Mesoamerica s Mystery Killer

摘要

A half-hour before sunrise, Emmanuel Jarquin pulls his four-wheel-drive pickup off the road near the rural town of El Paisnal and rumbles onto a sugar cane field. Jarquin, a physician, parks and steps into the sweet and smoky air, the cane having been charred the day before to burn off leaves and thorns. He walks toward the headlamps of several machete-wielding men who will start cutting at first light. "What are you bringing us?" one of the men cries in the darkness. "I'm bringing you health," Jarquin replies. Jarquin collaborates on a project studying a mysterious affliction of Central American agricultural workers known as chronic kidney disease of unknown etiology (CKDu). First reported in 2002, CKDu has no known links to diabetes or hypertension, the main causes of progressive renal damage worldwide. Much about CKDu is clouded by sketchy health statistics and the difficulty of distinguishing it from other kidney disease. But it appears to be spreading in the hot lowlands of Central America's Pacific Coast-and concerns are rising. In October, the Pan American Health Organization (PAHO) declared CKDu a "serious public health problem," with case reports streaming in from southern Mexico, Guatemala, Honduras, Nicaragua, Costa Rica, and Panama. In El Salvador alone, PAHO's latest figures say chronic kidney disease of all causes kills at least 2500 people in the country each year, and it's the main reason adults die in Salvadoran hospitals.