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Infections and Inequalities: The Modern Plagues

4.08  ·  Rating Details ·  2,251 Ratings  ·  73 Reviews
Paul Farmer has battled AIDS in rural Haiti and deadly strains of drug-resistant tuberculosis in the slums of Peru. A physician-anthropologist with more than fifteen years in the field, Farmer writes from the front lines of the war against these modern plagues and shows why, even more than those of history, they target the poor. This "peculiarly modern inequality" that per ...more
Paperback, 424 pages
Published February 23rd 2001 by University of California Press (first published 1999)
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Dec 08, 2010 edenstephen rated it it was amazing
This book, like all of Farmer's, is an excellent piece of scholarship. Much of the work is centered around the "pathogenicity of poverty," the idea that poverty, more than cultural or other anthropological factors, is crucial in examining the causes and transmission of infectious diseases. A medical anthropologist himself, Farmer frequently criticizes the anthropologist's obsession with "culture" -- in doing so, one often accuses voodoo, witchcraft, and animal sacrifice of being the instigator o ...more
Elizabeth Huff
Mar 26, 2013 Elizabeth Huff rated it really liked it
While I was aware at the drastic healthcare disparities that exist between nations, this book put a face and a name to those people and really quantified the magnitude of the disparity. We know that many diseases are treatable, even preventable with the proper infrastructure and medicine, but we don't want to spend money to help treat other people, even when it would help us in the long run. Let's just spend the money and deal with it all and be better off for it.
May 20, 2012 Libby rated it liked it
I have some mixed feelings about this book. First of all, I've been spoiled recently by some good, readable non-fiction, and this missed that mark. He does sprinkle in personal stories to his dense discussion of health initiatives, but even those come off as clinical. I also had a hard time with his complete disregard of making these programs financially feasible, and it occurs to me that this is because he has plenty of donors to his work. He is setting an impossible standard for the rest of th ...more
Mirna Sawyer
Jul 27, 2008 Mirna Sawyer rated it really liked it
I highly recommend Paul Farmer in general. This book's thesis is that the infections are worse where poverty is worse. And that basically public health is not merely an issue of behavior but one tied very strongly to environments and conditions made possible by the way wealth and power are distributed. It does get a bit redundant and definitely nihilistic like Sheper-Hughes but non-fiction nevertheless.
Katherine Sacksteder
Sep 02, 2007 Katherine Sacksteder rated it it was ok
I put this in my "read" section, only because I'm never going to finish it. It's terribly written and pretentious. I'm more interested in the biography of Paul Farmer than I am of actually have to slog through his overwritten prose.
Jul 24, 2008 Alicen rated it really liked it
Farmer does an excellent job discussing some of the sheer complexities related to infectious disease (particularly HIV and TB) prevention and the role that inequalities have in such prevention. A must read for anyone interested in thinking about social issues and public health.
May 02, 2012 Natalie rated it it was ok
This book goes into painstaking detail. The book is summed up as wealth equals health. I was thrilled during the intro, and less thrilled as I finished it.

We are tossing ineffective or inappropriate drugs at populations, or no treatment at all, that don't have the money. It's called "cost effective". It wouldn't be cost effective to treat everyone the same. Which is a sick joke. At the same time we are all sharing the same micobacteria. Politics, poverty, lower standard of living, war, ineffect
Jan 06, 2015 MerryMeerkat rated it it was ok

��2 Stars, don���t bother

Self Purchase for Kindle.

First Impression: Unremarkable

I hate it when books in series don���t take time to reintroduce the characters to you. I waited a long time between the first and second book and couldn���t remember everyone. This book just drops you back in and I found that annoying.

I liked the first one in the series ok, ����3.5 Stars but boy this one just was bad. You are dropped right back in with no reintroduction and there isn���t much description

Lindsay Wilson
This book was surprisingly good, despite the fact that it's now almost fifteen years old, and I've already noted the difficulty of reading about current events that aren't current anymore. However, this book has actually held up pretty well, mainly because the problems outlined by Farmer are still completely relevant, sad though that is.

I thought Farmer did a really great job pointing out the need for a balanced approach to HIV and TB treatment/prevention. While it is of course important to foc
Nov 11, 2014 Robyn rated it really liked it
Fascinating book blowing many poverty and disease myths out of the water. Found this book on the Bill Gates reading list and glad I picked it up. As other reviews have stated, it might be a tad academic and scattered, but an excellent, illuminating read. I am very interested in his other books since I learned so much with this one.

