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/