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Pathologies of Power: Health, Human Rights and the New War on the Poor

4.24  ·  Rating Details ·  3,236 Ratings  ·  192 Reviews
Pathologies of Power uses harrowing stories of life—and death—in extreme situations to interrogate our understanding of human rights. Paul Farmer, a physician and anthropologist with twenty years of experience working in Haiti, Peru, and Russia, argues that promoting the social and economic rights of the world’s poor is the most important human rights struggle of our times ...more
Paperback, 438 pages
Published November 22nd 2004 by University of California Press (first published 2003)
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This book is every human rights activist's dream come true, because Farmer documents his efforts to provide quality health services in poor communities around the world, and he shows how the struggle for adequate health care is unavoidably connected to the struggle for other human rights.

Through various case studies, Farmer demonstrates that, contrary to the claims of most governments and international agencies, public health crises in poor communities can in fact be avoided. Most governments a
Simon Wood
May 18, 2014 Simon Wood rated it it was amazing

I have known of Paul Farmer for years, principally through footnotes in his fellow Bostonian Noam Chomsky's books (whom Farmer thanks in his acknowledgements to this book) and in a variety of other books and articles over the years, and I thought it was about time that I became better acquainted with his writings and managed to get my hands on a copy of his 2004 book "Pathologies of Power".

Farmer's basic aim in this book is to argue for a working definition
Feb 06, 2010 Faye rated it really liked it
I read Mountains Beyond Mountains by Tracy Kidder which is about Paul Farmer, this is the first book I have read written by Paul Farmer. He calls himself a physician and an anthropologist which makes a lot of sense from what I know about him. I also saw Tracy Kidder speak once and talk about his experience learning about and becoming friends with Paul Farmer. In Pathologies of Power he talks about "structured violence" against the poor around the world and he points out that the lack of social a ...more
Meg Petersen
Feb 10, 2009 Meg Petersen rated it it was amazing
This probably isn't most people's idea of recreational reading, but Farmer's view of the aid community and how first world powers use aid and don't aid when they should really resonated with me. It's an angry book from one who knows just how angry we all should be. This has me looking for more of what he has written. I am particularly interested in more about Haiti. It wasn't always comfortable. We are all complicit in this and I could feel my own complicity as I read it. I thought about paralle ...more
W. Littlejohn
Oct 23, 2009 W. Littlejohn rated it really liked it
It's books like this that make me temporarily enraged with America, its obscene affluence, and hypocritical Christian support of it, and that make me want to abandon my trek toward academia and do something more useful, like helping the oppressed.

I should add that I'm not actually sure whether I should give this book 4 stars. From a Christian and theoretical standpoint, it's very lacking. He is not himself a Christian, and though he claims to draw on the insights of liberation theology to f
mis fit
May 23, 2014 mis fit rated it really liked it
this is a bit out of date now, but still really good. i like how farmer points out that income is not the only measure of inequality (obviously, but still..)-- you need health and opportunities to live a full life. this sort of grounds me after spending 3 years in grad school, where people tend to think so abstractly about what they are actually studying-- people!

one interesting aspect is the author's use of liberation theology as a starting point in putting the poor and sick first. in fact, the
Maureen Flatley
Mar 29, 2008 Maureen Flatley rated it it was amazing
This book by the brilliant physician and human rights activist, Dr. Paul Farmer, is the single most trenchant analysis of our global human rights crisis I have ever read. Weaving together the inescapable links between poverty, food, shelter and healthcare, Dr. Farmer's book is a damning indictment of the international aid community.
Eric Miller
Jan 08, 2014 Eric Miller rated it really liked it
Paul Farmer's professional titles are impressive, but at the core he is a physician-anthropologist serving the world's poorest people. He has tirelessly struggled to provide the absolute best healthcare to people in tremendous need, despite critiques that his approach is not cost-effective or sustainable. Pathologies of Power is Farmer's impassioned critique of the rampant inequality and human rights violations in the world today. It is his desperate plea for us to wake up and recognize that it ...more
Tara deCamp
Farmer stands emphatically on the side of the destitute, marginalized, and usually overlooked. His case studies exemplify the fate of millions of "nobodies" - the silent majority of the world's population who have no or inadequate heath care.

