When the State and Your Kidneys Fail: Political Etiologies in an Egyptian Dialysis Ward

Abstract: In this article, I describe how poor Egyptian kidney‐disease patients understand and experience their illness in terms of Egypt's larger social, economic, and political ills. The suffering that patients in end‐stage renal failure endure, as they articulate it, extends beyond the pathological kidney and implicates corrupt institutions, polluted water, the mismanagement of toxic waste, and unsafe food. End‐stage kidney failure patients in Egypt depend on state‐provided medical services, which they deeply mistrust. In this context, they understand the breakdown of their kidneys, their dialysis machines, and their bodies as a direct outcome of the breakdown of the welfare state. I argue that patients' perceptions of their disease and their mistrust of medical treatment and state service provision should make us reconsider how all etiologies are political. Further, the “political etiologies” in this case inform ethical decisions about kidney transplantation and maintaining life on dialysis. [bioethics, the body, kidney disease, organ transplantation, state welfare, neoliberalism, Egypt]