This paper examines how chronic kidney disease patients in Southern Thailand learn to live with dialysis technology. During my 10-month fieldwork with 11 patients and 10 family members at Phatthalung Hospital (November 2021-August 2022), I found that health literacy isn't just about learning medical facts—it's about making foreign technology meaningful within patients' own cultural world.
Three things surprised me. First, no one uses the medical term "dialysis" (ฟอกไต). Everyone says "washing kidneys" (ล้างไต) instead, turning a scary medical procedure into something as ordinary as doing laundry. This linguistic shift reduces fear and increases treatment adherence by making complex biomedical processes comprehensible within patients' existing cognitive frameworks. Second, I watched patients perform wai—the traditional Thai greeting—to dialysis machines before each treatment, and many consulted traditional healers alongside their doctors. These weren't acts of ignorance; they were smart strategies for making sense of technology that felt foreign. Third, patients taught each other through storytelling, creating their own education network that shared knowledge doctors never mentioned.
I call this "Cyborg Gratitude" (ความกตัญญูไซบอร์ก)—extending traditional Thai practices of respect and gratitude to medical machines. This challenges the usual assumption that patients simply lack information. Instead, they're creating sophisticated hybrid systems that blend medical treatment with cultural meaning.
This matters for health education and development work. If we want technology transfer to succeed, we can't ignore how people actually learn. We need programs that work with local knowledge systems, not against them.

Authors:
Worachet Khieochan, Mahidol University, Thailand
Penchan Pradubmook Sherer, Mahidol University, Thailand
Pimpawun Boonmongkon, Mahidol University, Thailand
Patreeya Kitcharoen, Mahidol University, Thailand

About the Presenter(s)
Worachet Khieochan, PhD Candidate in Medical and Public Health Social Sciences at Mahidol University, Thailand. Research interests: medical anthropology, cyborg studies, cultural embedding of technology, hemodialysis experiences in Southern Thailand.

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