Controlling diabetes or keeping life under control?: Experiences and understandings of a group of Sri Lankan migrants in Australia with type two diabetes

© 2014 Dr. Prabhathi Basnayake RalalageDiabetes is a key public health priority and a major health concern for many migrant communities including the Sri Lankan community here in Australia. Understanding people’s comprehensions of the disease and its management is essential to successfully address any related issues in order to avoid premature deaths and high public health costs. According to many health reports published over the past years Sri Lankan migrants have been identified as having a significantly higher prevalence of type two diabetes in Australia compared to the general Australian population. This ethnography revolves around a group of first generation Sri Lankan migrants with type two diabetes in Australia. This thesis relates their story of encountering and dealing with difficulties and complexities of migrant life while having to build a ‘successful’ life in Australia and also having to concurrently manage a chronic illness. While arguing that understanding of diabetes management cannot be just reduced or confined to level of compliance to medical advice and blood sugar measurement readings on the glucometer, I point out in the research that the stories of Sri Lankans with diabetes in a developed country are different to the stories of other South Asian migrants with diabetes living elsewhere in the world as examined in other studies. I show how Sri Lankans, despite possessing several socio economic and cultural advantages in the land of settlement, still encountered significant challenges to manage diabetes effectively. I demonstrate in the thesis how each person’s socio cultural ‘baggage’ they bring to Australia during migration from their motherland, affects their transplanted lives and how it in turn affects their health care seeking behavior concerning managing diabetes. I demonstrate that aspects that affect the Sri Lankans’ perceptions and actions regarding the management of diabetes derive from personal history, their attachment to the collective cultural history of the community, their aspirations of upward social mobility coupled with attaining a higher standard of living as well as from the pressure caused by the differences in their conceptualization of ‘control’ from that of the doctors. This thesis will be of interest to medical anthropologists, sociologists and social science researchers of migration and migrant health; health care providers particularly teams who provide diabetes care to migrant patients; and community health care workers. It will also be of specific interest to migrants with diabetes living in Australia and in other Western societies, who might be interested to understand the experiences and challenges of living with a chronic illness through the insights of a group of Sri Lankan migrants in Melbourne living with diabetes