Tag Archive | Central America

Mystery Kidney Disease in Central America

This week my radio story was broadcast on Public Radio International’s “The World.” This was an effort of a reporting project from The Center for Public Integrity and the International Consortium of Investigative Journalists.

Please read the excellent article written by Sasha Chavkin and Ronnie Greene for a more in-depth investigation of the story.

The following is an excerpt from the radio piece:

A mysterious epidemic is sweeping Central America – it’s the second biggest cause of death among men in El Salvador, and in Nicaragua it’s a bigger killer of men than HIV and diabetes combined.

It’s unexplained but the latest theory is that the victims are literally working themselves to death.

In the western lowlands of Nicaragua, in a region of vast sugarcane fields, sits the tiny community of La Isla. The small houses are a patchwork of concrete and wood. Pieces of cloth serve as doors.

Maudiel Martinez emerges from his house. He’s pale, and his cheekbones protrude from his face. He hunches over like an old man – but he is only 19-years-old.

“The way this sickness is – you see me now, but in a month I could be gone. It can take you down all of a sudden,” he said.

The story was also published here:

PBS NewsHour online

http://www.pbs.org/newshour/updates/globalhealth/july-dec11/kidney_12-13.html

BBC News in English and Spanish

http://www.bbc.co.uk/news/magazine-16007129

http://www.bbc.co.uk/mundo/noticias/2011/12/111213_enfermedad_renal_centroamerica_men.shtml

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We’re not looking for pity…maybe a little understanding

I arrived in León, Nicaragua. Rainy season here too, rivers of water flooded the streets and people waded through another day. It rains everyday in El Salvador too. I was just telling some friends that I am accustomed to worrying about my clothes drying on the line. It is part of life here to suddenly have to run home, thinking “la ropa, la ropa!”

Tomorrow I go, by motorbike with my equipment (I’ll let you know how that goes) to Chichigalpa and the community of La Isla. I am reporting on a story about the Chronic Kidney Disease epidemic affecting this region. This is also a serious problem in El Salvador and I have been doing interviews there as well.

But tomorrow I meet Maudiel, a young man of 19-years-old, dying of a type of kidney disease afflicting sugarcane workers. Doctors and scientists know this strain of the disease is different from the more common form caused by Diabetes and Hypertension.  The Salvadoran government has stepped up to the plate and is funding research about the disease.

Boston University was the first outside organization to be allowed by a sugar company here in Nicaragua to conduct a study.

http://ndt.oxfordjournals.org/content/early/2010/07/08/ndt.gfq385.full.pdf

The mystery remains though. Meanwhile Maudiel and his younger brother are both gravely ill with the disease. Maudiel’s father, grandfather and uncle died of the disease. After he got sick he continued to work under the identity of a woman, because he had no other option to support his family. He is not too sick to work.

Families like Maudiel’s have no money to pay for medical care and once the sugar companies let them go when they are too sick to work, they no longer have access to medical care.  I know I am going to learn so much more about this disease and the people it is affecting over the next few days. I will share what I learn. My radio piece will be broadcast on PRI’s “The World.” I have been collaborating with another journalist, Sasha Chavkin, and he will be writing a series of articles. He has been studying this epidemic for a couple of years.

This evening I settled at the Isla Foundation where I will be staying. This foundation was founded in 2008. It was formed to help educate the world community about this disease in hopes of finding a solution.

http://www.laislafoundation.org/La_Isla/Welcome.html

I took a walk by myself in León in search of some food, and because I figured it may be my only chance to be a little bit of a tourist. Of course, living in Central America, no matter what I am doing or where I am, I take in everything with the eyes of a foreigner. Everything is interesting and new.

