By Moravia de la O and Michaela Machicote
Sameena Mulla is Assistant Professor of Anthropology in the Department of Social and Cultural Sciences at Marquette University in Milwaukee, Wisconsin. She received her Ph.D. in Anthropology from Johns Hopkins University where one of her dissertation advisors was Veena Das. Her dissertation was titled The Institutionalization of Suffering: Time and Technique in the Medicolegal Sexual Assault Examination in Baltimore, MD and it forms the basis for The Violence of Care.
Mulla’s research focuses on sexual violence; institutions; law and the State; expert knowledge; race, gender, and the body; visual anthropology; medical technology; anthropology and philosophy; legal subjectivity; and the urban U.S.
You can listen to a short radio interview with Sameena Mulla about The Violence of Care here: http://wypr.org/post/understanding-violence-care
In The Violence of Care, Sameena Mulla uses an ethnographic approach to analyze the ways in which the medical and legal spheres interact during sexual assault forensic examinations and the impacts these interventions have on sexual assault victims. Mulla provides a critical analysis of these interventions based on four years of participatory research as a rape crisis advocate and extensive interviews with forensic nurses, sexual assault victims, rape crisis advocates, activists, law enforcement officials, and lawyers. Throughout, Mulla demonstrates how the specific form of care that results from the interaction of legal and therapeutic practices inflicts a particular violence upon sexual assault victims, framing the ways in which they understand their own experiences.
Mulla provides extensive analysis of the tensions that arise during sexual assault forensic examinations--highlighting the ways in which care for the victim becomes secondary to legal priorities, especially DNA evidence collection. Mulla highlights several key tensions including:
●The importance given to DNA samples and the urgency with which it must be collected overrides concerns for the victims’ physical comfort and emotional well-being.
●Medicolegal timelines established through the forensic examination do not always line up with victim’s notions of the time frame for the sexual assault.
●Foregoing the emotionally sensitive nature of sexual assault forensic examinations in favor of juridical criteria that seeks to establish the “truth” makes victims feel unsupported and, at times, distrusted by the forensic nurses.
●The legal framing of the victim and the specific emphasis on consent does not take into consideration the expansiveness of victims’ lives and contexts.
●Visual technology can lead to the fragmentation and objectification of the victim’s body.
●Forensic documentation as the intersection of legal protocols and medical techniques and how it can “reflect or erase the lived realities of sexual assault victims and their families while reproducing rape myths in the daily functions of the institutions themselves” (152).
●Institutional notions of the home as a safe space contrast with the reality of the home as the site of sexual violence in many cases.
●The “ideal” assault victim clashes with the reality of victims that may have drug addictions, a history of crime, and/or mental disorders.
1.How does an understanding of biopolitics and the ineffability of pain help us understand the impacts of forensic examinations on sexual assault victims?
2.What does it mean for the body to be the scene of the crime? (178)
3.How can we understand the geographies of “rape-able” bodies? In what ways are they constructed?
4.How did you understand the analysis of gender, race, and class in this text?
5.Does Mulla manage to write about sexual violence without creating “museums of suffering”? If not, why?
Ricardo, Quichi, Chris
Joao Biehl is Professor of the Department of Anthropology at Princeton University, working in the fields of Sociocultural and Medical Anthropology, Public Health and Science and Technology Studies. He is Co-Director of Princeton’s Program in Global Health Policy. His recent work includes Vita: Life in a Zone of Social Abandonment (2005) and Will To Live: AIDS Therapies and the Politics of Survival (2009), innovative ethnographic studies into the limits of the human condition through the experience and management of mental illness and AIDS, respectively. Both works were done in collaboration with photographer Torben Eskerod.
Initially, Biehl had written his PhD dissertation on the control of AIDS in Brazil, which in 1996 became the first developing country to institute a social policy of universal access to AIDS therapies, specifically through massive distribution of antiretroviral drugs (ARVs). During this time, he encountered the emergence of centers where the homeless, the sick, unproductive and mentally ill of the urban poor where left to die. These cites, which he calls “zones of social abandonment” were proliferating throughout the mayor urban centers of Brazil through the complex articulation of public health policies, medical institutions and pharmaceuticals economies in relation to neoliberal regimes of citizenship.
