Gnawing hunger and thirst never leave the Wayuu. As many as 5,000 Wayuu children have died over the past decade from malnutrition and a lack of basic medical care, according to activists and aid groups. Tens of thousands more subsist in a kind of nomadic desert wretchedness, their misery compounded by the corruption of Wayuu leaders and local officials who have channeled much of the government’s emergency aid into their pockets.

Italian photographer Nicolò Filippo Rosso first told me about his work in the Guajira when I met him in Colombia a couple of years ago. He wore a dusty leather jacket and a dirty backpack and told me he’d been sleeping in the desert and living on rancid goat meat for the past week. I bought him a salad and a cheeseburger.

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Rosso is an immersion photographer. He has spent much of the past two years living in the Guajira, entangling himself in the lives of the Wayuu and their problems. Most journalists who do this type of work get the images or the information they need and move on to another assignment. Rosso keeps going back, sometimes to take photographs of his subjects, but other times to take them to doctors.

Some of his images are disturbing, but, taken together, they tell a story of extreme economic and geographic marginalization — a people literally left in the dust.

The Guajira Peninsula where the Wayuu live is also home to one of the world’s largest open-pit coal mines, Cerrejon, owned by a British-Swiss-Australian conglomerate. Most of its massive output is loaded onto ships and sent to power plants in Europe.

The Wayuu and the advocacy groups that support them say the coal mine has made life in the Guajira considerably worse. Scarce water has been diverted to the thirsty mining operation, leaving the Wayuu with dry wells or water too contaminated to drink. The subsistence crops that once supplemented their poor diets have dried up.

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The company says it is bringing much needed jobs to an impoverished region and is committed to improving the lives of the Wayuu.

The first time he saw a pregnant, malnourished Wayuu woman, Rosso said he knew he wouldn’t be able to walk away easily from the Guajira. He wasn’t sure what to do when his subjects needed urgent medical care or food but realized the need to help them took precedence over the need to take pictures of them.

“If I have the means to save someone in an emergency, I have to do it,” he said, speaking from Bogota, the capital, where he now lives. “Sometimes I have to stop working and take someone to the hospital.”

Rosso sees the coal mine as a cause of the Wayuu’s extreme economic and geographic marginalization, as the energy needs of the global economy push them further to the edge. But he’s also seen their suffering worsened by corruption — their “leaders” taking aid money meant for hungry children.

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Some of the subjects in his photographs “are the most honest people I have ever met,” he said. “I walked with them through the desert for months, visiting communities and seeing hunger, malnutrition and death.”

“If I have the means to help them, by documenting their lives, or however else I can, I need to do it,” he said. “That’s what keeps me going back.”

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