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Pathologies of Power: Health, Human Rights, and the New War on the Poor, With a New Preface by the Author (California Series in Public Anthropology) ReviewPaul Farmer, perhaps the most famous 'Third World doctor' living today, has written an eloquent and moving plea for a reconsideration of modern approaches toward healthcare in the developing nations in this book, "Pathologies of Power". Based on his personal experiences of care in Haiti, but also his professional visits to Russia, Africa, Central America, Mexico, Cuba and many other places besides, Paul Farmer demonstrates that the problematics of healthcare and those of poverty and inequality are insolubly linked in these nations. Whoever says "heal the sick" must also say "end poverty", for the one is not possible without the other; and whoever says "prevent disease" must also say "destroy socio-economic inequality", for the one is not possible without the other. That is the message of this book.A large part of the work consists of reflections by Farmer on his experiences in Haiti and elsewhere and on the way in which the current worldwide economic structures engender a genuine and systematic violence against the rights of the poor. Strongly inspired by liberation theology (though not necessarily religious), Farmer eloquently and effectively contrasts the heavy importance attached to individual political and legal rights with the way in which the violations of rights done by structural inequalities and injustices is wholly ignored in the same circles that would complain about the former. Rights issues are the domain of jurists, development issues the domain of (liberal) economists; but the way in which the poor and weak are constantly crushed by the systematic repression that is poverty and inequality, at least as real and at least as much a violation as any torture, that seems to be the domain of nobody at all. As Paul Farmer clearly shows, even in the lately so blossoming domain of medical and bioethics the issue of socio-economic structures is completely swept under the carpet. As he says, this really is the "elephant in the room".
The same also goes for the oft-invoked importance of efficiency. Callous and counterproductive Western, often American, inspired healthcare policies in the developing nations (among which we must now sadly share Russia as well) generally fail at providing effective treatment against simple preventable disease such as TBC, because those medications that would actually help are considered "not cost-effective". This is in fact just a polite way of saying "we don't care about these people", but then phrased in a manner that will lead to less of an uproar in the newspapers. Farmer however is not fooled so easily, and sees this for what it is - a structural repression of the developing nations by the developed ones, in the name of "efficiency", i.e. efficiency in achieving the aims of the Western states.
This book is a very powerful work, and a strong indictment of the prevailing attitude towards healthcare and development issues and the little attention paid to their interrelation. It also demonstrates convincingly how the current worldwide economic system is bad for everybody's health. And what could be a more important thing than that?Pathologies of Power: Health, Human Rights, and the New War on the Poor, With a New Preface by the Author (California Series in Public Anthropology) Overview
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