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Pathologies of Power: Health, Human Rights, and the New War on the Poor 1st Edition

by Paul Farmer (Author)

4.6 232 ratings

Part of: California Series in Public Anthropology (50 books)

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Pathologies of Power uses harrowing stories of lifeand deathin 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.

Editorial Reviews

From The New England Journal of Medicine

There are many kinds of gifted physicians: clinicians, researchers, and those who build institutions. Paul Farmer is the rarest of all: a prophet. Pathologies of Power is a jeremiad on how the "structural violence" of denied opportunities, economic deprivation, violent despots (and the powers supporting them), and international financial organizations harm the health of billions of people who are so distant that they are glibly and uncomprehendingly referred to as living in a "third world." This summary does not do justice to the richness of the book. Farmer deftly weaves personal stories from his work with the dispossessed, careful academic notes, and well-chosen quotations from intellectuals, poets, and proponents of liberation theology. These citations introduce marvelous writers who are not well known to readers from the United States. Farmer builds from the 19th century's Rudolph Virchow, who argued that physicians must advance public health through political and social reform as "attorneys for the poor." Farmer's anecdotes about mobilizing the poor on their own behalf echo the work of Norman Bethune. And Farmer extends Jonathan Mann's fusion of human rights and medical ethics to health and human rights. Farmer, a physician and an anthropologist, offers a blistering critique of anthropologists who describe colorful folkways or bits of social problems, such as sexual barter, without illuminating how such practices are sustained by class and political history. This critique and Farmer's advocacy for oppressed persons mark this book as a prophetic work. Therefore, it is also a towering work of medical ethics. Farmer's critique of anthropology applies equally well to medical ethics, with its scholastic focus on moral curiosities and its decorous silence on "political" issues such as the lack of insurance or the ways in which the policies of international financial organizations affect health and health care for the world's poor. The prophetic voice speaks for the marginalized and can strike listeners as shrill, odd, or discomforting. Farmer skirts that risk by careful scholarship and compelling writing. That being said, I think he overrates the competence of Haiti's reelected president Jean-Bertrand Aristide and the success of Cuba's program to suppress the human immunodeficiency virus. Though he correctly notes the entrenched and mistaken pessimism of the international health authorities about the ability of dispossessed people to complete tuberculosis treatment, he overestimates the capacity of the available infrastructure in many poor countries to manage daily antiretroviral therapy. Such quibbles do not diminish the importance of his larger thesis. Farmer calls on physicians to mount a sustained engagement against human-rights abuses as the roots of disease, disability, and lack of access to health care. Health itself, rather than technical compliance with laws or accords, must be the standard for evaluating governments, foreign policy, and the national restructuring plans of such organizations as the International Monetary Fund. Expanding health services and democratizing information must be central to the global agenda of all physicians. Academic research and education must use the privilege conferred by their power and independence to articulate specific relationships between human rights and abuses of human rights with health and disease. We live in a time when epidemics keep pace with globalization and when the map of deprivation and human-rights abuses precisely overlays the atlas of war, disease, and terrorism. Farmer's sane prescription is more likely to work than is rationalizing neglect, dribbling charity, averting our eyes, or attempting to build a garrison state bounded by a cordon sanitaire. Pathologies of Power is a profound work; it deserves the widest possible audience. Steven Miles, M.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Review

"It's crucial that we confront the link Farmer reveals between social inequality and disease."--"Utne"

From the Inside Flap

"This is an angry and a hopeful book, and, like everything Dr. Farmer has written, it has both passion and authority. Pathologies of Power is an eloquent plea for a working definition of human rights that would not neglect the most basic rights of all: food, shelter and health. This plea has special potency because it comes from Dr. Farmer, a person who has proven that the dream of universal and comprehensive human rights is possible, and who has brought food, shelter, health, and hope to some of the poorest people on this earth."Tracy Kidder, author of The Soul of a New Machine and Home Town

"Farmer's brilliance and charisma leap from the pages of his book. He challenges us to face the urgent theoretical and political challenges of the twenty-first century by linking structural violence to embodied social suffering and in the process calls for a new definition of human rights. Once this book is out, we will no longer be able to remain complacently--or rather, complicitly--on the sidelines."Philippe Bourgois, author of In Search of Respect: Selling Crack in El Barrio