Zones of Social Abandonment
Vita, an asylum in the city of Porto Alegre, Capital of the state of Rio Grande do Sul, constitutes a “dump site” of the human bodies of those unwanted and unproductive members of society. The ethnography is centered in a woman resident, Catarina, who suffers from chronic pains, which she associates with hereditary rheumatism, against the indifference and incompetence of a plethora of health professionals who have had contact with her during her long clinic history.
As with the other anonymous inhabitants of these zones of abandonment, little is known about Catarina’s identity or subject position within the family and larger social context besides the diagnosis – or rather her stigma – of “madness” that came to replace her identity and personhood. Catarina resisted the exclusion and abandonment instrumentally forged through a history of interactions with mental institutions and the progressive rejection of her family nucleus. Faced with a human condition in which “voice can no longer become action” (p. 11) Catarina refused to be reduced to her physical condition and to accept social exclusion. She uses writing as a way to remember and think about the complex events of her life and the forces that shaped these events carrying her to her present state.
Crudely pointing to a routine of silence, oblivion, physical and symbolic violence, her “dictionary” as an act of writing, Biehl reveals, constitutes a powerful vehicle for mediating agency and desire, and for resisting the power of pharmaceutical control and the closure of identity imposed by family, diagnosis and other contextual determinations.
The fragmentary writings of Catarina stimulated Biehl to take a dialogical approach to ethnography, founded on an ethics of listening that enables him to find “pieces of truth” about Catarina’s physiological deterioration, her expulsion from social and family life, and about her resistance to being determined by these forces. First, he found structural similarities that linked the different stories of exclusion and abandonment that he discovered in Vita, stories that nevertheless remained invisible and disjointed to the actors that interacted with them on a daily basis. Second, overcoming the rejection to the fragmented mode of enunciation of patients medicated with psycho-pharmaceuticals, usually thought of as nonsensical, Biehl started to read in the writings not only the concrete effect of family and institutional exclusion, but also the resistance of a subject to be reduced to a meaningless unproductive entity with no ties to the world. The dictionary represents ultimately the struggle for an alternative symbolic order and an instrument of thought, agency and self -affirmation.
“Marked off as mad and left to dead, yet claiming understanding and desire”, Catarina, the author argues, gives meaning in her dictionary to “the circuits in which her experience took form and suggests that life is potentially inexhaustible” (p. 118). He uses Catarina’s writing to guide and focalize his analysis and thinks about her subjectivity as a “complex symbolic, social, and medical artifact in the making that illuminates the conditions of life, thought, and ethics in contemporary Brazil” (p. 118).
Within this analytical set up, Biehl proposes to focus on three related problems that Catarina’ subjectivity seemed to reveal:
1) How inner worlds are remade under economic pressures, a central aspect of subjectivity intimately linked to family relationships within specific political economic regimes and modes of production.
2) The domestic roles of pharmaceuticals as moral technologies, considering that psycho-pharmaceuticals played an important role in altering Catherina’s sense of being and her value for others (p.9).
3) The common sense that creates a category of unsound and unproductive individuals who are left to die, after being considered not worth of affection or care. Biehl proposes this as a fundamental problem of anthropology, which must assess those “judgments of reality [that] determine which kinds of lives societies support” (p.9). The question here is what is means to be human in a structural arrangement in which the possibility of agency, voice and action is foreclosed. He articulates the notion of the animalization to illustrate the result of the “machinery” of the zones of social abandonment.
The author assesses these problems by revising the medical archives of Catarina and listening to the discourses that mediate and explain the actions of health professionals, bureaucrats and activists, with respect to the mentally ill, revealing at the same time how neoliberal governance is reshaping public health policies. Furthermore, he approaches Catarina´s family to try to understand how structural changes in health institutions mediated by pharmaceutical trends of management and social control, restructure and define the systems of kinship and affect within the family. The multiple narratives he encounters reveal the social construction of Catarina´s madness and ultimately the social function that zones of abandonment play in getting rid of unproductive members of society by denying their citizenship. In the face of increasing economic and biomedical inequality and the breakdown of the family, “human beings are routinely separated from the normal political status and abandoned to the most extreme misfortune: death in life” (p. 38). Biehl demonstrates that “through the production of social death, both state and family are being altered and their relations reconfigured” (p. 21). Specifically, in the domain of health, the constant reconfiguration of economical, social and scientific rationalities determine and model new experiences of illness, subjectivity and social control.
