Participant observation was conducted to explore the understanding of diabetes and examine the implications of these understandings for providing effective patient centered care in Cameroon. Ethnographic techniques—content and thematic analysis—were used to analyze the data collected from diverse techniques. Most participants distinguished “natural,” “supernatural,” and “man-made” causes of diabetes. Such aetiologies guided the behaviour and approaches adopted for treatment and helped explain why biomedical and traditional healing frameworks could so readily be used in tandem. Clinical encounters are often only one small part of the diabetes care process, alongside recourse to traditional medicine. With rituals, agents causing diabetes are apparently more convincingly explained as powerful reinforcement and a cure promised in traditional medicine. Though it seems “irrational” and dangerous to clinics when patients alternate between therapeutic regimes or pursue both simultaneously, it seems perfectly rational and beneficial to patients and beyond. So long as biomedical practitioners fail to recognize that their patients will probably also have recourse to traditional medicine, they and their services may compound the problems they face for patients to discuss openly how they have been managing their condition. 1. Introduction Although sub-Saharan Africa remains afflicted by very high rates of communicable diseases, noncommunicable diseases occur at age specific rates above those found in rich countries, such as those of Western Europe and North America [1]. Diabetes is still relatively uncommon in rural areas but is becoming prevalent in urban areas, affecting about 5% of adults in urban Tanzania [2] and 5.8% in urban Cameroon [3]. WHO estimated in 2000 that the prevalence of diabetes for all age groups worldwide was to be 2.8% in 2000 and 4.4% in 2030 [4]. WHO estimated that 347 million people, worldwide, had diabetes in 2013 [4]. The organization had estimated that the total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. These statistics are further confounded by those of the International Diabetes Federation (IDF) which hold that today there are 382 million people living with diabetes. A further 316 million with impaired glucose tolerance are at high risk of the disease—an alarming number that is set to reach 471 million by 2035 [5]. Further, it is estimated by IDF that, by the end of 2013, diabetes will have caused 5.1 million deaths and cost USD 548 billion in health care spending. Without
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