I feel like everywhere I go there is a celebration. I have been an on-looker at more than one carnival or parade in El Salvador. Here León I encountered one as well, celebrating the medio ambiente (environment) of Nicaragua. Groups were dressed as animals, plants and other earthly creations. I had a similar experience one afternoon in Usulútan, El Salvador. I woke up from a nap to the sound of cymbals and drums. I walked outside to a procession of cars carrying little girls dressed as princesses and school band playing. There’s always a reason to celebrate and I realize more and more that people in Central America know this.

While I was eating my Chilaquiles for dinner, I was thinking. As I like to do from time to time.

I constantly find myself in humbled by the beauty of the land and the people on my journey thus far in Central America. Yet I am also always aware of the contrast to this beauty that is the extreme poverty, disease and violence that afflicts so many people in this region of the world. But make no mistake; they don’t want pity. From my experience so far, I see people finding strength and a reason to smile through the conflict. It reminds me to shut my mouth and keep moving forward. Maybe if people in the U.S., for example, knew more about the resiliency and richness of these cultures, they wouldn’t be marginalized in the news as dangerous, tragic situations.  “Oh those poor people.” Or “How do they live like that?” Guess what? Nothing is ever just one way, one side. I have seen the positive and inspirational characteristics of the cultures here. They also have a lot to be grateful for and they show it. I know this is true for many regions of our world, from where it seems we only hear the ugly. I’m not saying their struggles are insignificant by any means. It is sad, it is depressing and sickening what some people in this world have to fight through each day. We are just missing a lot only concentrating on the dark side. They are not only their sickness, their poverty, their conflict. Maybe I am rambling nonsense. That’s part of who I am too.

Here are some pictures from my evening stroll. More from Nicaragua later…

Guate: because one never knows…

Sorry friends. I know it’s been awhile and I still haven’t put up the promised post of a microbus ride in San Salvador. But please take this first. My amazing trip to Guatemala. 

This was my first trip outside of El Salvador since I arrived two months ago. We had a long weekend because September 15, last Thursday, was Día de Independencia (Independence Day) for the Central American countries of Guatemala, El Salvador, Nicaragua, Honduras and Costa Rica. Mexico also recognizes this date as its independence from Spain.

I have known that Guatemala was definitely one of the places I wanted to visit while here in Central America. So many people have told how what a beautiful country it is, especially Antigua. However, I am very happy that my friend insisted we spend most of our trip in the town of Panajachel.

In ‘Pana’ the indigenous culture of Guatemala is more apparent, more untouched than in Anitgua. Don’t get me wrong, Antigua was breathtaking, but the influence of international tourism and money is very apparent. The characteristics of Guatemalan culture appear more commercialized.  I was, however, only in Antigua for a day and a half so I really can’t make an educated judgment just yet.

The journey to Pana was a bit much. Three buses my friends, two of which were really crowded. They were three or four people to a seat in yellow school buses re-made into public transportation. I am somewhat accustomed to this though. Public transportation in El Salvador is very much the same. Although, as my Salvadoran friend pointed out, “In El Salvador we do not squeeze 3 or 4 people in one seat!” It was all part of the experience though.

We got to Pana at about 5 p.m. on Thursday. It was raining and a friendly man showed us to the main street of the town where we found “Mario’s Rooms.” Everything about this hostel was lovely, from the people who worked there to the authentic décor of the rooms. We shed our bags and our wet clothes to take in what was left of daylight in Pana.

Vendors lined the stone streets, displaying the beautiful and unique craftsmanship of Guatemala. Everywhere were the rich colors extracted from the earth are on display in the form of fabrics, bags, clothes and jewelry. I wanted one of everything. I had to remind myself that if I kept stopping to look at ‘things’ I wouldn’t enjoy enough of the natural beauty that surrounded me. 

We sat on plastic stools to eat tostadas from one of the many food vendors. The toppings are divided into sections: guacamole, beans and chile sauce create a pinwheel of color. Finally cilantro and onions are sprinkled over the top. We ended up having a conversation with the woman making the food about finding love, or more so, finding a good man. She has a daughter who is 30 years old and she told us she is worried she will never find a good man to marry. She left us with the advice that a man who believes in God is able to love and respect a woman. It was food for thought.

