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Juan Salgado used to be a hardworking, fit field cane farmer when he started off at the tender age of 16, laboring long hours in Nicargua's biggest sugarcane plantation During the sugar cane harvest, he'd swing a machete for hours, hacking at the thick, towering stalks.

Cut to the present, the 65-year-old Salgado is a gaunt, frail, ill man. He is too weak to slog at the cane fields anymore, his life made miserable by frequent cramps, headaches and nausea. Doctors say his kidneys are failing, but have failed to cite a reason for it. But Salgado isn't alone. Many of his peers has had it worse.

The question is what is the mysterious epidemic that is sweeping Central America and killing large number of men prematurely in El Salvador, Nicargua and Costa Rica? It's unexplained but the latest theory is that the victims are literally working themselves to death. And the terrorizing part – most of its victims are sugar cane workers.

The chronic kidney disease of unknown origin has claimed the lives of 20,000 men and afflicted thousands of other rural workers in Nicargua and six other countries along the Pacific coast of Central America so far. The strange part is no scientific investigation have managed to put a finger on the cause of this sudden illness. Normally, chronic kidney disease ails people in their 60s, 70s or 80s. But here, men in their 20s, 30s and 40s are dying of  sudden and unexplained kidney failure.

Strangely, there are no early signs of this disease. By the time a patient experiences pain, fatigue and high blood pressure, the kidney is already more than damaged.

Possibly the only clinical ways to battle the condition is through dialysis and transplant, both expensive. And in a region like Nicargua, where adequate health care is inaccessible, such treatments are far-fetched possibilities. Here, people have just one solution — to live with the pain until they die.

Why the illness is most common among the sugarcane workers in rural areas of Pacific regions in Central America is a mystery? While miners and stevedores too have fallen victim to it, experts fear that there is a mysterious connection between the patients and sugarcane farms.

A researcher, Cathatina Wesseling believes that this epidemic is an occupational hazard with “possibly one or more yet unknown environmental components interacting with occupational dehydration.” She deems chronic dehydration as one of the major factors behind this epidemic. Performing intense physical labor under harsh climate possibly causes these extremely dehydrated workers to resort to sugary soft drinks as they toil — something that exacerbates their kidney failure.

Again some blame it on genetic susceptibility or predisposition that makes the people in this belt of Central America vulnerable to chronic kidney diseases.

The only feasible ways to stop the predicament from wrecking a havoc is to provide adequate hydration, balanced diet and pauses between work to avoid over exertion to the workers. Screening the workers for kidney disease before they join work could also help the experts get a better insight into the epidemic.

As we speculate over the possible causes and treatments of CKD, we hope that the experts quickly find a way to put an end to their sufferings clinically.

AW: Suchorita Choudhury