Doctoral Dissertation Research: Chronic Kidney Disease, Environmental Risk and the Transformation of Agrarian Landscapes and Livelihoods

该项目研究环境疾病如何重新配置健康，知识和农业现代化之间的关系。近年来，一种神秘而严重的慢性肾脏病（CKDu）在世界各地的几个农业社区出现。受影响的主要是年轻和中年男性农业工人，他们没有患上通常与肾脏疾病相关的风险因素。虽然CKDu的确切原因仍然是科学不确定性的来源，但将疾病与农业景观联系起来的叙述已经吸引了大众的想象力，并影响了农民的种植实践，尽管是以不均匀，随意和知之甚少的方式。该项目建立在健康和科学技术研究（STS）的政治生态学的基础上，调查CKDu的原因的不确定性如何塑造健康-环境的相互作用和农业景观和生计。在这样做的过程中，它将说明农民对农业健康风险的看法和行动的复杂方式，同时阐明对环境疾病的有争议的理解如何从根本上重组农业实践，生产系统和专业知识关系。通过这项分析，拟议的研究将直接有助于制定政策和方案，促进疾病背景下的农业生计。自20世纪90年代初首次报道出现一种新形式的慢性肾脏病（CKDu）以来，斯里兰卡曾经的外围干燥区已成为一种流行病的中心，这种流行病正在慢慢削弱整个岛屿水稻带的农业社区。拟议的项目侧重于CKDu和农业实践之间关系的三个方面，以解释这种有科学争议的疾病是如何被改造成一个农业问题，以及产生了什么影响。首先，该项目调查了关于环境及其与疾病联系的想法是如何形成，加强和传播的。第二，它评估了农民的耕作方法如何因CKDu问题而改变，并记录了他们向本地水稻品种以及向有机或无化学品生产系统的转变，尽管这种转变在空间上是不均衡的，有时是暂时的。此外，本研究还调查了CKDu原因的不确定性如何介导农民与环境的相互作用，并形成了不均衡的采用本地种子作为疾病管理策略。最后，该项目研究了干旱地区的健康和农业现代化之间的关系如何随着时间的推移而变化，并为应对CKDu的当代农业转变提供信息。该项目综合了档案研究、人种学方法和家庭调查，以研究两个干旱地区的农业社区。这项研究的结果将提供有争议的农业环境卫生问题如何塑造疾病管理的做法，并产生新的农业生产形式的见解。虽然这项研究是基于对斯里兰卡CKDu流行地区农业生计变化的分析，但其研究结果将适用于在印度，埃及和中美洲等农业社区发现神秘肾脏病平行流行的其他地理区域。

This project investigates how environmental illnesses reconfigure the relationships between health, knowledge, and agricultural modernization. In recent years a mysterious and severe form of Chronic Kidney Disease (CKDu) has emerged in several agricultural communities around the world. Those affected are predominantly young and middle aged male agricultural workers who do not suffer from the risk factors typically associated with kidney disease. While the exact cause of CKDu is still a source of scientific uncertainty, narratives that link the disease to the agrarian landscape have captivated popular imagination and influence farmers' cultivation practices, albeit in uneven, haphazard, and poorly understood ways. This project builds upon political ecology of health and science and technology studies (STS) to investigate how uncertainty about the cause of CKDu shapes health-environment interactions and agrarian landscapes and livelihoods. In doing so, it will account for the complex ways that farmers perceive and act on agricultural health risks while illuminating how contested understandings of environmental illnesses can fundamentally restructure agricultural practices, systems of production, and relations of expertise. Through this analysis, the proposed research will contribute directly to the development of policies and programs that facilitate agrarian livelihoods in the context of disease. Since the first reports of the emergence of a new form of Chronic Kidney Disease (CKDu) in the early 1990s, Sri Lanka's once peripheral dry zone has become the epicenter of an epidemic that is slowly crippling agricultural communities across the island's rice belt. The proposed project focuses on three dimensions of the relationship between CKDu and agricultural practices to explain how this scientifically contested illness is remade into an agricultural problem, and with what effects. First, the project investigates how ideas about the environment and its links to disease are formed, reinforced, and circulated. Second, it evaluates how farmers' cultivation practices are changing in response to the problem of CKDu and documents their shifts to native rice varieties and also to organic - or chemical free - systems of production, albeit in spatially uneven and sometimes transitory ways. Additionally, this study investigates how uncertainty about CKDu's cause mediates farmers' interactions with the environment and shapes the uneven adoption of native seeds as disease management strategies. Finally, the project examines how relationships between health and agricultural modernization in the dry zone have changed over time and inform contemporary agrarian shifts in response to CKDu. The project integrates archival research, ethnographic methods, and household surveys to study two dry zone farming communities. Findings of this research will provide insights into how contested agri-environmental-health problems shape practices of disease management and give rise to new forms of agricultural production. While this research is anchored in an analysis of shifting agrarian livelihoods in CKDu endemic areas of Sri Lanka, its findings will be applicable to other geographic regions where parallel epidemics of mystery kidney disease are found in agricultural communities such as India, Egypt, and Central America.