Bio-media Citizenship and Chronic Kidney Disease of Unknown Etiology in Sri Lanka

ABSTRACT

In this article, I examine the crucial role of the biomedical industry, epidemiological and biomedical research, and the media in forming attitudes to and the understanding of chronic kidney disease of unknown etiology (CKDu) in Sri Lanka. Local conceptions of CKDu have been shaped by the circulation in the media of epidemiological research findings pertaining to the disease, biomedical interventions in the management of the disease in hospitals and clinics, community programs involving mass blood surveys and the testing of well water, and local food and health education programs carried out through village health committees. This process of circulation I identify as bio-media citizenship.

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KEYWORDS:

• Sri Lanka
• bio-media citizenship
• CKDu
• medicalization

Acknowledgments

I thank Gayan Samarasinghe, Theja Kumari Wijebandara, D. P. Shirani and Nirosha Lakmali for collecting field data. The insightful comments and suggestions made by the anonymous reviewers are acknowledged with appreciation. A special note of thanks goes to Dr. Prasannajit de Silva for reading the final version of the article and making many suggestions to improve its quality.

Funding

The fieldwork that led to this article was self-funded.

Notes

1. Communicated by Dr. Tilak Abeysekera, Consultant Nephrologist.

2. How people would know that they are affected by the disease was discussed at length in these programs. Fatigue, panting, lack of appetite, nausea, muscle cramps, pale appearance and weariness, profuse sweating, waking and passing urine at night, painful or difficult urination, white discharge, pains in joints, abnormal physical weakness or lack of energy, muscle contractions while asleep, and gradual reduction in hearing ability are all considered as symptoms of the disease. According to Public Health Inspectors and knowledgeable respondents, most symptoms begin to appear in the early stages of CKDu [CKDu stage 1 and 2]. If people are found with several symptoms, they are either asked to attend the clinic at the hospital or directed to the hospital by the PHI. Seroprevalence surveys carried out every two years help to identify people with CKDu even before the symptoms appear, as PHIs told me. Such people identified as “CKDu positives” are advised and directed to the hospital for treatment by the PHI who visits their homes.

3. http://news.monsanto.com/press-release/research-and-development/monsanto-reinforces-decades-data-and-regulatory-review-clearl.

Additional information

Funding

The fieldwork that led to this article was self-funded.

Notes on contributors

M. W. Amarasiri de Silva

M. W. Amarasiri de Silva, PhD, is an adjunct professor at the University of Pittsburgh, USA. He was formerly senior professor of Sociology at the University of Peradeniya, Sri Lanka. He is currently conducting research on chronic kidney disease of unknown etiology.