By Alicia Danze and Yoalli Rodríguez
Trained as both a literary scholar and political theorist, Elaine Scarry is the Professor of Aesthetics and General Theory of Value in Harvard University’s English Department. Her work is highly interdisciplinary, drawing on analysis of art, court records, the Constitution, torture testimonies, the Bible, etc.
Aside from authoring The Body in Pain (1985), Scarry has also written on the role of military bases in mysterious plane crashes, and the anti-democratic status of nuclear weapons. She specializes in 19th c. British novels and 20th c. drama, but uses her literary expertise to “solve social problems and save lives” (Eakin). In an essay titled “Poetry Changed the World,” Scarry goes into greater detail about her theory of language (and literature specifically) as having the power to eliminate pain:
“By ‘empathy’ …[I]…mean not the capacity of literature to make us feel compassion for a fictional being (though literature certainly does this), but rather the capacity of literature to exercise and reinforce our recognition that there are other points of view in the world, and to make this recognition a powerful mental habit. If this recognition occurs in a large enough population, then a law against injuring others can be passed, after which the prohibition it expresses becomes freestanding and independent of sensibility.”
Other books she has written include: Thermonuclear Monarchy (2014), Thinking in an Emergency (2011), Rule of Law, Misrule of Men (2010), On Beauty and Being Just (1999).
An interview with Elaine Scarry can be found here:
Eakin, Emily. “Professor Scarry has a theory.” The New York Times Magazine. 19 Nov. 2000. Web. October 12 2015. http://partners.nytimes.com/library/magazine/home/20001119mag-scarry.html
The Body in Pain. The Making and Unmaking of the World (1985)
According to Scarry, the etymology of pain is poena or punishment, and it “reminds us that even the elementary act of naming this most interior entails an immediate mental somersault out of the body into the external social circumstances that can be pictured as having caused the hurt” (16).
Elaine Scarry’s book has three main subjects: First, the impossibility to express physical pain: “It resists the objectification in language” (5); second, the political consequences of that inexpressibility; and third, the nature of both material and verbal expressibility or, the nature of human creation. Through examples like medical case histories, legal documents, Amnesty International testimonies, The Bible and Marxism, Scarry draws the relation between these matters.
The book is divided in two main sections: Part 1 is dedicated to the unmaking World through the analysis of torture and war, Part 2 describes the making of the world (the creation).
In the first chapter, Scarry describes the structure of torture. She argues that torture has is itself a language and a objectification. Torture consists in the infliction of pain (the body) and a primary verbal act of interrogation (voice). Torture disintegrates the perception of reality brought by intense pain. Scarry describes how during torture, the world of the prisoner is reduced to the room of torture, and the room itself becomes another weapon. In this sense, the de-objectification of objects, the “unmaking of the make is a process of externalizing the way in which the person´s pain causes his world to disintegrate, and at the same time, the disintegration of the world is here, made the direct cause of pain” (41).
Even if the physical reality is the room, there are two institutions - the trial and the machine - that are actually present during torture. Both are elaborations of the relation between the body and the State.
Scarry also analyses the agency during torture. Even if the prisoner appears to not have control of anything -- of the responsibility of his world, of his reality of his words and body-- he will understand his confession as a self-betrayal act. In this sense, the tortures “are producing a mime in which the one annihilated shift to being the agent of his own annihilation” (49).
Through the infliction of pain, there is also the display of the fiction of power which is the final product and outcome of torture, “should in the end be seen in relation to its origin, the motive that is claimed to be its starting point, the need for information” (58).
In the second chapter Elaine Scarry explores the structure of War. The premise is that the main outcome of war is injuring and that war is a contest. In the first section, she analyses how this immediate act of injuring disappears from the description of wars and weapons, transforming them in the imaginary into objects intended for security or power. For example, weapons are said to be used for protective and pacifist intentions.
Another confusion is when the interior of war activity is described for freeing or disarming ends.
Also, injuries are often described as “by-pas” which means accidental, unwanted and useless. “Here the injuries are seen as having occurred on the road to another goal” (74). In the second section, she describes how war is a contest strictly in terms of its structure (reciprocity, rules, agreements, winner-loser dichotomy). Scarry analyzes the question "What differentiates injuring from other acts on which a contest can be based?” One of the responses would be that war or injuring carries the power of its own enforcement. Another response to this question might be that the winner uses injured and dead bodies for the construction and substantiation of his ideas and reality. As the author repeats several times in this chapter, “What is remembered in the body is well remembered” (109). Injuring makes perpetually visible an activity that is past, and thus has a memorialization function. but also “injures refer forward to the future to what has not yet occurred, and thus have an as-if function. This might be called their fiction generating or reality-conferring function (121).”
