Pathologies of Power
Dr. Paul Farmer is an American anthropologist and physician, head of the Department of Social Medicine at Harvard University, and United Nations Deputy Special Envoy to Haiti. In the 1980s he founded Partners in Health in Boston, and its Haitian counterpart Zanmi Lasante. To say Farmer is an expert on Haiti, Global Health, and Infectious Disease would be a gross understatement. He’s written a very digestible article on Haiti that seems extremely germane to understanding Haiti in the days leading up to the Jan 2010 earthquake, and Tracy Kidder’s book on Farmer, Mountains Beyond Mountains, is not only inspiring and brilliantly written, but also required reading for many (if not the majority?) of undergraduates in the United States.
Although Pathologies of Power doesn’t directly address Measles, nor Africa or Southeast Asia (the two places currently most ravaged by measles), it nonetheless gives a very nice background into structural violence and the “preferential option for the poor” aspect of liberation theology.
If one considers we’ve had a measles vaccine since the 1960s, and have managed to eradicate measles within North America, then one must wonder why is it that within 50 years, at a cost of less than a dollar-per-vaccine, we haven’t eradicated measles in Africa? Although we’re getting close now, it’s only because “we” have taken on the challenge in the form of the Red Cross and World Health Organization, and then nearly forty years after the vaccine became available. One could use this opportunity to blame corrupt governments for not building infrastructure, for not creating effective nationalized vaccine programs. That however, is a fairly narrow view, and it’s important to ask why those governments are corrupt or otherwise unable to build infrastructure, how they stay in power, who funds them, and why in matters of life and death do rich countries not intervene in ways that produce positive and lasting outcomes. In the case of intervention, Farmer looks at attitudes that do and do not work, at the idea of neo-liberalism. He quotes Leonardo and Clodovis Boff, “in 1964 the Brazilian economy ranked 46th in the world; in 1984 it ranked 8th … there has been a considerable worsening of social conditions for the poor, with exploitation, destitution, and hunger on a scale previously unknown in Brazilian history.”
The book is replete with statistics to the point that it seems underwhelming to simply call it “information dense.”
Some random sobering statistics culled from sections of the book upon which I wore out my highlighter:
- 1.5million Chiapans (Mexico) have no medical services whatsoever. 63% do not have electricity. 90% do not have running water. 30% are illiterate.
- 40% of the Haitian population is without access to any form of primary healthcare.
- African American men in Harlem have shorter life expectancies than Bangladeshi men.
- More than 500,000 women die each year in childbirth. 99.8% of these deaths occur in developing countries.
- In South Africa the infant mortality rate among blacks is 10x that of whites.
- In the United States, one in four women has been the victim of a completed rape.
- The state of NY counts more men of color in its prisons than its public universities
- 110,000 Russian prisoners have active tuberculosis
As the cover says, this is “an angry and hopeful book.” Although it is dense with data and Farmer’s heartbreaking experiences, it lays out a clear and seemingly ‘too simple’ path for fixing the world’s ills: caring for and empowering the poor.
