278 C. Kierans
critical instance of the infusion of life by politics (Arendt 1958 ), which,
when harnessed to the interests of others, can do little more than fuel a
downward spiral of catastrophic impoverishment and further incapaci-
tation.
The Mexican case shows what happens when resource-intensive “bio-
technological solutions” are progressively dis-embedded from a wider
social infrastructure of welfare, entitlement and rights (Esping-Anderson
1990 ; Polayni 1944 ). Transplant medicine is not only left to the vagar-
ies of new markets in health care, but also to the ad hoc and fleeting
encounters that patients and their families must exploit in order to tem-
porarily link together a complex of treatments therapies, trials and tests.
The organisational difficulties which follow the profound lack of a
healthcare infrastructure are routinely pointed out by Mexican health
professionals as a way of marking out what they feel to be the radical
differences between health care in Mexico and countries such as the
UK, where I live and work. Hospital doctors, to illustrate, would go out
of their way to show me how bad things were in Mexico. They would
declare that no transplant programme could possibly be initiated in the
UK without appropriate funding, whereas in Mexico, they start in the
hope that money will be found as times goes on. While it is difficult to
argue with their assessment at one level, such sharply drawn national
comparisons have the unfortunate effect of making invisible elsewhere
what was dramatically and continually in relief for the Mexican medi-
cal staff: a political economy of health care, experienced in and through
a lack of adequate resources, falling levels of medically trained person-
nel, inadequate numbers of hospital beds, poor medical equipment,
insufficient varieties of drugs or stocks of blood, weak administrative
infrastructures, poorly coordinated strategies for health promotion and
health education, and many other things besides. Transplant medicine
in the UK was assumed to function in such a way that it broadly fit to
demand, resources and general service expectations. That much of the
above is present in the UK too suggests a more complex comparative
account is needed.