272 C. Kierans
healthcare providers, pharmacists, lab technicians, psychologists, social
workers and many others besides.
To support this fragile, painstakingly built-up structure of care,
Gloria, with much help from family and friends living in Mexico and
the USA, invested great effort in raising funds. She had also appealed to
people in her neighbourhood as well as local businesses to help finan-
cially support Carlos. To provide further help, his father had begun beg-
ging on the streets of Guadalajara. Together, they ensured that every
avenue to acquire much needed funds was exhausted. A local TV chan-
nel, on hearing about their situation, agreed to fund the surgery as well
as mother and son’s pre-transplant protocols and tests, on the condi-
tion that Gloria and Carlos participate in a special interest programme
on organ transplantation. The TV channel would trace the progress of
donor and recipient. It would emphasise the debt of gratitude Carlos
felt towards his mother, the appreciation both mother and son had for
their medical team, not to mention their wish to give thanks to God
and, of course, the TV channel for financing and supporting the opera-
tion. When I left mother and son recuperating in their hospital beds,
I was made aware by the doctors of the all-too-real risk of losing the
kidney, particularly given their next challenge, which was to raise more
money to cover the costs of cyclosporine, the immunosuppressant that
Carlos would need to prevent his body from rejecting the new kidney.
The challenges faced by families like Carlos’s are all too common
for the increasing numbers of CKD patients who attempt to access
transplant medicine with no form of social insurance and few welfare
entitlements, despite very recent attempts at healthcare reform.^5 Their
situation speaks to much broader global problems: increasing economic
insecurity, the rising incidence of chronic disease and the entrench-
ment of commodified healthcare. As comparatively more stable welfare
systems are experiencing the erosion of social protections and entitle-
ments,^6 the Mexican case can provide lessons beyond its own national
setting, a point I will return to in the concluding part of this chapter.
Mexico is characterised by profound social and health inequalities,
divisions which have been amplified rather than ameliorated by ongo-
ing waves of political and economic reforms and the increased mar-
ketisation of health care. As a mixed corporatist/neoliberal welfare state