Chronic Failures

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.

“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) "the book is sensitive to multiple theoretical lenses that unpack the rich ethnographic details in the local complex settings. It is a must-read for those interested in medical anthropology, clinical nephrology, science and technology studies, global health, and biomedical ethics as it shows how organ transplantation, a 'miracle' medicine of the twentieth century, actually exploits the poor." (Medical Anthropology Quarterly)

• Foreword by Lenore MandersonPrologueIntroductionEncountering Regimes of Renal Care: The Crucible of Experience                                    Chapter One               Studying Regimes of Renal CareChapter Two              Biopolitics and the Analytics of a Population on the Move                                                  Chapter Three            Labor: Producing Sickness and the State                                                                              Chapter Four              Brokering Healthcare: Paper-work, Negotiation and the Strategies of Navigation              Chapter Five              Exchange: Bodies as Sites for the Production of (Surplus) Value                                        Chapter Six                Transplant Scandals, the State and the ‘Multiple Problematics’ of Accountability              Chapter Seven            Political and Corporate Etiologies: Producing Disease Emergence and Disease ResponseEpilogue                                                                                                                                 References