She finishes the first part of the book by describing the difference between torture and war (with an exception for nuclear war) based on consent. In torture, the prisoner’s body is used to (de)construct a reality without his consent, whereas in war the consent exists. For the case of nuclear war, its structure is more close to torture because the population cannot give consent for their use of their bodies for the purposes of war, or they cannot surrender once the nuclear weapon is thrown.
In the second half of her book, Scarry describes the reverse process of ‘unmaking’ by showing the history of making (albeit in a Western-centric context). She sees imagination as the opposite extreme of pain. Imagining is the creation of and engagement with a world of objects without the experience of sentience; pain is sentience that obliterates the world of objects. Through imagination, we make a shareable world, and that world remakes us, but sentience (and pain) ground us in a certainty of reality, and the objects we make refer back to that embodied, sentient experience.
Scarry then analyzes two sets of texts that in structure and content reflect the human desire to create in order to rescue ourselves from pain. She posits that throughout history there has been a constant pattern of creating, of using tools to make objects that substitute for our bodies, and thereby end our suffering. She explores how humans had conceptually divided the act of creating into Body and Voice in the Old Testament: God was the Voice that created (and wounded), and humans were bodies that felt his existence. Humans came to believe through their wounds; it gave them a grounding certainty of reality (and the reality of God). However, wounding had a creative component, for out of their wounds were people altered and made over again.
In the New Testament, God made himself a body and became woundable as well. As a knowable, embodied and omniscient creator, the figure of Jesus transcended the Body/Voice divide, fulfilling humans’ oft-spoken wish to know, see, and touch God (made known through the creation of idols). This transformed humans’ relationship to their own bodies and pain, and altered their structure of belief. Divinity was no longer solely defined through pain, but through touch, healing and sentience. The weapon that God used to make himself known in the Old Testament is removed, or perhaps transformed into the figure of Jesus. His pain is his own; it is not associated with a higher authority. With an embodied God that could create and feel pain, touch and be touched, humans also changed their relationship to each other.
In the writings of Marx, Scarry notes the multiplying effects of self-substantiation through creation. Western civilization is itself an Artifact, an accumulation of objects made through work in attempts to displace our own pain. However, the meaning of the objects can be lost when we become too disembodied, as in the case of capitalists, or too embodied (and without Voice), in the case of workers. Bodies are also transformed into tools and artifacts; with the reproduction of artifacts and constant revision of ourselves in response to those artifacts, we objectify ourselves, and again face the problem of a Body/Voice divide.
Finally, Scarry focuses deeper on the process of world-making by examining the interior of artifacts. We’ve designed objects in a way that they should respond to our sentience, and we therefore expect a certain reciprocity when we engage with them. In a sense, we give them responsibility (and ourselves as creators are responsible for them). To greater and lesser degrees, these objects carry a human signature that reminds us of their origin in us. Certain objects work better when we are not constantly reminded that they are of our own designs, and other objects (like art, poetry, etc.) are explicitly made to reflect on the act of creating itself. Scarry concludes that imagination is our attempt to distribute the facts and responsibilities of sentience out into the world, in a way that can be shared and disembodied (opposed to the acuteness and privacy of pain).
We wonder how her analysis of pain and creation is particularized by her Western-centric focus; it’s possible that the history of sharing meaning in the world is very different from what she outlined in another cultural context. By not taking into account other cultural and historical forms in which pain is expressed or used, she runs the risk of overestimating the power of making and self-reproduction. Also, in the case of war, she analyses only on war between Nation-States -- but what about interior wars or non-institutionalized wars held by the State?
1. In light of events and conversations surrounding police brutality and state-sponsored (or state-complicit) terrorism, what do we understand “war” and “torture” to be today? Does Elaine Scarry’s description of them still fit?
2. Scarry posits that pain, although private, is a human experience. It is ineffable, but we can attempt to share something of our felt experience through the world we make. How do notions of intersectionality fit into her description of world-making, sharing and pain?
3. For Scarry, what are the powers and limits of imagination? In your opinion, what are its limits?
4. How does Veena Das’ notion of “work,” “time” and violence relate to Elaine Scarry’s notion of work and pain? Do you think it is useful to think of the two in relation to each other?
