The Social Determinants of Health and Industrial Agriculture in Guanacaste Sugarcane Plantations

By Chloe Boehm

Palo Verde is a verdant tropical forest filled with families of capuchin monkeys, skittish peccaries and mystical jabirus. However, directly adjacent to this veritable paradise are endless acres of sugarcane plantations. Just walking near these fields gives you a dizzying head rush of Roundup® herbicide, which we observed unprotected workers applying by the gallon. When we asked workers about their perceived occupational hazards, they responded in an unexpectedly nonchalant manner - they were not worried about their frequent contact with weed killer or sun overexposure. We saw the workers reaching into barrels of Roundup® with bare hands only to reach next for a sugary energy drink.

            Before our trip to the sugarcane plantation, we had a discussion about the social determinants of health, especially as they pertain to Chronic Kidney Disease of Unknown Origin (CKDu) in sugarcane workers. CKDu afflicts manual laborers throughout Mesoamerica, particularly in the agricultural sector. As we examined potential causes of CKDu, we discussed how the undocumented status of many migrant workers in Costa Rica (even in this country’s universal healthcare system) contributes to an inability to advocate for their own occupational health status. Without the political autonomy to mobilize and promote their biomedical agenda, undocumented sugarcane workers are unable to join the dominant biosocial community. The social determinants of health would lead us to believe that exclusion from this biosociality has an eventual pathological effect, manifested in the high prevalence of CKDu.

            These workers are subject to not only biosocial alienation but also economic exclusion. Manuel, a former sugarcane worker and a co-founder of the plantations in Guanacaste province, explained how the plantations have transitioned from a former cooperative between farmers to an industry-owned conglomerate. Manuel explained that the old cooperative raised money for the town’s school system, and that the school has had less money since the buy-out. I related this seemingly small structural change to the larger systemic shifts in global agriculture, shifts that often serve to further marginalize and disenfranchise poor rural farmers.

            The sugar produced also exemplifies the movement away from family farming practicing to the divisive monoculture system. In many ways, I see sugar as a catalyst for mass production. As a highly laborious crop that requires inputs from many agricultural and industrial settings, it produces a product that cheaply fuels industrial bodies. As we saw at the plantation, workers were powered by caffeinated, sugary beverages  – a manifestation of the capitalist labor created by the industrial sugar plantation. The relatively recent mass production of sugar highlights the role it plays in the modern industrial diet.

            My experience at the sugar plantation has given me a fresh interest in occupational health and industrial agricultural practices. Global health equity remains a lofty goal, but recognizing structural inequities as they occur and the powerful industrial networks they reinforce can help expose the biosocial vulnerabilities associated with marginalized populations. 
 

Photo Caption: Manuel explains the history of the sugarcane plantations in the Guanacaste Area (Photo by Sam Cothran)

 

Photo Caption: Bright-yellow Roundup herbicide (Photo by Sam Cothran)