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

这个项目调查了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疾病（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，他们没有与肾脏疾病典型相关的危险因素。虽然CKDu的确切病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，尽管以不均匀，偶然和知之甚少的方式。该项目以健康和科学技术研究（STS）的政治生态学为基础，调查CKDu病因的不确定性如何影响健康-环境相互作用、农业景观和生计。在此过程中，它将解释农民对农业健康风险的认知和行动的复杂方式，同时阐明对环境疾病的有争议的理解如何从根本上重构农业实践、生产系统和专业知识关系。通过这种分析，拟议的研究将直接有助于制定政策和计划，以促进疾病背景下的农业生计。自从20世纪90年代初出现了一种新型慢性肾脏疾病（CKDu）的第一批报告以来，斯里兰卡曾经的边缘干旱地区已经成为一种流行病的中心，这种流行病正在慢慢削弱岛上整个水稻带的农业社区。拟议的项目侧重于CKDu与农业实践之间关系的三个维度，以解释这种科学上有争议的疾病如何被改造成农业问题，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的联系的想法是如何形成、加强和传播的。其次，它评估了农民的种植方式如何因CKDu问题而发生变化，并记录了他们向本地水稻品种和有机或无化学物质生产系统的转变，尽管这种转变在空间上是不均匀的，有时是暂时的。此外，本研究还调查了CKDu病因的不确定性如何介导农民与环境的相互作用，并形成了采用本地种子作为疾病管理策略的不均匀性。最后，该项目考察了干旱地区健康与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了信息。该项目将档案研究、人种学方法和家庭调查结合起来，研究两个干旱地区的农业社区。这项研究的结果将为有争议的农业-环境-健康问题如何影响疾病管理的实践并产生新的农业生产形式提供见解。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其他地理区域，如印度、埃及和中美洲等农业社区发现类似的神秘肾病流行。

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.