La Isla Foundation visited El Salvador this month in order to finalize the study protocol for an unprecedented research project.

The Worker Health and Efficiency (WE) Program, a workplace intervention study, will improve working conditions for local sugarcane cutters while investigating the causes of CKDnT.

The first of its kind, the WE Program is designed to actively improve working conditions and provide sugarcane cutters with efficiency training in order to increase their productivity, reducing the overall exertion required for cane cutters to make a living.

By implementing worker trainings based on the U.S. Occupational Safety and Health Administration’s (OSHA) ‘Water.Rest.Shade’ recommendations, the WE Program will make the workplace safer for cane cutters.

Researchers will then measure how improved working conditions affect workers’ health and productivity. By tracking health over time, researchers hope to highlight causal factors contributing to CKDnT and prescribe ways to mitigate their effects. By tracking increased worker productivity, researchers hope to demonstrate incentives for other sugar mills to host similar interventions.

Over the course of three years, the WE Program will track 120 sugarcane cutters, or rozadores as they’re known in El Salvador, working in two locations: one in an area several hundred meters above sea level, where CKDnT prevalence rates are elevated; and another in the coastal lowlands, where rates are the highest in the country.

Through seven years of hard work and grassroots organizing, LIF has spearheaded the fight to end CKDnT. Now, with relevant stakeholders united at the same table to address the CKDnT crisis in collaboration, we are proud to share images of the teamwork and success achieved together after over a year of hard work designing the WE Program.

“8 hours in a board room”

LIF Senior Director of Public Health and Policy Ilana Weiss presents at the hosting sugar mill on the first day of the trip.

Mixed among mill management is Australian sugarcane expert Robert Quirk (left).

“Listen to the people”

LIF CEO and Co-Founder Jason Glaser and a sugarcane caporal discuss OSHA’s “Water. Rest. Shade.” recommendations at the latter’s home.

The caporal is responsible for a team of 300 cane cutters, who are at high risk of developing CKDnT.

OSHA’s recommendations, based on U.S. government studies of worker health under extreme working conditions, form the data-driven
justification for the working conditions improvements targeted by the designers of the intervention study.

“Camelbak and cane”

WE Program Field Coordinator Dr. Emmanuel Jarquin (founder of AGDYSA, El Salvador’s first and only
occupational health and safety consultant and trainer) assists a worker with the prototype Camelbak
water carrying backpack in front of pledged participants in the three-year intervention study.

Such packs are often touted as a potential solution to chronic dehydration, which is a likely cause of CKDnT epidemic.
Camelbak is now working directly with LIF and the sugar mill hosting this study in order to supply packs to workers.

“Designing the blade”

LIF Community Coordinator Cristhian Velasquez and LIF Media Producer and Communications Manager Tom Laffay
check out machetes currently being distributed for cutting sugarcane at the sugar mill hosting the study.
Part of the efficiency program designed by Robert Quirk includes a technique for every worker
to curve his or her own machete to better suit their physical stature, decreasing the exertion needed to cut cane.

The result: increased work efficiency, hopefully leading to a significant increase in cane cut per worker,
which would allow workers to take more breaks at no loss to their earnings.

“Maximum capacity”

LIF CEO and Co-Founder Jason Glaser pauses to speak with a hemodialysis patient at Hospital Rosales in San Salvador.

A 43-year-old former cane worker from San Luis Talpa, the man was one of six randomly selected patients interviewed by LIF’s media team.

All six men were former sugarcane workers. All men had CKDnT. Eight identical rooms spanned in both directions,
each filled to capacity with CKDnT patients. During a filmed interview, Dr. Ricardo Leiva, director of the dialysis
ward of the largest public hospital in El Salvador, expressed the severity of the situation.

“We have no more room here,” he said. “We are practically turning patients away.”