Paper short abstract:

Through kidney failure, Yolŋu embody uncertain social geographies. Uncertainties about patients' trajectories are governed through discourses of medical risk and responsibility. Discourses shaping the distribution of dialysis services over space project moral value onto people, practices and places.

Paper long abstract:

Yolŋu embody uncertain social geographies through end stage kidney disease. Most Indigenous Australians with end stage kidney disease undertake life-sustaining dialysis treatment. In the Northern Territory, 80% of all people requiring dialysis become displaced from remote communities, relocating to urban centres to access treatment, the vast majority of whom are Indigenous.

In limited dialysis services in remote communities, patients receive highly technical treatment, hundreds of kilometres away from hospitals. Access to scarce services in remote communities amongst rapidly expanding numbers of patients and contention over the expansion of remote services have been mediated by contests over the risks and responsibilities of dialysis. Based on multi-sited ethnographic fieldwork with Yolŋu renal patients, health professionals and policymakers, I consider how uncertainties about the trajectories of patients' bodies and lives are governed through discourses of medical risk and responsibility; and how counter-discourses articulated by Yolŋu register the existential threats that urban dialysis and displacement present. I describe how multiple discourses seeking to shape the distribution of dialysis services over space project the moral value of a good life and a good death onto people, practices and places.