Of fatness, fitness and finesse : Experiences and interpretations of non-communicable diseases in urban Uganda

This paper explores the experiences and interpretations of non-communicable diseases in two secondary Ugandan cities: Mbale and Mbarara. Drawing inspiration from the concepts of social determinants of health, and geographic scholarship on embedded gendered and classed power dynamics, I employ a qualitative exploration and thick description to analyse data from twenty-two in-depth biographic interviews. Interviewees were from a range of circumstances, including, as AbdouMaliq Simone described, ‘the missing people’. Findings detail aspects of life with diabetes, obesity or hypertension in these cities, noting some views of wider social determinants, and some possible barriers to effective non-communicable disease management. Analysis of interpretations around gendered difference in obesity, in particular, revealed provocative conceptualisations of gendered livelihood strategies interwoven with body size beliefs, and the realities of oft-times insecure daily urban lives. The paper makes apparent the value of incorporating qualitative study, together with quantitative assessments, to investigate the experiences and interpretations of non-communicable disease in a specific context. In addition, the work provides insight into barriers to healthy urban living in the current socio-economic context of Ugandan, and potentially other sub-Saharan African, cities