In this photo taken Tuesday, Jan. 24, 2012, Segundo Zapata, 49, is seen inside a hospital in Chinandega, Nicaragua, Zapata, chronic renal failure patient and former sugar cane cutter of the San Antonio sugarmill during 19 years. A mysterious epidemic is devastating the Pacific coast of Central America, killing more than 24,000 people in El Salvador and Nicaragua since 2000 and striking thousands of others with chronic kidney disease at rates unseen virtually anywhere else. Many of the victims were manual laborers or worked in the sugarcane fields that cover much of the coastal lowlands.