Reading a lot of economics -- and even a lot of politics inspired by economics -- and then reading Farmer, I'm struck by how arid the former sounds in contrast to the latter. A cold calculus might explain to us why we should treat the poor well. Maybe we can
Jan 07, 2011 Harrison rated it really liked it
Shelves: justice
Paul Farmer’s Pathologies of Power is a written protest against the structural violence suffered by the poor. The first half of the book is devoted to anecdotes from his time spent in the rural highlands of Haiti, the HIV quarantine facilities of Guantanamo, the autonomous zones of Chiapas, and the prisons of Russia. Through these anecdotes Paul gives voice to the suffering poor in these areas in a way that neither dehumanizes nor romanticizes their suffering, a rare feat in literature about pov ...more
Jun 28, 2013 Paul rated it it was amazing
"Pathologies of Power" is a very important resource for those seeking to understand and morally diagnose the obscene global inequalities in health. Dr. Paul Farmer is an intimate witness to the suffering and struggle of the global poor and neglected. Farmer's voice is deeply prophetic in both exposing the "structural violence" towards poor people by depriving them of the necessary conditions and resources to live healthy and hopeful lives, and advocating passionately on behalf of those catching ...more
Dec 16, 2014 Amber rated it really liked it
This book used the level (or lack) of health care in poor communities around the world to demonstrate the structural violence and injustice inherent in neoliberalism. Doctor Farmer approaches the subject with the research and facts of a clinical practitioner, but through his empathy and anger he is able to call into question the real commitment to human rights and justice around the world. For some reason this book left me hopeful.
Mica Verendia
Jul 01, 2009 Mica Verendia rated it really liked it
This was assigned to me in my Development Anthropology class years ago, but I'm re-reading it, because I probably missed a lot of things that my frazzled, school-tasked brain disregarded because I had to write a specific paper on it. So far, I am right. Truly eye opening, and despite the fact that it's a more scholarly read, it's an easy read and totally engrossing, that is, if you're a public health nerd like I am.
Apr 09, 2016 Bettina rated it it was amazing
This is a must read for any health professional interested in human rights, or any health professional for that sake. Very informative - teaching us about structural violence, the responsibility we in the developed world with all our priviledges bear for for this violence and it's victims. A clear voiced call to action.
Jul 30, 2011 Madeleine rated it really liked it
Shelves: nonfiction
What do I even say about this book? Paul Farmer's my hero. These essays are amazing. If I ever write a book (ha), I want it to be this smart and this angry and this beautiful.

...see, I have only trite things to say about this. That's how good it is. So read it.
Aug 01, 2014 Colleen rated it really liked it
"What do all of these victims have in common? Not language or gender or political views; not religion or race or ethnicity. What they share, all of them, is poverty and, generally, an unwillingness to knuckle under. Pathologies of power damage all concerned - and who isn't concerned - but kill chiefly the poor. These crimes are the symptoms and signs of structural violence. Indeed, when we regard the perpetrators of these crimes from any comfortable reserve, it is important to recall that with o ...more
Jake Losh
May 08, 2016 Jake Losh rated it it was ok
Recommended to Jake by: Travis
This is a detailed book with nuanced arguments and heart-rending stories of the travails of the poor and underserved. As a newcomer to discussions of human rights, social rights and access to health care – indeed, health care generally – I welcomed the perspective that Paul Farmer brings in this well-written book. I'd also call out that everything is scrupulously cited and noted. Indeed, the notes are a significant chunk of the text and full of great details.

The crux of Farmer's argument is that
Oct 28, 2008 Mirwais marked it as to-read
i will learn the way of treating patients
May 04, 2015 Jaclyn rated it it was amazing
I like learning from books. This book taught me a number of things (read: statistics, vocabulary, frameworks) that I didn't know before. By itself, that usually pushes me toward a 4- or 5-star rating. But Farmer argues in such a way that I found myself near or in tears many times throughout the book. Maybe that's one of the unhelpful responses to overwhelming inequity, but it's what happened and it was powerful for me. I love that this is more than a decade old now; it provided great fodder for ...more
Jan 20, 2016 Jack rated it really liked it
It's a rare enough occasion when a book fundamentally changes your mind about something in a meaningful way. This 2001 book from Paul Farmer did just that, it has fundamentally pivoted the way I see neoliberal capitalism, inequality and poverty, and the suffering arising from these. Whatever complaints I might raise later in this review, the fact that it has made me see a part of the world in a new light is amongst the highest praise I can offer.

To me this was a book about so called "stupid dea
Nov 02, 2014 Oliver rated it liked it
I've now read a few of Farmer's books and books about him, and this seems to be his most radical manifesto in his call for health care as a human right. He does a masterful job of arguing his point about structural violence and how societal and economic factors can preclude the poor from accessing healthcare in the places they live, through his live examples in Haiti, Peru, Russia, and southern Mexico. I can definitely draw on my own experiences here in rural Guatemala to prove his point. I trul ...more
Nov 26, 2008 Drew rated it liked it
Shelves: anthropology
Prior to my trip to Santa Fe, I finished reading Pathologies of Power: Health, Human Rights, and the New War on the Poor, by Paul Farmer. I wanted to finish it up before I moderated our HIV/AIDS panel at CGS’s second annual conference. I wanted to see if there was any great material I could draw on for my portion of the panel.

