Incendiary essays by public health's foremost messenger
This book is a collection of several essays that Dr. Farmer wrote while he was on-site in several of the areas where Partners in Health (an org he co-founded, which provides healthcare for the poor, regardless of ability to pay, including case management of complex diseases such as HIV and multidrug resistant TB) operate. From Haiti to Chiapas to the TB colonies in Russia's prisons to Boston's slums, Farmer--ever the anthropologist--is able to see beyond the symptoms he treats and points to a common cause for the poverty, disease, and suffering that he and his colleagues try to alleviate: structural violence. Hence, what one reviewer (who gave an unfavorable review) commented: that what he wrote is repetitive. I think that was the point Farmer was trying to make: these problems all have the same cause.
The book is divided into two parts: in the first part, he describes the situation; in the second part, he provides analysis. Structural violence is the thread that is woven through all of these essays. The overall effect, as you can guess, is unpleasant. After finishing this book, I had the same feeling in my stomach I got when I saw a motorist deliberately run over a slow-moving critter crossing the road late one night. It is a feeling of anger and revulsion, which Farmer--ever the physician--seeks to treat with the very last chapter (Rethinking health and humanrights).
I admit his prose sometimes ventures out into the realm of the abstract (he is an academic after all), but concrete stories about people being beaten by soldiers and left for dead make his message loud and clear. He is angry about what he sees and he wants us to be angry too, and rightly so. Why, he asks, in the age of medical advancements and human rights, do we continue to see people dying 'stupid deaths' from preventable causes? It is an important question to ask, given that the fields of medicine and human rights generally think they don't have anything to do with each other. This book should be required reading for anyone who is studying medicine, be it clinical or public health. It should also be required reading for anyone who thinks about studying international human rights law. Finally, concerned citizens of 'donor countries' would be interested to read this book too, if only to urge our lawmakers to make sure that our tax money is not being used to fund dictatorships and dirty proxy wars.
Buy this book! Paul Farmer is a highly effective individual, and shows how one man can and did make a difference. He opens the window on what's going on in Latin America.
Review from Branddenotes.blogspot.com
I liked it best for introducing me to the concept of "structural violence" - essentially whenever the way an economy is set up guarantees that people at the bottom will be victims of violence - whether de jure (rape, murder) or de facto (preventable diseases, hunger). And also for introducing me to some excellent liberation theologians who reminded me that not all religious people are despicable hypocrites, and some top, top poets.
Farmer's perspective on countries full of structural violence like Haiti and "shock therapy" Russia is intensely personal, and his entire book comes from one who spends more time curing people than sitting in an office or library and writing. Not to say that is a good or bad thing, but that is the style in which the book is written.
How are we all responsible for each other? This book will bring that connection quite clear.
Pathologies of Power uses harrowing stories of life-and death-in extreme situations to interrogate our understanding of humanrights. Paul Farmer, a physician and anthropologist with twenty years of experience working in Haiti, Peru, and Russia, argues that promoting the social and economic rights of the world's poor is the most important human rights struggle of our times. With passionate eyewitness accounts from the prisons of Russia and the beleaguered villages of Haiti and Chiapas, this book links the lived experiences of individual victims to a broader analysis of structural violence. Farmer challenges conventional thinking within human rights circles and exposes the relationships between political and economic injustice, on one hand, and the suffering and illness of the powerless, on the other. Farmer shows that the same social forces that give rise to epidemic diseases such as HIV and tuberculosis also sculpt risk for human rights violations. He illustrates the ways that racism and gender inequality in the United States are embodied as disease and death. Yet this book is far from a hopeless inventory of abuse. Farmer's disturbing examples are linked to a guarded optimism that new medical and social technologies will develop in tandem with a more informed sense of social justice. Otherwise, he concludes, we will be guilty of managing social inequality rather than addressing structural violence. Farmer's urgent plea to think about human rights in the context of global public health and to consider critical issues of quality and access for the world's poor should be of fundamental concern to a world characterized by the bizarre proximity of surfeit and suffering.