“When I Don’t Have Money, I Don’t Eat”: A Critical Hermeneutic Study of Diabetes in Liberia

Abstract

Diabetes is a growing public health concern in Liberia, where an estimated 2.1% of the population live with the disease. The challenges with diabetes in Liberia are enormous. Diabetes places immense socioeconomic pressure on individuals and their families and burdens an already overstretched health care system still recovering from the destructive effects of the 14-year civil war. While efforts towards rebuilding the health care system in Liberia are ongoing, people with diabetes experience significant challenges accessing social, economic, and health-care resources to manage their illness. Purpose: The goal of this critical hermeneutic study was to explore what is it like to live with diabetes in Liberia. Methods: Through purposeful sampling, 10 adults with diabetes were recruited from a publicly funded hospital in Monrovia, Liberia. Data were collected using a photovoice method, wherein participants photographed their everyday experiences of living with diabetes. Results: We identified three themes that answered the question of what is it like to live with diabetes in Liberia: living with diabetes means living with 1) food insecurity, 2) trying to access a health care system that was not built to respond to diabetes, and 3) using faith to cope and foster hope. Conclusion: The experiences of people living with diabetes in Liberia are under-researched, pointing to a gap in knowledge. The findings from this study address this gap in the literature by providing a clearer picture of the impact of diabetes on individuals and families. We provide tangible recommendations to local governments and policy makers on interventions that may improve health outcomes and quality of life for people living with diabetes in Liberia.

Keywords

• Diabetes
• Critical Hermeneutics
• Photovoice
• Lived Experiences
• Liberia