Paper short abstract:

This paper reports on ethnographic research on the rise of kidney failure among Mexico’s poor and the problems associated with accessing renal replacement therapies and the complex political and economic context within which these services are organised.

Paper long abstract:

Mexico has seen major changes to the nation's public health, with rates of infectious diseases falling while chronic conditions such as Kidney Failure are rising rapidly. Access to health care, however, is characterised by widening inequalities, attributed, in part, to the complex structuring of health care in the country. This is administered by way of a social security system, with health insurance available to people employed by the state or who work for private corporations. The majority of the population (i.e., those living in poverty) have severely restricted access to renal services and are forced to continually appeal to wider family and social networks, both in Mexico and the US, to support payment for this resource-intensive condition. Drawing on ethnographic research of Mexico's most active transplant programme and current thinking in critical medical anthropology, this paper examines the delivery of and access to renal services by Mexico's uninsured. It focuses attention on state failure, neo-liberalism and the increasing fragmentation and politically-driven delivery of renal replacement services.