Pathologies of Power: Health, Human Rights, and the New War on the Poor.

Abstract

Pathologies of Power: Health, Human and the New War on the Poor. Farmer, P. Berkeley and Los Angeles, Calif, University of California Press, 2005, hardcover, 402 pp, $27.50. Pathologies of Power, is a text that examines medicine in the age of globalized poverty. Farmer writes from the point of view of a physician and anthropologist who has much experience dealing with poverty in his own medical practice in rural Haiti. He challenges us to look beyond the obvions symptoms of the nameless, faceless poor, in order to critically examine societal structures, which are the real causes of poverty and oppression in the world today. The term structural violence is used to describe the unequal distribution of power within the world and the resulting offenses against human dignity. The book begins with a foreword written by economist and former Nobel Peace Prize winner, Amartya Sen. It appears that Farmer is using his mentor, Sen, to extend appeal of his central thesis to a larger audience. This strategy opens the door for Farmer to take many professions to task for their role in the development and maintenance of structural violence. Will we choose to participate in an authentic multidisciplinary dialogue and explore a badly needed paradigm shift of power in order to make the world a better place? In the foreword, Sen states, Paul Farmer teaches us how to stop whistling and start thinking. We have reason to be grateful. Pathologies of Power is then divided into 2 parts. The first part entitled Bearing Witness sets the stage to open our eyes, hearts, and consciousness as Farmer presents case studies of victims of structural violence. He shares stories of his patients and describes how structural violence has impacted not only their lives, but also the choices they and their families have had to make for survival. Farmer brilliantly allows his audience to connect on an emotional and personal level with these characters as a way to engage his readers with the nameless and faceless poor of the world. He then deconstructs, with almost angry chastisement, the policies and structures in place that promote inequality and perpetuate the oppression of the poor. Farmer effectively channels that moral outrage into praxis, which allows his readers to examine the possibilities of change. He is quick to point out that because many of the societal structures that oppress others have been created by humans, they can also be changed by humans if we are willing to accept a paradigm shift of power. According to Farmer, with the possibility of a paradigm shift, one can find hope in making the world a more just place for all. The second part of the book, titled One Physician's Perspective on Human Rights, expands the discussion of the role of structural violence to issues of health care. Farmer's chapters open with dramatic quotations and poems written from the voice of the nameless, faceless poor. This strategy is an example of critical pedagogy used to further engage the reader in the serious topic of human rights. Farmer takes his readers through exhausting moralizing rhetoric, and yet, in this process, he is able to create a sense of hopefulness. Aid, rather than trade, initiatives continue to perpetuate the cycle of oppression. He also implicates international lending organizations, the World Trade Organization, and development projects. The fact that we all play a role in structural violence either by our actions or our complacency can be disconcerting. Farmer, however, challenges us to look beyond the present situation, to engage in creating a better vision of the future, and to work for change within the system. After exposing the problems associated with structural violence, Farmer makes a case for his solution to the global problem of structural violence. He examines the various social justice models of charity, development, and liberation. In Farmer's opinion, charity models are deeply flawed as a system of oppressors helping the oppressed perpetuate the theme of structural violence. …