What do you think causes diabetes?
In 2014, one of my professors who is a medical anthropologist along with a team of translators, medical doctors and other health care professionals went to Senegal first, and then Burkina Faso to conduct research on how elderly people who have type II diabetes and/or hypertension in these two countries manage their disease(s).
They conducted interviews in French with elderly diabetic and hypertensive patients and asked them questions such as: “what do you think are the symptoms of diabetes” and “what have you done to treat your illness?” amongst others. The point of the interviews and this research has been to understand how these patients manage their illnesses, to see if they really understand how to take care of themselves and to find out what infrastructure needs to be put in place to help them. For example, some patients said that their drugs were too expensive so, there needs to be a way to make these drugs cheaper and more accessible.
In August 2015, my professor brought back these interviews which her team had conducted in digital form. I started working with her on them because she needed someone who was interested in health care (in Africa) and who understood French. My job was to code the interviews using MAXQDA which is a qualitative data analysis software. After coding, I analyzed the interviews in order to draw out important themes and patterns from the data. I was basically asking myself: “what are patients saying?” It was through my analysis that I saw that drugs were too expensive for some of them.
After working with about a hundred interviews, my most engaging finding has come from the diabetic patients in Senegal. One of the questions which the patients were asked was: « D’après vous, quelle est la cause du diabète? » which means: “In your opinion, what causes diabetes?” Majority of the patients named food as the leading cause of diabetes. According to them, over-consumption of sugary drinks such as Coke, sweets and pastries causes diabetes. They also mentioned complex carbohydrates such as rice. Sugar is a leading cause of diabetes according to them because they get it for cheap from Mauritania, a neighboring country.
This response was expected. It was not anything out of the ordinary but guess what they say is the second-leading cause of diabetes? This is where it gets interesting:
Some patients believe that their diabetes comes from God; that he has afflicted them with this illness. One woman, when asked what she thinks is the etiology of diabetes said:
“For me, it is the will of God because all the things that we say that cause diabetes, I did not do them; God has given me diabetes, it is a divine will” (Translated)
God as an etiology of diabetes would not be a problem if patients still made sure to get treatment. However, some of them admit that they refuse to take medicine for their diabetes, that they refuse to change what they eat and refuse to diet. They refuse to do anything about their illness except pray. They believe that since their disease comes from God, he alone, not man-made drugs, can cure them.
It is clear that religion has a great influence on people’s attitude towards health and for some, it shapes the way they manage their illnesses, which can be detrimental to them. This is especially if they are religious. A large majority of the Senegalese population is Muslim and a quick search on Google puts the number at 92%. It is necessary to note, however, that this research was conducted in a rural town and is obviously not representative of the sentiments of the entire people of Senegal.
I struggled a little before writing this post. So far, most of the posts I’ve written have been on love, relationships and sadness but a week ago, I told myself I was going to try writing something educative. So, I kept asking myself what my goal was and where I planned to go with this post. Was I trying to educate people on something that I think is important or point out something important? I called a friend, presented my problem to her and asked for advice. She said: “You mustn’t have a point. It can just be you sharing because your work is interesting.”
I did see other interesting answers from my analyses but the relationship between God and diabetes was by far the most interesting one. I guess the next step for the team would be to find a way to make sure that patients are properly educated on the etiology of diabetes (and hypertension). In the meantime, this is me just sharing what I’ve been working on because it’s interesting.