Reviews
Pathologies of Power: Health, Human Rights and the New War on the Poor, by Paul Farmer, Amartya Sen
jackwwang's review against another edition
4.0
It's a rare enough occasion when a book fundamentally changes your mind about something in a meaningful way. This 2001 book from Paul Farmer did just that, it has fundamentally pivoted the way I see neoliberal capitalism, inequality and poverty, and the suffering arising from these. Whatever complaints I might raise later in this review, the fact that it has made me see a part of the world in a new light is amongst the highest praise I can offer.
To me this was a book about so called "stupid deaths," and the systems, regimes, and causes underlying the conditions that allow them to happen. These are deaths caused by conditions readily treatable by modern medicines: infections, tuberculosis, AIDS, etc. These are deaths that almost exclusively plague the poor, and the structured way in which the poor are both more susceptible to contracting these conditions, and the systemic way that they are consistently precluded from receiving the care that would save their lives is what Farmer calls "structural violence," Stupid deaths and the idea of structural violence.
Farmer boldly implicates neoliberalism, by which he means:
The "ideology that advocates the dominance nance of a competition-driven market model. Within this doctrine, individuals viduals in a society are viewed, if viewed at all, as autonomous, rational producers and consumers whose decisions are motivated primarily by economic or material concerns."
I felt very called out by this argument. Farmer insists that I, indeed all of us (anyone reading this review is extremely likely to be a beneficiary of the neoliberal order) are complicit in simply benefitting from the neoliberal regime. Such an order is portrayed as one in which the beneficiaries reap the fruits because the poor necessarily must suffer. It's an indictment that, reviewing the history of the last few centuries, I find difficulty mustering up s compelling argument against.
Farmer's voice is seething with anger. Given how he views the world and the amount of suffering he has witnessed, I don't blame him. In fact the fact that this book has turned me around in a lot of ways is likely due in large part due to the conveyed sense of indignation and urgency.
Farmer goes through examples of structural violence and the firsthand accounts of its victims in Haiti, Chiapas, and TB in Russian prisons. He makes a compelling argument that the best first step to acknowledge and addressing these problems is to listen to the voices of the victims. All too often we dismiss and silence these voices in favor of academic thoughts from the west, or our own half baked paternalistic ideas of what's best for others. If there's one clear takeaway from this work, it must be that we must stop silencing the voice of the poor.
Lastly however, there is a gap between describing the wrong and prescribing a right. In this sense I was left wanting by the end. Farmer strongly spoke for "social justice" without clearly explaining what that entails and how it will right the wrongs he has described. He does not quite own up to the fact that he has not offered a blueprint for fighting structural violence systemically. I do not mean to trivialize his calling attention to silenced voices and systemic injustices all too often muted, but he seems to give the impression that the path to addressing these issues is clear and doesn't quite acknowledge that it'll be a very hairy problem to disentangle. Maybe I'm just frustrated that the answers are not clear now that I've started acknowledging the problems.
For all human beings capable of empathy, this is strongly urged reading.
To me this was a book about so called "stupid deaths," and the systems, regimes, and causes underlying the conditions that allow them to happen. These are deaths caused by conditions readily treatable by modern medicines: infections, tuberculosis, AIDS, etc. These are deaths that almost exclusively plague the poor, and the structured way in which the poor are both more susceptible to contracting these conditions, and the systemic way that they are consistently precluded from receiving the care that would save their lives is what Farmer calls "structural violence," Stupid deaths and the idea of structural violence.
Farmer boldly implicates neoliberalism, by which he means:
The "ideology that advocates the dominance nance of a competition-driven market model. Within this doctrine, individuals viduals in a society are viewed, if viewed at all, as autonomous, rational producers and consumers whose decisions are motivated primarily by economic or material concerns."
I felt very called out by this argument. Farmer insists that I, indeed all of us (anyone reading this review is extremely likely to be a beneficiary of the neoliberal order) are complicit in simply benefitting from the neoliberal regime. Such an order is portrayed as one in which the beneficiaries reap the fruits because the poor necessarily must suffer. It's an indictment that, reviewing the history of the last few centuries, I find difficulty mustering up s compelling argument against.
Farmer's voice is seething with anger. Given how he views the world and the amount of suffering he has witnessed, I don't blame him. In fact the fact that this book has turned me around in a lot of ways is likely due in large part due to the conveyed sense of indignation and urgency.
Farmer goes through examples of structural violence and the firsthand accounts of its victims in Haiti, Chiapas, and TB in Russian prisons. He makes a compelling argument that the best first step to acknowledge and addressing these problems is to listen to the voices of the victims. All too often we dismiss and silence these voices in favor of academic thoughts from the west, or our own half baked paternalistic ideas of what's best for others. If there's one clear takeaway from this work, it must be that we must stop silencing the voice of the poor.
Lastly however, there is a gap between describing the wrong and prescribing a right. In this sense I was left wanting by the end. Farmer strongly spoke for "social justice" without clearly explaining what that entails and how it will right the wrongs he has described. He does not quite own up to the fact that he has not offered a blueprint for fighting structural violence systemically. I do not mean to trivialize his calling attention to silenced voices and systemic injustices all too often muted, but he seems to give the impression that the path to addressing these issues is clear and doesn't quite acknowledge that it'll be a very hairy problem to disentangle. Maybe I'm just frustrated that the answers are not clear now that I've started acknowledging the problems.
