Hidden Under the Indian Sun was originally published in The Atlantic (USA) in January. The short film on CKDnT affecting communities in Eastern India was produced by independent photojournalists, filmmakers, and La Isla Network collaborators Tom Laffay and Ed Kashi together with Talking Eyes Media.

In the vast rice fields of Andhra Pradesh, Southeastern India, a form of Chronic Kidney Disease (CKDnT) is killing workers and leaving their families in a state of economic despair. The causes of the disease range from chronic dehydration, pesticide contamination and heavy metals in the water sources. This disease is being investigated throughout the world, from Central America to the Middle East, and now India. Hidden Under the Indian Sun follows a young student, Maheshwari, whose father is on dialysis and now unable to work digging wells in the rice fields since being diagnosed with CKDnT. Her dedication to her studies and her dreams of becoming an engineer are threatened, as she is duty bound to care for her father. Her story illustrates the collateral impact of this disease on families, particularly the younger generations.

Not far away lies another farming village, Balliputtuga, which has 126 widows due to the same nefarious disease. Here, a middle aged woman, Lakshmi, recounts the death of her husband and her necessity to work the fields to feed her family, even as she has developed the disease as well. Her story is emblematic of the toll this disease takes on community’s livelihoods and survival.
As Indian researchers begin to join a global alliance to investigate this epidemic, in order to prevent it, thousands of families in Southeastern India contend with the consequences of this hidden disease.

Below, Laffay explains the background and process of the film.



Photo: Tom Laffay

Who else formed your team?

I collaborated on this project with photojournalist Ed Kashi as well as up-and-coming Nicaraguan filmmaker Keybin Cortedano (assistant editor), and Julie Winokur and her great team at Talking Eyes Media, which provided support in the completion and distribution of the film. We’ve all been collaborating together for years with La Isla Network. While in India, Arun Kumar and Aruna Katragadda made our trip possible by arranging community connections with the people who tell this story and translating our conversations. The superb radio journalist Rhitu Chatterjee also contributed to the story and encouraged me to eat pan for the first time… Our team wouldn’t have been complete without her!

When and how did you come across the CKDnT disease for the first time?

I personally came across the CKDnT epidemic when I moved to Nicaragua in October 2011. I met a journalist there who was interested in the issue and we decided to do a short video report on the situation. At the time, I did not know about La Isla Foundation (now known as La Isla Network) or the complexity of the disease prevention efforts and related social issues, nor the global reach of the epidemic. When we completed the short film, A Cycle Of Death, we gave it to La Isla Foundation to use in raising awareness. I never would have thought that five years later, I would still be walking down the same road, through the sugarcane fields to communities in Chichigalpa, as well as documenting the issue and advocating on behalf of affected populations in El Salvador, India and Sri Lanka as well as Nicaragua. It’s been a journey, and there’s a lot of road ahead of us.




Photo: Ed Kashi

What made you to start working on this?

I decided to really dedicate my work to this issue due to the experiences I had with people affected by this disease and their families in Chichigalpa, Nicaragua. There, more than 10,000 people have died in the past 15 years more or less, and the conditions people live in, the treatment they receive from the local companies and governments is appalling. It’s really a form of systemic violence the way people are worked to the point of death and are denied their basic rights. When I connected with local and foreign activists who were just as outraged and dedicated as I was via La Isla Foundation, led by Jason Glaser, I knew I would be a part of team that could make real change for the people affected.

Which parts of the world you have covered till now?

Since starting coverage of the CKDnT epidemic in Nicaragua, both Ed Kashi and I have covered the WE Program, an innovative worker health intervention designed to prevent the onset of CKDnT among sugarcane workers in El Salvador. We also visited Sri Lanka in June of 2017, which will result in another short film within the next two months. I am investigating CKDnT in Colombia as well and there are more areas that researchers are beginning to identify. La Isla Network will be keeping the public up to date on those places this year.




Photo: Ed Kashi

Which places in India did you visit while working on UTIS?

In India, we visited a number of communities, mainly in Andhra Pradesh. We spent time in Nellore, Kota and outlying villages in the area. We also spent some time in Chennai at the medical university where a conference was held about the disease. We later travelled south to Puducherry and Marakkanam, where we visited salt flats. Clinicians had reported some CKDnT cases among salt workers, so we got a chance to check in on early investigations. Finally, we traveled north to Visakhapatnam before continuing our investigation in Sompeta, Palasa, and Balliputuga.


What do researchers believe is the cause of CKDnT?

Most researchers think it is multi-causal. Heat stress and dehydration are fairly widely accepted to be base factors contributing to the disease, and to me that is not surprising. The agricultural work I’ve seen under blazing hot sun, as in sugarcane and the industries showcased in this short film, is mortally dangerous without proper water, rest and shade. If workers don’t have access to those basic conditions, they’ll get sick. That to me is a given.

Any other experiences if you would like to share?

I’d just like to express how incredibly friendly and open people were with us in India, from the communities where we shared some incredible meals and conversations, to the doctors and researchers in the various hospitals we visited to the cooperation of the local governments and I hope that this film can bring more attention to this serious issue. This truly is a global problem, and we need a global collaboration to address it. Learn more about the issue and research here at laislanetwork.org and follow my journey as a photojournalist working on CKDnT on Instagram: @laislanetwork.