Tactics of diabetes control: Turkish immigrant experiences with chronic illness in Berlin, Germany.

摘要

This thesis explores Turkish migrants’ practices of diabetes care in Germany. Healthudstatistics frequently identify minority groups as vulnerable to chronic illness andudTurkish-origin Germans are said to be more likely to suffer from type 2 diabetes thanudGermans or Turks in Turkey. Anthropological studies on marginal population groupsudwith diabetes explore experiences of social suffering and inequality that influenceudsuch high illness prevalence, or investigate how conflictual lay beliefs and medicaludencounters affect illness care. Those studies that analyse active diabetes patient andudhealthcare practices concentrate on the majority population. Drawing onudethnographic fieldwork in Berlin from September 2006 to September 2007, thisudthesis examines how Turkish Berliners actively engage in diabetes care, and thusudjoins two themes seldom connected: illness practices and marginality. Initialudinterviews with healthcare professionals alluded to a Turkish migrant patient groupudliving in deprivation and immobilised by high illiteracy rates, lacking language skillsudand health knowledge. Despite such experience of marginality, ethnographicudexploration revealed that informal diabetes care, for example through a Turkishlanguageudself-help group, is nonetheless individually and collectively negotiatedudwhere formal care is inadequate. On the one hand, the thesis investigates practices ofuddiabetes control in learning, monitoring and manoeuvring diabetes. Rather thanudrepresenting the common image of the inert, disadvantaged migrant patient, TurkishudBerliners of the self-help group engage in deliberate “tactics of diabetes control” toudmake their chronic illness experience habitable. On the other hand, the thesisudexplores how “diabetes among Turkish-origin Berliners” can be a form of sociality,udpolitical activism and economic enterprise that involves many social actors not onlyudpatients and their healthcare professionals, in order to fill a provision gap.