Of course, this was not the only notable street food I consumed during my trip. Later the same evening, I can say without shame, we consumed a second meal of pork, rice, beans, guacamole, tortillas and coffee by gaslight in the street. The tortillas in Guatemala are similar in flavor and texture to those in Salvador. They are also made with maiz, but they are slightly thinner. I had a delicious piece of fruit pie with banana, guava, apple and I believe, fig with a merengue topping. I tried hot chocolate made with rice, strange texture, but decent taste.

This was just in Pana. In Antigua for breakfast one morning I had Chile Relleno stuffed inside a delicious roll with lettuce, guacamole and curtido. The Chile Relleno in Guatemala is different, of course, than the Mexican version I am used to.  Their version is filled with veggies as well. I smoked Hookah and ate custard cooked with rose water in a Mediterranean Bar where we sat next to a group of young Israelis travelling through Central America. I ate pasta with calamari and saw the most elegant McDonald’s I have ever seen equipped with a trendy café.

Me and my fellow monchileras (backpackers) got a little crazy in a bar one night in Panajachel called “Pana Rock.” Yes. It sounds cheesy and it was a little cheesy. I am thinking it is some spin off of Hard Rock Café, a marketing scheme I suppose. Maybe there is or will be a “Roma Rock” or “Paris Rock” for example. I don’t know. The second band that played was bearable, even kind of good for a couple of songs. We had a lot of fun dancing once the D.J. started. But mostly, as usual, I enjoyed people-watching. It was an eclectic mix of extranjeros and locals. I do not like to generalize, but I feel like I can spot a group of backpackers from Spain a mile away at this point.

 One day in Pana we took a boat across Lake Atitlan to the beautiful pueblo of San Pedro.

I also broke down at one point when I couldn’t understand a financial transaction. Trying to figure out the exchange rate compounded with the language barrier I face on a daily basis got to me I suppose. Before that various decisions had been made about money that I couldn’t understand nor calculate in my head. For a control freak like me, this proved to be too much. It was a good lesson for me to learn to ‘let it go.’ I am grateful I have good friends who are understanding and patient. We were able to laugh about the love fest that ensued in the street while they were consoling me. There are moments when I need my native tongue to feel I am myself. Language is truly amazing. I have to come to realize how much I am able to communicate without being fluent in a language, but also how much I miss for the same reason.

Getting to Antigua was an adventure in itself. Two buses, both very crowded. It was a beautiful day though and the driver had some old Ranchera music playing. Although I had to grip the handle bar on top of the seat in front of me to keep from sliding off as we whipped around sharp turns, I managed to take a little nap leaning against my friend. Again, we also three to a seat with the aisles full. 

We got to Antigua in the late afternoon. After dinner I got my first look at Antigua by twilight. It was beautiful. Although there were a lot people out and about, it still felt peaceful.

Below is the arc and clock tower of the city marking the center of the city. After passing under the arch it opens up into a square with a park and at the top, Cathedral San Jose.

 One of my favorite moments during the trip was getting up early the last morning to walk around by myself in Antigua. I needed some space and wanted to see more of Antigua in the daylight. The air was sweet and fresh and the streets were quiet. As I walked I greeted people who were sharing the early Sunday morning with me. A few motorcycles and mopeds flew by, trucks carrying people locals to church, restaurant workers and shopkeepers were preparing for the stream of tourists that would pass through their doors that day.

I passed by many historical sites, ruins of old buildings beaten down by time but still standing. I was reminded of wandering around Rome where the remnants of history are everywhere you turn.

I returned to see San Jose Cathedral in the sunlight and caught the end of a morning service.

I ate my Chile Relleno sandwich, drank coffee and watched pigeons in front of the church in Merced Park.

Thank you Guatemala. It was beautiful and I hope to see you again soon.