In 2008, the Office of the Compliance Advisor Ombudsman (CAO) received a complaint from former workers of Nicaragua Sugar Estates Limited (NSEL)—a client of the International Finance Corporation (IFC)—claiming they were suffering and dying from a kidney disease that in their opinion was related to their work at NSEL. It was a disease about which they had little information. The workers further claimed that their ability to feed their families, generate income, and improve their living conditions was severally compromised because of the disease. People were dying, and a cycle of mistrust, recrimination, and denial characterized the relationship between the group of complainants and NSEL. Tensions ran high among groups of former NSEL workers, who were protesting outside the company facility, and several court actions had been filed against NSEL. This was the situation when the complainants requested CAO’s intervention to promote dialogue to address these issues with NSEL. From 2008 to 2015, CAO convened a dialogue process for the group of complainants suffering from this chronic disease, and NSEL, to find joint solutions. This case study tells the story of what happened. Through the dialogue process, stakeholders were able to focus on local, practical, effective, and sustainable outcomes for all involved. The challenge was for stakeholders to move beyond making judgments and finding fault. With time and through dialogue, the focus for some began to shift from communities’ demand for compensation to forward looking efforts to obtain scientific information on the causes of their chronic kidney disease, achieve sustainable outcomes for the community, raise awareness about CKD, and generate solutions to address a public health issue that scientists and the Pan American Health Organization (PAHO) now consider an epidemic affecting Nicaragua and other countries in Central America