W5: It Can’t Always Be About Science

This week we learned about the critical medical theory and within that, structural violence. The definition took me by surprise; based off of the term I expected more physical violence. Paul Farmer, an anthropologist and medical professional, defines structural violence as, “Structural violence is one way of describing social arrangements that put individuals and populations in harm’s way. The arrangements are structural because they are embedded in the political and economic organization of our social world; they are violent because they cause injury to people” (Gabriel, 2016). This made me rethink my typical definition of violence and realize that Farmer is correct in saying that the harm some people experience due to their status is considered violence.


In the 5.1 lecture Gabriel talks about how in Western medicine we are so focused on biomedicine that it causes controversy. An excerpt from The Spirit Catches You and You Fall is shared about how a physician was so focused on the biomedicine aspects of his patient he refereed to the little girl as a he in all of his notes (Fadiman, 1997). The author then went on to claim this is the, “best and the worst of American medicine” (Fadiman 1997). This resonated with me as I think it summed up my thoughts on biomedicine. This is something that Western medicine needs to work on. We have amazing knowledge and technology on the biomedicine aspect, but need to include the social and cultural perspective in treatment plans.


Another problem with ignoring the social or economic factors of people is the false perception of emerging diseases. Farmer talks about how most “emerging” diseases are not new and have been contained in the past. In Partner to the Poor, he asks, “If certain populations have been long afflicted by these disorders, why are the diseases considered “new” or “emerging”? Is it simply because they have come to affect more visible-read, more “valuable- persons?” (Farmer, 1996). Farmer goes on to explain common misconceptions of emerging diseases and how most come down to the political and socioeconomic status of those effected. I found this piece very interesting and shocking. To find out that Ebola, which scared America fiercely, has been around for a while and affected more people before that certain outbreak was appalling. I think we need to help those countries or communities that do not have easy access to medical help. If they contract an emerging disease chances are it will not be contained and will spread out of the community. Another point Farmer made was that malaria is considered a “tropical disease”, but civil war soldiers were affected by malaria and they were no where near what I would consider a “tropical” environment (Farmer, 1996). I find it confusing that something as threatening as emerging diseases has been linked to demographic and social changes, but not much is being done about it. Another startling fact I found was from the Structural Violence organization, “A more recent study found 291,000 deaths attributable (in the US, in the year 2000) to poverty and income inequality, two social conditions that are closely tied to structural violence” (Burtle, 2003). Some doctors are always claiming that “race” is connected to genes and diseases people are susceptible to, but maybe it is just the way different races are treated that cause the data to appear this way. I also believe the media could help a lot. These days with the technology, news stations can spread the word about anything they want so quickly. If they helped show how these “emerging diseases” are far more common than we believe maybe more process would be made. The quote Farmer ends the chapter with, from Leon Eisenberg and Arthur Kleinman, I think perfectly sums up the conflict and solution of structural violence and Western medicine, “The key task for medicine, is not to diminish the role of the biomedical sciences in the theory and practice of medicine but to supplement them with an equal application of the social sciences in order to provide both a more comprehensive understanding of disease and better care of the patient” (Farmer, 1996). There is nothing wrong with our very advanced biomedicine ways, but it can’t always be about the science.


Burtle, Adam. “Structural Violence.” Structural Violence. 2010. Accessed August 05, 2016. http://www.structuralviolence.org/structural-violence/

2 thoughts on “W5: It Can’t Always Be About Science

  1. Hiya,
    I liked your full inclusion of Farmer’s definition (in mine I only did the first bit, as I didn’t want it to look like I was trying to force the word count). People often forget the structural violence seldom is as obvious as an abusive police or military force to its citizens. Often it’s a system that sets it up for those who don’t benefit from it to be more likely to suffer violence. While some would say that might argue technicalities in that, AIDS isn’t the final reason why people die, since they contract an infection that tends up being their final cause of death, but we will still say it is a deadly disease. Just because it isn’t what might be written as the perpetrator of violence or the final cause of death does NOT mean it had no impact.
    I also loved your section on how emerging diseases aren’t really new, but instead infecting people who are ‘worth more’. While ethically the average person would say we’re all worth the same, very few people in the US cared about people dying of Ebola until it came to light that we may be at risk. The reference to Civil War fighters is important here. This is because they were made up of men of various socio-economic levels, and many fell victim to Malaria and other similar illnesses because of the risks of their situation. Poor diet, close quarters, in ability to treat properly, and the at-risk treating those who are sick. It creates a cycle of the sick and dying infecting the living trying to care for them, until it, like Ebola in one of the videos we watched with the grandmother who lost her entire family, wipes out everyone it is capable of doing.

  2. Emma,

    I was also very surprised by what physical violence meant. I almost like that the word sounds so “serious” because I feel like a lot of policy isn’t questioned when it really should be. Perhaps phrasing them this way will cause more people to think about the effects of policies on the less privileged. With Ebola we saw many people die because their countries’ lacked the methods, education, and/or technology necessary to save them. Lives were lost, which sounds pretty violent to me.
    I also really loved how you talked about in the part in Spirit that accounted pros and cons of modern biomedicine: they are so far removed from the person they treat. It’s as though western doctors treat people as machines instead of people, and this lack of being personable with patients is somewhat connected to the disconnect biomedicine has with less advantaged countries. I feel this was an important theme of the class, one which I wish I would have touched on more in my own paper. I completely agree with you that “emerging diseases” aren’t actually “emerging” at all in the world, they are merely starting to affect people with more privileged nations. It’s so important to recognize the importance of interdisciplinary between subjects, just like science and social science!

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