Dr Paul Farmer 'asked uncomfortable questions'

Excerpt from Lucy Gaffney's Thesis. She notes. 'It was on the GBV in the camps after the earthquake. But the history and vulnerability of Haiti and its women are so interlinked, that's why I used Dr Farmer's writings.'

 She shared this with me after news came of Dr Farmer's passing. 

By Lucy Gaffney

Violence is traditionally conceptualised as direct physical or psychological violence. However, Johan Galtung's concept of structural violence expanded that orthodox view of violence and used it to describe indirect violence, which is not necessarily tied to an identifiable actor or agent (Galtung, 1969). Galtung linked his conceptualisation of structural violence to social injustice, and It was widely considered a seminal work in peace and conflict studies. This violence "is built into the structure and shows up as unequal power and, consequently, unequal life chances".

Physician and Anthropologist Paul Farmer's used Johan Galtung's framework of structural violence to examine the intersection between universal healthcare and human rights. He asked uncomfortable questions about the inequitable structure of power which resulted in unequal access to medical attention and education, and the link between poverty and disease.

In his seminal Book 'Pathologies of Power' (Farmer, 2005), Paul Farmer looked at how some nations such as Haiti, with a history of slavery, racism, and neo-colonialism, have been denied basic human rights. These rights such access to health care, education, and other social services, led to Haiti's inability to deal with the earthquake of January 12, 2010.

At 4:53 pm on Tuesday, January 12, 2010, a 7.0-magnitude earthquake lasting 35 seconds devastated Haiti's capital, Port-Au-Prince, and several other locations. An estimated 300,000 lives were lost, and nearly 1.5 million homes were destroyed (Schuller & Morales, 2012). It is calculated that more than 1 million people began living in the 1300 displacement camps created around the country (Katz, 2013). However, as Paul Farmer writes, this was not just a 35-second event, but a process which was '…historically deep and geographically broad…' (2011, p. 2).

He viewed Haiti's history and its relationship with the International community, the tragic earthquake of 2010, the subsequent cholera outbreak, and today's ongoing violence, as interrelated and linked to the structural violence experienced by the nation of Haiti. He regarded Haiti's vulnerability as a nation as a result of the structural violence in its colonial history.

Macroeconomic policies interlock with a nation's population, and the adverse outcomes of these policies experienced by the Haitian people, were a form of structural violence. His book 'Haiti, after the earthquake' examined the lived experiences of people 'who live in poverty or are marginalised by racism, gender inequality or, as in the case of Haiti, 'a noxious mix of all of the above' (Farmer, 2011). Haiti's vulnerability from poverty, environmental destruction, and political chaos, often orchestrated outside the country, began with its history of colonialism and slavery, with its original Taino population destroyed by a combination of slavery and illness imported by early settlers. The Independence sought and gained in 1804 came at a price and Haiti, eager for trade and recognition, began its inequitable relationship with major nations through their agreement to pay reparations (Farmer, 2011, p.127).

Through all his books he wrote on Haiti, what emerges is his quest to make visible the invisibility of violent, embedded structures, ensuring that these inequities are made live by the stories of humans. He wrote, 'Health care does not exist in a separate universe from politics' (Farmer, 2011, p. 23).

Bibliography

Farmer, P., 1996. On Suffering and Structural Violence. Daedalus, 125(1, Social Suffering), pp. 261-283.

Farmer, P., 2005. Pathologies of Power - Health, Human Rights, and the New War on the Poor. Berkeley: University of California Press.

Farmer, P., 2006. The Uses of Haiti. 3rd ed. Monroe: Common Courage Press.

Farmer, P., 2011. Haiti after the Earthquake. New York: PublicAffairs.

Galtung, J., 1969. Violence, Peace, and Peace Research. Journal of Peace Research, 6(3), pp. 167-191.

Katz, J. M., 2013. The Big Truck That Went By - How the World Came to Save Haiti and Left Behind a Disaster. 1st ed. New York: Palgrave Macmillan.

Martin, H., Lewis, T. M. & Martin Morain, N., 2012. A Critical Review of Haiti Earthquake of 2010: Key Development Problems and Focussed Solutions. Japan, The 8th Annual Conference on International Institutions for Infrstructure, Renewal and Reconstruction (IIIRR).

Schuller, M. & Morales, P. eds., 2012. Tectonic Shifts: Haiti Since the Earthquake. 1st ed. Sterling: Kumarian Press.