A Durham labor leader is closing in on 40 days without solid food, having lost 35 pounds since he began a hunger strike against Amazon, all in protest of what he alleges are company policies that delay emergency medical response for warehouse workers. Italo Medelius-Marsano, 32, says he will reach the 40-day mark next week despite doctors urging him to stop.
Medelius-Marsano launched the hunger strike against Amazon, consuming only water for 31 days before his weight loss was documented, according to The News & Observer. He is a leading figure in Carolina Amazonians United for Solidarity and Empowerment, known as CAUSE, and his protest centers on a demand that Amazon end what he describes as an inhumane policy discouraging workers from calling 911 during emergencies. He is also pushing for town hall meetings at Amazon warehouses and negotiations with the Amazon Labor Union.
“Nobody should go to work and not return home to their family,” Medelius-Marsano said, describing the stakes of his campaign in stark terms. He has also described feeling light-headed himself while doing heavy lifting and forklift work on the job, a detail that underscores the physical demands he says Amazon warehouse workers face daily.
Allegations of Delayed Emergency Response
CAUSE has cited a specific case in March in which a worker collapsed on the floor, with the group alleging that Amazon wellness staff took more than 30 minutes to arrive. Per CAUSE, Amazon managers did not call 911 after the worker collapsed, and the worker was later sent home and died the next day, according to the group's account. Amazon has disputed having any policy that discourages workers from calling 911 and maintains it encourages employees to call 911 or alert management during emergencies.
Medelius-Marsano has also claimed that Amazon's in-house medical team does not include doctors, part of his broader argument that the company's internal AmCare system is inadequate for serious medical crises. Separately, workers at an Amazon facility in Oregon were reportedly told to work around a deceased worker's body, according to employees quoted by news outlets this year. Amazon has disputed those accounts of the Oregon employee's death, saying CPR-trained team members treated the worker until EMS arrived.
Federal regulators have taken an interest in these kinds of claims before. The U.S. Department of Labor's Occupational Safety and Health Administration cited Amazon in April 2023 for failing to provide proper medical treatment to injured employees at a New York facility, following earlier warning letters in 2016 and 2023 about deficient AmCare clinic practices, according to the U.S. Department of Labor. Separately, the U.S. Senate Committee on Health, Education, Labor, and Pensions launched an investigation in June 2023, led by Sen. Bernie Sanders, into Amazon warehouse health and safety standards and delayed medical care, as reported by In These Times.
A Labor Attorney With Deep Local Roots
Medelius-Marsano is not simply a warehouse employee turned protester. He serves as Secretary of CAUSE and General Counsel for the North Carolina Tenants Union, and in June 2026 the Durham City Council reappointed him to the Durham Workers' Rights Commission through 2028, an advisory body that counsels local government on labor standards and worker protections. He moved to North Carolina from Peru as a child, worked in agricultural fields as a teenager, and later served as N.C. state chair of the Justice For All party in 2024 and vice-chair of the Durham Mayor's Hispanic/Latino Committee during the COVID-19 pandemic, according to WFAE.
That civic standing gives his hunger strike added political weight in Durham, where CAUSE has been expanding its organizing push. The group's campaign has moved beyond Garner into Durham, targeting four smaller Amazon facilities including the roughly 1,000-employee RDU5 warehouse on National Way, as Payday Report detailed in November 2025. Organizers argued that smaller sites could foster stronger cross-facility worker solidarity than the massive Garner hub.
An Uphill Fight After a Lopsided Election Loss
CAUSE's push comes after a stinging defeat. In February 2025, workers at Amazon's 2-million-square-foot RDU1 fulfillment center in Garner rejected union representation by a vote of 2,447 to 829, with roughly 76% of the 4,300 eligible workers participating, according to INDY Week. Amazon workers at the Garner fulfillment center voted overwhelmingly not to unionize, but CAUSE challenged the results with the National Labor Relations Board, alleging corporate anti-union coercion, and Amazon reportedly engaged in heavy-handed anti-union tactics before the election, per a CNBC report. CAUSE has vowed to continue its organizing effort regardless of the outcome.
Medelius-Marsano has said Amazon workers cannot escape anti-union propaganda or surveillance on the job, pointing to company offerings like birthday round tables, gemba meetings and the VOA board as examples of an open-door approach he considers insufficient. Amazon maintains it has an open-door policy and that its leaders are available to listen to employee issues and concerns. The company continues to contest the results of the 2022 Staten Island election in which Amazon Labor Union workers voted to unionize, a dispute it has not dropped even years later.
The broader numbers illustrate why organizing in North Carolina is such a steep climb. The state recorded a 2.4% union density rate among wage and salary workers in 2024, tying South Dakota and South Carolina for the lowest in the nation, according to The National Law Review, even as private-sector union density nationwide dropped to 5.9%. Associates at the Garner warehouse can walk up to 25 miles during a single shift, earning starting wages between $18.50 and $23.80 an hour — double the state's $7.25 minimum wage but still below Wake County's calculated living wage for single adults.
What Comes Next
Medelius-Marsano has said his body is weak but his spirit is strong, and he intends to continue the hunger strike despite doctors' urgings as he approaches the 40-day threshold. The National Institutes of Health has reported that humans can survive roughly two months without food, though prolonged fasting carries serious health risks. It remains unresolved whether federal labor regulators will rule on CAUSE's pending election challenge, and how Durham officials will respond as the union's organizing push continues to expand across the city's Amazon facilities.
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