If the following chapters started out with methods from the classic anthropological genre of life histories, many slowly turned into death histories—a painfully apt term I owe to Jim Boon.39 Some of these stories are just fragments someone wanted to share. But others, more sustained collaborations with those I at times came to think of as friends, are perhaps more like elegies.40 Garinagu have always written beautiful elegies, sung on disquieting scales across porches and in living rooms as well as ancestral temples. As Roy and Phyllis Cayetano describe, in such Garifuna lyrics, “people and events can be recorded in songs like little pictures which become public property and remain, long after the former becomes a matter of history.”41
There is a certain sense in which my writing now feels like a partial mirror held to such gestures of memory. Just looking at my field notes when I work at night, hearing the voices of dead friends from Belize in interview tapes, and looking at pictures from this project became an experience of constantly encountering ghosts and trying to find ways to engage the dead and their memory. The attempt feels heavily borne because of my sense of helplessness and complicity in being unable to prevent their deaths.42 Yet at this point, finding a way to tell these stories feels like part of my own ethical response to what I saw—maybe the only one still available. Trying to write feels not only like a postscript to the ethical dilemmas I encountered during fieldwork, but also like a gesture toward appending the lives of these untimely dead. These chapters are offered as corrigenda in the (hugely insufficient) sense of a place where they might still be alive.
But I cannot write about normalized death from the outside; there is no outside. I could only study the unequal systems I was caught in together with others and note our vastly different positions within them. Many understood the imminence of their own deaths much better than I did at the time, testing me as a channel to an imagined public record or wider stage with agendas of their own. Gestures of transformation pressed against the jagged edges of things that none of us could change, the playful and painful bound together. I never managed to shed the contradictory roles that have been part of playing the role of ethnographer since colonial times, though I tried to perform them more collaboratively: aspiring mediator, tolerable resource boon, academic authority, implicated naïf.
In some especially tense moments, I sometimes found my face freezing into an overwrought smile in an effort to appear at least well intentioned in my foolishness. Garinagu men wear masks with smiles like these when they dance the Jankunu dance around Christmas, with seashells stitched to their knees. They make the white masks out of cassava strainers painted pale pink and decorated with forced frozen smiles, satirizing the colonial absurdity of slave-owning white people and uniformed soldiers.43 Above their whiteface the dancers wear hats decorated with garish paper flowers and bits of mirrors. But maybe these Wanaragua masks also capture more than they mean to, or at least something they do not purport to be rendering. There is a certain helpless white smile of someone who wants to be good but does not know how to face the violence of the past they are tied to, which resembles both the mocking Jankunu mask and my strained smiles in those moments. (Upon meeting a stranger, many old Garinagu women will stare down your cursory smile and not return it until they know you well enough for you to deserve it. I admired the wounding honesty of this habit.)
Masked character in Jankunu (Wanaragua) performance.
I have learned a great deal from the writings of anthropologists who work to unmask systems of structural violence. But for my own project, I gradually felt a more disquieting truth when acknowledging that I did not even know how to unmask myself.
SLOW CARE
Many of the individuals I met in Belize came to number among the millions of worldwide deaths now attributed to diabetes each year.44 Somehow, the slow-moving quality of chronic conditions like diabetes—what U.N. Secretary General Ban Ki-moon once called a “public health emergency in slow motion”—seems to make it only more daunting to imagine reversing its spread in the future.45 A range of disturbing statistics suggests that today’s policy approaches have not slowed the rise of global diabetes rates or mortality; to the contrary, these figures appear to have accelerated worldwide each year they have been tracked. According to the latest projections of the International Diabetes Federation, the condition “affects over 425 million people, with this number expected to rise to over 600 million within a generation.”46 No health institution that I am aware of predicts that current interventions might be able to curb the problem on a population level. In this light, there is global resonance to what was probably the single thing I heard repeated most often by the Belizean and Garifuna individuals with diabetes who contributed to this project: “It is my children I’m worried about.”
Every story in the rest of this book is really the same story that Mr. P taught me to see—chronic strains that slowly cause bodies to fall apart and the people trying to keep each other together. In fact, each chapter retells that same story again, from a different angle. When it comes to diabetes, this repetition is no narrative accident. Fatigue and relentless repetition are the defining features of what makes diabetic sugar harrowing—people trying to stave off bodily loss and failing organs day in and day out, year in and year out, over and over again, utterly foreseeable, likely coming anyway.
It was only people’s work of maintenance, caring for each other in the face of all this, that never stopped surprising me. When one new mother told me that her dream with diabetes was to try to maintain for her kids, I paused expectantly, waiting for her to finish. She shook her head. “And so I must work hard to keep myself,” she said. I waited with my pen poised for her to complete the sentence—to keep herself healthy, to keep herself going? But as we sat in silence, I realized that she meant the expression simply as it was—to keep herself, all of herself: the feeling in her nerves, her fingers and feet, eyesight, life. I closed my notebook.
A slow epidemic both is and is not like other forms of violence.47 It plays with time. It breaks down stories, as Rob Nixon memorably wrote in his description of “slow violence”48—and unevenly wears on different bodies, Lauren Berlant emphasizes of “slow death.”49 But writing can play with time too—allow for taking a step back and making visible processes and their errata over a “long arc,” as people and places intimately shape each other. If the slow violence of sugar continues to saturate many of these stories, its harms demanded the kinds of practices I often saw in Belize, which I came to think of as slow care—ongoing and implicating joint work in the face of chronic debilitation.50 That is not a caveat. It is the guiding frame for the rest of this book.
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