These images were made during collaboration with La Isla Foundation to focus on Nicaraguan sugarcane workers affected by fatal Chronic Kidney Disease of unknown cause (CKDu). With CKDu impacting 68% of male workers in some communities, where nearly 1-of-3 is in end-stage renal failure, this epidemic is both a public health crisis and a social injustice. Since Nicaragua’s largest sugarcane company practices intimidation and labor abuses, organizing community response to this tragedy is difficult. Furthermore, since local press do not cover the issue because of feared advertising revenue loss from powerful corporate conglomerates, CKDu is often shrouded in silence.