What's the price of lobster? 352 lives

In the small Honduran village of Cocobila, a few metres from the Caribbean Sea, there is a small cemetery filled with the graves of young men. Amid the makeshift, worm-holed crucifixes and sun-bleached plastic flowers, Carlos Evans has just been buried. He died four days ago, aged 32, leaving a wife and two small daughters to survive without a breadwinner.

Like most of the indigenous men on this part of the Mosquito Coast, he made his living diving for lobsters destined for American and European restaurants. And like many of those buried around him, Carlos was killed suddenly – and horribly – by the bends.

It is impossible to say what proportion of men from the Mosquito Coast are killed or left paralysed diving for lobster for the international market: there has never been a census of this region, so no one knows how many live here. Accessible only by sea or air, it is a land of wiry mangroves, indigo lagoons and thick jungle, home to an ethnic group called the Miskitos. At least 4,200 Miskito men are thought to be living with permanent disabilities due to diving accidents – half the estimated number of lobster divers. The shores of the Mosquito Coast are so inundated with paralysed men that some places look more like colonies for war veterans than fishing villages.

Since 2003, the Association of Disabled Miskito Divers has registered 352 deaths from the bends, but this is a conservative figure: many will have been killed at sea never to be accounted for, and hundreds more will have died at home, slowly, from diving injuries. The Cocobila cemetery is one of many graveyards dotted along the coastline that have become monuments to the true price of luxury food.

Alexis Valderramos has come to pay his respects to Carlos. Barefoot and wiry, his leathered face looks older than his 29 years. He has been diving for lobster since he was 15, making up to 10 fishing trips a year. His next voyage into the Caribbean departs from Cocobila beach tomorrow – and I will be joining him, filming his dives for Channel 4's Unreported World. Without much effort, Alexis can point out the tombs of six other lobster divers: one directly beside Carlos, two more – brothers – are buried feet away, killed in separate accidents last year. He looks down at Carlos' fresh grave with wide eyes. "Right now, I'm sad and afraid," he tells me. "He was my friend. All the divers here were my friends, I've worked with them all. I'm afraid I may also go down the same path."

Alexis says he has no choice but to risk the same fate – he has a family of seven to support. For the Miskitos, lobster is a necessity, not a luxury. Diving is one of the few ways to make money in this isolated region, the most neglected part of an impoverished country. If men like Alexis want to earn a living – and don't want to get involved in the only other established industry here, drug trafficking – they must risk their lives on the high seas. It is a gamble largely ignored by wholesalers and consumers: we will buy dolphin-friendly tuna, but we don't demand that our lobster is caught in a way that doesn't harm humans.

The 60ft lobster ship that Alexis will share with more than 100 other men for the next 12 days is supposed to be one of the most modern and comfortable in the Caribbean, but if animals were transported in these conditions there would be an international outcry.

The dingy, filthy dormitory is like a battery chicken coop: bunks are stacked three high with no room to sit up, each bed shared by two divers. The air here is blue with marijuana smoke and thick with the smell of rum, even at six in the morning. The more spacious deck is given over to giant racks of air tanks and an enormous freezer to store their catch. From the geography of the ship alone, it is obvious the lobsters are considered far more important than the men who catch them.

Miskito men have always dived for lobster, but it was only recently that scuba equipment became necessary. A few decades ago, they could wade out and scoop them up metres from the shore. When multinational seafood suppliers started exporting Caribbean spiny lobster on an industrial scale, they became harder to find. Rampant overfishing now means divers have to sail for at least 13 hours to reach the first banks where lobster can be found, plunging as deep as 150ft to scramble on the ocean bed for their catch. They are paid per pound of lobster – on a good day they might make £30 – and they descend 12 to 15 times a day to maximise their chances, when only three or four dives beyond 90ft would be considered safe.

When lobster divers started suffering horrific injuries, the Miskitos did not understand what was happening. Many believed it was the curse of a vengeful mermaid, angry that they'd taken so much from the sea. But now they know they know the more prosaic truth: it is because they have surfaced too fast, or plunged too deep, for too long. Decompression sickness – the bends – happens when a diver moves too quickly from high to low pressure, causing nitrogen bubbles to form inside the body. When the bubbles lodge in the joints or nervous system, they can leave the diver paralysed. A bubble that reaches the lungs or brain can be fatal. Death from the bends can be particularly disturbing to witness: it is sometimes accompanied by heavy bleeding from the nose, ears and mouth. Every diver on Alexis' ship tells me they have experienced some degree of decompression sickness.

One look at the kit provided by the ship makes it clear why they might be forced to ascend rapidly. Alexis is diving with no depth gauge or air gauge. He says the only way he will be able to tell if his air is running low will be when it becomes difficult to breathe. His tank is tied to his back with a frayed piece of rope, knotted at his waist. "It always lets me down. When it breaks you have to go up quickly and the pain hits you," he says, as if pain is a normal part of going to work. The ship's captain tells me they don't bother getting better kit because the divers can't be trusted with it. "Sometimes we buy equipment in good condition for the divers, and when we return from the trip there's nothing left."

At the docks of La Ceiba, the coastal town 300 miles from the Mosquito Coast that is the centre of the lobster trade, a small diving boat is unloading $72,000 (£54,000) worth of lobster – an average haul from a 12-day trip. This is where the chaos and disorder of the lobster ships gives way to industrial precision and efficiency. The indigenous Miskito divers couldn't live further from this world.

It would be easy for the company to tell the wholesalers who buy their lobster whether it was caught in traps or by divers, but the plant manager tells me customers don't ask. "What they're more concerned about is the quality and the handling of the product," he says. "They want to be sure that the product will not harm whoever buys or consumes it."By the time the lobster reaches the processing plant, the harm it may cause to the person who produces it is long forgotten.

Few know the epidemic of decompression sickness better than Dr Elmer Mejia, a specialist in hyperbaric medicine who has dedicated his life to helping the Miskito divers. As long as the lobster season is running, his La Ceiba clinic is busy, sometimes with 10 or more patients taking turns inside his decompression chamber. Many arrive in a state of panic, incontinent, often completely paralysed. Only treatment in the chamber can save their lives.

I arrive at his clinic when Roque Francisco is horizontal on Dr Mejia's assessment table. This is the second time Roque has had the bends:10 years ago, he was paralysed from the neck down while diving for lobster, but recovered after several sessions in a decompression chamber, and immediately went back to diving. Dr Mejia says it is common for him to save the life of a patient several times. His job is rewarding and frustrating in equal measure.

"No one other than the Miskitos dive for lobster, all their young people are diving. The future of this ethnic group is being threatened," Dr Mejia says. "There's no difference between what is happening here and blood diamonds in Africa. People should be more responsible about what they buy."

Boycotting Caribbean lobster isn't the answer – the Miskitos rely on it for their survival – but if we ask basic questions about where our lobster comes from, then those who catch it would be more likely to have proper equipment, training and medical support. Until there's better regulation and more alternatives for the isolated people of the Mosquito Coast, Miskito men will continue to risk their lives to bring us affordable luxury.

Jenny Kleeman's film for Unreported World, Honduras: Diving into Danger, will be broadcast tomorrow at 7.30 on Channel 4. It can also be watched at channel4.com

Diving for lobsters

100 Number of men who man the average lobster ship.

£72,000 Value of a ship's haul after 12 days at sea.

$39.99 Price of a Caribbean lobster to US consumers.

4,200 Miskito men living with permanent disabilities due to diving accidents.