"A passionate critique of conventional biomedical ethics by one of the world's leading physician-anthropologists and public intellectuals. Farmer's on-the-ground analysis of the relentless march of the AIDS epidemic and multi-drug resistant tuberculosis among the imprisoned and the sick-poor of the world illuminates the pathologies of a world economy that has lost its soul."Nancy Scheper-Hughes , author of Death without Weeping: the Violence of Everyday Life in Brazil

"In his compelling book, Farmer captures the central dilemma of our timesthe increasing disparities of health and well-being within and among societies. While all member countries of the United Nations denounce the gross violations of human rights perpetrated by those who torture, murder, or imprison without due process, the insidious violations of human rights due to structural violence involving the denial of economic opportunity, decent housing, or access to health care and education are commonly ignored. Pathologies of Power makes a powerful case that our very humanity is threatened by our collective failure to end these abuses."Robert S. Lawrence, President of Physicians for Human Rights and Edyth Schoenrich Professor of Preventive Medicine at the Bloomberg School of Public Health, Johns Hopkins University

"Farmer has given us that most rare of books: one that opens both our minds and hearts. It stands as a model of engaged scholarship and an urgent call for social scientists to forsake their cushy disregard for human rights at home and abroad."Loïc Wacquant, author of Prisons of Poverty

"Paul Farmer is an original: a powerful writer, an insightful theorist, and a human rights activist on behalf of the health needs of some of the poorest and most excluded people on the planet. Pathologies of Power brings together all his strengths, as a thinker and an activist. Every health worker, human rights teacher, and government official who seeks to improve the health status and life chances of their fellow human beings simply must read this book."Michael Ignatieff, author of Human Rights as Politics and Idolatry

"Paul Farmer is a great doctor with massive experience working against the hardest of diseases in the most adverse circumstances, and, at the same time, he is a proficient and insightful anthropologist. Farmer's knowledge of maladies such as AIDS and drug-resistant tuberculosis, which he fights on behalf of his indigent patients, is hard to match. But what is particularly relevant in appreciating the contribution of this powerful book is that Farmer is a visionary analyst who looks beyond the details of fragmentary explanations to seek an integrated understanding of a complex reality."Amartya Sen, Nobel Laureate, Economics

From the Back Cover

"This is an angry and a hopeful book, and, like everything Dr. Farmer has written, it has both passion and authority. Pathologies of Power is an eloquent plea for a working definition of human rights that would not neglect the most basic rights of all: food, shelter and health. This plea has special potency because it comes from Dr. Farmer, a person who has proven that the dream of universal and comprehensive human rights is possible, and who has brought food, shelter, health, and hope to some of the poorest people on this earth."Tracy Kidder, author of The Soul of a New Machine and Home Town

"Farmer's brilliance and charisma leap from the pages of his book. He challenges us to face the urgent theoretical and political challenges of the twenty-first century by linking structural violence to embodied social suffering and in the process calls for a new definition of human rights. Once this book is out, we will no longer be able to remain complacently--or rather, complicitly--on the sidelines."Philippe Bourgois, author of In Search of Respect: Selling Crack in El Barrio

"A passionate critique of conventional biomedical ethics by one of the world's leading physician-anthropologists and public intellectuals. Farmer's on-the-ground analysis of the relentless march of the AIDS epidemic and multi-drug resistant tuberculosis among the imprisoned and the sick-poor of the world illuminates the pathologies of a world economy that has lost its soul."Nancy Scheper-Hughes , author of Death without Weeping: the Violence of Everyday Life in Brazil

"In his compelling book, Farmer captures the central dilemma of our timesthe increasing disparities of health and well-being within and among societies. While all member countries of the United Nations denounce the gross violations of human rights perpetrated by those who torture, murder, or imprison without due process, the insidious violations of human rights due to structural violence involving the denial of economic opportunity, decent housing, or access to health care and education are commonly ignored. Pathologies of Power makes a powerful case that our very humanity is threatened by our collective failure to end these abuses."Robert S. Lawrence, President of Physicians for Human Rights and Edyth Schoenrich Professor of Preventive Medicine at the Bloomberg School of Public Health, Johns Hopkins University

"Farmer has given us that most rare of books: one that opens both our minds and hearts. It stands as a model of engaged scholarship and an urgent call for social scientists to forsake their cushy disregard for human rights at home and abroad."Loïc Wacquant, author of Prisons of Poverty

"Paul Farmer is an original: a powerful writer, an insightful theorist, and a human rights activist on behalf of the health needs of some of the poorest and most excluded people on the planet. Pathologies of Power brings together all his strengths, as a thinker and an activist. Every health worker, human rights teacher, and government official who seeks to improve the health status and life chances of their fellow human beings simply must read this book."Michael Ignatieff, author of Human Rights as Politics and Idolatry

