Stupid Deaths
· renowned global health advocate,
· medical anthropologist,
· cofounder of Partners In Health, and
· chair of the Department of Global Health and Social Medicine at Harvard Medical School.
· U.N. Special Adviser to the Secretary-General on Community-based Medicine and Lessons from Haiti.
The most publicly influential anthropologist since Margaret Mead and her mentor, the “founding father” of U.S. anthropology, Franz Boas.
· Seeing the world from the perspective of the planet’s poorest. Unlike many doctors (and anthropologists for that matter), Farmer has lived for decades with his patients, first in Haiti and later in communities from Rwanda to impoverished neighborhoods in Boston.
o “It took me a relatively short time in Haiti,” Farmer writes of the beginnings of his career in his 2003 book Pathologies of Power, “to discover that I could never serve as a dispassionate reporter or chronicler of misery. I am only on the side of the destitute sick and have never sought to represent myself as some sort of neutral party.”
· Farmer’s work is unflinchingly committed to social justice, global equity, and the idea that health care is a human right, beginning with what he calls “the most basic right . . . to survive.” Like his medicine, Farmer’s anthropology is thus an anthropology in service to the poor.
o Importantly, this does not mean an anthropology of the poor. Farmer is well aware that “writing of the plight of the oppressed is not a particularly effective way of assisting them.” After all, anything one might say is likely to be used against them.
o Instead, Farmer is interested in studying and exposing the “processes and forces that conspire” to constrain the agency of the poor and that cause poverty, disease, and suffering.
· Interest in the root causes of poverty and the diseases has led to his analysis of “structural violence.”
o Drawing on the work of Norwegian sociologist Johan Galtung, Farmer calls attention to powerful forms of everyday violence, like poverty, hunger, and poor health, that can be just as deadly as the violence of bullets and war but that tends to be caused by social forces, political and economic institutions, and the decisions of policymakers.
§ The root causes of a Haitian contracting HIV/AIDS are to be found not in personal irresponsibility but in the displacement of a village by a dam planned and funded by powerful actors in Washington, D.C.; by the impoverishment the dam created; and by the long-term impoverishment of Haiti through centuries of subjugation at the hands of the United States and European powers dating to the days of slavery.
· Farmer’s is a bio-sociocultural-political-economic-historical anthropology.
o His work as both an anthropologist and a physician revolves around the lives of individuals suffering amid powerful structural forces. He combines an empathetic understanding of people’s lived experience and how people make meaning in their lives with a political, economic, and historical analysis of the large-scale forces that shape individual lives. Coupled with an appreciation for the biological vectors of disease causation.
· His tireless commitment to creating positive social change and to using his anthropological and medical skills to help improve the lives of the poor.
o (When told he should spend more time with his wife and child in Paris, Farmer responded, “But I don’t have any patients there.”)
· Community based and sustainable health care development.
o Farmer and Partners In Health, emphasize working in solidarity with those they serve; training Haitians and others to become doctors, nurses, and community health care workers; and building sustainable health care infrastructures designed to be part of public health care systems.
o Haitian counterpart organization Zanmi Lasante
§ IMPACT (according to Kidder in Haiti)
· Zanmi Lasante had built schools and houses and communal sanitation and water systems throughout its catchment area [in central Haiti].
· Vaccinated all the children
· Greatly reduced both local malnutrition and infant mortality.
· launched programs for women’s literacy and for the prevention of AIDS
· Reduced the rate of HIV transmission from mothers to babies to 4 percent—about half the current rate in the United States.
· When Haiti had suffered an outbreak of typhoid resistant to the drugs usually used to treat it, Zanmi Lasante had imported an effective but expensive antibiotic, cleaned up the local water supplies, and stopped the outbreak throughout the central plateau.
· In Haiti, tuberculosis still killed more adults than any other disease, but no one in Zanmi Lasante’s catchment area had died from it since 1988.
· Partners in Health (PIH) has accomplished far more since its inception.
o serves some 2.4 million people in 12 countries, in settings that include post-genocide Rwanda, Peruvian slums, and Russia’s prisons.
o In devastated post-earthquake Haiti, PIH recently inaugurated a 300-bed, state-of-the-art, solar-powered university teaching hospital that represents the country’s largest post-earthquake reconstruction project.
· PIH and Farmer reject conventional public health wisdom about what’s “possible” in the provision of health care in impoverished settings.
o They reject arguments that treatments available in wealthy countries like the United States aren’t “cost effective” in settings like Haiti.
o Guided by the radical idea that all human lives are equal, that PIH should provide the same quality of care to the poor that the wealthy want for their own family members, that health care is a human right, PIH and Farmer demand nothing less than a “preferential option for the poor.”
“That goal is nothing less than the refashioning of our world into one in which no one starves, drinks impure water, lives in fear of the powerful and violent, or dies ill and unattended,” Farmer says in a National Public Radio “This I Believe” essay.
“Of course such a world is a utopia,” Farmer continues, “and most of us know that we live in a dystopia. But all of us carry somewhere within us the belief that moving away from dystopia moves us towards something better and more humane. I still believe this.”