We prevent harm on a global scale

Photo credit: Ed Kashi

Our strategy:

Prevention, Resilience, Efficiency, and Protection

Climate change is here. We believe that protecting workers is essential to meeting the moment. Our goal is to ensure that workers globally are protected from risks on the job, like extreme heat and others driven by climate change. We do this through our Prevention, Resilience, Efficiency, and Protection program, or PREP.

This strategy guides our work, like our transdisciplinary research projects and advising programs. We bridge companies and communities with the expertise and resources to protect their workers, utilizing data-driven and site-specific methods to ensure lasting change.

The Center of Excellence combines all aspects of this model, creating a comprehensive framework for climate change adaptation. We have created a Center of Excellence at Ingenio San Antonio, a leading sugar mill operation in Nicaragua that produces sugar, alcoholic beverages, and biofuel. We invite potential partners to visit the Center of Excellence to learn how they can adapt our proven methodologies and hear from the people carrying out this work day to day.

Keystone Programs

Ongoing and Past Programs

Partner Organizations & Institutions:


ENSURE-Nepal is a four-year project led by La Isla Network through a cooperative agreement with the U.S. Department of State Office to Monitor and Combat Trafficking in Persons. The program is studying the socioeconomic factors that prompt labor migration from Nepal, and workplace illness/injury stemming from heat stress that occurs abroad.

The intervention is one of the first of its kind to address trafficking among Nepali labor migrants, using evidence-based intervention development research. The program’s overarching aim is to pinpoint interventions for every stage of the migrant journey.

Partner Organizations & Institutions:

PREP for Change

PREP for Change (P4C) is La Isla Network’s most significant project to date. It is funded by a cooperative agreement from the U.S. Department of Labor. The project’s overarching goal is to promote safe and healthy workplaces in Honduras, Guatemala, and El Salvador.

P4C takes a preventive systems approach to prevent kidney injury and other workplace illnesses and injuries, while pursuing increased productivity and a return on investment. The program aims to improve the use of existing social protection systems, often used by workers and families impacted by workplace illnesses and injuries.

Finally, P4C influences decision making by employers, unions, and government to safeguard workers from heat stress and other climate change-driven risks that result in workplace illness/injury.


Collaboration with Bonsucro

We work with Bonsucro, the global certification body for sugarcane producers, to drive multistakeholder programs aimed at the protection of workers. We do this through the Bonsucro Impact Fund, which supports projects that address critical sustainability challenges in the sugarcane sector.

We’ve worked with Ingenio San Antonio, and most recently are working with Diageo to assess and address the risk of heat stress among sugarcane cutters in the Dominican Republic and Barbados, and to assist in the implementation of worker protection protocols.

Partner Organizations & Institutions:

Campos de Esperanza

Campos de Esperanza project was a four-year project led by World Vision that focused on preventing and reducing child labor in the states of Oaxaca and Veracruz, particularly in the sugarcane and coffee sectors. La Isla Network led a component of the project on occupational safety and health, focusing on the prevention and management of occupational chronic kidney disease.


PAHO Collaboration

Our Lead Epidemiologist Ineke Wesseling was contracted by the Pan American Health Organization to research the landscape of health and work in Central America and the Dominican Republic, as well as the policies addressing occupational chronic kidney disease.

Partner Organizations & Institutions:


The Disadvantaged Populations eGFR Epidemiology Study (DEGREE) was an international collaboration between researchers across disciplines dedicated to better understanding the prevalence and geographic scope of CKDnt.

Its goals were to inform local communities, healthcare systems, and governments of the scope and scale of CKDnt, to understand if there are factors in common between geographies affected, and to accurately measure whether the prevalence of CKDnt is worsening or improving over time.

Partner Organizations & Institutions:

WE Program

In 2014, La Isla Network assembled a multi-stakeholder team under the banner of the Worker Health and Efficiency (WE) Program to find and implement solutions to the CKDnt epidemic in El Salvador.

After publishing the first results of the WE Program in 2015, we split into two organizations: (1) Fundación Comunitaria Isla, the local Nicaraguan NGO that independently remains focused on local community development, and (2) La Isla Network.

Technical Advising to Companies:

Assess, Address, Assist

La Isla Network advises companies to help protect their workforce. We do so through our data-driven OSH and organizational management assessment protocols, under our triple-A framework of Assess, Address, and Assist. These reduce harm and protect worker health, while pursuing increased productivity and a return on investment.

Climate change is making heat stress a worldwide problem

Heat stress has been a perennial problem in the tropics. Now, climate change is exacerbating the threat of occupational heat exposure beyond these regions, including the United States and Europe. As a result, at-risk workers are experiencing intensified levels of heat-related illness, injury, and death.

United States

In the United States, workers in agriculture and construction are the most at risk for heat-related injury, illness, and death.

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As recently as September six grape pickers died in the Champagne region of France after working in 95 degree Fahrenheit heat.

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The Gulf & Nepal

By 2021, more than 6,500 migrant workers in construction died in Qatar since it won the right to host the World Cup over a decade, a portion of them from Nepal.

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In Australia, thousands of workers gathered outside state parliament in February 2024 demanding the resignation of Industrial Minister after one person died and 25 had been injured due to heat stress on Queensland worksites.

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In 2010, Qatar won the right to host the 2022 FIFA World Cup. Migrant laborers constituted the workforce needed to build the infrastructure for the World Cup. Nepali migrant laborers formed the largest share of that workforce. In 2020 alone, 30,000 Nepali migrant laborers went to Qatar to work.

Even with a plethora of laws regulating recruitment and work conditions, Nepali migrant laborers faced extreme heat for hours on end. Between 2011 and 2020, an estimated 6,500 migrant laborers died, including 1,641 Nepali migrant laborers, making it the deadliest sporting event construction project in recent memory.

Of those who didn’t die in the heat, many succumbed to kidney injury and CKDnt. La Isla Network communicators Ed Kashi and Tom Laffay with TIME Magazine’s Aryn Baker published “The Dangerous Game,” revealing the sweltering conditions that Nepali migrant laborers faced in Qatar. Research conducted by the Nepal Development Society and LIN found that 31% of patients in two large dialysis centers based in Kathmandu were returnee migrants, and 50% of returnee migrants were less than 40 years old.

The best available data found that between 2000 and 2010, agricultural workers had approximately

0 times
followed by construction workers with 13 times the risk, compared to all other industries.

Of all heat-related illness deaths,

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 of them occurred in the construction industry, followed by agriculture at 21.0%.