"Paul Farmer is a great doctor with massive experience working against the hardest of diseases in the most adverse circumstances, and, at the same time, he is a proficient and insightful anthropologist. Farmer's knowledge of maladies such as AIDS and drug-resistant tuberculosis, which he fights on behalf of his indigent patients, is hard to match. But what is particularly relevant in appreciating the contribution of this powerful book is that Farmer is a visionary analyst who looks beyond the details of fragmentary explanations to seek an integrated understanding of a complex reality."Amartya Sen, Nobel Laureate, Economics

About the Author

Paul Farmer is Presley Professor of Medical Anthropology at Harvard Medical School, Chief of the Division of Social Medicine and Health Inequalities at Brigham and Women’s Hospital, and Founding Director of Partners In Health. Among his books are Infections and Inequalities: The Modern Plagues (California, 1999), The Uses of Haiti (1994), and AIDS and Accusation: Haiti and the Geography of Blame (California, 1992). Farmer is the winner of a MacArthur Foundation "genius" award and the Margaret Mead Award for his contributions to public anthropology. Amartya Sen, whose work challenges conventional market-driven economic paradigms, is the winner of the 1998 Nobel Prize in economics. He teaches at Trinity College, Cambridge University.

Excerpt. © Reprinted by permission. All rights reserved.

From the Foreword: "Paul Farmer is a great doctor with massive experience working against the hardest of diseases in the most adverse circumstances, and, at the same time, he is a proficient and insightful anthropologist. Farmer's knowledge of maladies such as AIDS and drug-resistant tuberculosis, which he fights on behalf of his indigent patients, is hard to match. But what is particularly relevant in appreciating the contribution of this powerful book is that Farmer is a visionary analyst who looks beyond the details of fragmentary explanations to seek an integrated understanding of a complex reality."-Amartya Sen, Nobel Laureate, Economics

Product details

Publisher ‏ : ‎ University of California Press; 1st edition (April 25, 2003)
Language ‏ : ‎ English
Hardcover ‏ : ‎ 419 pages
ISBN-10 ‏ : ‎ 0520235509
ISBN-13 ‏ : ‎ 978-0520235502
Lexile measure ‏ : ‎ 1360L
Item Weight ‏ : ‎ 1.1 pounds
Dimensions ‏ : ‎ 6 x 1.1 x 9 inches

Best Sellers Rank: #787,171 in Books (See Top 100 in Books)
- #343 in Anthropology (Books)
- #745 in Health Care Delivery (Books)
- #972 in General Anthropology

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Paul Farmer

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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."

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Customers find the book insightful, well-researched, and beneficial. They describe it as an interesting read with a simple and straightforward writing style. The book speaks out for the poor and vulnerable, providing perspective on humanitarian crises. Readers appreciate the author's compassion and call for quality health care and human rights.

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20 customers mention "Insight"20 positive0 negative

Customers find the book insightful, well-researched, and beneficial. They say it helps build a critical mind and is an essential read in the field. The subject matter is always topical and interesting, making it an excellent teaching resource for social sciences. Customers consider it important and one of the five most important books they have read in their lifetime.

"...prose of an investigative reporter and brings provocative interdisciplinary voices of others---Gustavo Gutiérrez, Paolo Freire, Cornel West, Amartya..." Read more

"...the implementation of the said recommendations saved lives, improved healthcare outcomes, and positively impacted the lives of the sick and..." Read more

"...That said, the book is still unique and not a repeat/rehash of prior work as is so very common...." Read more

"...His books, and this one in particular, are excellent teaching resources for any of the social sciences" Read more

12 customers mention "Readability"12 positive0 negative

Customers enjoy the book. They find it interesting and praise the author as brilliant, down-to-earth, and energetic. Some read it for school or in their spare time.

"I got this book for my Poverty and Global Health class and really enjoyed reading it...." Read more

"A phenomenal read, I was required to complete this ethnology for a 200-level Cultural Anthropology course that emphasized the concepts of..." Read more

"Always love a great Paul Farmer read! This one is packed full of powerful social justice lessons. I learned a lot reading this book." Read more

"to make this short and sweet. simply one of the five best books, one of the five most important books, I have read in my lifetime...Paul Farmer is..." Read more

5 customers mention "Pacing"5 positive0 negative

Customers find the book informative and easy to read. They appreciate the well-written, organized content with detailed descriptions. The arguments are simple and based on an equitable foundation.

