Chronic Living, University of Copenhagen

In April I will give a paper at the Chronic Living conference organized at the University of Copenhagen. My paper is titled: “Imagined Timescales: Diabetes prevention as a driver of complications.”

Abstract: Across the Samoan islands, people are immersed in prevention discourses, so that most can recite these public health messages: eat less, exercise more. Yet, diabetes rates have continued to climb, as have complications, which are a leading cause of death and disability. This paper explores how clinicians imagine their patients living with complications in time to understand the limitations of prevention frameworks. Most Samoans I encountered did not associate clinically significant symptoms of diabetes with diabetes. Instead skin infections or neuropathy were considered Indigenous sicknesses that only Samoan people could develop, sometimes called ma’i Samoa (Samoan sickness). In turn, people would seek traditional healers. Clinicians suggested that this process, and traditional healers in particular, were the engine of rising complications that led to high rates lower limb amputation. This explores how clinicians imagine this scenario by situating those they care for in as living in a traditional, timeless present. By placing people living with complications in this particular timescale, they certainly obscure the social and economic drivers of diabetes. But, this paper suggests even further that the singular focus in diabetes interventions on prevention might help explain this scenario. The paper thus reflects on the consequences of a global obsession with prevention and considers how this might be a driver of complications—on the rise around the world as well.