Stefanie Puszka
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Accommodating care through strategic ignorance
The ambiguities of kidney disease amongst Yolŋu renal patients in Australia’s Northern Territory
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Chronic diseases such as kidney disease and the way they are governed can lead to uncertain bodily states, social conditions and temporalities of life. Yolŋu, an Australian Indigenous people, are afflicted by an epidemic of kidney disease. Through ethnographic research with Yolŋu patients and public health actors, the chapter considers how the uncertainties of kidney disease are mobilised and politicised in attempts to shape the governance of renal services. Drawing on F.G. Bailey, the chapter explores the conflicts and contradictions that arise within biomedicine and its intersection with Yolŋu practices of kinship and health, and how they are navigated and exploited by patients and in healthcare systems. The chapter argues that medical risk technologies do not necessarily lead to bodily certainty, and can institutionalise ambiguity by transforming social and temporal dimensions of health. The chapter shows that practices of strategic ignorance amongst some public health actors, and relations of care and alliance between patients and health professionals, offer an alternative means to governing health through the ambiguities of kidney disease and dialysis treatment. These moves do not seek to resolve underlying tensions and contradictions in renal patients’ health and care, enabling epistemic openness and moments of alliance between Yolŋu and public health objectives.

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