When the Blood Sweetens: Diabetes and Vulnerability Among the Ikojts of Oaxaca

This thesis explores the Ikojts' social representations and lived experiences of type 2 diabetes (henceforth diabetes) in Southern Mexico. Despite the prevalent urban impact of the diabetes epidemic, diabetes is increasingly affecting rural and, disproportionately, indigenous communities. This epidemiological profile has prompted the reading of diabetes in terms of an ethnoracial disease (Montoya 2011), with the consequence of downplaying the social, environmental and political-economic factors behind it. A central issue is how indigenous peoples themselves make sense of diabetes as the institutions of science and the state scrutinise and turn their focus to their bodies.

Drawing on one year of fieldwork in the Ikojts community of San Dionisio del Mar, in Oaxaca, this thesis examines the multiple, sometimes contradictory ways in which the Ikojts live, narrate, make sense of and cope with diabetes. Adopting a critical phenomenologically inspired

approach, this thesis focuses on the body as the prime site where experience is arrayed and where greater forces -- history, political economy, culture -- inscribe themselves. I argue that the Ikojts conceive diabetes as an idiom of and for vulnerability. In fact, diabetes is simultaneously the embodied manifestation of structural and ordinary violence and the bodily metaphor through which the Ikojts express emotional distress, compelling concerns, and duress, which characterise much of their daily lives. In this 'other' light, diabetes is not connected so

much to genetics as it is to the experience of vulnerability.

Through the exploration of a wide range of local experiences -- from domestic tensions, to witchcraft accusations, to breaks in moral order, changes in foodways, the fearful anticipation of disease, and the distrust in biomedical practitioners -- I analyse the manifold nature of vulnerability: its ontological character, subjective dimension, and structural organisation. Fully aware of the perils of superimposing categories such as 'vulnerable' or 'marginal' to human groups, this thesis presents an experience-near conceptualisation of vulnerability which sheds light on the complexities of living with diabetes in a hostile place and which goes beyond dominant understandings of diabetes as the result of populations' vulnerability to risky genetics or 'unhealthy' lifestyles.