11 Valued Matter: Anthropological Insights ... 271What follows in this chapter is heavily indebted to contemporary
work in the anthropology of transplantation as well as to a broader lit-
erature within and beyond anthropology on ideas of value. Drawing on
Marx and Arendt, I argue that the production of value—in this particu-
lar case, “surplus value”—is created as bodies and organs are worked on
by public, para-public and private agents and agencies in preparation
for transplantation. In the section which follows, I open with a vignette
which provides the reader with an introduction to the circumstances
poor, uninsured Mexican patients face when they discover they need a
new kidney.
Living-Related Organ Donation: Access Without
Entitlement
In a small two-bed isolation ward, in a Mexican public hospital, Carlos
lay on top of his bed, watching a small portable TV. His small, thin
child-like frame belied his 20 years of age. 15 of these years had been
marked by progressively worsening kidney disease, the last three of
which spent moving back and forward between forms of peritoneal^3
and haemodialysis treatments,^4 which he experienced across two pub-
lic hospitals, three private clinics and in his own home. On this par-
ticular day, he was recovering from long-awaited transplant surgery. His
mother and organ donor, Gloria, was resting in another ward, a floor
below. Both were relaxed and in good spirts. Their doctors stressed
that Carlos and Gloria were typical of the type of family they treated
at the public hospital, meaning they were poor and on the margins of
Mexico’s complex healthcare and social insurance systems. As a con-
sequence, they were faced with the necessity of financing not only the
transplant surgery, but the litany of tests, required drugs, modalities of
dialysis, all manner of associated equipment (biopsy needless, surgical
thread, catheters, dialysate solution), various forms of medical care and
hospital stays, necessary for preparing for an organ transplant. The care
they were receiving at this public hospital was an outcome of years of
negotiation with all manner of health professionals, public and private
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