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The Kidney and the Cane

Planetary Health and Plantation Labor in Nicaragua

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Critical Global Health: Evidence, Efficacy, Ethnography

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Book

Pages: 240

Illustrations: 6 illustrations

Published: May 2025

Author: Alex M. Nading

The recent unprecedented growth of Nicaragua’s sugarcane industry has brought promises of more jobs, better health care, and cleaner energy. But these promises have been overshadowed by an epidemic of chronic kidney disease of nontraditional causes (CKDnt). Unknown before the late 1990s, this disease has sickened and killed thousands of sugarcane plantation workers. Scientific studies link the disease to rises in mean average annual temperatures, chronic water scarcity, and the overuse of toxic agrochemicals. CKDnt is now understood as a consequence of global climate change. In The Kidney and the Cane, Alex M. Nading situates this epidemic within a deeper history of sugarcane plantation violence, arguing that CKDnt is not a result of climate change: it is climate change. Outlining a place-based approach to planetary health, Nading follows activists, scientists, and residents in the sugarcane zone wrestling with the consequences of plantation life. Along the way, he raises critical questions about the capacity of corporations and states to care for people and ecosystems; the ability of citizens and experts to regulate toxic substances; and the future of work on a warming planet.

Praise

“Offering compelling storytelling, fresh insights, and stunning connections, Alex M. Nading outlines the futility of isolating the cause of chronic kidney disease of nontraditional causes (CKDnt) while also showing the limits of fixes based in liberal structures of contestation. He shows how the work involved in keeping bodies and production alive in Nicaragua’s sugarcane zone is tantamount to life support; bodies cannot be cured, although their repair remains essential. In this way, CKDnt serves as a bellwether of planetary health.” - Julie Guthman, author of The Problem with Solutions: Why Silicon Valley Can’t Hack the Future of Food

The Kidney and the Cane is an evocative ethnography of life in and around Nicaraguan sugar plantations that also serves as an incisive portrait of planetary health. The examination of contemporary plantation labor allows Alex M. Nading to weave together questions of human and environmental health in entirely novel and often harrowing ways. A fantastic book for anyone interested in labor, agriculture, health care, or the environment.” - Kregg Hetherington, author of The Government of Beans: Regulating Life in the Age of Monocrops

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Author/Editor Bios

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Alex M. Nading is Associate Professor of Anthropology at Cornell University and author of Mosquito Trails: Ecology, Health, and the Politics of Entanglement.

Table Of Contents

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Notes on Words, Names, and Places  vii
Prologue. Lives Worth Supporting  ix
Introduction  1
1. Grievance, Ground, and Grace  21
2. Atmospheric Fixes  45
3. Renal Environments  65
4. Toxic Mediation  85
5. Working Conditions  107
6. Plantation Patienthood  129
Conclusion  151
Acknowledgments  159
Notes  163
Bibliography  189
Index  217

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Sales/Territorial Rights: World

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Additional Information

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Paper ISBN: 978-1-4780-3187-1 / Hardcover ISBN: 978-1-4780-2866-6 / eISBN: 978-1-4780-6086-4 / DOI: https://doi.org/10.1215/9781478060864