"...His ideas are radical, in part, because they are simple and based on an equitable distribution of health, regardless of wealth...." Read more

"...He writes in an easy style that makes what he is trying to convey, easy to digest...." Read more

"The book was pretty battered, frayed & bent edges. Is certainly readable but to describe it as ‘in good shape’ is inaccurate in my opinion" Read more

"Needed as a school text and it was informative and easy to read." Read more

4 customers mention "Compassion"4 positive0 negative

Customers find the book compassionate. It provides insights and perspective on humanitarian crises, creating sympathy and a call to action for quality health and human rights.

"...It speaks truth to power and it speaks for the destitute sick. Take two aspirin, lie down, and read the book...." Read more

"...assume a broader educational mandate, and secure more resources for health and human rights...." Read more

"A little difficult to read but it creates a great sympathy and call to arms for quality healthcare" Read more

"Once again, Farmer provides essential insights and perspective on humanitarian crises. Essential reading in the field!" Read more

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Patti M. Marxsen
Take Two Aspirin and Read This Book
Reviewed in the United States on April 10, 2004
Verified Purchase
Paul Farmer's "Pathologies of Power" will probably give you a headache, undoubtedly cause sleep disturbance, and very likely turn your stomach. In short, it will make you sick. But if you are well enough to read this and rich enough to consider purchasing the book, you are better off than the "disposable millions" whose lives he illuminates and honors in this indictment of global public health as-we-know-it. In this passionate and well-researched treatise, a world-class physician takes his own disciplines of medicine and anthropology to task for failing to ask the right questions. Then, noting that the U.S. pharmaceutical industry is the most profitable industry in the most affluent country in the world, he blows through its defense of those extraordinary profits like a gust of fresh air. A similarly searing deconstruction of health policymakers' rationale for "cost-effectiveness" and their elite argot of oppression reveals a blame-the-victim mentality that plagues the world and explains why, in the midst of unprecedented wealth, over 40 million Americans are without health insurance of any kind. And that is just the beginning.

While Farmer's hospital in Haiti, Zanmi Lasante, is not the only hospital to successfully combat the forces of poverty and disease in that country (Hôpital Albert Schweitzer in the Artibonite Valley predates Farmer's project by nearly three decades), his twenty-year presence in Central Haiti has resulted in a deep understanding of how structural violence on a global scale is a leading cause of disease and death among the world's poor, wherever they may live. Drawing on case-study examples from Haiti, South America, Cuba, Siberia, and the United States, he deftly illustrates why tuberculosis deaths, which he describes as 95 percent curable with inexpensive medication developed many years ago, "occur almost exclusively among the poor, whether they reside in the inner cities of the United Stated or in the poor counties of the Southern Hemisphere." Addressing the growing trend of multi-drug resistant strains of TB, Farmer discusses "tuberculosis as punishment" in the world's prison populations and delivers a wake-up call to those who might consider themselves immune from this, and other, infectious diseases.

In his critique of the commodification of healthcare, Farmer speaks of "orphan drugs" drugs that are simply not developed because they are needed by people who cannot pay for them, the sale of organs by those without resources to those with money, and the equally revolting multi-million dollar compensation packages of pharmaceutical company CEOs and managed care executives. In the midst of this catalog of inequity, he wonders why medical ethics courses in American schools of medicine focus so narrowly on the "quandaries of the fortunate" like whether or not to refuse a particular technology or whether or not to leave a loved one in a prolonged coma when millions are condemned to death or disease before they learn to walk. Even the World Health Organization (WHO) does not escape his critical analysis: "... the language of social injustice is increasingly absent from public health parlance," he notes.

Farmer is one of those remarkable doctors working in remote places who, somehow, finds the energy to look up from his daily workload and ponder the underlying causes of the suffering he treats. Furthermore, he writes about it in the brisk and engaging prose of an investigative reporter and brings provocative interdisciplinary voices of others---Gustavo Gutiérrez, Paolo Freire, Cornel West, Amartya Sen, Jon Sobrino, Nancy Scheper-Hughes, to name a few---to bear on his march toward social justice. His ideas are radical, in part, because they are simple and based on an equitable distribution of health, regardless of wealth. Bringing the observe, judge, act methodology of liberation theology to bear on global public health, Farmer advocates a "preferential option" for the poor, a redefinition of medicine as a healing profession (as opposed to medicine-as-commerce), and a new understanding of healthcare as a basic human right, for all.