Not only is it the ethical thing to help all the world's people deal with treatable, deadly diseases, it's enlightened self interest to do so as boundaries and border
Peter Chindavong
Sep 10, 2016 Peter Chindavong rated it really liked it
This is by-far the densest book I've read. I found myself having to lookup every other word. Paul Farmer beautifully hybridizes anthropology and medicine. He brings to light some important social-determinants of health, which he believes are poverty, racism, and social inequality. However, I didn't think Dr. Farmer proposed a clear and concise solution to this. He criticizes professionals in both fields. I get a slight sense of sarcasm in some parts of his writing. I personally love Paul Farmer ...more
Shela Sundawa
Sep 11, 2014 Shela Sundawa rated it it was amazing
Shelves: favorites
"Upon reflection, perhaps we physicians are the ones who need to clean up our act. In saying this, I do not wish to exaggerate the power of doctors and other providers; increasingly, it is the pharmaceutical and health care industries, and also federal governments, who call the shots on questions of access to effective medical care. But the power of medicine stems not merely from the wonders of science. It stems, too, from the power of moral suasion. We can call for certain measures not because ...more
Nov 18, 2008 Lindsey rated it really liked it
An analysis of modern medicine's approach to TB and HIV treatment in Haiti and Peru by a medical doctor/anthropologist (the subject of the biography Mountains Beyond Mountains) who runs a clinic in western Haiti. Very insightful analysis of why TB treatment in such settings is often ineffective and where anthropology and health workers often fall short in identifying why patients are often "non-compliant" with extensive TB treatment regimens (i.e., they usually can't afford the meds). Farmer is ...more
Sep 02, 2007 Andrew added it
Farmer attacks the fatalistic and morally flawed view that expensive therapies for multiple-drug-resistant TB and HIV/AIDS should not be employed in developing countries because they are not "cost-effective." As one who has worked for years in rural Haiti, Farmer no doubt knows about the scarcity of resources that development and health workers (not to mention Haitians themselves) face, his point is rather that we cannot afford not to treat those cases, first of all because we have a moral imper ...more
Jun 22, 2016 Paul rated it it was amazing
I am a fan of Dr. Paul Farmer. His works are a blend of medical anthropology, cutting ethical analysis, and bearing witness to concrete human suffering. Like his other works, Farmer argues that dramatic social inequalities lead to dramatic inequalities in vulnerability to infectious diseases, where poor marginalized people are typically the victims. He rebuts notions that the unique vulnerability of the poor and marginalized to deadly but preventable infections are due to personal irresponsibili ...more
Aug 04, 2014 Redpoet rated it it was amazing
Somewhere along the line a friend gave me the book Infections and Inequalities by Paul Farmer...and then I forgot to read it. A little while back I picked it up and started my way though it. Well, it is more than ten years old and discusses times even earlier on then that, but I can tell you now it is an amazing book. I am so impressed that I ordered two more books of his. My interest is, of course, multi faceted. I have a background of working in a free health clinic which included the early an ...more
Jun 25, 2008 Chandra rated it it was amazing
Another great heart-wrencher from Farmer, who uses his well founded anger to expose the suffering of the poorest people in the world, namely those in Haiti with HIV and TB. Farmer's work in the rural areas are inspiring, combating the poverty and prejudice that seem determined to keep the sick poor. Traveling between one of the US's most affluent hospitals in Boston to the remotest and most impoverished regions of Haiti, Farmer straddles two worlds, and is in a unique position to comment on the ...more
Jul 14, 2012 Diane rated it liked it
Shelves: medicine, non-fiction
Paul Farmer is one of my heroes. Epidemiology and Public Health are two of my most important interest areas. I knew much of what is written about in Infections and Inequalities but it was a good review and it certainly points out how little progress we have really made. Farmer argues for better cultural integration into medical interpretation of disease and bemoans the seeming inability of health institutions to see the importance of issues of race, poverty and gender in disease. The book has so ...more
Jessica Beth
Dec 16, 2015 Jessica Beth rated it really liked it
Infections and Inequalities is an important piece of literature that is an absolute must-read for practitioners, sociomedical scientists and anyone interested in global public health. Farmer counters many of the misconceptions surrounding health problems for the poor, and calls for an immediate reconceptualization of infectious disease to include an outlook that considers poverty, social inequalities and discrimination based on race, gender and class. Farmer recounts on his work as a medical pra ...more
Aug 04, 2012 Andy rated it it was ok
This is an odd book. One of the bizarre aspects is a running diatribe about the way that global health money is spent on prevention instead of on treatment. First of all, it's not either/or. Secondly, if you had to choose, why not overweight prevention, which would save more lives than treatment? Thirdly, what is he talking about? In AIDS, for example, the global health money has been disproportionately spent on treating people with anti-retrovirals vs. preventing infection with condoms, etc. Th ...more
Nov 10, 2011 Sehar marked it as to-read
Shelves: incomplete
Paul Farmer is speaking from extremely intimate experience when he talks poverty and disease. He is an anthropologist and physician that analyzes disease in its relation to its context which includes history, economy, politics, war and so forth. His view is comprehensive and points to deep structural problems that go along with these diseases (tuberculosis, AIDS, etc). Structural violence is one of the primary factors that underly who gets HIV and who doesn't, for example. Anyone who wants a coh ...more
Sep 08, 2014 Beatrice rated it liked it
Infections and Inequalities deals with several social and medicinal issues, particularly as they are present in Haiti, from an anthropological perspective. The author seeks to communicate the idea that social structures integrate issues of infections into their difficult realities, resulting in greater struggles for those in poverty. On the other hand, the studies also emphasize the importance of medicinal and technological work alongside social developments. While I enjoyed the specific stories ...more
Apr 15, 2011 Bologna_frog rated it it was ok
Jake suggested it although he did not get through it.

