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exploring “efficacy”

In a recent trip to Long Beach’s Gatsby Books, I picked up a couple dozen political books. Many were written by authors I’d never before encountered, which didn’t deter me from picking up their works.

I’ve read a few of the books I picked up that day, and I’m glad to have found each of them. That being said, I feel a special gratitude for the Gatsby-acquired book I’m currently reading: doctor Paul Farmer’s Pathologies of Power: Health, Human Rights, and the New War on the Poor.

I’d never heard of Farmer (“Presley Professor of Medical Anthropology at Harvard Medical School”) before I happen to pick up this book on the strength of its title. I’m grateful the title caught me; Amartya Sen’s introduction coupled with the first few pages of Farmer’s words had me totally, absolutely hooked.

Having grown up devastatingly poor, I understood the impact of powerlessness–of poverty–on life outcomes. As I wrote in “Bernie, Because I Was Poor,” 

Growing up poor in the United States means constant distress. I learned this watching my single mom struggle to raise me and my three siblings.

Poverty in the U.S. means forever worrying about food, shelter, transportation, child care, health care, and that the next paycheck won’t come. It means isolation, predation, and the constant, vocal judgment of the many who believe worth determines wealth. Poverty is a vulnerability, for predators understand that the mother who can barely afford food cannot possibly afford attorneys.

I testified against one predator, but my sisters and I met at least eight more between us. We were unpeople to society, and predators knew it. We were vulnerable; our frailty, a gift to predators.

Of course, we didn’t need predators to show us that we were worthless. We saw it every day when children and adults alike told us our clothes were funny, our manners strange, and our mom a failure.

It was important for our betters to say these things. Saying them affirmed our comparative social standings. They were worthy, while we, the poor, were worthless.

These words are hard for many loving USians (of all political affiliations) to understand. In an “advanced” economy, why should poverty impact not only day-to-day experience, but matters like life expectancy?

I seldom meet anyone US-born who understands how profoundly this impacts all of life. Anyone who understands, without my fumbling to explain, what a stunning accomplishment it is that my siblings and I not only survived poverty but have managed to … do something like succeed.

It’s thus that I feel a rush of awe and thanks when I find someone who doesn’t require explanation to begin understanding. Someone who unabashedly uses terms like “structural violence” to describe the ways that poor people around the world are hurt and made to suffer by those who–wittingly or unwittingly–benefit from their poverty.

Paul Farmer fits handily in the category of those who understand without explanation. More than merely understanding, he expresses what he’s learned in ways that even make me say “aha!” (despite all my early experiences taught me).

I’m glad he’s out there practicing medicine and anthropology. Trying to change the world. Trying to make people see what so many people would rather not see: that many people suffer so that we you don’t.

selected quotes from the first few chapters of pathologies of power:

a rising tide of inequality breeds violence.

Neoliberalism generally refers to the ideology that advocates the dominance of a competition-driven market model. Within this doctrine, individuals in a society are viewed, if viewed at all, as autonomous, rational producers and consumers whose decisions are motivated primarily by economic or material concerns. But this ideology has little to say about the social or economic inequalities that distort real economies.

one alarming feature of structural violence is that bullets are increasingly unnecessary when defenders of social and economic rights are silenced by technocrats who regard themselves as “neutral.”

the absence of social and economic power empties political rights of their substance.

only if unnecessary sickness and premature death don’t matter can inegalitarian systems be considered efficacious.

  1. November 30, 2017 at 6:11 pm

    “Clearly, no single axis can fully define increased risk for extreme human suffering. Efforts to attribute explanatory efficacy to one variable lead to immodest claims of causality, for wealth and power have often protected individual women, gays, and ethnic minorities from the suffering and adverse outcomes associated with assaults on dignity.”

  2. November 30, 2017 at 6:15 pm

    “the World Health Organization now acknowledges that poverty is the world’s greatest killer: ‘Poverty wields its destructive influence at every stage of human life, from the moment of conception to the grave. It conspires with the most deadly and painful diseases to bring a wretched existence to all those who suffer from it.'”

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