Maura's Reviews > Pathologies of Power: Health, Human Rights and the New War on the Poor

This book is every human rights activist's dream come true, because Farmer documents his efforts to provide quality health services in poor communities around the world, and he shows how the struggle for adequate health care is unavoidably connected to the struggle for other human rights.

Through various case studies, Farmer demonstrates that, contrary to the claims of most governments and international agencies, public health crises in poor communities can in fact be avoided. Most governments and international agencies primarily concern themselves with the cost effectiveness of addressing health crises in poverty-stricken areas; Farmer demonstrates how small things-—like providing patients with a small stipend to buy more nutritious food, giving out mosquito nets, or providing transportation to health clinics-—can prevent disease and increase patients’ chances of recovery. He shows that rather than treating a disease or an individual patient, investments must made in the whole community. Much of his discussion focused on foreign countries, but I was glad to see that he also addressed the U.S.’s denial of adequate health care to the poor. Throughout the book, he stresses that structural violence is the root cause of premature deaths among the poor, and therefore structural violence must be addressed if human rights are to be protected. I appreciated his observation that the human rights movement is also partially to blame for public health crises, because it has largely failed to adequately fight for the recognition of health care as a human right.

Since I don't have a medical background, I found his case study on multi-drug-resistant tuberculosis particularly informative, because he explains how governments and well-meaning international aid organizations can actually make things worse by only partially funding efforts to control TB. Treatment of TB requires intensive and expensive drug therapy, but if patients get the wrong type of drugs, or receive them at the wrong time or in insufficient quantities, their symptoms worsen and the virus becomes even more resistant to drugs, thus further endangering the patient and the public. Farmer uses this to illustrate his main argument: that only substantial, long-term community investments can truly protect the health and human rights of the poor.

Overall, I found Farmer to be incredibly well-informed, eloquent, and thoughtful. Oh yeah, and one of things I appreciated most: nearly all the books I read are 'downers,' ie, they talk about all the depressing problems that plague humanity without really proposing any solutions. Farmer not only discusses solutions, but his case study of Haiti demonstrates how he's actually been able to make a difference in people's lives by tying the struggle for health care into the struggle for other economic rights--access to nutritious food, clean water, transportation, etc. Unlike most books of this genre, it didn't make me feel like giving up in despair--instead, I pulled out my checkbook, and have been donating regularly to his org ever since, because I find their work incredibly admirable and important.

The only reason I'm giving it 4 instead of 5 stars is because I found it a bit dry and hard to get through. I also felt his chapter on the Zapatistas didn't flow well with the rest of the book.