Vishala Parmasad

Improving the management of Type 2 diabetes mellitus through a focus on its sociocultural dimensions.
Faculty of Arts
William McKellin
Trinidad and Tobago

Why did you decide to pursue a graduate degree?

As a physician in Trinidad, I have observed and treated negative and tragic consequences of poor access to medical care and poor long-term management of chronic diseases. These negative outcomes were often subsequent to gaps between medical management recommendations and the social, cultural and economic contexts in which they were to be applied. I came to believe that there was significant potential to bridge such gaps by integrating methods and insights from the social-sciences into health-care policy formulation, especially in view of the purely economic basis on which policy decisions were increasingly being made. I therefore chose to combine my clinical practice with research into health from a social-science perspective. I hope that this will eventually reshape health policy in my national context.

Why did you decide to study at UBC?

UBC is internationally renowned both for its research opportunities and its interdisciplinary endeavors. The combination of the excellent reputation of the Department of Anthropology, the long experience of my supervisor at integrating medical and anthropological problematics, and the beautiful environs made this an inevitable choice.

What was the best surprise about UBC or life in Vancouver?

The Department of Anthropology has consistently provided me both with rich intellectual opportunities and a very supportive environment. Living at the graduate student residence, Green College, in my first year also provided many opportunities for formal and informal interdisciplinary engagement. Through the relationships formed in these different settings, I've been pleasantly surprised to have found another home in Vancouver.

What do you hope to accomplish with your research?

I hope that my research will open the way for more critical and nuanced analyses of "non-adherence" with medical recommendations in non-Euro-American, multi-cultural contexts of medical care. Over my training and practice as a physician working in the health sector in Trinidad, I observed that medical recommendations often appear to unaccountably fail when applied to specific, local contexts because the cultural and structural contexts of health care have not been considered or adequately researched. I hope, from my research, to produce recommendations tailored to the local context that will directly impact the management of Type 2 diabetes in Trinidad and Tobago. I also plan to produce a more general framework for lifestyle modification and self-management that can facilitate new ways of thinking about the management of other chronic diseases.

What has winning a major award meant to you?

Winning this award was very encouraging and motivational for me - both because it acknowledges the contribution that graduate students can make through their research and because it acts as a spur for future accomplishment. This award will allow me greater flexibility to pursue my own research in Trinidad and Tobago, and to obtain feedback regarding my work at conferences and workshops internationally. I would like to thank the Trustees for the vote of confidence and to let them know that it has encouraged me to redouble my efforts and exceed my own expectations.

What advice do you have for new graduate students?

Try to keep your focus on your goals without simultaneously losing sight of the beauty of Vancouver and the many opportunities available for enjoying the area. Take part in as many things as you can, while keeping one eye on your deadlines. They do have a way of creeping up. Most importantly, don't forget that life is lived all at once: try to enjoy everything you do!


Learn more about Vishala's research

Dietary habits are among the most important and modifiable causes of chronic diseases such as Type 2 diabetes mellitus. Studies show significantly improved outcomes upon implementing dietary change. There is, however, well-documented resistance to dietary change amongst some populations with the highest disease prevalence, including various groups of First Nations people in Canada and the USA. This is in part because of the complex relationships between cultural identity, history, memory, religion and power that are instantiated through the symbolic features of dietary practices. My research will be conducted among East Indians in Trinidad, who have similar prevalence rates to First Nations Peoples in Canada, and also have low "compliance" or "adherence" with recommended dietary changes. Such "non-compliant/non-adherent" behavior is often imbued with moral overtones that negatively impact the medical care received. Given the complex significance of diet, transformations require not the "compliance/adherence" of an individual patient, but of complex interconnected systems that delimit patient "agency". These include regular family routines, established networks of friends, community relations and socio-economic structural constraints. My research aims to qualitatively explore the interaction of medical notions of compliance/adherence and patient notions of agency in the context of family, social networks, and ethnic community. Integrating epidemiological and ethnographic methods, I will map the perceptions and perspectives of doctors and patients in both clinical and non-clinical settings of diabetes care.