Toward the end of a chapter entitled "Listening for Prophetic Voices," Farmer distills his argument into a call to action: "We thus find ourselves at a crossroads: healthcare can be considered a commodity to be sold, or it can be considered a basic social right. It cannot comfortably be considered both of these at the same time. This, I believe, is the great drama of medicine at the start of this century. And this is the choice before all people of faith and good will in theses dangerous times."

Pathologies of Power is a lucid and alarming statement from a fearless physician. It speaks truth to power and it speaks for the destitute sick. Take two aspirin, lie down, and read the book. In spite of its consciousness-raising side effects, this may be the beginning of a cure for what ails the world.

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R. Yusuf
Positive Review
Reviewed in the United States on June 22, 2010
Verified Purchase
In Pathologies of Power Dr. Farmer has provided critical evidence of health care as it is effected by social and global inequalities. He discusses cases regarding AIDS and the Haitian Boat Refugees, structural violence in Haiti and Mexico, multi-drug resistant TB in Russia, community based health projects in Chiapas, amongst other reflections on relevant cases and history. The book makes a forceful argument for the need to integrate health and human rights to improve the livelihoods of marginalized people. Professor Farmer recommends the following to complement present efforts to achieve the new health and human rights agenda: make health and healing the symbolic core of the agenda, make provision of services central to the agenda, establish new research agendas, achieve independence from powerful governments and bureaucracies, assume a broader educational mandate, and secure more resources for health and human rights. Furthermore, Dr. Farmer has provided evidence showing that the implementation of the said recommendations saved lives, improved healthcare outcomes, and positively impacted the lives of the sick and marginalized.

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Kat
Good Book, Great Insights
Reviewed in the United States on May 3, 2019
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I got this book for my Poverty and Global Health class and really enjoyed reading it. The book itself provides a great insight into the lives of those who live in poverty. It's a very eye-opening book and it helped a lot in my class, highly recommend.

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fruitjuicer1
A way of life
Reviewed in the United States on February 11, 2023
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This is a philosophy, a way of life, ethical living. If you don't give any of your money to charity, move on.

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Carol j Montgomery-Taylor
ATeaching Resource Like No Other
Reviewed in the United States on July 3, 2015
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Paul Farmer is well known in the anthropological world as well as within the christian world. He works to make social issues known to the greater public for the greater good. Through his own work in Haiti, South America, and Russia, he illustrates the turmoil prevalent in our world. He writes in an easy style that makes what he is trying to convey, easy to digest. He shares with the reader situations and circumstances where he has tried to make a difference. His books, and this one in particular, are excellent teaching resources for any of the social sciences

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Amazon Customer
A great read. A great buy
Reviewed in the United States on March 30, 2021
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The book was in great condition. I’m enjoying it so much. I’m glad I bought it.

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Lynn Rist
Political Structural Violence is allowed by denying healthcare to the poor.
Reviewed in the United States on March 13, 2020
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I like everything about this book. It should be mandatory for every Medical student, History, Sociology, Psychology, Snd Political Science student. Structural violence is a new important phrase that I learned meaning if a country denies people with pre-existing medical conditions that as a form of violence because it leads to death by structure of politics. Also if the poor cannot afford medical care which is a human right that is a form of structural violence.

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John Brown
to make this short and sweet. simply one of the five best books
Reviewed in the United States on September 23, 2014
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to make this short and sweet. simply one of the five best books, one of the five most important books, I have read in my lifetime...Paul Farmer is a remarkable man...

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Top reviews from other countries

Amazon Customer
No MRP on book
Reviewed in India on May 7, 2019
Verified Purchase
Book is no doubt is good but there is no MRP. On what basis the amount is charged. Will return this Item. This is not expected from Amazon.

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DCC
An important book to look at the ultimates causes of disease.
Reviewed in Canada on July 27, 2016
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A classic book that looks at causes behind the causes of disease. Well worth reading (other than the longest series of acknowledgments I have ever seen in a book) and particularly important for physicians to understand why diseases occur beyond the proximate causes.

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S Wood
Farmer in Fields of Horror and Hope
Reviewed in the United Kingdom on May 18, 2014
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I have known of Paul Farmer for years, principally through footnotes in his fellow Bostonian Noam Chomsky's books (whom Farmer thanks in his acknowledgements to this book) and in a variety of other books and articles over the years, and I thought it was about time that I became better acquainted with his writings and managed to get my hands on a copy of his 2004 book "Pathologies of Power".

