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

4.24  ·  Rating details ·  3,722 Ratings  ·  215 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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Simon Wood
Jul 29, 2013 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
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
Dec 22, 2009 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
Jan 30, 2009 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
Jan 30, 2018 rated it it was ok  ·  review of another edition
My main takeaways from this book were an appreciation for the lyrics of Bertold Brecht and some additional knowledge about tuberculosis in Russia and AIDS in Haiti from around the year 2000. That is not without value.

It is easy to see how the structural violence is turned against the poor on the matter of health, and to see the importance of health, and how it is tied in with access to food and clean water and all of the obvious things. And maybe that's the problem, is that it is kind of obviou
Dec 02, 2010 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
W. Littlejohn
Oct 20, 2009 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
Maureen Flatley
Mar 29, 2008 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.
Jan 25, 2018 rated it really liked it
Its an interesting read, that can be an eye opener for some people
Eric Miller
Jan 06, 2014 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
Nov 10, 2016 rated it really liked it
I was first introduced to Paul Farmer when I read Tracy Kidder's Mountains Beyond Mountains this past summer. While Kidder's book dwells on Farmer's life specifically, this book — by Farmer himself — takes a much broader view and outlines the doctor's convictions on poverty, health, human rights, international aid and policies, and how they all come together to create structural violence that keeps the poor ill and oppressed.

Farmer assumes a certain level of familiarity with his concepts, fro
Jun 16, 2013 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
mis fit
May 20, 2014 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
Mica Verendia
Jul 01, 2009 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.
Dec 04, 2014 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.
Oct 20, 2009 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.
Oct 28, 2008 marked it as to-read
i will learn the way of treating patients
Jul 31, 2010 rated it it was amazing
This book is a clear call to action. If you've been following my reviews, you know that I've had an epiphany of sorts from following Dr. Paul Farmer's work. He's the doctor to the poor, the one who cofounded Partners in Health, which treats poor people in nine different countries all over the world, in some of the settings of extreme poverty. They've been working in Haiti for about 25 years, since the early 80s.

His books have raised my awareness of what's actually going on in the world. This is
Dec 30, 2016 rated it it was amazing
Wow! The notes alone! The notes are referenced to the page numbers, which is so handy, especially when you're flipping back and forth between the notes and the text. I'm beginning to think, after reading a few books, written by anthropologists, that this is unique to their style, having these referenced notes. Everyone should do this! The notes are supportive of the text and include some additional treats as well. Here are a few of my favorites:

Chapter 2. Note 67. Referencing an essay by Noam C
Cindy Leighton
"We thus find ourselves at a crossroads: health care can be considered a commodity to be sold, or it can be considered a basic social right."

Written in 2005, this look at who "deserves" access to quality health care becomes only increasingly important. Farmer uses case studies of resistant TB in Russian prisons, lack of access to life saving AIDs medicine in Haiti, the Zapatista uprising, and many other situations where access to basic lifesaving medicines is denied because of poverty, to argue
Apr 01, 2018 rated it really liked it
Humanitarian physician/anthropologist Paul Farmer uses his privileges as a Harvard prof to challenge several pillars of the American establishment, to bear witness to the impoverished (Haiti, Chiapas, Russian prisons) by outlining causes/effects of structural violence:

1) American foreign policy: inescapable, yet Western ideological censorship does wonders!

2) Market Liberals/technocrats: Farmer cites the great saying that Liberals think bad things in the world stem from accidents! This root of im
Apr 22, 2018 rated it liked it
My first Paul Farmer book, so it took getting used to how academic he writes. The first half was full of engaging stories about his travels and work around the world - he draws fascinating contrasts between the HIV/AIDS sanatoriums enacted by Cuba and the US-created detention center for HIV+ Haitian refugees in Guantanamo. I was also riveted by the description of how drug-resistant TB is running rampant through Russian prisons. However, the second half turns much more dry and textbook-y.

I do app
Jake Losh
Apr 03, 2016 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
This is one of those books I wish everyone would read. Farmer is a passionate physician-anthropologist who writes persuasively about social justice issues and human rights abuses in a way that is eye-opening and powerful. He calls for action to help the poor and the sick through pragmatic solidarity and advocates a preferential option for the poor in terms of access to health care. He argues that pursuing human rights from only a legal standpoint is ineffective and a waste of time-- social and e ...more
Jun 13, 2017 rated it it was amazing
Farmer lays out his case for an ethical imperative to provide global medical care regardless of social standing or ability to pay. He lays out examples of neglect and abuse, refutes weak excuses for not providing care that rely on neoliberal economic forces, chastises NGOs and the structure of convenience surrounding human rights, and looks to liberation theology for a moral and ethical foundation for his arguments.

The book is somewhat dated in that it was written in around 2000. Most of the sit
Bruce Campbell
Mar 25, 2017 rated it it was amazing
Even though this book was published in 2003, it is as relevant today as ever. Actually, even MORE relevant.

Paul Farmer spares no one in his search to reverse the structural violence that ties poverty and deprivation to poor health outcomes and, as he tells us they are called in Haiti, "stupid deaths." He challenges governments, NGOs, philanthropists, ethicists, the mainstream press, pharma, physicians, and universities to find new ways to bring justice to the poor in low- and medium-resource set
Aug 10, 2017 rated it it was amazing
Shelves: science-related
I was enthralled with Paul Farmer's work as shared in Tracy Kidder's book "Mountains Beyond Mountains". I finished this book "Pathologies of Power" just before listening to him and Dr. Jim Kim address the American Anthropological Society in DC and was not disappointed. In fact, I was very much impressed. I watched the documentary about parts of his work "Bending the Arc". We each need to understand how our "first world choices" affect others around the world and in our own communities.
Jan 30, 2018 rated it it was ok  ·  review of another edition
I like the case studies and reading about the specific examples that he used to further his questions about bioethics and medicine, it just was very dry and hard to get through.
Jin Z
Jan 31, 2018 rated it it was amazing
This should be a required textbook for all students in medicine and public health.
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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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“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.” 2 likes
“Do we see [human disparity] as a human predicament--an inescapable result of frailty of our existence? That would be correct had these sufferings been really inescapable, but they are far from that. Preventable diseases can indeed be prevented, curable ailments can certainly be cured, and controllable maladies call out for control. Rather than lamenting the adversity of nature, we have to look for a better comprehension of the social cuases of horror and also of our tolerance of societal abominations.” 1 likes
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