The Economic Impact of CKDnt on Households: Survey Findings from a Pilot Study of a Workers’ Association, Asochivida, and of the Communities of La Isla, Manhattan, and Candalaria, Nicaragua

The Economic Impact of CKDnt on Households: Survey Findings from a Pilot Study of a Workers’ Association, Asochivida, and of the Communities of La Isla, Manhattan, and Candalaria, Nicaragua
Author: Heath Prince, PhD
Date: April 2020
Publication Type: Report, 13 pp.
Prepared for the La Isla Network, with funding from the Deutsche Investitions und Entwicklungsgesellschaft (DEG)

Executive Summary
The following findings are drawn from a pilot survey of households in 3 communities in Chichigalpa, Nicaragua, including La Isla, Manhattan, Candelaria, each of which provide labor for the Ingenio San Antonio sugar mill, and from Asochivida, an association of ex-mill workers and their widows.  The sample of households is a purposive sample drawn specifically from households that have, or had, a member with Chronic Kidney Disease of non-traditional Etiology (CKDnt).  As such, it is not meant to be a convenience sample or a random sample and, therefore, is not meant to be representative of the whole populations in these communities.  Instead, the intent is to examine the nature of the economic effects that CKDnt has on households and their communities as a pilot study to assess our questionnaire and the feasibility of conducting a representative survey of this nature in this area.

Survey responses paint an interesting picture of those households affected by CKDnt; in general, respondents are less educated than the national average, earn considerably less than other rural workers, such as coffee bean pickers, and have a monthly income that falls far short of reported monthly expenses.  This shortfall leads to borrowing from a range of sources, exhausting savings, and preventing them from growing savings.  A substantial proportion of households are those with neither parent working, and a smaller, but still seemingly large, proportion of households has had a child leave school to help bring in income.  The vast majority claiming to need medical assistance with CKDnt do not receive it.

On the other hand, respondents report that they generally believe that hard work and their own initiative are better predictors of their own, personal success than are fate and more powerful people.  Nearly three-fourths report that they would move away for a better life, but also report that they either cannot afford to, have nowhere to go, and/or cannot leave their family and friends.  Perhaps because they feel trapped in their current situation, a majority report that they expect life to become more difficult in the future, but they are, nonetheless, hopeful for their children’s futures.

Our comparison of households with lower- and higher-earnings is revealing in several respects: higher-earners are far more likely to borrow in general, but less likely to report having spent their savings due to CKDnt; despite fairly wide differences in mean earnings, both groups similarly report that they have bought food on credit recently; and counterintuitively a significantly larger percent of lower-earners report saving some of their income than higher-earners.  Lower-earners feel considerably stronger about being in control over what happens in their lives, but both groups attribute success in life to hard work, and both groups are equally optimistic about their children’s futures, even as they feel concerned about their own.

The picture that emerges from this initial examination of these two sub-populations is consistent with the picture presented by the totality of the households we surveyed—total earnings are inadequate to meet their needs, but for a few households, and the majority believes that hard work contributes to success.  Nonetheless, there is concern among most that earnings in 2020 will be worse than 2019.