The Human Thing To Do

One of the better definitions of Structural Violence as is given by the famed Dr. Paul Farmer, “Structural violence is one way of describing social arrangements that put individuals and populations in harm’s way.” This, as has been discussed, in central to epidemiology in the regards for the strong divide between the haves (those with access to modern medical and scientific advancements) and the have-nots (those who lack this access) when it comes to who is at most at risk for the morbidity and mortality of infectious diseases. The simple fact is, the lower your income and access to these advancements are, the higher risk you are to contract, get sick, and die from infectious diseases.

Reading the book The Spirit Catches You and You Fall Down, by Anne Fadiman shows a clear picture of this in some of her chapters. The Hmong, a mountainous people who have lived at high elevations for much of their history in China, and later Laos, had not dealt with illness like Malaria, which are much more common in the lower, hotter regions of where they resided. During, and even more so towards and follow the end of the Vietnam War, the Hmong were placed into small, compact refugee settlements, since much of their previous land had be destroyed in the war. With an inablity to return to their homes, and forced to live in these squalor settlements or immigrate to someplace new and strange, diseases and illnesses that the Hmong had little to no previous experience with ran rampant. Between the close quarters, lack of any treatment (traditional or otherwise), and inability to find ways to prevent the illnesses, many suffered and died.

Back to Dr. Farmer, who was interviewed frequently during the Ebola crisis, and is a well-respected individual in the Public Health community. In his interview with Democracy Now!, Farmer said, “Pathogens don’t have borders… or don’t respect them.” This is part of a larger argument he was making, which amounts to the simple truth that if we want to optimally and fully protect our self (American) we need to look after and ensure treatment for the poorest of the world. Ebola wasn’t a new illness during this most recent outbreak. In fact, it was discovered in 1976 in Africa, and outbreaks have occurred quite sporadically in Africa before and since (CDC, About Ebola). The recent one gained such attention for much the same reason anything does in American media, it did or could affect us at home. The fear of an infection coming stateside drove its attention, not the fact it was killing by the hundreds. The spread of this illness, as said by Farmer in his interview, could’ve been lessened or stopped altogether if there were cohesive, effective public health initiatives in place to prevent it. But because the people affected were mostly poor, and thus lacking something as simple as effective prevention protocol (personal protective gear like gloves, masks, clean syringes, etc) which are so common-sense in America that I was required to wear gloves when applying band-aids to kids the summer I worked as an on-site Health Office for a YMCA camp.  Overall, Dr. Farmers idea that the best way to protect ourselves is to protect everyone, especially the poor whom experience extreme structural barriers to health care, is accurate. Pathogens don’t care about borders, race, sex, or income. This is especially true in our current time, where global travel is as quick and easy as it is. A cross ocean trip that took months now takes only a sizeable portion of a single day. If we continue to do nothing until another outbreak hits, it is only a matter of time before we move to slow and it becomes a pandemic. To protect ourselves, we must protect everyone. It isn’t just the smart thing to do, it’s the human thing to do.

“About Ebola Virus Disease.” Centers for Disease Control and Prevention. 2016. Accessed August 05, 2016.


2 thoughts on “The Human Thing To Do

  1. I liked the way you started it with explaining structural violence using the haves and have-nots. Most of the time you consider that phrase it is when discussing personal possessions or belongings, something like the phrase keeping up with the Jones’. It’s almost chilly when you consider it in the sense of having access to health care; something considered to be a basic human right. I said something similar when you stated that the lower your income and access to supportive care the higher your risk of contracting, spreading, and dying from an infectious disease would be. The data that has been collected shows that as a country becomes more industrialized, there is a decrease in death from infectious disease, while dying from diseases like stroke, cancer, and coronary heart disease increase.
    The way you noted that the Hmong were contracting these highly infectious disease because of the refugee camps was correct, what I hadn’t thought about was that they were even more susceptible because they had never been exposed to anything like this before. Being from a remote mountain village, many of the diseases common to over-crowded cities would be completely foreign to them. Their immune systems stood no chance, additionally because they had never been exposed to diseases like this they did not even have a holistic approach to treating the afflicted.

  2. Hi Jacob! Great post, you really brought up some very important topics and facts that were brought up this week. I like how you began by stating the simple fact that if you have a lower income, you have less access to health care, the higher risk you have of getting sick and contracting various diseases. I really liked how you mentioned that if we want to look out for ourselves and keep our own country safe, we need to look over other countries as well. This is so true, we can just as easily contract a disease form a different country that we can in our own. People travel every day and germs are not shy, it is so easy for a disease to cross borders, and the world needs to understand and prepare for this. I like how you went in to the travel aspect of this. It is extremely easy in this day and age to go places we never could before, and because of this diseases spread incredibly easy. If the world wants to stop these diseases it needs to stop putting priority on the developed people and nations and help those that don;t have access to healthcare or live in poor countries, because they can just as easily spread it as anyone else.

Leave a Reply