In the lush western lowlands of Nicaragua a mysterious kidney disease is sweeping through the tiny sugar growing community of La Isla and devastating the impoverished town's residents.br Targeting scores of men working on the fields, it has surpassed HIV and diabetes combined as the biggest killer of males in the embattled Central American country.br Sugar cane is the backbone of La Isla's economy. But increasingly the work comes with a high cost.br (SOUNDBITE) (Spanish) RESIDENT, AMPARO MEJIA SAYING:br "There are children, people sick from creatine (nitrogenous organic acid) and chronic kidney disease. There are people on dialysis and they are still sick. We know that no one is going to get anything from them (sugar cane factory) but they will answer to God,"br A heavy burden for the poor inhabitants of the town, locals are often forced to make a tough decision between feeding their families or protecting their lives.br (SOUNDBITE) (Spanish) RESIDENT, CRISTINA ORDONEZ SAYING:br "We are scared because this is the only area where we work. If we don't work then we don't eat," .br The epidemic has killed so many husbands and left families destitute that many are now calling the town of La Isla, which means "The Island", "the Island of Widows."br Doctor Nery Olivas blames the working conditions.br (SOUNDBITE) (Spanish) DOCTOR NERY OLIVAS SAYING:br "It is common in sugar cane workers but it is not directly related to this, it's more to do with the environment they work under. When they cut the canes the conditions are very hot and they don't drink enough water or that there are contaminants in food. Arsenic or other things such as insecticides could be the cause but we can't say exactly that this is the cause of chronic kidney disease that is common in many people in the area."br With Nicaragua's sugar exports generating some $130 million in revenue in 2010, any fight against the the country's powerful agribusiness industry will likely be a tough one.