Global heating is having a deadly impact on Nicaragua’s sugar cane workers, who toil in temperatures of up to 45C

At the Sacuanjoche clinic in Chinandega, the largest city in Nicaragua’s sugar cane-growing region, nephrologist Nelson Garcia does the rounds of his patients. Many are suffering from chronic kidney disease (CKD); most fell ill while working long hours under the beating sun in the nearby sugar cane fields, and now have damaged and failing kidneys.

“People arrive with a host of symptoms here; some are really nauseous, or vomiting, or have severe diarrhoea,” Garcia says, adding that although unsure exactly how many people he has treated for heat stress and related kidney diseases this year, he knows it is a lot. “Others are physically weakened, tired, or have nasty muscular cramps, while others complain about having no appetite or libido – there really are so many symptoms.”

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