damage in humans or animals; however, there are no data available to assess whether current work practices at ISA are resulting in acute kidney damage.’(p.49)
The Boston University Hygiene Study did not claim to establish or dismiss causes of the epidemic like the above ISA comments (and intentionally incorrect and out of context quotes) attempt to suggest. The actual take away is that much more research/data collection needs to be done, Boston needs the funding to do it, and two areas that need a lot more investigation are the issues of pesticide exposure and dehydration/heat stress. What is clearly needed is an independent and vigorous Causality Study lead by regional experts so that capacity can be built to address and monitor this epidemic, and problems like it, both now and in the future.
WHAT HAS BEEN LEFT OUT?
ISA has left out other information in the Boston Hygiene Study. One glaring example is ISA neglecting to give proper respirator cartridgers to workers who apply chemicals. These cartridges have clear warnings that demonstrate that this equipment is not intended for use in the way Ingenio San Antonio is implementing it,
“Overall, it seems likely that exposure to agrichemicals has decreased over time and that PPE (personal protective equipment) is controlling exposure to agrichemicals to some extent, but the high frequency of agrichemical use, poor decontamination procedures, and the use of respirator cartridges not recommended for use with organic vapors likely result in exposures to agrichemicals that vary by job and chemical. (p 44)”
While we highly respect BU, many of the findings reported in the Boston Study after their brief, 1-week field visit with ISA, ASOCHAVIDA (a group of sick ex-workers and community members) and the unions friendly to ISA stand in direct contrast to what we have witnessed and documented in our years of work in the area.
Aside from ASOCHAVIDA, Company Reps, and Unions Reps (all unions at ISA are known to be friendly to company interests), some current workers were also briefly spoken to by Boston University. However, they were spoken to informally and while on the job. La Isla has long established that current workers have been threatened with black listing if they talk to outsiders about their views regarding treatment at work on or off the job. I find it unlikely that people under such threats and without other economic recourse would risk their job in such a brazen fashion.
Many of the findings in the Boston University study also stand in contrast to what has been shared with us by current workers who spoke to us from the relative safety of their own homes. A report is being prepared that will address these disconnects and we hope to work with Boston University in order to provide them and the CAO process with this important information.
Of special interest is that some of our witnesses cut cane as illegal child laborers for ISA for years. These same individuals have since been denied work once they were of age due to their now having IRC/CKD as young as 19. Finally old enough to work legally, they are now too sick to do so according to company records.
Somehow, some of them can still work for ISA using ID numbers of family members. We find that problematic and completely contrary to claims made by the report via the company and the unions that are friendly to it. More to come on this topic in our pending report that addresses these disturbing disconnects.
Finally, many workers have informed us that, in the chemical storage warehouses at ISA, the labels are routinely taken off of the chemicals they are forced to use when the prying eyes of scheduled visits are not present.
CUTTING TO THE CHASE
We have no agenda at La Isla other than the support of workers’ rights along with the needs of workers’ families and their communities. We ultimately don’t really care who or what is responsible for the epidemic other than that information’s ability to aid in a meaningful intervention.
ISA, on the other hand, has an obvious agenda they have continually demonstrated: to deny and delay finding the cause of this epidemic instead of funding a credible and special-interest-free Causality Study carried out by a qualified regional organization who understands the cultural dynamics at play in this situation. ISA apparently spends more on misleading Google ads that will pop up when someone types in certain key words in their Gmail accounts or Google searches than on proper respirator cartridges for their workers.
Let us be crystal clear: While we are interested in the proceedings the CAO process does not represent all those affected by present or past work practices at ISA in Chichigalpa, or the rest of western Nicaragua. There are several groups and literally thousands of individuals aside from ASOCHAVIDA (whose membership is only 1800) that have a stake in this epidemic and are not represented in the CAO process mentioned in the ISA response to this blog. It serves only ISA to claim ASOCHAVIDA as ‘the most important’ group. It is an absurd statement and there are presently divisions within that organization as people are dissatisfied with the current process via the CAO as they feel their views and concerns have been marginalized.
It seems to us now that, instead of operating in good faith, ISA is more interested in making exclusionary claims that ASOCHAVIDA is the most important stakeholder in all of this and, therefore, uniquely represents those affected. That not being enough, they are engaging in picking and choosing from the findings of the CAO process instead of aggressively getting to the bottom of what is causing this epidemic that has left thousands dead so it can be addressed intelligently, quickly and compassionately.
I’ve got no issue with cutting to the chase or repeating what needs to be made completely clear to those interested in this issue:
A neutral and professionally done causality study by regional experts would put this issue to bed and help build local capacity so that we may all work on trying to end this nightmare that has killed and widowed thousands throughout Western Nicaragua and other sugar producing lowland regions in Central America. There is an opportunity to work together here and I hope that some day soon ISA decides to do the right thing and work for and aid their stakeholders at large instead of holding up one small group as a representative for all.
While expensive, this is a solution that is most certainly affordable to ISA and should be worth the price. This epidemic affects the very people that have made their wealth possible-The Workers at Ingenio San Antonio. We support them and I hope that those who are reading this will help us do that good work. More info at http://www.Laislafoundation.org
Jason R Glaser
Director of La Isla Foundation USA
laislafoundation.org
Our friend and freelance photographer, Constantino Schillebeeckx, has published and submitted his photographic work of La Isla and Chronic Kidney Disease to 