Abstract:
Chronic Kidney Disease with uncertain etiology (CKDu) has been a hazard in the
North Central Province and surrounding areas since the late 1990s and early 2000s.
Scientists from diverse disciplines have been attempting to identify the etiology of
CKDu but have not reached concrete conclusions. The objective of this paper is to
explore the health-seeking behaviour of CKDu patients and their illness-management
strategies at different stages of disease progression. An ethnographic study was
conducted in Madhawachchiya and Padaviya DS Divisions. The study sample
included 90 patients, caretakers, community leaders, and healthcare providers. Illness
narratives were collected using a phenomenological perspective. In-depth interviews,
focus group discussions, key-informant interviews, and observations were used for
data collection. Ninety percent of patients were diagnosed with CKDu when they
sought treatment for different disorders. Only 10% were diagnosed using screening
programmes. Health-seeking behaviour was scrutinized and was seen as a process of
illness response from a social behaviour perspective. Two interrelated trends have
been emerging. Patients have initiated their treatment process by attending CKDu
clinics. Simultaneously, a trend of exploring multiple therapeutic options as
complementary to biomedicine, where social networks play a key role in sharing
relevant information, was observed. Various healers are mushrooming in response to
the growing demand. Fifty percent of patients utilize Ayurvedic treatment when the
disease progresses. Narratives reveal that Ayurvedic treatment has an ability to
manage ill-health and improve the functional capacity of patients. No remarkable
disparities based on gender identity were found. The context demands a
complementary and integrated approach towards health service delivery. Policy must
be altered to make better use of alternative therapies to biomedicine in addressing
health hazards.