Valerie Gaimon and Jazmine Wells
Key terms: torture, body, punish, discipline, gaze, surveillance, panopticon
Foucault’s Discipline & Punish is talked about frequently across all disciplines, usually in regard to surveillance and/or conformity. We should discuss Foucault in terms of the violence enacted on the body through discipline and punishment. Foucault states that “punishment like forced labor or even imprisonment—mere loss of liberty—has never functioned without a certain additional element of punishment that certainly concerns the body itself: rationing of food, sexual deprivation, corporal punishment, solitary confinement” (16). The body is the focus of punishment. As you read think about what the body is being disciplined to do, or better yet prevented to do, and the type(s) of violence that result from this discipline. Also, take into consideration the different crimes that rear punishment, and if a crime is even necessary to enact punishment.
Foucault explains how intuitions (prisons, schools, hospitals) use architectures and methods of surveillance to expose the body to a constant state of visibility. These institutions act as spaces where discipline can either be instilled or punishment can be distributed. Our discussion of Agamben touched on space, but we should talk more about the violence and pain associated with these spaces. Foucault argues “it is spaces that provide fixed positions and permit circulation…they guarantee the obedience of individuals, but also a better economy of time and gesture” (149). Foucault also states that the art of punishing relies on a technology of representation (obstacle-signs); one must fear the image of the punishment before and after committing a crime. Space places a role in this punishment, as it can be a symbol or signal for punishment. What then do we do when we are focused to occupy a space that constantly reminds us of a punishment we cannot escape? Take the colonialism for example; are we not living in a violent space? Are our bodies not the constant object of punishment because of where we live?
Foucault recounts the history of the criminal body’s punishment to show the shift from physical to analogical punishment—where “the power that punishes is hidden” (105). Meaning, punishment now comes from the nature of things instead of the will of the legislator so that one doesn’t see man committing violence against man. Ideologies and institutions are used to restore public morality, which requires a certain standard of normalcy. Therefore it is a must that we discuss the violence in sameness. How do we take into account the bodies that have been othered, that are punished even though they didn’t commit crimes, or that are constantly under surveillance because their bodies are marked? How do we write about the constant pain these bodies undergo because the space they occupy reminds them of a punishment they had no way of preventing?
Foucault’s text works on the assumption that the body has committed a crime and therefore needs to be punished. We should use Foucault’s framework to discuss the bodyies that are being disciplined, punished, and/or under surveillance, not because they committed a crime, but because their race, class, and gender are a crime. We then need to discuss how using pain, memory of pain, or thought of pain resulting from a punishment as a tactic to discipline is a form of violence, as it retains the body in a constant state of suffering. Foucault admits that the body is the object of punishment, but it must also be acknowledged that certain bodies are punished more often and more severely.
“Violence, Peace, and Peace Research” by Johan Galtung
Johan Galtung articulates an expansive definition of violence that is not necessarily tied to clearly identifiable, individual actors inflicting harm, which he terms structural violence. Galtung initially defines violence as present when humans are “influenced so that their actual somatic and mental realizations are below their potential realizations” (1969, 168). He lists six dimensions to characterize violence: physical/psychological, negative/positive, object/no object harmed, acting subject/no acting subject, intended/unintended, and manifest/latent, classifying structural violence within the fourth category as a violence that has no person that acts. Instead, this form of violence is built into structures and manifests itself in unequal power and consequently unequal opportunities. While it can also result in direct bodily and mental harm, its principal identifying feature is social injustice (Galtung, 1969, 170-171). He goes on to discuss the relationship between personal and structural violence and relates them to his distinction between negative peace (absence of personal violence) and positive peace (absence of structural violence), concluding that both forms of violence are extremely harmful and eradicating one should not be done at the expense of the other.
Galtung’s call for a more expansive conception of violence that can account for systemic injustice and oppression, as opposed to individual actions, was an innovative contribution at the time. However, his arguments rely on binaries and ultimately downplay the multidirectional and mutually reinforcing nature of different forms of violence. Similarly, he seems to naturalize structural violence over what he calls structural peace based on currently existing violences and hierarchies that are actually not natural at all, but rather legacies of colonialism and white supremacy (see Das, Fanon, Mbembe and Smith). Galtung’s mathematics training leads him to spend much of his time pondering ratios, constants, logical relationships and quantifying the gains and losses incurred by his two forms of violence--as if violence can fit into a matrix. Finally, Galtung minimizes the extent to which non-decision makers (top dogs, in his parlance) participate in violent structures and can therefore be said to have some responsibility. This topic merits much more discussion, as does the issue of intentionality, especially when consequences are violent.
