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Accepted Paper:

“Only when something is wrong” – appropriating and improvising glucometer use among diabetes patients in Malawi.  
Misheck Nkhata (Teesside University)

Paper Short Abstract:

The glucometer is considered as vital in self-management of diabetes in most high-income settings. Patients and health care workers in low and middle-income countries appropriate it in ways that facilitate care and social relations, as they live with uncertainties of diabetes and its management.

Paper Abstract:

Among diabetes patients in most high-income countries, a glucometer (a blood glucose measuring technology) is an important, if not indispensable, technology for self-management of diabetes. However, this technology is often appropriated and improvised beyond its envisaged uses in low and middle-income countries, where the prevalence of diabetes is increasing among younger and poorer people, and experienced alongside infectious and chronic diseases. This paper is based on twelve months of ethnographic fieldwork using interviews, participant observation, and informal conversations in patients’ homes and diabetes clinics at a rural mission hospital and a referral teaching hospital in the Southern Region of Malawi. The aim of the study was to explore how patients live with and manage diabetes in Malawi. While the glucometer is envisaged as a technology for individual use, patients and health care workers used the same glucometer among different patients to facilitate care. Within rural health facilities, it was used for monitoring sugar levels among all patients attending diabetes clinics. Due to challenges in sourcing testing strips and batteries, patients used the glucometer “only when something was wrong” rather than as a continuously as a self-management technology. It was used in response to uncertainties in diabetes as a condition but also its management practices. Following Annemarie Mol who explores what diagnostic devices can do, the glucometer in this context was vital in maintaining and facilitating social relations among patients but also between patients and health care workers.

Panel P210
Technology matters: ethnographies of technological adoption beyond the Western world
  Session 1 Thursday 25 July, 2024, -