This chapter examines perhaps the most significant outcome of the mediated settlement between sugarcane plantation residents and sugar corporations: access to hemodialysis for dozens of people with late-stage kidney disease. The chapter charts the journeys of hemodialysis patients back and forth from the sugarcane zone to the hemodialysis wards of Nicaragua’s capital, Managua. Not all those who are offered the opportunity to receive dialysis treatment accept it, and not everyone who does accept it sees it as an unambiguous good. Moreover, those who qualify for this benefit constitute a decided minority of all those affected by the epidemic. Through stories about the ambivalence of patients toward treatment, the chapter shows how corporate social responsibility, a key element of most designs for planetary health, has the effect of reinforcing a view of labor that is as old as the plantation itself, namely, that working bodies are fungible and interchangeable.