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Title: Pathologies of Power: Health, Human Rights, and the New War on the Poor by Paul Farmer ISBN: 0-520-23550-9 Publisher: University of California Press Pub. Date: 01 April, 2003 Format: Hardcover Volumes: 1 List Price(USD): $27.50 |
Average Customer Rating: 4.5 (6 reviews)
Rating: 4
Summary: Sobering
Comment: Reasoned yet impassioned dialogue on a variety of issues. Americans needn't feel left out of this either, as we are still the only industrialized country in the world without a universal health care system. geocities.com/singlepayerweb
Rating: 5
Summary: Take Two Aspirin and Read This Book
Comment: Paul Farmer's "Pathologies of Power" will probably give you a headache, undoubtedly cause sleep disturbance, and very likely turn your stomach. In short, it will make you sick. But if you are well enough to read this and rich enough to consider purchasing the book, you are better off than the "disposable millions" whose lives he illuminates and honors in this indictment of global public health as-we-know-it. In this passionate and well-researched treatise, a world-class physician takes his own disciplines of medicine and anthropology to task for failing to ask the right questions. Then, noting that the U.S. pharmaceutical industry is the most profitable industry in the most affluent country in the world, he blows through its defense of those extraordinary profits like a gust of fresh air. A similarly searing deconstruction of health policymakers' rationale for "cost-effectiveness" and their elite argot of oppression reveals a blame-the-victim mentality that plagues the world and explains why, in the midst of unprecedented wealth, over 40 million Americans are without health insurance of any kind. And that is just the beginning.
While Farmer's hospital in Haiti, Zanmi Lasante, is not the only hospital to successfully combat the forces of poverty and disease in that country (Hôpital Albert Schweitzer in the Artibonite Valley predates Farmer's project by nearly three decades), his twenty-year presence in Central Haiti has resulted in a deep understanding of how structural violence on a global scale is a leading cause of disease and death among the world's poor, wherever they may live. Drawing on case-study examples from Haiti, South America, Cuba, Siberia, and the United States, he deftly illustrates why tuberculosis deaths, which he describes as 95 percent curable with inexpensive medication developed many years ago, "occur almost exclusively among the poor, whether they reside in the inner cities of the United Stated or in the poor counties of the Southern Hemisphere." Addressing the growing trend of multi-drug resistant strains of TB, Farmer discusses "tuberculosis as punishment" in the world's prison populations and delivers a wake-up call to those who might consider themselves immune from this, and other, infectious diseases.
In his critique of the commodification of healthcare, Farmer speaks of "orphan drugs" drugs that are simply not developed because they are needed by people who cannot pay for them, the sale of organs by those without resources to those with money, and the equally revolting multi-million dollar compensation packages of pharmaceutical company CEOs and managed care executives. In the midst of the catalog of inequity, he wonders why medical ethics courses in American schools of medicine focus so narrowly on the "quandaries of the fortunate"¯like whether or not to refuse a particular technology or whether or not to leave a loved one in a prolonged coma¯when millions are condemned to death or disease before they learn to walk. Even the World Health Organization (WHO) does not escape his critical analysis: "... the language of social injustice is increasingly absent from public health parlance," he notes.
Farmer is one of those remarkable doctors working in remote places who, somehow, finds the energy to look up from his daily workload and ponder the underlying causes of the suffering he treats. Furthermore, he writes about it in the brisk and engaging prose of an investigative reporter and brings provocative interdisciplinary voices of others¯Gustavo Gutiérrez, Paolo Freire, Cornel West, Amartya Sen, Jon Sobrino, Nancy Scheper-Hughes, to name a few ¯to bear on his march toward social justice. His ideas are radical, in part, because they are simple and based on an equitable distribution of health, regardless of wealth. Bringing the observe, judge, act methodology of liberation theology to bear on global public health, Farmer advocates a "preferential option" for the poor, a redefinition of medicine as a healing profession (as opposed to medicine-as-commerce), and a new understanding of healthcare as a basic human right, for all.
Toward the end of a chapter entitled "Listening for Prophetic Voices," Farmer distills his argument into a call to action: "We thus find ourselves at a crossroads: healthcare can be considered a commodity to be sold, or it can be considered a basic social right. It cannot comfortably be considered both of these at the same time. This, I believe, is the great drama of medicine at the start of this century. And this is the choice before all people of faith and good will in theses dangerous times."
Pathologies of Power is a lucid and alarming statement from a fearless physician. It speaks truth to power and it speaks for the destitute sick. Take two aspirin, lie down, and read the book. In spite of its consciousness-raising side effects, this may be the beginning of a cure for what ails the world.
Rating: 3
Summary: 3.5 stars
Comment: I greatly respect Dr. Farmer's work and have followed Partners In Health's efforts in Haiti over the last several years. While this book has substantive significance in its attempts to discuss several public health and human rights crises in their social, economic, and political contexts; I think it fails to make a cohesive point or tell a cohesive story in the way that a book (rather than a collection of essays) demands. As a public health and human rights worker, I understand where Farmer was trying to go with his writing but I don't think he actually gets there in a coherent way. Perhaps he should have focused only on one health issue or country in order to more fully flesh out his thesis.
I do recommend this book as well as a visit to the Partners in Health web site at www.pih.org.
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Title: Mountains Beyond Mountains: Healing the World: The Quest of Dr. Paul Farmer by TRACY KIDDER ISBN: 0375506160 Publisher: Random House Pub. Date: 09 September, 2003 List Price(USD): $25.95 |
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Title: Infections and Inequalities: The Modern Plagues, Updated Edition With a New Preface by Paul Farmer ISBN: 0520229134 Publisher: University of California Press Pub. Date: 05 February, 2001 List Price(USD): $19.95 |
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Title: The Uses of Haiti, Updated Edition by Paul Farmer ISBN: 1567512429 Publisher: Common Courage Press Pub. Date: 15 April, 2003 List Price(USD): $19.95 |
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Title: Dying for Growth: Global Inequality and the Health of the Poor by Jim Yong Kim, Alec Irwin, Joyce Millen, John Gershman, Jim Young ISBN: 1567511600 Publisher: Common Courage Press Pub. Date: July, 2000 List Price(USD): $29.95 |
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Title: AIDS and Accusation: Haiti and the Geography of Blame (Comparative Studies of Health Systems and Medical Care, No 33) by Paul Farmer ISBN: 0520083431 Publisher: University of California Press Pub. Date: August, 1993 List Price(USD): $19.95 |
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