Imploding Dialysis

Hafsah Hachad, Janina Kehr, Maren Jeleff

OUR PROJECT

Haemodialysis is a medical technology that uses a machine to cleanse the blood outside the body of people with chronic kidney failure. It is estimated that there are 3–4 million haemodialysis patients worldwide. However, at least as many people would require dialysis treatment to survive, yet do not receive it.

Kidney health is particularly vulnerable to the effects of climate change. In the future, more and more people worldwide, especially in the Global South, will suffer from kidney failure due to heat, toxins and chronic diseases. However, due to its high energy, water and disposable material consumption, as well as the frequency of treatments, dialysis currently takes place primarily in strictly regulated, resource-rich contexts in the Global North. At the same time, it contributes to climate change worldwide due to its resource intensity. Three international companies currently dominate the global dialysis market, but their machines do not sufficiently consider the possibilities of recycling, reuse or application in contexts with limited resources.

In our interdisciplinary science-art project, we start from the technological object which is the hemodialysis machine to shed light on the paradoxes, inequalities and possibilities for changing healthcare in times of climate change and global injustice. We try to do so by interrogating the technological object in various settings and ‘imploding’ it materially and symbolically to reveal its diverse political, economic and social dimensions and global connections, ultimately in order to make them changeable.

We began photographing the machine in its habitual context, as it is usually imagined: a medical device and a powerful fetish that has the ability to extend life through the quasi-magical filtering of blood in a hospital. We then extracted a discarded machine from its clinical context, literally and physically deconstructing it in its functional units and individual parts with the help of a bioengineer, and documented the process photographically. The dismantling of the dialysis machine, and thus the opening of the technological ‘black box’ of dialysis, expands the ways technology and its powers can be conceptualized. Our aim is to encourage a critical and creative analysis of the imaginaries, power structures, material relations, and environmental effects the technical object embodies.

In current imaginaries of dialysis treatment in hospitals, the focus is oftentimes on the ‘here and now’, and the technological object as such is not interrogated. Analytical attention is therefore entirely absorbed by this limited spatiotemporal context of technologized treatments in the hospital. Imploding the physical object of the dialysis machine enables us to expand the space and time for reflection. It allows to multiply the scales of analysis, taking into account patients and ecosystems, the pragmatic and the conceptual, the medical and the political. Through this process, we aim to demonstrate that every component of the machine embodies not only medical aims, but also political, economic and environmental values. By imploding the machine, we thus intend to make the world contained within the technical object visible in all its material and symbolic complexity. Opening up the machine also means opening up the field of possibilities for alternative approaches.