La Isla (the island) is a community in Nicaragua entirely surrounded by sugarcane fields. Mortality rates among sugarcane workers due to CKDu are so high in La Isla that survivors refer to it as La Isla de Vuidas, "The Island of Widows." La Isla Foundation emphasizes the importance of local capacity building and comprehensive epidemiological research in its efforts to form alliances with leading occupational and environmental health experts at CISTA and of the SALTRA network. Although La Isla Foundation initially believed the epidemic to be a local phenomenon in Nicaragua, three years of networking and research with CISTA and SALTRA suggest that CKDu affects sugarcane producers from southern Mexico to Ecuador. Also, a potentially related epidemic among field laborers in Sri Lanka, India and other countries has recently drawn international attention.