Pathologies of Power: Health, Human Rights, and the New War on the Poor (California Series in Public Anthropology, 4) | 
| Author: Paul Farmer
Creators: Paul Farmer, Amartya Sen
Publisher: University of California Press
Category: Book
List Price: $18.95
Buy Used: $8.49
You Save: $10.46 (55%)
New (37) Used (57) from $8.49
Avg. Customer Rating:  19 reviews
Sales Rank: 8619
Media: Paperback
Edition: 1
Number Of Items: 1
Pages: 438
Shipping Weight (lbs): 1.6
Dimensions (in): 8.9 x 6 x 1.1
ISBN: 0520243269
Dewey Decimal Number: 305.569
EAN: 9780520243262
ASIN: 0520243269
Publication Date: November 22, 2004
Availability: Usually ships in 1-2 business days
Shipping: Expedited shipping available
Condition: Very Good unmarked condition, owners name inside front cover, expedited shipping is available
|
| Also Available In:
|
| Similar Items:
|
| Editorial Reviews:
Product Description
Pathologies of Power uses harrowing stories of life--and death--in extreme situations to interrogate our understanding of human rights. 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.
|
| Customer Reviews: Read 14 more reviews...
 Admire Paul Farmer, but not necessarily his book; read Kidder instead March 22, 2008
7 out of 7 found this review helpful
Paul Farmer has long been famous, I take it, within the medical community as a brave lifesaver in some of the world's most destitute places. He's lived in Haiti for 20-some years, tending to the poor and sick. He used his success against tuberculosis there as a springboard into Russia, where he's helped prevent the spread of Multidrug-Resistant Tuberculosis (MDRTB) within and beyond the country's prison population. He is, to put it succinctly, a saint.
His fame spread to a much broader audience with the publication of Tracy Kidder's Mountains Beyond Mountains: Healing the World: The Quest of Dr. Paul Farmer. Mountains Beyond Mountains is a hopeful, awe-inspiring, life-changing book. A couple years after reading it, I picked up Farmer's own Pathologies of Power, expecting great things.
It shouldn't be surprising that Farmer is a true Christian. Reading a lot of economics -- and even a lot of politics inspired by economics -- and then reading Farmer, I'm struck by how arid the former sounds in contrast to the latter. A cold calculus might explain to us why we should treat the poor well. Maybe we can justify redistribution to the poor because their utility from one marginal dollar is higher than that for a wealthy person. Or maybe we should aim to stop MDRTB in prisons because those prisoners will go out into the outside world and infect the nonpoor. Farmer cuts through that: *we should help the poor because they are poor, and it is our obligation as humans to serve the least fortunate*.
Not only that: we should help them because, in most every case, their poverty is a sign that we have failed them. Farmer angrily ticks off case after case, most of them straight from his first-hand experience, where what initially looks like a senseless, random death is seen to be a symptom of a deeper systemic problem. The most haunting of these may be the death of a young Haitian girl named Acephie who contracted HIV from a Haitian soldier. She had sex with him because soldiers are some of the few Haitians with dependable salaries. But what led Acephie into that position of economic dependence to begin with? It didn't help that the Haitian government, with the blessing of Western development agencies, had evicted Acephie's family years before to build a dam; the family had to move to higher, poorer ground because of someone's idea of what was good for them. The road from there leads more or less directly to the AIDS death of a Haitian girl. (James Scott's Seeing Like A State contains a lot more tragedies in this direction.)
Pathologies of Power is filled with stories like that. It is not a hopeful book; it is very, very bitter. This despite Kidder's blurb on the cover to the contrary: Kidder recognized the anger, but saw hopefulness that I didn't.
We won't permanently end the suffering of the poor, says Farmer, until we fix the causes of that suffering. He labels these causes "structural violence." Structural violence is what leads poor Haitians to die of preventable disease ("stupid deaths," to use the Haitians' phrase) because the World Health Organization deems their treatment "cost-ineffective," while pharmaceutical companies get wealthy and we argue over the cost-effectiveness of keeping old Americans alive longer. A world devoted to lifting up the least fortunate would stop the stupid deaths first. Drug companies and governments would help the poor *even if there were no money to be made from them*.
Based purely on its message, I couldn't recommend this book highly enough: everyone should learn to think like a true Christian in the midst of rapacious capitalism. But stylistically it's a chore; Farmer is angry, and is lashing out in all directions. His anger leads him to repeat himself 20 or 30 times throughout the book, and to offer very few actual solutions. Which is surprising: the man himself lives to solve the problems of the destitute.
So I think it's vital to differentiate Farmer The Man from Farmer The Author. That's also why I'd recommend that you go right out and read Mountains Beyond Mountains instead: it teaches the same powerful lessons, only a lot more concisely and inspiringly.
 Pathologies of Power March 6, 2008
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.
Health and survival as human rights May 30, 2007
2 out of 2 found this review helpful
Paul Farmer, perhaps the most famous 'Third World doctor' living today, has written an eloquent and moving plea for a reconsideration of modern approaches toward healthcare in the developing nations in this book, "Pathologies of Power". Based on his personal experiences of care in Haiti, but also his professional visits to Russia, Africa, Central America, Mexico, Cuba and many other places besides, Paul Farmer demonstrates that the problematics of healthcare and those of poverty and inequality are insolubly linked in these nations. Whoever says "heal the sick" must also say "end poverty", for the one is not possible without the other; and whoever says "prevent disease" must also say "destroy socio-economic inequality", for the one is not possible without the other. That is the message of this book.
