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AIDS and Accusation: Haiti and the Geography of Blame (Comparative Studies of Health Systems and Medical Care) Paperback – August 9, 1993

ISBN-13: 978-0520083431 ISBN-10: 0520083431
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Editorial Reviews

From Library Journal

Physician and anthropologist Farmer studied the impact of AIDS on the impoverished people of Haiti, and his portrayal for his doctoral dissertation, of a small rural village--its clinic, religious life, folk healers, and voodoo beliefs--brings Haitian culture powerfully to life. He provides an extensive history of the country, finally exploring the connection between suffering and blame: Americans have blamed Haitians for "causing" AIDS, while Haitians have accused one another of "sending" it through sorcery. Rarely is a book based on a dissertation so engaging. Highly recommended for academic and subject collections.
- Judith Eannarino, Washington, D.C.
Copyright 1992 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.


"This superbly crafted volume is dedicated to explaining and refuting a popular U.S. Belief that AIDS came to the United States from Haiti. . . . Farmer has made an outstanding scholarly contribution to the 'anthropology of suffering, ' the assessment of illness as perceived and experienced by a patient embedded in an interlocking fabric of culture and history. "-- "Medical Anthropology Quarterly

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Product Details

  • Series: Comparative Studies of Health Systems and Medical Care (Book 33)
  • Paperback: 338 pages
  • Publisher: University of California Press (August 9, 1993)
  • Language: English
  • ISBN-10: 0520083431
  • ISBN-13: 978-0520083431
  • Product Dimensions: 9 x 6 x 0.7 inches
  • Shipping Weight: 13.6 ounces
  • Average Customer Review: 4.8 out of 5 stars  See all reviews (8 customer reviews)
  • Amazon Best Sellers Rank: #1,378,384 in Books (See Top 100 in Books)

More About the Author

Paul Farmer is UN's Deputy Special Envoy for Haiti and Chair of Global Health and Social Medicine at Harvard. He is also Professor of Anthropology at Harvard Medical School, chief of Social Medicine and Inequalities at Boston's Brigham and Women's Hospital, and founding director of Partners In Health. Among his numerous awards and honors is the John D. and Catherine T. MacArthur Foundation's "genius award."

Customer Reviews

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Most Helpful Customer Reviews

26 of 29 people found the following review helpful By A reader on August 7, 2002
Format: Paperback
Farmer's excellent historical ethnography of Haitian illness (as seen through the contemporary context of the world AIDS epidemic), proves the necessity of developing anthropological approaches to understanding health systems and implementing medical care. The diagnosis and analysis of sickness, disease, illness, and treatment should go hand-in-hand with the cultural understanding of local systems of blame, accusation, causation, and cure. Where most approaches to medicine are based on the "Westernized" first-world nations' understanding of the causes of illness (tainted as well, as Farmer shows, by systematic "blame the victim" and shame techniques), the adoption of these approaches in treating the illnesses of other peoples can be catastrophic. Three ethnographies make up the structure of a detailed historical inquiry )
The longstanding tradition of conceiving of illness through the lens of powerlessness shapes the contemporary lives of the people in Haiti with whom Farmer worked. Although they could see the effects of the illness, people in this region were obsessed with the cause of the illness, and felt the need to understand AIDS through a constructed narrative of blame. A deep belief in their religion led villagers to look for the source of witchcraft that could possibly be harming them, and elaborate stories about neighbors, jealousies, and rivalries flourished as a result. Any improvement in the standing of one member of the society (through wealth, status, relationships, acquisition of property or food, or political power through employment or marriage) adds to the structure of distrust and blame.
Farmer's book shows how disturbingly complex and deep the layers of mistrust, misinformation, and the effects of racism, are.
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8 of 10 people found the following review helpful By A Customer on February 4, 2000
Format: Hardcover
This book dispels the common myths of Haitians and AIDS. It also shows very clearly the heavy involvement of the United States in creating the poverty Haiti has faced. This book makes use of statistics well, but unfortunately, at this point those stats are many years old. When Farmer wrote this book, only three people in the village of Do Kay had died of AIDS. Now, with huge percentages of Haitians exposed to HIV, the picture must certainly look different. This book is a geat candidate for a revised edition some time in the future.
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2 of 2 people found the following review helpful By ND on January 26, 2011
Format: Paperback
AIDS and Accusations is an interesting narrative about the social and epidemiological history of HIV in Haiti. Above all, this book should be read with an open mind - and understood with a grain of salt. Less a medical book than an anthropologic account, Farmer's approach provides an understanding of the impacts of HIV and of Haitian responses to the emergence of the disease in both social and epidemiologic contexts.
Farmer erects a national and cultural history to frame the discussion. Though the stated purpose of the book appears to be illustrative, he takes the opportunity to draw several conclusions regarding related topics. The subtitle of the book is predictive when characterizing these conclusions. Farmer recalls frequent detrimental Western, and particularly American, interventions into Haiti and he is quick to cast essentially the entirety of the blame for Haiti's hardship on these interactions. Though such criticisms are vogue, especially in academia, the accusations appear to reflect a primarily personal understanding of events at the expense of a more complex, and (perhaps saliently) less dramatic perspective.
Despite his ironic accusations, Farmer adds a heartbreaking intimacy to the story of Haitian HIV victims, and truly to the story of Haiti, herself.
He proposes an unconventional understanding of AIDS in Haiti, but his view is both powerful and beneficial. The compassion and humanity that are evident in Farmer's account are welcome additions to the body of literature on Haiti.

Additionally, on a medical note, Farmer makes a compelling epidemiologic case for an America-to-Haiti origin of HIV, though recent genetic studies have since supported the Africa-to-Haiti-to-America pathway. The issue has not been settled.
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10 of 14 people found the following review helpful By Amber on January 3, 2000
Format: Hardcover
I read this book for a medical anthropology class and found it incredibly interesting in its discussion of the politics and racism involved in the US treatment of AIDS in Haiti. It delves into how the American presence and influences lead to and exasperated the widespread AIDS and poverty problems in Haiti.
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