This is a great book, which really helped drill in his concept of “a preferential option for the poor”. It laid out a solid epidemiological case and backed it up with deep
Apr 29, 2010 Mariana rated it it was amazing
I so enjoyed this amazing, angry, revolutionary, and thought-provoking book based on the premise: each human holds the right to effective health care. Paul Farmer practices what he writes for at least 27 years.

"To act as a physician in the service of poor or otherwise oppressed people is to prevent, whenever possible, the diseases that afflict them but also to treat and, if possible, to cure. So where’s the innovation in that? How would a health intervention inspired by liberation theology be di
Jason Yang
Jul 29, 2011 Jason Yang rated it it was amazing
Wow, what a powerful, angry depiction of social injustices in global health. Paul Farmer makes no secret his disdain for the chronic, institutional barriers for deploying modern medical advances to the world's poor (what he terms structural violence).

I found this work both sobering and motivating - sobered by the reality that I live in a hypocritical state, motivated by the opportunity to see things change.

While I overall agree with the challenges toward a change in the global health infrastruct
Oct 21, 2011 Rebecca rated it it was amazing
Paul Farmer is a doctor who, for the last 20 or so years made his lifes' work helping the poor. In this book Farmer takes on the disconnect between being poor and access to proper health care. He uses case studies to explain his point. Having spent most of his time outside of the United States and in countries like Russia and his favorite place, Haiti and Cuba. He weaves personal stories, case notes and well chosen quotes from poets and influential people to tell the story of these chronically d ...more
Apr 20, 2008 John added it
This book is about suffering, public and individual health, poverty, and the human right to be healthy. It makes the case that access to health care is an often violated human right and that this is unacceptable on moral grounds, drawing on examples from Farmer's personal observations in Haiti, the US, Russia, Peru, and Mexico. There is heavy criticism of global inequality. I think I need to re-read the book to fully understand it, though. Occasionally I had trouble knitting together the ideas i ...more
Josh Meares
Oct 29, 2012 Josh Meares rated it really liked it
Paul Farmer's book isn't the most well-written book you'll ever read, but it's one of the most consistently challenging. I'm not sure that I agree with his liberal theological framework, but his collection of stories, his documentations of the uses of power and its effects on those who are the most vulnerable, is like opening up a crypt. The air is stale and bitter, but hopefully, we can begin to cleanse the situation.
Here are some of my favorite quotes:

If assaults on dignity are anything but ra
Nov 03, 2012 Jamie rated it it was amazing
A moving account of how the asymmetry of social and economic power can prevent the sharing of opportunities and limit the control of people over their own lives. Farmer points to the damaging effects of 'structural violence' "...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, some of them punishment for efforts ...more
Apr 05, 2012 Laura rated it it was ok
Shelves: textbooks
The first bit of this book was quite gripping and compelling, but like a preacher who doesn't know enough to sit down after he's gotten his point across and quit preaching while his subject - and his audience - are still fresh, Farmer continues to belabour his topic until the reader gets bored, frustrated and possibly aggravated. Farmer is obviously passionate about his topic, as well as dogmatic, but I feel, he's also unrealistically utopian. Yes, I agree that the poor should be able to access ...more
Nov 16, 2007 Zachary rated it really liked it  ·  review of another edition
Shelves: health
Pathologies of Power is the impassioned work of Dr. Paul Farmer (whose life was detailed in Mountains Beyond Mountains), a doctor on a mission to provide health care to the world's poor. In Pathologies of Power, Dr. Farmer discusses the systems that cause those living in poverty to suffer increased threats to their human rights, especially their health, a concept he terms "structural violence." He goes on to write that more must be done than simply researching and recognizing these human rights ...more
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GMax Only For Your Best Health Powerty 1 2 Jul 21, 2014 04:26AM  
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Paul Farmer is a U.S. anthropologist and physician, the Presley Professor of Medical Anthropology in the Department of Social Medicine at Harvard University, and an attending physician at Brigham and Women's Hospital in Boston, Massachusetts. In May 2009 he was named chairman of Harvard Medical School's Department of Global Health and Social Medicine. His medical specialty is infectious diseases. ...more
More about Paul Farmer...

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“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” 0 likes
“Farmer points to what he calls "structural violence," which influences "the nature and distribution of extreme suffering." The book is, as he explains, "a physician-anthropologist's effort to reveal the ways in which the most basic right-the right to survive-is trampled in an age of great affluence." He argues: "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.” 0 likes
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