“We are the living dead,” or; the precarious stabilization of liminal life in the presence of CKDu

Authors: Nari Senanayake*, University of Kentucky
Topics: Health and Medical, Qualitative Methods, Cultural and Political Ecology
Keywords: Slow death, mystery kidney disease, liminality, dry zone Sri Lanka, health geography
Session Type: Virtual Paper
Day: 4/9/2021
Start / End Time: 1:30 PM / 2:45 PM
Room: Virtual 39
Presentation File: No File Uploaded


This paper examines how residents in Sri Lanka’s dry zone traverse the boundaries between life and death in the shadow of a mysterious and deadly form of kidney disease (CKDu). Based on long-term ethnographic research, I investigate how everyday encounters with kidney disease treatment generate distinct space-times of liminality, or ‘death in life.’ As part of this analysis, I first document how treatment intervals are stretched to extreme limits in contexts where resources and medical equipment are limited. Specifically, by rationing hemodialysis therapy in an attempt to accommodate the growing demand for this treatment, local medical practitioners distend necessary dialysis cycles from two to four days. Drawing on patient testimonies, I demonstrate how this experience of hemodialysis is embodied as a particularly agonizing and debilitating zombie-like-state. Next, I describe attempts to enact sterile home environments, or ‘bubbles,’ to accommodate diseased bodies and how these efforts run up against conditions of extreme poverty. I profile stories of life in the bubble and illustrate how it has come to represent a diminished form of existence, where health is temporarily prolonged but always at risk of destabilization. Across these encounters, I argue residents’ experiences of ‘care’ provide important points of entry for troubling dichotomous categorizations of life and death and bodies and environments.

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