Traveling with Sugar. Amy Moran-Thomas

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      Galega officinalis, the plant source that became the blockbuster diabetes drug metformin, at the Kew in London.

      Looking back at these families’ survivance⁵¹ with diabetes unfolds the small moments that make up this epidemic—allowing a chance to pause and reflect on how these realities came to be, and to try learning from the moments of remaking and recovery already underway. Their struggles bring to life Mintz’s argument that the point of drawing out social histories of sugar is to remind each other that “there is nothing natural or inevitable about these processes.”⁵² In contrast to how bleak many global projections can make the situation feel, the Belizeans profiled in this book taught me to approach the rise of epidemic diabetes not as a settled past or an inevitable global future—but instead (as an anthropologist once wrote of co-envisioned struggles elsewhere) more like “a story we are all writing together, however we appear before one another—ready, set, go.”⁵³

Past Is Prologue

       Sugar Machine

      Told me to keep my eyes open for the white man named Diabetes who is out there somewhere carrying her legs in red biohazard bags tucked under his arms.

      —Natalie Diaz, “A Woman with No Legs”

      Sugarcane sprouted bright green along the dirt road where I was looking for Sarah’s house. Some patches were cultivated by people; but other stalks grew wild in ditches of their own accord, hybrids strayed from forgotten stocks. When colonial botanists collected cane specimens, they often noted which stands had “escaped” from nearby plantations. Sugar only needs to be planted once; then it can keep reproducing, unless interrupted.

      Media headlines about diabetes always seem to show bodies getting bigger, but the stories I heard in this stretch of Caribbean Central America more often focused on fears of getting smaller. If you sat and talked with people, missing body parts were often central to how they told stories and measured time. Some felt phantom pains or dreamt at night about running. Others, like Mr. P, watched with dread as it happened in their families or heard about beloved elders lost piece by piece. Nurses said that feet bitten by venomous snakes were easier to heal than those poisoned by sugar.

      In Belize, this common name for diabetes traveled across languages: súgara in Garifuna, shuga in Belizean Kriol, azúcar in Spanish, kiha kiik in Kekchi Maya, or ch’uhuk k’iik (sweet blood) in Mopan and Yucatec Maya.¹ Some people described the dismemberments as a quietly surreal spectacle their families were already living with amid a lack of public acknowledgment: “They cut my grandmother down to a lone torso.” Others spoke of dying in small pieces, like “my arm died that time” or “her eyes died first.” A Garifuna spiritualist with diabetes told me of the new addition to her ancestral prayers—protection for “Feet, legs, toes, hands, fingers, arms, eyes. Amen.” When a Maya seamstress walked into a mobile clinic without realizing there was an embroidery needle sticking out of her numb foot, the visiting physician knew that she likely had diabetes before the two ever exchanged a word.

      SWEETNESS

      Sweet foot—a limb macerated due to diabetic injuries—is common enough that you can find the term alongside other diabetes vocabulary in the Belize Kriol dictionary:

      sweet fut n. abscessed foot due to diabetes. Sayk a weh Misa Jan ga shuga, ih gi ahn sweet fut. Because Mr. John has diabetes, it gave him an abscessed foot.

      sweet blod phr. 1) sweet personality. Raja eezi fi laik kaa ih ga sweet blod. Roger is easy to like because he has a sweet personality. 2) diabetes. Dakta seh Ah hafu kot dong pahn shuga kaa Ah ga sweet blod. The doctor says I have to cut down on sugar because I have diabetes. See: shuga.

      shuga n. 1) sugar. Bileez sen lat a shuga owtsaid. Belize sells a lot of sugar overseas. See: kayn. 2) diabetes. Dakta tes mi ma blod an ih seh ih mi ga shuga. The doctor tested my mom’s blood and said that she had diabetes. See: sweet blod.²

      Sweet feet I heard said when it happened on both sides, which had become Sarah’s predicament some seven years before we met. In the Stann Creek District of Belize where she lived, an estimated one in four people (and one in three women) lived with type 2 diabetes,³ and some five out of six amputations were due to sugar’s complications.⁴ Certain images sounded straight out of a war story, like when the hospital’s incinerator broke down once and everything had to be buried. But at the same time, it almost felt like nothing had happened.

      The home that Sarah invited me to visit again felt comforting and bright. Its paint flaked into pretty layers, like sycamore bark. The rooms smelled of coconut rice and fresh laundry. I never saw her play the tambourine, but its open crescent hung on a nail next to a mosquito net she had improvised from a bedsheet to prevent insect bites. (She developed this strategy after once hosting a botfly in her knee, which took almost a year to heal because of high blood sugar’s complications). “My treasure chest,” Sarah joked of the container she showed me. Amid the cozy jumble of a lived-in room, her glass box of diabetes technologies looked like a tiny museum case. Among bottles of pills and other archived medical treatments, it held a broken blue and gray blood glucose meter.

      “I just don’t know what caused it,” Sarah said of her sugar, which was what she called the condition she had been living with since 1978. She had always been slender in build, like many people I met who defied any easy conflation of diabetes with obesity. When her first foot started going bad, she said, it had started with a corn on one toe. It had just gotten “miscarried away.” Miscarriages also figured centrally in women’s stories about the effects of untreated sugar, and mortality during pregnancy for both mother and child is another diabetes phenomenon that is likely widespread globally (though reliable statistics are hard to locate).⁵ Sarah’s sister living with uncontrolled diabetes had been somewhere among these uncounted women, dying along with her baby during childbirth.

      Sarah fondly recalled the Kriol midwife, Mrs. D, who used to go door to door to visit those she knew were sick. “Every house. She would walk.” She used to bathe and bandage Sarah’s ulcers to prevent infection. After Mrs. D died of cancer, the centralized health system was never able to replace her day-to-day care work in the village—part of a bigger story about homecare visits growing less frequent across Belize as old midwives СКАЧАТЬ