Pathologies of Power by Paul Farmer
In Pathologies of Power, Paul Farmer seeks to reveal the ways in which the most basic right–the right to survive–is infringed in the era of globalization and scientific progress, affirming that this should be considered the most pressing problem of our time (Farmer, 2005, 6). The author links the problems he discusses – health and human rights among the poor – with the macro structural processes derived from the establishment of neoliberalism doctrines. Thus, he asserts that “human rights abuses are committed in the name of defending and promoting some variant of market ideology” (Farmer, 2005, 6).
Farmer’s analysis is grounded in his professional experience as a physician and in his ethnographic work as medical anthropologist with various communities in Latin America and Russia. The book uses specific case studies to examine the struggle for social and economic rights as they relate to health– offering, what he terms, a critical assessment on conventional notions of human rights. For Farmer, the problem of human rights has been largely the domain of juridical experts. He advocates for a multidisciplinary approach to assess how the lack of economic and political power is intrinsically related to human rights abuses. Human rights violations, he argues, are not accidents, nor they are random in their distribution or effects (Farmer, 2005, 7). Rather, they are “symptoms of deeper pathologies of power” intrinsically linked to structural social conditions which determine the distribution of abuse and suffering (Farmer, 2005, 7). Moreover, he links public health problems with human rights abuses, arguing that “the social determinants of health outcomes are also the social the social determinants of the distribution of assaults on human dignity” (Farmer, 2005, 19).
He uses Galtung’s notion of structural violence as a category that encompasses a broad range of offenses against human dignity, including poverty, social inequalities of race, or gender, and unequal distribution of public services, including differential access to health. In other words, a “violence that does not involve bullets, knives, or implements of torture” (Farmer, 2005, 8). He defines structural violence as suffering that is “structured by historically given (and often economically driven) processes and forces that conspire to constrain agency” (Farmer, 2005, 40). Within this theoretical framework, he counts people who experience poverty as “experts” in structural violence. Thus, he proposes the central claim that human rights abuses are best understood from the point of view of the poor.
Farmer proposes a program of research and action to work towards the equal distribution of scientific advances–particularly in medicine and public health services–and links it to struggles for social and economic rights (Farmer, 2005, 18). Notably, the authors goes beyond mortality (and other traditional markers) as an indicator of success and/or failure in medicine and public health, emphasizing poverty, inequality, and other forms of structural violence and their impacts on health. He argues that social justice must be central in medicine and public health, and that civil rights cannot really be defended if social and economic rights are not (Farmer, 2005, 9). He references Catholic liberation theology’s “preferential option for the poor” as a guiding principle throughout, making the argument that poverty is the most significant defining characteristic in terms of who is most likely to suffer. His line of argumentation centers on economic factors (class and poverty) and downplays race, neglects to discuss gender beyond conflating it with “women,” and makes no mention at all of intersectionality (Crenshaw 1991) despite dancing near similar concepts.
In Chapter 1, he shares the stories of two Haitians to reveal how structural forces affect and determine the violence experienced by the population in rural Haiti, which becomes embodied as suffering and manifested in sickness. For Famer, political and economic forces create the conditions for large scale epidemics such as AIDS, tuberculosis, and other infectious and parasitic diseases (Farmer, 2005, 40). In Haiti, the continuation of a despotic dictatorship and corruption, created (and left a legacy of) conditions of extreme poverty, lack of institutional infrastructure, and, in some cases, total absence of public health services. He discusses the case of a young woman named Acéphie, who, like other women in Haiti, are forced into unfavorable unions that increase their risk of contracting AIDS (Farmer, 2005, 39). He also discusses the case of Chouchou, who like other young men are deprived of the rights to free speech and political participation, silenced through torture and executions (Farmer, 2005, 40). With these two cases, Farmer highlights the fact that in Haiti, AIDS and political violence are two leading causes of death among young adults and are in fact caused by the same forces (Farmer, 2005, 40).