Stories were interesting the first time, but they get rehashed to make the same point repeatedly. I would have been good after maybe 50 pages. That may be the result of this being a compilation of essays.

Disease treatment is disease prevention, for Infectious Disease.
If current best treatments are too expensive for use in developing countries, what does that mean about the value we place on life?
MDRTB needs to be treated as well as simple tube
Jun 26, 2015 Lauren rated it it was amazing
Shelves: med
A call to action that still rings true today, fifteen years later: "If we lived in a utopia, simply practicing good medicine or conducting quality research would be enough. But, no matter how you slice it, we live in a dystopia. Increasingly, inequalities of access and outcome characterize our world. These inequalities could be the focus of our collective action as engaged members of the healing and teaching professions, broadly conceived. We have before us an awesome responsibility--to prevent ...more
Dec 16, 2011 Cathy rated it liked it
From a public health perspective Paul Farmer is amazing.... he has done so much work for the people of Haiti, Peru and the poor in parts of Boston. This book, Infections and Inequalities shows that. Keep in mind this book was not a mindless read. It was far from it.... This book could be considered more of a technical hand book for the public health professional. For that reason I liked it. It is good to get a reminder of all that needs to be done from a public health standpoint, considering tha ...more
Jul 25, 2009 John added it
The thing I like about Farmer's writing is that it is an account of his actions which show that he actually gives a damn about sick and poor people and doesn't merely say he does. He backs up his assertions with his own boots-on-the-ground anthropological studies and (good) clinical outcomes in places that might reasonably be called hell. This is a good book to follow The Spirit Level by Richard Wilkinson and Kate Pickett if you want a deeper look at the causal link between economic/social inequ ...more
Nov 25, 2007 Stephy rated it liked it
Recommends it for: folks who read for inspiration
There are great differences in the way medicine reaches different parts f the globe, and some people who work very hard to level that playing field a bit. This author moves with a seeker's eye toward and past the bugaboo that disease is punishment from the gods, into what I think of as Physician/Solution seeking. it's a hard to read book, and some of the prose is challenging, on an emotional level, for some readers. There is hope here too, for humanity and the cures, I'm glad someone is working ...more
May 23, 2007 Sujata rated it it was ok
I learned everything I needed to in the first chapter. After that, the same concept was repeated over and over.
Plus, somebody unfamiliar with the field, may be convinced. However, important arguements against the concepts presented in the book are overlooked. For example, I think cultural appropriateness should not be completely overlooked. In addition, there are only limited funds available, especially for this field.
Mary Olive
Sep 06, 2009 Mary Olive rated it liked it
The book was good, but I wasn't in the correct frame of mind to read an anthropological text for fun. Read it on and off for over a year, but am glad that I finished it. Disease treatment and socioeconomic factors really cannot be ignored if we are ever going to solve the world's problems. Don't try to pick up for fun, but if you are seriously interested in infectious disease and case studies about how to treat it in the developing world, this is the book for you.
Feb 11, 2012 Kirsten rated it liked it
Three stars is a compromise. For ideas and scholarship I'd give it five stars. Farmer's framework is as relevant today as ever. A must-read for anyone in the social sciences, international development, or politics. For writing I'd give it zero stars. This book in written, not in English, but in Academicese. I despise Academicese, which made grad school a test of endurance. I recommend this book only for graduate students and academics, not for civilians!
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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
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“There is nothing wrong with underlining personal agency, but there is something unfair about using personal responsibility as a basis for assigning blame while simultaneously denying those who are being blamed the opportunity to exert agency in their lives” 10 likes
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