ABSTRACT This article explores the instability of facts surrounding former sugarcane workers in Nicaragua with Chronic Kidney Disease of Non-Traditional Causes (CKDnt). CKDnt is a progressive disease that has been linked, albeit inconclusively, to working conditions in sugarcane plantations and other extreme environments. It emerged in the early twenty-first century, at a time when the social and political value of agricultural labor in Nicaragua and across the Americas was shifting due to the rise of new regimes of corporate responsibility and neoliberalized systems of state care. Partly as a result of a lack of conclusive knowledge about what causes the disease, former workers receive uneven medical and social benefits from both sugarcane corporations and the Nicaraguan social security system, the Instituto Nacional de Seguridad Social (INSS). This article traces the parallel emergence of Nicaragua’s agro-economy and the INSS during the twentieth century, and it draws on ethnographic research with ex-workers to understand how the making of facts about work and the making of facts about health shape each other. The article argues that the disposability of labor is not an inherent feature of monocrop capitalism; rather, disposability emerges as corporations and state authorities work strategically to manage the inherent porosity of the boundaries between plantations and their socio-political surroundings.
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