Manuel Antonio Tejarino used to be a lean, fit field hand. During the sugar cane harvest, he'd swing a machete for hours, hacking at the thick, towering stalks.
Now Tejarino is slumped in a faded, cloth deck chair outside his sister's house on the outskirts of Chichigalpa, Nicaragua.
Tejarino's kidneys are failing. He's grown gaunt. His arms droop by his side. In the tropical midday heat, he alternates between wiping sweat off his brow and pulling a sweatshirt up over his bare chest.