Towards a feminist political ecology of health: Mystery kidney disease and the co-production of social, environmental, and bodily difference

Abstract

This article argues for a more rigorous engagement with intersectionality within political ecologies of health. Building on the work of feminist scholars who explore the co-production of social and ecological differences, I examine how health improvement schemes that target practices of natural resource use concentrate value (economic and ecological) and health dividends in particular bodies at the expense of others. As part of this intervention, I draw on long-term and ongoing ethnographic research in north-central Sri Lanka. This region is an endemic zone for a mysterious and deadly form of kidney disease (CKDu) as well as the site of frenzied health improvement intervention. Specifically, and in response to scientific studies that link kidney disease to agrochemical use and drinking water, an increasingly diverse range of actors, from different branches of the state apparatus to private industries and civil society organizations, have invested heavily in reconfiguring the region’s water supply infrastructure and agrarian landscapes. Through an analysis of resident testimonies, I demonstrate that the burden of subsidizing these new “healthful” practices of water provision and agricultural production is unevenly experienced, as are residents’ abilities to adopt and maintain them over time and space. More crucially, I illustrate how schemes designed to heal turn on the production of differentiated harms, including new gendered labor burdens for poor women, and intensified agrochemical use for ecologically and economically resource-poor farmers. Developing these narratives toward a feminist political ecology of health, I demonstrate how social, ecological, and bodily differences intersect to constitute new patterns of health and harm in the dry zone. I conclude by reflecting on how this approach can explain the paradoxical effects of well-intentioned disease mitigation strategies.