The Everyday Politics of Risk: Managing Diabetes in Fiji

ABSTRACT

In this article, I investigate how diabetes-related risks are experienced and managed in Fiji. Neoliberal discourses implore patients to be risk-averse and blame poorer Indigenous (iTaukei) people with diabetes for “irresponsible” treatment choices and medication “noncompliance.” Drawing on ethnographic fieldwork conducted during 2015–16, I suggest lower-income iTaukei people with diabetes face multiple layers of risk in everyday life beyond biomedical definitions, including spiritual threats; cultural politics; and limited healthcare access. People with diabetes pragmatically weigh up these risks when choosing whether to seek treatment, be it biomedical, faith-based, pharmaceutical, or herbal remedies. Better understanding how patients experience and manage risk will improve diabetes care.

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KEYWORDS:

• Diabetes
• treatment-seeking
• medication compliance
• Fiji
• risk
• uncertainty

Acknowledgments

I am grateful to Celia McMichael for her assistance in collecting and analyzing the data, to Michael O’Keefe for helping with key informant interviews, and to Akesh Narayan for facilitating the research. Thanks to Susanna Trnka, John Taylor, and Celia McMichael for collaborating about the conceptual significance of managing medical uncertainty. Thanks to anonymous reviewers for insightful comments and to Niko Besnier for comments on an earlier draft.

Supplemental data

Supplemental data for this article can be accessed on the publisher’s website.

Notes

1. Global estimates of the separate prevalence of type one diabetes versus type two diabetes in the statistics do not exist. However, the majority of cases are type two (WHO 2016).

2. I am grateful to my colleagues Susanna Trnka, John Taylor, and Celia McMichael who helped to think through the conceptual significance of managing medical uncertainty.

3. While most Indo-Fijians are Hindu or Muslim, some have also converted to Christianity.

Additional information

Funding

This project was supported by a grant from La Trobe University’s Transforming Human Societies Research Focus Area.

Notes on contributors

Tarryn Phillips

Tarryn Phillips is Senior Lecturer in the Department of Social Inquiry at La Trobe University and author of Law, Environmental Illness and Medical Uncertainty: The Contested Governance of Health (2015).