Farmer's basic aim in this book is to argue for a working definition of Human Rights that includes those social justice: in general those social and economic rights which articles 22-27 of the UN Declarations of Human Rights (1948) describe. His particular expertise is in the medical sphere and it is that aspect that the book primarily, but far from solely, focuses on. The first part of the book is based around his experiences with the Non-Governmental Organisation "Partnerships in Health" (which he co-founded in 1987) in Haiti, Cuba, Mexico (Chiapas) and Russia. Haiti is where Partnerships in Health started its first Clinic in an area of Central Highlands where a World Bank funded Dam had submerged the best farming land driving the peasants onto higher, far less fertile land, where they struggle to live off the land, and their community fragments with individuals losing hope and not infrequently ending up in the slums of Port-au-Prince. In Cuba Farmer compares the treatment of HIV+ Haitian refugees at the US base in Guantanamo Bay (after the coup of 1991) and the Cuban's own record with their own HIV+ nationals at Santiago de las Vegas. The former is described as an "Oasis to Haitians" in the New York Times, the latter is generally pilloried in the press and subjected to criticism by Human Rights Groups. The reality Farmer unearths is a brutal, inhuman "quarantine" facility at Guantanamo, and a decent, caring open facility at Santiago de las Vegas. Reality is, not for the first time, the exact opposite of what the mainstream media would have us believe.

In Chiapas the focus is on the lives of the indigenous population and their Zapatista uprising which began in 1994. This was an effort by the poor marginalised Indians of the province in southern Mexico to free themselves of the "structural violence" and oppression of the Mexican state which by then had been a de facto one party state for decades. In Russia Farmer visits prisons, including those where prisoners with Tuberculosis are isolated, with completely inadequate treatment, looking to set up a partnership with the Russian Department of Justice in order to provide the best and most effective care for those who are being left to die in Russia's massive prison system (second in size per capita to that of the United States).

In the second part of the book entitled "One Physician's Perspective on Human Rights" Farmer reflects on the experiences he describes in the first part, including a definition of what he terms "structural violence" (in short, a form of violence where some social structure or social institution harms people by preventing them from meeting their basic needs) and an exploration of the ideas of Liberation Theology with its preference for looking out for the poor and impoverished. It's perhaps best to quote Paul Farmer at length to get the best idea of where he is coming from:

"In short, this "one physician's perspective on human rights" may be summed up as follows: just as the poor are more likely to fall sick and then be denied access to care, so too are they more likely to be the victims of human rights abuses, no matter how these are defined. By including social and economic rights in the struggle for human rights, we help to protect those most likely to suffer the insults of structural violence. It is my belief that the liberation theologians, in advocating preferential treatment for the poor, offer those concerned with human rights a moral compass for future action. A preferential option for the poor, and all perspectives rooted in it, also offers a way out of the impasse in which many of us caregivers now find ourselves: selling our wares and services only to those who can afford them, rather than making sure that they reach those who need them most. Allowing "market forces" to sculpt the outlines of modern medicine will mean that these unwelcome trends will continue until we are forced to conclude that even the practice of medicine can constitute a human rights abuse." (p138)

Subsequent to the publication of this book Farmer came a special envoy under ex-president Clinton (whom he criticises in relation to the his administration's policy towards Haiti and Haitians in the first part of the book) for Haiti. Hopefully his close proximity to established power, which I'm certain he's done for quite pragmatic reasons and laudable aims wont blunt Farmers deservedly caustic critique of the way in which the world's poor are treated, either medically or in more general terms. It certainly is difficult to believe that the author of this excellent book, finely written and offering a deep analysis and profound critique of the concept of Human Rights, as well as making a strong case for their definition to include Social and Economic Rights, would act other than for the poor.

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K-Nine
you know "structual violence"?
Reviewed in Japan on December 7, 2006
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Dr. Farmer and his associates "Partners In Health" pursue "pragmatic solidality" for the destitute sick. They exert a right-based approach, in which social and economic rights for those who are deprived or oppressed by power are protected under liberation theory they assert. Now, I learn that, in a world of affuluence, you should recognize public health and equal access to medical care, where the rights of the poorest are abused through "structual violence." In the end, Dr. Farmer and his colleagues redistribute goods and services to narrow the gap between the rich and the poor in this harsh new world or "globalization."

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khundy
Very Good
Reviewed in Canada on February 2, 2012
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Item was very good. It was in very good condition and quality, and exactly as described. Item was received very quickly.

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