Pathologies of Power Quotes

“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”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“Laws are not science; they are normative ideology and are thus tightly tied to power. Biomedicine and public health, though also vulnerable to being deformed by ideology, serve different imperatives, ask different questions. They do not ask whether an event or a process violates an existing rule; they ask whether that event or process has ill effects on a patient or a population.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“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.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“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.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“As Phillipe Bourgois notes, paraphrasing a warning issued by Laura Nader years ago: "Don't study the poor and powerless, because everything you say about them will be used against them." I hope to have avoided lurid recountings that serve little other purpose than to show, as anthropologists love to do, that I was there.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“There is an enormous difference between seeing people as the victims of innate shortcomings and seeing them as the victims of structural violence. Indeed, it is likely that the struggle for rights is undermined whenever the history of unequal chances, and of oppression, is erased or distorted.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“But the worst of the expense lies with the medications, and there is no reason for their high and fluctuating prices: the drugs have been off patent for decades, and we know that the same companies sell the same drugs at wildly different prices in different countries. Drug prices should not constitute the chief barrier to effective therapy for all patients... With less complaining, and more coordination, international public health authorities could have brought these prices down rapidly, as we have learned by our efforts to do so.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“The current human rights movement in Africa - with the possible exception of the women's rights movement and faith-based social justice initiatives - appears almost by design to exclude the participation of the people whose welfare it purports to advance.' - Chidi Anselm Odinkalu”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“Statistics no longer frghten us. But pictures of the starving children of Biafra, of Haiti, or of India, with thousands sleeping in the streets, ought to. And this entirely apart from the horrors that befall the poor when they struggle to deliver themselves from their poverty: the tortures, the beheadings, the mothers who someow manage to reach a refuge, but carrying a dead child--a child who could not be nursed in flight and count not be buried after it had died. The catalogue of terrors is endless.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“In this increasingly interconnected world, we must understand that what happens to poor people is never divorced from the actions of the powerful. Certainly, people who define themselves as poor may control their own destinies to some extent. But control of lives is related to control of land, systems of production, and the formal political and legal structures in which lives are enmeshed. With time, both wealth and control have become increasingly concentrated in the hands of a few. The opposite trend is desired by those working for social justice.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“Some of the problems born of structural violence are so large that they have paralyzed many who want to do the right thing. But we can find more resources, and we can find them without sacrificing our independence and discernment.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“By 1995, some 7 percent of all African American adult males were interned [in prison]. As Loic Wacquant has remarked, the state of New York counts more men of color in its prisons than in its public universities. It is important to note that these trends reflect changes in policy rather than changes in behavior.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“Certainly, patients may be noncompliant, but how relevant is the notion of compliance in rural Haiti? Doctors may instruct their patients to eat well. But the patients will 'refuse' if they have no food. They may be told to sleep in an open room and away from others, and here again they will be 'noncompliant' if they do not expand and remodel their miserable huts. They may be instructed to go to a hospital. But if hospital care must be paid for in cash, as is the case throughout Haiti, and the patients have no cash, they will be deemed 'grossly negligent'.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“The United States granted asylum to exactly eight of 24,559 Haitian refugees applying for political asylum during that period [1981]... only 20 percent of those polled [in the US] said immigration should be easier for Haitians, while 55 percent said it should be more difficult. After a decade during which less than 0.5 percent of Haitian applicants were granted asylum, one wonders how much more difficult it could be.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“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. If assaults on dignity are anything but random in distribution or course, whose interests are served by the suggestion that they are haphazard?”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“If access to health care is considered a human right, who is considered human enough to have that right?”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“The insight is, in a sense, an epidemiological one: most often, diseases themselves make a preferential option for the poor. Every careful survey, across boundaries of time and space, shows us that the poor are sicker than the nonpoor. They're at increased risk of dying prematurely, whether from increased exposure to pathogens (including pathogenic situations) or from decreased access to services-or, as is most often the case, from both of these "risk factors" working together.2 Given this indisputable association, medicine has a clear-if not always observed-mandate to devote itself to populations struggling against poverty.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“Should the frenzied quest for access to power and wealth be regarded as serving a social good simply because those who were historically underrepresented in the past are now filling roles that involve replicating inequality?”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“Managing inequality almost never includes higher standards of care for those whose agency has been constrained, whether by poverty or by prison bars.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“While these racial differentials in mortality have provoked a certain amount of discussion, public health expert Vicente Navarro recently pointed to the "deafening silence" on the topic of class differentials in mortality in the United States, where "race is used as a substitute for class." But in 1986, on "one of the few occasions that the U.S. government collected information on mortality rates (for heart and cerebrovascular disease) by class, the results showed that, by whatever indicators of class one might choose (level of education, income, or occupation), morality rates are related to social class.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“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. If assaults on dignity are anything but random in distribution or course, whose interests are served by the suggestion that they are haphazard?”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“All these aspects which make up the overall picture of the state of humanity in the late twentieth century have one common name: oppression. They all, including the hunger suffered by millions of human beings, result from the oppression of some human beings by others. The impotence of international bodies in the face of generally recognized problems, their inability to effect solutions, stems from the self-interest of those who stand to benefit from their oppression of other human beings. In each major problem there is broad recognition of both the moral intolerableness and the political non-viability of the existing situation, coupled with a lack of capacity to respond.

If the problem is (or the problems are) a conflict of interests, then the energy to find the solution can come only from the oppressed themselves.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“Medicine becomes pragmatic solidarity when it is delivered with dignity to the destitute sick... By including social and economic rights in the struggle for human rights, we help to protect those most likely to suffer the insults of structural violence.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“Or should we ask pardon from the dead, our dead, those who die 'natural' deaths of 'natural causes' like measles, whooping cough, breakbone fever, cholera, typhoid, mononucleosis, tetanus, pneumonia, malaria, and other lovely gastrointestinal and lung diseases? Our dead, the majority dead, the democratically dead, dying from sorrow because no one did anything, because the dead, our dead, went just like that, without anyone even counting them, without anyone saying "ENOUGH!" which would have at least given some meaning to their deaths, a meaning which no one ever sought for them, the forever dead, who are now dying again, but this time in order to live." - Zapatistas on being offered a pardon in exchange for their surrender”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“It was not until 1986 that the Department of Health and Human Services (HHS) began to draft laws requiring immigrants to be tested for and found free of HIV. This legislation was sponsored in the Senate by Senator Jesse Helms and was approved - unanimously - in June 1987. "This Senate action was extraordinary," notes a legal opinion, "in that it assumed a responsibility, previously entrusted to the HHS, to determine which communicable diseases would be grounds for excluding aliens.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“Since Guantanamo is not technically on U.S. soil, the Bush administration lawyers developed a torturous rationale:
'While conceding that the Haitians are treated differently from other national groups who seek asylum in the U.S., the Government claimed that the U.S. Constitution and other sources of U.S. and international law do not apply to Guantanamo - this despite the fact that the U.S. military base at Guantanamo is under the exclusive jurisdiction and control of the U.S. Government.”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“Anthropologists and others who take these as research questions study both individual experience and the larger social matrix in which it is embedded in order to see how various social processes and events come to be translated into personal distress and disease. By what mechanisms, precisely, do social forces ranging from poverty to racism become *embodied* as individual experience?”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor

“The headlong stream is termed violent
But the river bed hemming it in is
Termed violent by no one.

The storm that bends the birch trees
Is held to be violent
But how about the storm
That bends the backs of the roadworkers?

Bertolt Brecht, "On Violence”
― Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor