CHICHIGALPA, Nicaragua – You won’t see a road sign pointing to “La Isla de Viudas,” or “The Island of Widows,” as it’s not the community’s official name. It’s a nickname born from a horrific body count.

In the past 10 years, it’s believed that hundreds, if not thousands, of residents of Chichigalpa — mostly male sugarcane workers — have died from chronic kidney disease, or CKD. That in a city of nearly 60,000, roughly the size of Ames, Iowa.

The mysterious and hidden epidemic, first highlighted by the Center for Public Integrity, has claimed thousands more lives across Central America. In El Salvador and Nicaragua alone, the number of men dying from the excruciatingly painful disease has risen five-fold in the last two decades. High rates of CKD also have been found in rural villages in India and among the rice paddies of Sri Lanka.