There are at least two plants relevant to the topic of global diabetes that were growing on Saint Vincent on the day of Garifuna exile, both of which British companies would later sell back to the descendants of those Garifuna people who were packed into the hold of the warship called Experiment and its fleet. The primary one was sugarcane. But another was a weedier specimen with tiny pale flowers that the British had bioprospected from Turkey long ago—Galega officinalis, the botanical source for metformin, which is today the most widely prescribed diabetes pharmaceutical in the world.26
Westindische Inseln, 1848, with mainland Belize mapped as an insulin (island) of the British Empire.
An estimated three-quarters of the Garifuna population died during this forced removal from Saint Vincent to Central America, especially while being held captive on the isle of Balliceaux. Many of their ancestral crops were also lost during this time, although survivors managed to keep cassava plants alive in the ship’s hold, watering them with their sweat.27 But the majority of their medicines, foods, and vegetables fell into possession of British planters, who sent samples back to London for agricultural exhibits and testing by pharmaceutical companies. The British called this the Garifuna people’s “transition.”
In public health, the term epidemiological transition is often applied to explain the rise of chronic conditions (such as diabetes) in the late twentieth century.28 In contrast, this book aims to craft a troubled, interrupted, and slowed-down version of this transition story: one that approaches the uneven distributions of diabetic sugar in relation to the ongoing effects of colonial legacies and modes of knowledge making. To do so, it builds on the arguments of numerous scholars who have considered the interrelations between colonial violence and rising diabetes elsewhere in the world, and considers ethnographic realities in relation to these shape-shifting histories.29
No one factor alone can explain the way the odds have gradually been stacked against healthy agriculture in places like Belize. But if you take a step back and play the history over again slowly, there is a before and after to how food systems have changed. For Garinagu, some of the relevant episodes upon arrival in Belize could include many small incidents: The colonial creation and subsequent neglect of Garifuna land reserves. The year the farming demonstrators got defunded. The year the government stopped selling the variety of rice that people knew how to grow.
Many tracts of land have been sold to foreigners to cover diabetes medical bills. The changing kinds of foods sold in local grocery stores also each had a history. More recent shifts only compound much longer histories of dispossession: Back in the 1790s, British authorities had dispatched natural scientists to define racial markers in hopes of disproving the Garifuna’s dual ancestry as both Black and Indigenous in an effort to deny them legal rights to their ancestral territory. Even today, Garifuna people still struggle to be legally recognized as Indigenous by the state—part of a new era of land sovereignty struggles and agricultural transformations that this account explores, in relation to nutritional changes and gradually rising diabetes rates.30
For all that has changed since the days of Saint Vincent, there are certain disturbing continuities over the centuries: sugar remains a primary sign of violence and uneven injuries, and industrial profit continues to accumulate around preventable deaths and patterned land dispossessions. In this sense, the struggles with diabetes described in this book could be read as only the latest chapter in five hundred years of traveling with sugar.
In Sweetness and Power: The Place of Sugar in Modern History,31 Sidney Mintz famously argued that the rise of a British “sweet tooth,” related to changing factory labor that drove global demands for sugar, could only be fully understood as part of a global system that relied on the exploitation of land and labor on sugar plantations in the Americas. Yet Mintz actually began his investigations on this matter with a much more granular mode of anthropological storytelling about Caribbean sugar: the individual life history, which narrated the experiences of one person’s trajectory working in cane. This approach revealed social dynamics without assuming any individual was modal or “representative” of a given population.32 Mintz’s later account of sugar as global commodity in Sweetness and Power was an attempt, he said, “to trace backwards” the norms he encountered in the course of individual life history work.
The realities of diabetes examined here might be considered living sequelae of the transformations that Mintz described, sugar out of place in modern history. In what follows, I try to bring these two ways of approaching the anthropology of sugar—individual life histories, and global histories of racial capitalism33—together in the same book. Talking with people and thinking with their own insights into their conditions, as my teachers João Biehl and Adriana Petryna show, “compels us to think of people not as problems or victims, but also as agents of health”34—and co-envisioned ethnography as an “open system” for public exchanges that may continue long after books end.35
In juxtaposing life histories with global stories of commodities in systems, the aim is an ethnographic version of world systems theory that stitches together glimpses of global processes and infrastructures with their living consequences for people. There is, inevitably, some trade-off in depth when trying to assemble bits and pieces from this broad scope, at times only gesturing toward enormous literatures with deep relevance—anthropologies of environmental change and food studies, ethnographies of medicine and global health, social studies of science and technology, settler colonial and postcolonial histories, debility and disability studies, work on maintenance and infrastructure, and Belizean and Garifuna cultural histories, among others. While a more narrow framing might make academic analysis easier, it would not do justice to the stories of individuals who are dealing with elements from all these intersecting arenas in trying to live with the erratic sugar in their bodies.
I approach such fraught storytelling guided by Mintz’s insight that none of us exists outside the global legacies of sugar—to the contrary, he argued, we are each related in ways that we might not understand. In this view, the uneasy position of my own whiteness is not something to be disclaimed. It is a constitutive part of the global legacies of sugar in question, and a role I occasionally perform as narrative foil.
Whatever else the diabetes journeys recounted in this book suggest, they are also haunted by thwarted and incapacitated travels: life-giving mobility that got occluded or made unthinkable for others, even while often available to me. It is painful to recognize that after all these years of trying to share connective experiences and find commonality with the people who appear on these pages, the places where our paths diverged may be more illuminating than any of the junctures where they joined up for a short while. The unjust gap between my “travels with sugar” and those of others also sheds light on chronic infrastructures much bigger than any of us—ones that you are somehow positioned by too.
In an aging world system, there are “remainders of violence”36 at play with power of their own, exceeding anyone’s conscious intent. But exactly what that meant (or might come to mean) for this story was not easy to name. The more that people taught me about their actual ways of living with sugar, the more these suggestive parallels with bloody histories seemed to both provoke and defy easy conjugation.
Sweetness and . . .
What?
ERRATA: METHODS AND MISTAKES
I have always been unsettled by errata: strange little scraps of text appearing at the edge of feature news stories and journal articles, like misplaced footnotes that set straight some error from a past edition gone by. The irony of errata is a fundamental one: by definition, corrigenda are uncorrectable corrections. The flawed template has already gone to press; revisions are no longer possible. All that is left to do is append, painstakingly detailing these mistakes and noting how they might be written otherwise for future versions. Errata are always details out of time and out of place, residues of errors coming to public awareness at least one issue too