Health and Structural Violence
What are the strongest determinants of health?
How does structural violence affect health?
We will explore the questions through some videos, reading and discussions.
Video introducing Paul Farmer and Partners in Health
Excerpts from "Pathologies of Power" by Paul Farmer
"How the Government Created High Risk Communities" Reading and Study Guide
Define and Apply
Excerpts from "Pathologies of Power: Health, Human Rights and the New War on the Poor” by Paul Farmer, 2005.
Human rights violations are not accidents; they are not random in distribution or effect. Rights violations are, rather, symptoms of deeper pathologies of power and are linked intimately to the social conditions that so often determine who will suffer abuse and who will be shielded from harm. (p. 7)
For well over a decade, I have grappled, as have others with conditions that could only be described as violent - at least to those who must endure them. Since the misery in question need not involve bullets, knives, or implements of torture, this misery has often eluded those seeking to identify violence and its victims. Decades ago, and at about the same time, libertarian theologians and scholars such as Johan Galtung began writing of “structural violence.” In this book, as elsewhere, I use this term as “a broad rubric that includes a host of offensives against human dignity: extreme and relative poverty, social inequalities ranging from racism to gender inequality, and the more spectacular forms of violence that are uncontestedly human rights abuses… (p. 8)
In each of these situations, acts of violence are perpetuated, usually by the strong against the weak, in complex social fields. In each of these situations, a set of historically given, and often enough, economically driven conditions - again , here termed “structural violence” - guarantee that violent acts will ensue. (p. 9)
The term is apt because such suffering is ‘structured’ by historically given (and often economically driven) processes and forces that conspire—whether through routine, ritual, or, as is more commonly the case, the hard surfaces of life—to constrain agency. For many, including most of my patients and informants, choices both large and small are limited by racism, sexism, political violence, and grinding poverty. (p. 40)