Chronic Failures: Kidneys, Regimes of Care, and the Mexican State
by Ciara Kierans
Rutgers University Press, 2020 eISBN: 978-0-8135-9668-6 | Paper: 978-0-8135-9664-8 | Cloth: 978-0-8135-9665-5 Library of Congress Classification RC918.R4 Dewey Decimal Classification 616.614
ABOUT THIS BOOK | AUTHOR BIOGRAPHY | REVIEWS | TOC
ABOUT THIS BOOK Chronic Failures: Kidneys, Regimes of Care and the Mexican State is about Chronic Kidney Disease (CKD) and the relentless search for renal care lived out in the context of poverty, inequality and uneven welfare arrangements. Based on ethnographic research conducted in the state of Jalisco, this book documents the routes uninsured Mexican patients take in order to access resource intensive biotechnical treatments, that is, different modes of dialysis and organ transplantation. It argues that these routes are normalized, bureaucratically, socially and epidemiologically, and turned into a locus for exploitation and profit. Without a coherent logic of healthcare access, negotiating regimes of renal care has catastrophic consequences for those with the least resources to expend in that effort. In carrying both the costs and the burden of care, the practices of patients without entitlement offer a critical vantage point on the interplay between the state, markets in healthcare and the sick body.
AUTHOR BIOGRAPHY Ciara Kierans is a reader in social anthropology in the Department of Public Health and Policy at the University of Liverpool in the United Kingdom. She is the coauthor of Social and Cultural Perspectives on Health, Technology and Medicine: Old Concepts, New Problems.
REVIEWS
“Chronic Failures unfolds a chilling account of the pathological regimes of renal care in Jalisco, Mexico, written in taut prose that is at once theoretically incisive and full of telling ethnographic texture. Moving deftly across the specific and entangled relations of bodies, markets, and state, this book brilliantly weaves together clinical paper-work and polluted lake water, pharmaceutical tianguis and charitable billionaires, media scandals and a mysterious new form of chronic kidney failure into a compelling indictment of the mirage of biomedical salvation. Kierans lays bare how sickness itself is made into a form of consuming labor – one that more often produces hardship and harm rather than health.”
— Megan Crowley-Matoka, author of Domesticating Organ Transplant: Familial Sacrifice and National Aspiration in Mexico
“Kierans offers an extraordinary portrait of the challenges underlying efforts to survive kidney failure in Mexico. 'Regimes of care' extend far beyond clinical interventions, incorporating (and insisting upon) the ongoing labors of kin, including the transport challenges of ongoing dialysis treatments, the oppressive cost of immunosuppressant drugs post-transplant, the limits of universal insurance and its bureaucratic burdens, and even the necessity of having a microwave at home. This beautifully written, thought-provoking work stands out as an important contribution to social scientists’ writings on the sociomedical dimensions of organ failure, healthcare disparities, and on the entanglement of suffering and hope.”
— Lesley A. Sharp, author of The Transplant Imaginary
TABLE OF CONTENTS
Cover
Series Page
Title Page
Copyright
Dedication
Contents
Foreword by Lenore Manderson
Prologue
Introduction: Encountering Regimes of Renal Car—The Crucible of Experience
1: Studying Regimes of Renal Care
2: Biopolitics and the Analytics of a Population on the Move
3: Labor: Producing Sickness and the State
4: Brokering Healthcare: Paper-work, Negotiation, and the Strategies of Navigation
5: Exchange: Bodies as Sites for the Production of (Surplus) Value
6: Transplant Scandals, the State, and the “Multiple Problematics” of Accountability
7: Political and Corporate Etiologies: Producing Disease Emergence and Disease Response
Chronic Failures: Kidneys, Regimes of Care, and the Mexican State
by Ciara Kierans
Rutgers University Press, 2020 eISBN: 978-0-8135-9668-6 Paper: 978-0-8135-9664-8 Cloth: 978-0-8135-9665-5
Chronic Failures: Kidneys, Regimes of Care and the Mexican State is about Chronic Kidney Disease (CKD) and the relentless search for renal care lived out in the context of poverty, inequality and uneven welfare arrangements. Based on ethnographic research conducted in the state of Jalisco, this book documents the routes uninsured Mexican patients take in order to access resource intensive biotechnical treatments, that is, different modes of dialysis and organ transplantation. It argues that these routes are normalized, bureaucratically, socially and epidemiologically, and turned into a locus for exploitation and profit. Without a coherent logic of healthcare access, negotiating regimes of renal care has catastrophic consequences for those with the least resources to expend in that effort. In carrying both the costs and the burden of care, the practices of patients without entitlement offer a critical vantage point on the interplay between the state, markets in healthcare and the sick body.
AUTHOR BIOGRAPHY Ciara Kierans is a reader in social anthropology in the Department of Public Health and Policy at the University of Liverpool in the United Kingdom. She is the coauthor of Social and Cultural Perspectives on Health, Technology and Medicine: Old Concepts, New Problems.
REVIEWS
“Chronic Failures unfolds a chilling account of the pathological regimes of renal care in Jalisco, Mexico, written in taut prose that is at once theoretically incisive and full of telling ethnographic texture. Moving deftly across the specific and entangled relations of bodies, markets, and state, this book brilliantly weaves together clinical paper-work and polluted lake water, pharmaceutical tianguis and charitable billionaires, media scandals and a mysterious new form of chronic kidney failure into a compelling indictment of the mirage of biomedical salvation. Kierans lays bare how sickness itself is made into a form of consuming labor – one that more often produces hardship and harm rather than health.”
— Megan Crowley-Matoka, author of Domesticating Organ Transplant: Familial Sacrifice and National Aspiration in Mexico
“Kierans offers an extraordinary portrait of the challenges underlying efforts to survive kidney failure in Mexico. 'Regimes of care' extend far beyond clinical interventions, incorporating (and insisting upon) the ongoing labors of kin, including the transport challenges of ongoing dialysis treatments, the oppressive cost of immunosuppressant drugs post-transplant, the limits of universal insurance and its bureaucratic burdens, and even the necessity of having a microwave at home. This beautifully written, thought-provoking work stands out as an important contribution to social scientists’ writings on the sociomedical dimensions of organ failure, healthcare disparities, and on the entanglement of suffering and hope.”
— Lesley A. Sharp, author of The Transplant Imaginary
TABLE OF CONTENTS
Cover
Series Page
Title Page
Copyright
Dedication
Contents
Foreword by Lenore Manderson
Prologue
Introduction: Encountering Regimes of Renal Car—The Crucible of Experience
1: Studying Regimes of Renal Care
2: Biopolitics and the Analytics of a Population on the Move
3: Labor: Producing Sickness and the State
4: Brokering Healthcare: Paper-work, Negotiation, and the Strategies of Navigation
5: Exchange: Bodies as Sites for the Production of (Surplus) Value
6: Transplant Scandals, the State, and the “Multiple Problematics” of Accountability
7: Political and Corporate Etiologies: Producing Disease Emergence and Disease Response
Epilogue
Notes
References
Index
About the Author
ABOUT THIS BOOK | AUTHOR BIOGRAPHY | REVIEWS | TOC