Kidney disease research in El Salvador finding a place in rural Ohio

By Joseph Barbaree

Copy edited and produced Laura Straub

A sickeningly sweet industry might be one cause of Central America’s widespread kidney disease epidemic. And researchers at one unlikely institution could soon prove it.

News broke in the past year of kidney disease affecting communities in El Salvador and Nicaragua among others in Central America. A total of some 24,000 deaths were recorded beginning in the year 2000.

Researchers are now trying to spur government action to prevent further deaths after a plea for help from El Salvador’s Minister of Health.

Included in the efforts to solve the mystery are researchers from a small community in rural Ohio.

Dr. Dina Lopez, professor of geology at Ohio University in Athens, is a native Salvadoran living in the United States. Her research focuses on multiple environmental problems, including acid mine drainage in El Salvador.

Dr. Diana Lopez, courtesy of the Ohio University
Department of Geology.

Investigating the soil composition

Lopez is now leading an international investigation of soil conditions in El Salvador to determine the present levels of chemical pesticides in communities most widely affected by kidney disease and failure. There’s speculation that the sugar cane industry is a primary factor.

Collaborating with Lopez is Dr. Carlos Orantes, a clinical health physician in El Salvador. Orantes studied the rural agricultural region of Baja Lempa and found that one in four men had kidney disease. Most of these men were not diabetic, a common symptom of the disease.

After interviewing 775 members of the community, Orantes found that more than 40% reported exposure to a number of chemical herbicides and pesticides.

Paraquat, glyphosate and hedonal were most widely reported and led Orantes to his belief that prolonged exposure to these causes the health problems among workers. Each chemical is reported to have some detrimental effect.

“These chemicals are banned in the United States, Europe and Canada, and they’re used here, without any protection, and in large amounts that are very concerning,” said Orantes.

Spurred by the work of Orantes, Lopez began collecting soil samples from the regions affected by kidney failure in mid-2011.

Sugar cane and kidney failure

Helping Lopez at Ohio University is student researcher Darcy VanDervort. They traveled to El Salvador in August and collected soil samples, which they are analyzing for chemical presence.

VanDervort runs statistical analyses and maps data in order to compare regions of sugar cane production with areas of concentrated kidney failure.

Traditionally, sugar cane fields are burned after the
harvest to kill off any insects or eggs
in the field.  Photo courtesy of Erika Blumenfeld

“My maps are showing that the areas are overlapping – a lot,” said VanDervort.

She is finding that the most concentrated areas of kidney disease are in the coastal regions of the country and at the border between La Libertad and La Paz. Northwest of San Salvador is also highly concentrated.

As many as 65 per 1,000 inhabitants are affected by kidney disease in these regions.

Once Lopez and VanDervort conclude the statistical mapping and soil analysis, they will send a report to the Ministry of Health in El Salvador.

But they can’t yet conclude decisively that the use of pesticides in the sugar cane industry is solely to blame. “We think it’s multi-factorial,” said VanDervort. Presence of heavy metals and difficult working conditions may be part of the cause.

The results of preliminary research, such as that conducted by Orantes in his study of Baja Lempa, have led only a handful of environmental groups to speak out against the practices of the agricultural industry. Among those in El Salvador is the Mangrove Association, organized by EcoViva, which coordinates several community-led grassroots initiatives for environmental change.

Even when more substantial evidence is produced, regulatory change may still be years away for El Salvador.

How this affects America

This means the continued export of sugar products to the United States from countries that use possibly harmful herbicides and pesticides. The United States in 2011 imported some 330,000 metric tons of sugar from Central America, constituting roughly 23% of total sugar imports.

For now, the fate of laborers in El Salvador is a waiting game until action is taken either by the Salvadoran government to regulate the use of chemicals or sugar producers begin regulating their products through third party certification.

Until then, Lopez and VanDervort will continue to explore the causes of Central America’s deadly epidemic, one whose roots remain elusive.