There are no other organizations besides ours providing free direct legal services to communities disappearing from Chronic Kidney Disease in Nicaragua.


The problem

Researchers have linked poor labor conditions to an epidemic of Chronic Kidney Disease of non-traditional causes (CKDnT) sweeping across Central America. One of the populations most acutely affected by the epidemic is sugarcane cutters in Western Nicaragua. Nicaragua has the highest mortality rate from kidney disease in the Americas. 

Limited healthcare treatment options and resulting medical complications mean that a CKDnT diagnosis in Nicaragua will lead to a slow and painful death. In the past ten years, approximately 46% of male deaths in Chichigalpa, the most affected town, were caused by CKDnT. This epidemic devastates not only the lives of sugarcane workers, but the well-being of their families and entire communities. For more information on CKDnT, please see our Resources page.

Social Security = sustenance and survival

When sugarcane workers become sick, they are fired from their jobs and often illegally denied social security benefits and compensation for their occupational illness, leaving their families with no income and forcing their children out of school and into labor. Obtaining social security benefits in the poverty stricken rural sugarcane communities of Nicaragua can mean putting food on the table, accessing specialized medical care, and keeping sick workers' children in school.

Our response

Profesionales para la Auditoria Social y Empresarial (PASE) a Nicaraguan labor rights organization, in collaboration with La Isla Foundation, began a Legal Services Office in June 2015 (see "Who is PASE" below for more). This office, now independently run by PASE, focuses on helping those affected by CKDnT including sugarcane workers, ex-sugarcane workers and their families, collect what they are owed. The office provides FREE legal assistance to workers by bringing claims for social security and providing advice on related labor rights issues.

Through its provision of direct services, the office identifies trends in labor rights violations and barriers to healthcare. Using this information, the project engages with international and domestic stakeholders to advocate for improvements to work conditions and social security reform.

For more information about our services go to Goals and Activities. 

What We've Achieved

  • Opened a Legal Services Office: Our Legal Services Office, managed by PASE, is located in Chinandega Nicaragua, a small city centrally located between the two biggest sugar producers in Nicaragua. We have been in full operations for over a year and have a full case load and an exemplary staff providing high quality services for FREE. We take on a minimum of 5 additional clients every month. The average household size among the affected communities is 6 people, which means that the project reaches approximately 30 more people every month through direct advocacy services.

    In addition to free services, our project pays for client costs associated with transportation to and from the office, photocopies, and medical evaluations required for their cases. Our clients are all living in extreme poverty and they would not be able to access their benefits if we did not cover these modest costs.


  • Published a Manual on Social Security:  The project published a comprehensive 123-page guide explaining agricultural workers’ social security rights in understandable language - the first manual of its kind in Nicaragua. The manual is regularly distributed to clients, unions, community organizations, medical clinics, and individuals throughout CKDnT affected communities. See our manual under Resources.
  • Conducted Trainings of Community and Union Leaders Across Western Nicaragua: By the end of this year, the project will have conducted social security trainings for over 180 community leaders who are now capable of assisting hundreds of workers and their families, many of whom cannot read or write. Trainings have been highly participatory and results from post-training surveys are overwhelmingly positive.