Date of Award

Spring 1-1-2015

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Lori M. Hunter

Second Advisor

Jennifer L. Bair

Third Advisor

Sanyu A. Mojola

Fourth Advisor

Jill L. Harrison

Fifth Advisor

Joe Bryan


Chronic Kidney Disease of unknown cause (CKDu) is a negative health outcome associated with intensified sugarcane agriculture in northwestern Nicaragua. The municipality of Chichigalpa, located in the Department of Chinandega in northwestern Nicaragua, is the largest sugar-producing region in the state and residents experience CKDu mortality at a rate 13 times higher than the national average. Those directly affected tend to be young men who work as agricultural laborers in the sugarcane fields, often under stressful and unsafe work conditions that expose them to intense heat and pesticides.

Qualitative methods were used to interview 48 households about the implications of CKDu morbidity and/or mortality on household livelihood decision-making. Findings show that household livelihood strategies are socio-culturally, politically, and ecologically constrained. Also, women are now engaging in sugarcane field labor to replace lost income of ill or deceased male breadwinners, resulting in an emasculation of agriculture. Key findings also detail how livelihoods are social practices embedded in power-laden social relations at multiple scales. Further, an embodied livelihoods perspective is developed to explain why sugarcane workers continue to engage in sugarcane field labor despite the known risk of developing CKDu.

This study offers insights into why poor and marginalized social groups engage in certain livelihoods and not others, and how such choices become naturalized. Importantly, this research moves beyond rational actor-oriented livelihood perspectives by embedding decisions into a political-ecological approach, while also allowing actors agency in their decisions to make a living and make living meaningful.