Long-accepted models of causality cast diseases into the binary of either “contagious” or “non-communicable,” typically with institutional resources focused primarily on interrupting infectious disease transmission. But in southern Belize, as in much of the world today, epidemic diabetes has become a leading cause of death and a notorious contributor to organ failure and amputated limbs. This ethnographic essay follows caregivers’ and families’ work to survive in-between public health categories, and asks what responses a bifurcated model of infectious versus non-communicable disease structures or incapacitates in practice. It proposes an alternative focus on diabetes as a “para-communicable” condition—materially transmitted as bodies and ecologies intimately shape each other over time, with unequal and compounding effects for historically situated groups of people. The article closes by querying how communicability relates to community, and why it matters to reframe narratives about contributing causalities in relation to struggles for treatment access.

中文翻译：

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什么是可交流的？在无法确定的流行病中未明原因的伤害和“赶上”糖尿病

长期以来公认的因果关系模型将疾病归为“传染性”或“非传染性”的二元模式，通常其制度资源主要集中在中断传染性疾病的传播上。但是在伯利兹南部，就像当今世界上许多地方一样，流行​​性糖尿病已成为主要的死亡原因，并且是导致器官衰竭和肢体截肢的臭名昭著的原因。这份人种学论文是照料照料者和家人在公共卫生类别之间生存的工作，并询问传染病与非传染病结构分叉的模型或在实践中无能为力的模型有何反应。它提出了将糖尿病作为“准传染性”疾病的另一种关注重点，因为随着时间的流逝，身体和生态相互紧密地相互影响，从而实质性地传播糖尿病，对历史悠久的人群产生不平等和复杂的影响。本文通过询问可沟通性与社区之间的关系，以及为什么要重新组织有关为获得治疗机会而造成的因果关系的叙述的重要性，来结束本文。