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Paper short abstract

Drawing on ethnography with CKDu patients in rural Andhra Pradesh, this paper shows how care poverty is lived, with people shifting between caregiver and care-receiver roles, and women bearing disproportionate physical, emotional, and economic burdens across households and communities.

Paper long abstract

Care poverty is not only about the absence of services but about how people experience and navigate unmet care in daily life. In this paper, I examine care poverty ethnographically, drawing on long-term fieldwork with people living with Chronic Kidney Disease of Unknown Aetiology (CKDu) in the Uddanam region of Andhra Pradesh. I focus on how chronic illness, social expectations, and fragile healthcare infrastructures intersect to shape who receives care, who provides it, and how it is negotiated within households and communities.

CKDu’s unknown aetiology and insidious onset mean the disease is often detected only at advanced stages, producing persistent uncertainty and repeated engagements with biomedical institutions that rarely yield clear answers. In prolonged engagements, illness and diagnosis blur, and care emerges not as a discrete service but as continuous, relational labour, echoing Alex Nading’s work on chronicity and embodiment.

Through in-depth conversations, repeated encounters, and participant observation, I trace how unmet care needs are woven into everyday rhythms: journeys to distant hospitals, patching together medicines, recalibrating work and rest, and tending to bodies that refuse linear progression. Care is emergent, negotiated, and embedded in moral worlds, resonating with ethnographies of care (Buch, Mol, Ticktin).

Rather than treating caregiver and care-receiver, formal and informal care, or objective and subjective needs as fixed, this paper shows how people move fluidly between these positions as they ‘get by’ with CKDu, with caregiving falling primarily on women, whose exhaustion, strain, and precarity are continually negotiated across households and social networks.