“They don’t talk about it, but I think our diabetes is also caused by all the chemicals,” Sarah’s sister-in-law told me. Publications supporting her suspicion indeed existed in the literature—many chemicals are endocrine disruptors, which population-level studies report lead to a heightened risk of diabetes and weight gain.43 But proof was not possible to demonstrate causality for her case of diabetes in particular, which is of course the point about not being able to tell where sugar begins or ends. An abundance of population studies elsewhere suggests that the growth in both type 1 and type 2 diabetes is exacerbated by exposure to pesticide runoff from agricultural and other synthetic chemicals and pollution in food, air, and waterways. The haze of what Vanessa Agard-Jones calls “accreted violence”44 from agricultural pesticides remains a legacy throughout the Caribbean and Latin America. In this context of limited foods and abundant chemicals, Sarah’s name for her glucose meter, “sugar machine,” struck me as an apt frame for the way this region—if not much of the agro-industrial world system—is fast becoming a “diabetes machine.”
CHRONIC LANDSCAPES
“I dug that driveway,” Theo told me as we drove down a road that cut through plantations. We were headed in the direction of Sarah’s village from some fifty miles north. Theo hit the brakes to slow down at the rusty bridge, craning to check for anything coming from the other direction. He said the bridge was so narrow because it was not actually designed for people or cars. It had been built as a railroad trestle for United Fruit’s old banana train. That was why the two-lane highway contracted there and only one car could squeeze through at a time. The traces were hard to detect; United Fruit and their rail lines were long gone by then. There are new companies on the old plantations today, but the most radical change imaginable for this land now is a switch from bananas to other fruit.
I loved driving between Belmopan and Dangriga through the Maya Mountains with Theo because he knew things like that. I gathered between the lines of his stories that Theo, charismatic even as an old man, had been a heartbreaker in his younger years. He knew every village. Itinerant driving was his favorite line of work now, he said, but over the years he had also worked picking oranges, walked survey through Belize’s forests, sung country ballads, traveled abroad, done odd jobs of all kinds, and traded fish when there still used to be a lot of fish in the sea. He described the days when there didn’t used to be any bars but each house distilled its own liquor from rice or pineapples that was crystal clear. He showed me the neem tree with leaves that he boiled sometimes to help manage his blood sugar.
“I see children nine, ten years old dying of diabetes,” Theo said as he shook his head, eyes on the road. He had diabetes, too, as did most of his friends. They were learning from each other’s misfortunes. Theo told me how one of his toughest friends had been found mysteriously dead in a hallway at home. The death looked so odd, with the house suggesting signs of struggle, that the police ran tests to see if he had been murdered. But they could find no signs of foul play. Theo thought that probably his friend had woken up realizing he had low blood sugar (more immediately dangerous than high blood sugar) and had fought to crawl his way to the kitchen. He almost made it. Since then, Theo always kept a few pieces of hard candy in his pocket and in the car, to eat along the road and make sure he didn’t pass out while driving.
Theo stopped at a curve in the mountains and bought two chicken tamales, handing me one. We stopped at a gas station to unfold the banana leaves coated in ash. Most people in Belize speak English, but it is filled with phrases you do not hear anywhere else. In Theo’s words for the highway, the low traffic reflectors edging the forest were “cat eyes” and the speed bumps were “sleeping police.” He showed me the field where he had faced a fer-de-lance in an orange tree and the place where he had emerged from months of working in the forest and learned his father had died. It always felt like whatever scene Theo was describing from decades ago was just out of sight of the window. Theo pointed out where the banana workers that United Fruit brought from Jamaica used to live along the highway and recalled how, as a Garifuna man working nearby, he was often mistaken for one of them.
By the time I had accompanied mobile care teams through those orange and banana plantations of Stann Creek, most of the workers were from Honduras, Guatemala, or El Salvador, with a handful born in Belize. This made it strange to be part of a group that arrived with an English-language diabetes education video depicting white North Americans in sweaters, who did not look like anyone (except me) on the plantations where we showed it. “Your pancreas is the size and shape of an average banana,” one memorable line went, an anatomical cartoon of organs secreting keys and dots that flashed on the screen. A visiting Garifuna nurse prepared her glucometer for testing while the educational video—if anyone was able to understand it—was instructing the banana workers to avoid eating the exact types of food that were sold from the attached company store.
Only a few of the workers had high sugar that day (and were told to follow up at the hospital). I was put in charge of carrying the red plastic sharps box containing several hundred dollars’ worth of used blood glucose testing supplies. The mobile team was attentive and kind, and their gestures seemed appreciated by the workers. But the machines already had theories built in, which made it feel like we were at once too early and too late: years too late to prevent exposures to pesticides or to the carbohydrate-heavy diets that seemed visible all around, but years too early to measure their effects. We all got sent home with bunches of green bananas. I handled mine carefully after seeing the metal claws used to dunk them in caustic chemicals, thousands of bananas floating in shallow baths under signs reading NO FOOD.
Belize’s beautiful landscape, spotted with mango trees and covered in flowering vines, often gives visitors the impression of a paradisiacal garden. This lush appearance makes it particularly paradoxical that much of the country would easily qualify as a food desert today, according to U.S. definitions (which are based on factors like miles of distance and transportation difficulties to purchase healthy food; limited, high-priced selection of vegetables at those locations; and overall poverty levels). Potentially arable land that could (but does not) support vegetable agriculture in Belize only accentuates the manmade ironies underpinning food deserts most anywhere.
The territory now bounded as Belize once produced food for an Indigenous population of two million. Yet today, this same land is unable to grow enough vegetables for Belize’s current population of 380,000. Pesticides are often hailed as necessary for scale, but Maya techniques of soil engineering allowed for larger-scale agricultural productivity than the monocropping on that same land now.45 Even a few decades ago, when individual Kriol families in southern Belize used to grow more kitchen gardens along the coast, some would travel to nearby ancient Maya ruins to obtain the rich soil from the areas where pre-Conquest inhabitants buried waste using methods to optimize the soil’s later chemistry (including burning in particular sequences, and strategically distributing materials like nitrogen-rich seashells).
Today, the majority of vegetables sold in Belize are imported and pricey in contrast to surrounding countries. “You know,” a man from the Yucatán told me, “in Mexico, poor people go into town to sell vegetables. Belize is the only country I know where most villagers go into town markets empty-handed to buy them.” As the history book British Honduras: Colonial Dead End reprised of Belize: “Its land laws [are] far behind the Republics of Spanish America [that] have laws for the encouragement of agriculture, which in spite of revolution and misrule, have attracted immigrants when this Colony has repelled them.”46 Reflecting on this archival source, the authoring historian acknowledged that “the ‘progressive’ land tenure system in Spanish Honduras was almost a replica of the ejido system or Indian