In Chapter 2, Paul Farmer contrasts the U.S.’ detention of HIV-positive Haitian refugees and Cuba’s AIDS treatment program to highlight structural violence in Haiti and its connection to U.S. immigration and foreign policy. Farmer discusses the harrowing experiences of HIV-positive Haitian refugees who were detained by the U.S. government on Guantanamo Bay and analyzes how U.S. immigration and foreign policy led to the serious human rights violations they experienced. For Haitians, like Yolande Jean, the decision to leave was a result of the repression and violence they experienced at the hands of the U.S.-backed Haitian military. Unfortunately, as a Haitian seeking refugee status in the U.S., she was subjected to terrible human rights violations—particularly because she was HIV positive (Farmer, 2005, 61). Farmer also connects U.S. foreign policy towards Cuba and Haiti—and the embargos levied against them—to the poverty experienced in these countries. Farmer is rightly outraged at the violence that Yolande and other refugees experienced while detained at Guantanamo Bay—pointing to the ways in which the media, popular opinion, and myths about Haitians helped to support this abuse (Farmer, 2005, 66-68). However, he makes no mention of race or racism as the driving forces behind this violence. Farmer criticizes the lawyers and human rights workers who supported the Haitian refugees who were held at Guantanamo for not going far enough in their condemnation of the conditions that they experienced, but he also falls short as an ally in his analysis by failing to mention race or racism.
In Chapter 3, Farmer briefly describes autonomous Zapatista communities’ struggle for healthcare, land, food sovereignty and Indigenous recognition. His discussion of the economic aspects of the structural violence of neoliberalism that decimated local Mexican communities and created many of the conditions that sparked the Zapatista uprising the same year that NAFTA was approved is a relevant addition. However, he again tries to frame the whole struggle as one of “the poor” rather than Indigenous peoples, which misses the real essence of their struggle and is problematic given his admittedly-limited experience in the region (Farmer, 2005, 104). While he ends the chapter on a hopeful note of “resistance,” his post-script addresses the 1997 paramilitary massacre of 45 residents of Acteal. The Mexican government had a nearly identical reaction to this massacre as it has had to the forced disappearance of 43 students from Ayotzinapa 17 years later: denying all involvement, instigating a much-criticized investigation, and making few arrests (Farmer, 2005, 112).
In Chapter 4, Farmer describes the tuberculosis epidemic that affected Russian prisons in the 1990s and early 2000s. He focuses on the care for patients with “multidrug-resistant tuberculosis” (MDRTB) and the debates, both in Russia and internationally, about how best to address this epidemic. According to Farmer’s experience, the best way to deal with this epidemic is by treating prisoners with second-line drugs, which are very costly (Farmer, 2005, 122). However, many people believe that this treatment would not be “cost effective.” Farmer takes them to task for “calling for less than the highest quality of care for the incarcerated” and points out that drugs could be more affordable and the health care budget larger (Farmer, 2005, 128). Farmer’s analysis points to the structural causes of this epidemic, including shrinking public health budgets in Russia, the unexplainable high price of TB medicine, and the socioeconomic conditions that have held to so many young men being jailed. As a physician Farmer takes a humanitarian approach to social justice work, which falls short in its analysis of how rights-based frameworks and international human rights institutions can serve to co-opt and compromise social movements even where they also provide limited forms of social inclusion as part of an entrepreneurial political and economic project (Hale, 2011).
1. Paul Farmer and Johan Galtung both write about structural violence and its relationship to physical violence—Farmer frames it as human rights abuses, while Galtung talks about personal physical violence. What other forms of violence are present in the case studies that Farmer writes about? How are these forms of violence related/connected to structural violence? Does Galtung’s framework of the six dimensions of violence capture the different kinds of violence we have talked about so far?
2. In the Introduction, Farmer discusses the “second silence” of anthropology: of noting and respecting a silence instead of insisting on an answer. He also briefly discusses the tensions of bearing witness: “The boundary between bearing witness and disrespectful (or self-interested) rooting is not always evident, even to those seeking to be discerning. And, to be honest, writing of the plight of the oppressed is not a particularly effective way of assisting them” (Farmer 2005, 26). However, he does give detailed accounts of individuals’ experiences, at times making his book seems like a “museum of suffering.” How does his account of people’s stories contrast with Veena Das’ use of silence and the way she writes about women in India? Which strategy is more successful/effective?
3. How does Galtung’s intended/unintended dimension of violence relate to last week’s discussion of “Ichi’s Brain, Ishi’s Ashes?” Is there a difference between how Farmer uses Chouchou Louis and Acephie Joseph as examples and Koening’s use of Ichi?