Now you see it, now you don’t: Tracing the shifting in/visibility of CKDu in Dry Zone Sri Lanka

Authors: Nari Senanayake*, Pennsylvania State University
Topics: Medical and Health Geography, Cultural and Political Ecology
Keywords: Kidney Disease, Uncertainty, Scale, STS, Dry zone Sri Lanka
Session Type: Paper
Day: 4/12/2018
Start / End Time: 8:00 AM / 9:40 AM
Room: Balcony M, Marriott, River Tower Elevators, 4th Floor
Presentation File: No File Uploaded


Chronic Kidney Disease of Unknown Etiology (CKDu) is a mystery illness that not only frustrates scientific attempts to explain its cause but also, evades clear-cut systems of biomedical classification. In fact, CKDu only exists as a distinct disease category by excluding known risk factors and known causes of kidney disease. Stated simply, it is an illness that it is defined by what it is not. Drawing from research in rural Sri Lanka, I examine three inter-related sites of knowledge production about this mystery illness: the laboratory, the clinic, and regional health statistics. In each of these settings, I analyze the instability of CKDu, illustrating how its status as a distinct category of disease shifts across space and scale. Additionally, I examine how uncertainty about this mystery illness is reconfigured through practices of clinical pragmatism in ways that profoundly shape opportunities for effective disease management. I discuss the implications of these findings for the discipline of geography, arguing geographers can enrich existing studies of uncertainty with their perspectives on scale, spatiality, place, and human-environment relations.

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