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.
 

Organ transplant in Mexico is overwhelmingly a family matter, utterly dependent on kidneys from living relatives—not from stranger donors typical elsewhere. Yet Mexican transplant is also a public affair that is proudly performed primarily in state-run hospitals. In Domesticating Organ Transplant, Megan Crowley-Matoka examines the intimate dynamics and complex politics of kidney transplant, drawing on extensive fieldwork with patients, families, medical professionals, and government and religious leaders in Guadalajara. Weaving together haunting stories and sometimes surprising statistics culled from hundreds of transplant cases, she offers nuanced insight into the way iconic notions about mothers, miracles, and mestizos shape how some lives are saved and others are risked through transplantation. Crowley-Matoka argues that as familial donors render transplant culturally familiar, this fraught form of medicine is deeply enabled in Mexico by its domestication as both private matter of home and proud product of the nation. Analyzing the everyday effects of transplant’s own iconic power as an intervention that exemplifies medicine’s death-defying promise and commodifying perils, Crowley-Matoka illuminates how embodied experience, clinical practice, and national identity produce one another.

New Organs Within Us is a richly detailed and conceptually innovative ethnographic analysis of organ transplantation in Turkey. Drawing on the moving stories of kidney-transplant patients and physicians in Istanbul, Aslihan Sanal examines how imported biotechnologies are made meaningful and acceptable not only to patients and doctors, but also to the patients’ families and Turkish society more broadly. She argues that the psychological theory of object relations and the Turkish concept of benimseme—the process of accepting something foreign by making it one’s own—help to explain both the rituals that physicians perform to make organ transplantation viable in Turkey and the psychic transformations experienced by patients who suffer renal failure and undergo dialysis and organ transplantation. Soon after beginning dialysis, patients are told that transplantable kidneys are in short supply; they should look for an organ donor. Poorer patients add their names to the state-run organ share lists. Wealthier patients pay for organs and surgeries, often in foreign countries such as India, Russia, or Iraq. Sanal links Turkey’s expanding trade in illegal organs to patients’ desires to be free from dialysis machines, physicians’ qualms about declaring brain-death, and media-hyped rumors of a criminal organ mafia, as well as to the country’s political instability, the privatization of its hospitals, and its position as a hub in the global market for organs.