For all human beings capable of empathy, this is strongly urged reading.
ateeb's review against another edition
5.0
don't bother with the audiobook it's awful But this book fundamentally changed the way i think about medicine. i truly believe all physicians should read this book and take notes.
i look forward to reading it again
i look forward to reading it again
djasson's review against another edition
3.0
Prior to my trip to Santa Fe, I finished reading Pathologies of Power: Health, Human Rights, and the New War on the Poor, by Paul Farmer. I wanted to finish it up before I moderated our HIV/AIDS panel at CGS’s second annual conference. I wanted to see if there was any great material I could draw on for my portion of the panel.
This is a great book, which really helped drill in his concept of “a preferential option for the poor”. It laid out a solid epidemiological case and backed it up with deep ethnography. It seems that Paul’s combination of anthropology and medicine are perfect for confronting the deeper structural issues of modern plagues. He argues effectively about the fallacy of cost effectiveness. We must treat people with infectious diseases. It’s not fair to offer one class of people one thing and another class a lesser option. He also argues that treatment vs. prevention is a false dichotomy. With millions already infected with HIV and millions with TB (both regular and multiple drug resistant strains), we don’t have the option to exclude those who are already sick. Their sickness is often a manifestation of structural violence. The situations they find themselves in contribute as much, and often times more, to their infections than do their individual agency (ability to affect their own lives).
Infectious disease in the modern world is as much about class and politics as it is about bacteria and viruses.
I found an earlier book of his, [b:Infections and Inequalities|10233|Infections and Inequalities The Modern Plagues|Paul Farmer|http://photo.goodreads.com/books/1166152608s/10233.jpg|12952]: The Modern Plagues, to be a better read. But this book is certainly one to have in your hand. I wanted to say have on your shelf, but these types of books need to be used, not just used to decorate your bookshelves.
This is a great book, which really helped drill in his concept of “a preferential option for the poor”. It laid out a solid epidemiological case and backed it up with deep ethnography. It seems that Paul’s combination of anthropology and medicine are perfect for confronting the deeper structural issues of modern plagues. He argues effectively about the fallacy of cost effectiveness. We must treat people with infectious diseases. It’s not fair to offer one class of people one thing and another class a lesser option. He also argues that treatment vs. prevention is a false dichotomy. With millions already infected with HIV and millions with TB (both regular and multiple drug resistant strains), we don’t have the option to exclude those who are already sick. Their sickness is often a manifestation of structural violence. The situations they find themselves in contribute as much, and often times more, to their infections than do their individual agency (ability to affect their own lives).
Infectious disease in the modern world is as much about class and politics as it is about bacteria and viruses.
I found an earlier book of his, [b:Infections and Inequalities|10233|Infections and Inequalities The Modern Plagues|Paul Farmer|http://photo.goodreads.com/books/1166152608s/10233.jpg|12952]: The Modern Plagues, to be a better read. But this book is certainly one to have in your hand. I wanted to say have on your shelf, but these types of books need to be used, not just used to decorate your bookshelves.
jdoetsch's review against another edition
3.0
I couldn't really get into this book. It's possible that I misunderstood the overall thesis of the book.
He did a very good job going into details of rights abuses in various parts of the world (mostly Haiti). What was missing for me was some sort of unifying theory or framework to deal with these abuses. It just didn't really draw me in.
He did a very good job going into details of rights abuses in various parts of the world (mostly Haiti). What was missing for me was some sort of unifying theory or framework to deal with these abuses. It just didn't really draw me in.
renae24's review against another edition
4.0
Evaluates current health care crises in Haiti, Russia, Guantanamo Bay, and other countries. It's a scary look at major diseases threatening our world and the problems with health care.
garmstrong's review against another edition
4.0
Paul Farmer is my favourite anthropologist who I look up to very much - this book is easy to read, is not laden down by academic jargon and is eye opening and important.
bdivakaran's review against another edition
3.0
Paul Farmer is an inspiration to me and his voice is so important. This book felt a bit dated as I read it, but he informs readers about important past events and argues crucial moral/ethical points that arise from them which are today no less relevant/important. He calls for not just consideration of these questions, but action to protect the rights and health of the most vulnerable humans. This is a intellectual book, requiring work to slog through at points, but I'm glad to have read it to glean from his insights.
jaclyn_youngblood's review against another edition
5.0
I like learning from books. This book taught me a number of things (read: statistics, vocabulary, frameworks) that I didn't know before. By itself, that usually pushes me toward a 4- or 5-star rating. But Farmer argues in such a way that I found myself near or in tears many times throughout the book. Maybe that's one of the unhelpful responses to overwhelming inequity, but it's what happened and it was powerful for me. I love that this is more than a decade old now; it provided great fodder for additional digging and understanding where the topics about which he wrote then are now. My first exposure to Farmer was through Tracy Kidder; I really enjoyed having first-hand access to Farmer's thoughts and emotions.