“EvFarmerery man who lives is born to die…that recognition is tragic enough, but the reality is sadder still. We try to pack in a few worthwhile things between birth and death, and quite often succeed. It is, however, hard to achieve anything significant if, as in sub-Saharan Africa, the median age at death is less than five years”.

Paul Farmer’s Pathologies of Power: Health, Human Rights, and the New War on the Poor encompasses this powerful statement. The author focuses on power in relation to poverty and health and manifests his experiences as a physician and anthropologist throughout the text. The main aspect of the book stresses how human action or inaction can lead and has led to poverty and injustice. Farmer analyses how living conditions and homelessness are linked to the resettling of the poor and large based government constructions. Building projects are established in the areas where most farmers live and they are forced to relocate. The relocated people are often moved to infertile land and health problems begin to ensue. Health and death are related to political, economic, and social systems which are often controlled by those in power. The people who are mostly affected by health and death are the poor. Farmer calls this link structural violence. In the process of structural violence, the poor have little to no access to health care whether it be facilities or even just products. Farmer criticizes this feat as he believes health care should be a human right. The book also talks about the U.S. foreign policy and the international market. The author presses on the social unequal structure of our world and how socioeconomic status is an issue in relation to human rights and health. The rest of the book talks about modern western medicine and how people all need access to modern technology and health care.

As a student, reading the summary may seem like the book will be a complex text. This is not the case however; Farmer does not use hard to understand jargon and instead writes in a simple way as if writing in his journal. The manifestations of his experiences on each page make it easier for an audience as young as high school students to understand. Willis and Trondman’s (2000) wish list for ethnography are checked off in Farmer’s book. The author focuses on social phenomena to help the audience have a better understanding of what is going on. When Farmer writes about the patients he treats from military beatings or social health problems he is giving us a glimpse into the social structure of the region. The second thing on Willis and Trondman’s (2000) wish list is the centrality of culture. In the ethnography Farmer explains the living conditions of those who are relocated due to large governmental projects. He touches on how most of the poor have their culture and materials disrupted. Third on the wish list is critical focus in research and writing which Farmer checks off by again focusing on how powerinequalities impact the social livelihoods of people. The fourth and final wish list is an interest in cultural policy and cultural politics. The ethnography talks about U.S. foreign policy and international markets as well as access to modern Western medicine and technology. I think the most important thing for an ethnography is to let the audience have a better understanding of what is going on. Each of these characteristics have been checked of in the text. Therefore, Farmer’s ethnography is a decent enough book for students to grasp and to sympathize over.

Though Farmer’s book has Willis and Trondman’s wish list checked off he has a couple more wish lists to attend to. There are more things Farmer would have to add to his narrative if he wants Brucato (2011) wish list checked off. Brucato (2011) criticizes Farmer for leaving out important factors that are also related to poor health and human rights. He claims Farmer filed to acknowledge three aspects of globalism which are industrial production, the destruction of cultures because of colonialism, and diminishing traditional medicine and healing. These aspects are related to one another in some way and globalism cannot be the only thing blamed for poor health care and injustice. I would have to agree with Brucato on that as I believe there are deep rooted issues in our world. The systems put in place that cause structural inequality are not only in relation to socioeconomic status. Holmes (2003) also agrees saying that Farmer should assess inequality based on gender, ethnicity, sexuality, and citizenship as well. I also like what Brucato says about different cultures having different ways of healing. Not everyone uses Western medicine and not everyone responds to Western medicine the way Westerners do. In ourglobal world of today maybe traditional medicine may be even better as it has more organic properties and it not mass produced. Some people may prefer to use what they are used to in terms of health care because it worked for hundreds of years. Despite all that both critics agree these limitations in Farmer’s ethnography do not take away from the overall gist of the book. That is, global inequality and exploitation of the poor in a capitalist society. He is not wrong there, but I agree there should be more to his stance. There are various factors he could have used to strengthen his book.

This book will add to your knowledge of the global world. It talks about a lot of things the youth of today already know, especially when you have taken a development studies class. It just builds onto the knowledge of globalization and globalism. It’s like a different perspective on our world today. Instead of having different factors Farmer just focuses on one and I think it is interesting to see his one perspective of globalism. It may be a bit faulty because it does not talk about other factors but he is not wrong about what he is saying. There definitely are systems that are hierarchical and unequal in our world and shedding light on those problems is doing more to help than not.

Paul Farmer and Patient

The more we are aware of all the factors the easier it is for us to pinpoint the underlying issue. Overall, I would say the ethnography contributes to a socialist point of view. If you believe socioeconomic status can cause health problems in the poor and modern Western medicine should be a human right for everyone in the world, then this is the book for you.

Word Count: 1165


Brucato, Ben, “Review of “Pathologies of Power” by Paul Farmer.” WordPress, (2011).

Farmer, Paul, Pathologies of Power: Health, Human Rights and the New War on the Poor (London: University of California Press, 2003)

Seth Holmes, “Pathologies of Power: Health, Human Rights and the New War on the Poor (review),” Perspectives in Biology and Medicine 48, no. 1 (2005): 153-156.

Willis, Paul and Mats Trondman, “Manifesto for Ethnography.” Ethnography 1 no.1 (2000): 5-16.


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