A large part of the work consists of reflections by Farmer on his experiences in Haiti and elsewhere and on the way in which the current worldwide economic structures engender a genuine and systematic violence against the rights of the poor. Strongly inspired by liberation theology (though not necessarily religious), Farmer eloquently and effectively contrasts the heavy importance attached to individual political and legal rights with the way in which the violations of rights done by structural inequalities and injustices is wholly ignored in the same circles that would complain about the former. Rights issues are the domain of jurists, development issues the domain of (liberal) economists; but the way in which the poor and weak are constantly crushed by the systematic repression that is poverty and inequality, at least as real and at least as much a violation as any torture, that seems to be the domain of nobody at all. As Paul Farmer clearly shows, even in the lately so blossoming domain of medical and bioethics the issue of socio-economic structures is completely swept under the carpet. As he says, this really is the "elephant in the room".
The same also goes for the oft-invoked importance of efficiency. Callous and counterproductive Western, often American, inspired healthcare policies in the developing nations (among which we must now sadly share Russia as well) generally fail at providing effective treatment against simple preventable disease such as TBC, because those medications that would actually help are considered "not cost-effective". This is in fact just a polite way of saying "we don't care about these people", but then phrased in a manner that will lead to less of an uproar in the newspapers. Farmer however is not fooled so easily, and sees this for what it is - a structural repression of the developing nations by the developed ones, in the name of "efficiency", i.e. efficiency in achieving the aims of the Western states.
This book is a very powerful work, and a strong indictment of the prevailing attitude towards healthcare and development issues and the little attention paid to their interrelation. It also demonstrates convincingly how the current worldwide economic system is bad for everybody's health. And what could be a more important thing than that?
Pathologies of Power May 12, 2007
2 out of 3 found this review helpful
Read this book. Paul Farmer is one of the few who can enlighten us to a more profound understanding of the mechanisms that underlie disease in so many of its forms. He sees farther than most of us and comes to his conclusions with a gigantic intellect and hard hard hands-on work with the poor and ill for over 2 decades in Haiti and elsewhere. He is our Albert Schweitzer. His concept of "structural violence", that set of social and economic intrastructure deficits that set aside "rich" from "poor" and lays open the environment for not only the contagious diseases like TB and HIV, but also allows for the malnourishment and the reduced choices in nutrition, allows for the maintenance of the dearth of available health care resources, sanitation and educational systems, the conflation of which prevents protection against the illnesses of poverty, puts the reader into the realm of being forced to see a hidden and dirty truth. His prose is mutedly angry. His emotions are unmistakably righteous. His undressing of some of the "liberal" NGO mentality is eye opening. He is the real deal. Read his elegant words and get a glimpse at reality. We are sadly blinded to it by some of the "pathologies" of the powers that be. I have been a physician for almost 30 years. I've given this book to my sons who are young physicians. The thoroughness of his presentation of the causes of the societal ills that allow for the illnesses, and the bibiography that supports his theses are encylopedic in scope. Again, he is the real deal.
 passion for the poor January 18, 2007
5 out of 6 found this review helpful
Paul Farmer is a Harvard MD and PhD (anthropology), clinician, tuberculosis specialist, author of numerous books and scholarly articles, recipient of a MacArthur "genius" grant, and Professor of Medical Anthropology at Harvard Medical School--when he is not living in a hut in his beloved Haiti where he founded Partners in Health, or traveling a quarter million miles a year to lecture, visit prisons, or meet with George Soros or the Gates Foundation. Most important of all, Farmer is an unapologetic, outspoken, and radical advocate for the poorest of the poor. Adequate health care, he insists, is a basic human right for every human being, and our world is failing miserably in this regard. His fascinating life story is told by Pulitzer Prize winner Tracy Kidder in the book Mountains Beyond Mountains (2003).
According to a World Bank study from 1993, today in Sub-Saharan Africa "the median age at death is less than five years," (p. xi; no typographical error). Such deplorable disparities between rich and poor, Farmer writes, are not random occurrences, they are not accidental, inescapable or necessary. Rather, they result from pathologies of power, human agency, and structural violence. Quoting the liberation theologian Jon Sobrino, "The poor of the world are not the causal products of human history. No, poverty results from the actions of other human beings" (p. 143). Which is to say that the brutal asymmetry that consigns over half the world to wretchedness is not irremediable. Resignation, in fact, is the most inexcusable choice we could make. However daunting and complex, we can ameliorate these unacceptable conditions if we make other choices: "This book is a physician-anthropologist's effort to reveal the ways in which the most basic right--the right to survive--is trampled in an age of great affluence, and it argues that the matter should be considered the most pressing one of our times" (p. 6).
Farmer spends considerable time charting anecdotal evidence from his two decades of clinical practice serving the poorest of the poor. These detailed case studies from Haiti, Chiapas, Peru, Russia and Cuba are not mere examples but instead emblematic of the problem. Further, following liberation theologians who have deeply influenced him, Farmer strongly advocates listening carefully to the voices of the poor themselves, in their own words, and not only to health "experts" in Geneva, New York and Paris. "I believe," writes Farmer, that 'the poor and impoverished of the world, in virtue of their very reality, constitute the most radical question of the truth of this world, as well as the most correct response to this question'" (p. 202).
Some will dismiss rhetoric like that as from a wild-eyed idealist, or an angry extremist, but Farmer would respond that what is extreme and harsh are the conditions of way too many human beings in the world, which ought to evoke anger, and not his passionate advocacy for them (p. 254). Rather than merely "manage" these horrible social inequalities, Farmer challenges each one of us to make a difference by what he calls "pragmatic solidarity" with the poor.
|
|
|
