Public and private policy shifts
Formally, both countries and private companies were reticent when it came to addressing CKDnT. Costs associated with treatment and liability are believed to be the motivation for such delay. At least two sugar millers did in-house studies that concluded that the driver of disease is related to work practices, but the millers claimed publicly that workers drank too much bootlegged alcohol or pointed at other unfounded causal mechanisms.
Attitudes are shifting. A new Costa Rican policy addressing dehydration and heat stress as the apparent conditions for the disease has been adopted. Prior to the decree, the Costa Rican government repeatedly consulted La Isla Foundation (LIF) and several partners. They also conducted their own population-based study. The El Salvadorian government has taken the issue seriously, as has the most progressive private sugar mill in that country, El Angel. This mill formerly worked with DoL-ILAB to address child labour via the sugar association in that country.
In September 2015, Pantaleon, the largest miller in the region, shared data going back eight years that demonstrates intervening on heat stress, acclimatization and dehydration cut the incidents of disease in its workforce by half. Clearly they should have shared this information earlier, but they seem to be taking a new strategy that we hope to support.
Meetings with the Mexican and Guatemalan governments have gone well and they seem to be taking the issue into account. The Dutch Foreign Ministry has discussed the possibility of making this issue a flagship of their better work project. Furthermore, meetings with US State Department and USAID have led to discussions on how they may support workplace interventions, policy enforcement and more.
Currently, a trip with Karolinska Institutet, University College London and London School of Hygiene and Tropical Medicine is planned for LIF to visit India and Sri Lanka. Government and academic institutions in both countries have been receptive to the outreach. The focus is now on setting up a research hub network.
About WE Program
The WE Program is a collaborative tool designed to end the epidemic of Chronic Kidney Disease of non-traditional causes currently affecting agricultural laborers in equatorial communities around the world. It achieves this by:
- Generating knowledge
- Translating results
- Connecting stakeholders
Partners of the WE Program include Solidaridad, La Isla Foundation, OSHA, AGDYSA, Camelbak, Australian Cane Farmers, El Angel Mills and the Dutch National Lottery.