Farmer: Pathologies of Power: Health, Human Rights, and the New Berkeley by Hayley Gow



Pathologies of power  is an analysis of the “powerless and the poor” done by by paul farmer a physician and anthropologist who looks to deconstruct the political, economic and social inequalities that have left many in desolate poor and sickness. Paul Farmer’s perspective is from a privileged account but he uses this point of view to give a voice t
o those marginalized and oppressed both within and across nations. Eric Stover who analyzes Farmers argument beyond the law nicely summarizes the neoliberal context that “leaves behind the powerless, the destitute and the truly disadvantaged, tram280634
pling on their most basic human right – the right to survive – in the quest for greater prosperity and affluence among the influential classes” (Stover 2004, 178-179). This ethnography is about bringing light to the suffering that results from structural disadvantages and rooted inequalities that leave people in the wake of poverty and illness. Farmers focuses on exploring the role, distribution and access to medicine and healthcare as both an exploration of human rights and social inequalities, in hopes for greater magnitudes of change. Ultimately Farmer implicates an ethical approach that calls to action change for structural disadvantages. Erika Bourguignon summarizes Farmers argument as “extreme poverty and the social and political conditions that give rise to it- Farmer calls this “structural violence”- deny people that right and produce ‘unnecessary’ deaths. ‘Unnecessary’ because given present-day means of prevention and cure, those able to afford health care do not die in this mann. This discrepancy between the rich and the poor, individuals and countries, is the ‘leading ethical question of our time’ one too often ignored” (Bourguignon and Farmer 2004, 175).

Farmers highly incorporates an underlying theme of social issues in which he educates people on social justice and human rights issues through analyzing the notion of suffering that seems invisible to those who do not experience it on a day to day basis. Through analysis of the exploitation of global capitalism and the structures that both create inequalities and confine the poor and sick, he looks at the affects of HIV, tuberculosis as well as the impact of gender and race on lived experiences.


This ethnography is appropriate as a student readership as it has suitable characteristics that are challenging but also readable both in relation to content and structure. An ethnography that is appropriate for student readership is one that often challenges the reader and allows them to delve into relevant issues. The subject is also relevant for students because it adds a basic level of comprehensive understanding that can often be overlooked within students day-to-day live’s and “memorizing” of content. Often students, like myself can go from one day to another looking at information but not engaging with the content, instead Paul Farmer influences you to really think about the ways in which people are affected and how these structures and inequalities are created and recreated within societies around the world. It allows students to connect with world issues that are often outside of their day to day “norms” as well. logo

A good ethnography has characteristics that challenge you to not only think about and analyze the facts but also to understand the structural reasonings that create these realities. While this ethnography follows many of the ethnographic characteristics laid out by Marcus and Cushman, the author excels at three in particular. Farmer effectively uses everyday life situations, data based own ethnographic field work and use of disciplinary jargon to create Pathologies of Power. The author makes excellent use of everyday life situations for the theme of extreme suffering can often be incomprehensible and distant from the targeted audiences experiences. By incorporating everyday life examples Farer makes the argument and experiences significantly more relatable and allows the reader to connect with the issue more easily. Incorporating specific individual accounts of everyday life examples makes the structural disadvantages real allowing the reader to fully understand the magnitude and affects these structural disadvantages can have on one’s life. For example “Acephie’s Story” found in chapter one was a story of a Haitian poor women who turned to an arrangement with a soldier whom had AIDs to improve her life chances, which ultimately led to her demise. Further more the data based on Farmer’s own ethnographic field work formed a comprehensive structure that allowed the reader to remain interested while he included a variety of writing styles from personal stories, medical reports, statistics and points of view from both privileged and oppressed peoples. For example when looking at “drug-resistant tuberculosis” in prisons Farmer included accounts from prison doctors, prisoners and comments from the community more broadly to make a holistic account to understanding the structural reasonings and the lived experiences within overcrowding and medical issues within prisons. Lastly Farmer as a physician and anthropologist effectively used disciplinary jargon to both legitimize the authors point of view and argument and allowed the reader to always connect back to a main academic argument. Despite the inclusion of many stories, personal accounts and ultimately informal writing styles, the use of disciplinary jargon helped to reify the authors expertise and critique.


There is a variety of appropriate audiences that this ethnography can appeal to. People who are in power relations (ie. privileged and oppressed) and are capable of making efforts that can transform the structures keeping people oppressed and marginalized in todays society. It is also appropriate for anyone who is interested in issues with human rights, social justice movements and marginalized groups. Really the readership can be for anyone who wishes to expand their knowledge and systems of thought. For me the ethnography really helps one to think critically and analyze the evidence, allowing me to holistically consider and not just assume people live in the conditions they do just “because” but rather to recognize the forces that are keeping these people marginalized and oppressed. This critical thinking helps to add to the underlying themes and conversations of basic human rights, social justice movements and the inequity that exists both within the third and first worlds. It can be added to conversations about political structures and support and even the increasing affects of globalization especially in light of broader concerns about the role, distribution and access to medicine and healthcare.

Ultimately while I found Farmers book equally as challenging as it was interesting, it allowed me to delve into issues that are prevalent in society but often overlooked which makes my question why if this issue is so widespread, have serious efforts to challenge this paradigm have not occurred. This in turn makes me question and curious towards the legitimacy of
social programs, government structures, global financial SOCIALJUSTICEinterdependencies etc. and the exact role they play in both the development and underdevelopment of regions and peoples.

Word Count: 1206


Farmer, Paul,and Amartya Kumar Sen. 2003. Pathologies of Power: Health, Human Rights, and the New Berkeley: University of California Press

Stover, Eric. 2004. “Review: Pathologies Of Power: Health, Human Rights, And The New War On The Poor”. Sigma Xi, The Scientific Research Society 92 (178-180).

Bourguignon, Erika, and Paul Farmer. 2004. “Pathologies Of Power: Health, Human Rights And The New War On The Poor”. The Antioch Review 62 (1): 175. doi:10.2307/4614627.


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