"We Know Where We Stand": Contesting and Constructing Knowledge in Nicaragua's Chronic Kidney Disease Epidemic

Sugarcane workers in northwestern Nicaragua are suffering from chronic kidney disease of non-traditional causes (CKDnt) at extremely high rates. In the small town of Chichigalpa alone, CKDnt causes 46% of male deaths (Kurzrok et al. 2013). This paper examines the CKD epidemic as a fundamentally structural problem, not merely a biological abnormality, because it is closely linked to labor exploitation, poverty, human rights violations, and historical context. Grounded in literature from medical anthropology and medical sociology and based on two months of ethnographic field research in northwestern Nicaragua, it analyzes how knowledge production interacts with scientific uncertainty about CKDs specific biomedical causes. It posits that scientific knowledge does not close controversy, but rather proliferates uncertainties, thereby forestalling the potential for rights claims. A strictly scientific understanding of CKD diffuses responsibility for addressing its structural causes, distracts from structural violence, and diverts attention away from the urgency of CKD deaths.

Name thesis:degree_name

Latin American Studies

Level thesis:degree_level

Thesis

Discipline thesis:degree_discipline

Latin American Studies

Year

2015

Author dc:creator

• Leister, Sarah

Contributors dc:contributor

• Smith, Lindsay
• Whooley, Owen
• Field, Les

• kidney disease
• sugarcane
• structural violence
• labor
• Nicaragua
• Central America
• medical anthropology
• knowledge

Language dc:language

English

Repository record dc:identifier

https://digitalrepository.unm.edu/ltam_etds/9

OAI identifier oai:identifier

oai:digitalrepository.unm.edu:ltam_etds-1008