Capital Accumulation Through Labor Exploitation as Determinant of Health: CKDnT in Guanacaste

Employing the dialectical method Marx developed in his critique of political economy, this work seeks to advance beyond an understanding of the proliferation of chronic kidney disease of nontraditional etiology (CKDnT) in Guanacaste, Costa Rica as a purely epidemiological development and towards its understanding as a concrete manifestation of capitalist accumulation. This research aims to display the form determinations of a material process such as CKDnT through a critical, descriptive analysis of the production and reproduction of the temporary migrant labor force at the El Viejo, Taboga and CATSA mills. This is contextualized through an analysis of the transformations suffered by Costa Rica’s national sphere of accumulation between 1970–2022. We conclude that, despite expanding the minimum scale of production–a condition necessary to displace small capitals in the sector and thus the brutalized forms of exploitation that they promote–the sugarcane sector still requires a seasonally exploited and overall degraded workforce: a need that posits the conditions for CKDnT proliferation.