Bittersweet Migrations: Type II Diabetes and Healing in the Hmong Diaspora

Abstract

As the seventh leading killer in the United States, type II diabetes disproportionally burdens minorities and those of lower socioeconomic standing, especially immigrant and refugee communities. However, why might a segment of a refugee population engage in return migration to places of exile for healing? Examining disease as socially and physically produced, this project investigates the multiple meanings behind return migrations to Laos and Thailand for Hmong-Americans with type II diabetes and who are 50 years and older. Based on 30 months of multi-sited ethnography, conducted in the clinic setting of St. Paul, Minnesota and the sites of Hmong-American travel destinations in Laos and Thailand, this dissertations argues that diabetes management focuses on the discipline of the somatic body through glucose monitoring, diet, and exercise. Yet, Hmong-American patients surface the need for social care-to attend to the social chronicity of being displaced refugees. Feelings of bodily difference and displacement in diabetes narratives produce a fluid Hmong-American subjectivity that actively remembers the past and places of familiarity. Nostalgia, melancholy, return migration, reception and discourse by Hmong-Lao and Hmong-Thai, and the embodiment of place and herbs, creatively engages in social care, centered around social continuity of kinship and origin. Through the social fields of the diabetic body, Hmong-Americans, Hmong-Lao, and Hmong-Thai, that a (de)territorialization of the Homeland, a place of exile, is transformed for a Hmong-American belonging. Yet, paradoxically, discourse about a cure from diabetes and a true Hmong-American return migration is often spoken as through death. The claim to death restructures the social order of chronic disease management (where death is often displaced) and Hmong-American racial position in the U.S. Death as an ultimate form of cure and return is a political claim to an eternal Hmong body politic.