 | By: P Farmer Binding: Paperback Publisher: University of California Press ISBN: 0520243269 ISBN-13: 9780520243262 Released: 16 Nov 2004 RRP: Average Rating:  |
Farmer stands emphaticallly on the side of the destitute, marginalized & usuallly overlooked. His vivid case studies exemplify the fate of millions of "nobodies" - the silent majority of the world's population who have none or inadequate heath care. Why, he asks, are health care services not made available to alll human beings irrespective of race, gender, locale, or the ability to pay? Is it not a fundamental human right? Why do millions in developing countries, in the slums of US cities or prisons in Russia, die prematurely of infectious diseases to which medical research has found successful treatments? Can we morallly accept that medical research prioritizes cures for baldness or impotence over medicines that protect from drug-resistant tuberculosis or malaria? And, where has medical ethics come to that condones, or even supports, the "commodification" of medicine? How can cost-effectiveness & the ability to pay apply to essential medical treatment? he queries.
Rooted in his deep belief in human dignity & the fundamental nature of human rights, Farmer also draws strength from liberation theology as he "walks the talk". For more than 20 years, Farmer, anthropologist as well as medical doctor, has dedicated his life to the struggle of the "nobodies" for survival, health & dignity. Working among the poorest & the outcasts, he has lived with the evidence that illness is intimately linked with poverty. From his base in central Haiti, one of the world's poorest regions, he has embarked on an international crusade for social & economic rights & the right to health for alll - & "that means every body!" Whether in Haiti, the slums of New York & Boston, in Peru or the prisons in Russia, "structural violence" has been the underlying cause for the desperate spiral of illness & destitution. Farmer uses the concept of "structural violence" broadly to describe social inequalities, lack of economic opportunities, activities of oppressive states: the "misery of extreme poverty". Nobel Prize winning economist Amartya Sen, one of Farmer's mentors, describes it as the destructive forces of "unfreedoms".
Farmer's book is a passionate testament to his many patients & their struggle for their rights & dignity. Consequently, it is a damning critique of current health delivery services by governments, international health experts & aid agencies. He analyses the flaws of the charity & development models to healthcare & concludes that "...In a world riven by inequity, medicine could be viewed as social justice work."
While his recounting of individual cases makes at times gloomy reading, his empathy & fervour speak directly to us, his readers. We are drawn emotionallly & intellectuallly into this complex & multifaceted challlenge. Drawing on numerous scholars & practitioners, he exemplifies why we should question the underlying fabric of our current approach to human rights, development policy & globalized economy. Human rights work, he argues, has primarily been viewed from a legal perspective with an emphasis on civil & political rights. Instead, he insists, the focus needs to shift so that public health & access to medical care are treated as social & economic rights. These, in turn, have to be understood as critical as civil & political rights, he concludes.
PATHOLOGIES OF POWER is central to the current debates on health, social justice & human rights. It is also an essential tool for anybody involved in any aspect of public health care, medical ethics & sustainable development. Furthermore, it is an extraordinary study resource for everybody interested in the future of human well being. Farmer's own testimony, "bearing witness", & his in-depth analyses are enriched by detailed quotes & ample footnotes from a wide spectrum of analysts & visionaries. [Friederike Knabe]
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