W5: “Structural Violence” and the “Emerging” Disease

“Structural violence”, as used by Paul Farmer,  is a term used to describe when social structures (and the powers that govern them) “stop individuals, groups, and societies from reaching their full potential” (Farmer et al.: 2006). These actions can take many forms including disproportionate access to basic human needs such as education and health care. These infringements often go unnoticed by society at large because they are so ingrained in our daily lives, yet they still cause harm to those affected (Farmer et al.: 2006). Western culture has such a laser focus on finding biological causes for illness, when it should actually focus on biosocial causes instead, that it often ignores the social aspects of the illness experience (Farmer et al.: 2006). As Dr. Farmer mentions during his interview on Democracy NOW!, “You can’t have a smart quarantine without ‘real care’ for the people being quarantined” (Film 5.1 – Democracy NOW!, 2014). Dr. Farmer states that once the infected people are grouped up and isolated from the general public, they are not receiving the basic care that they need (or that they would receive here in the United States) because local governments do not have the resources necessary to provide adequate care (Film 5.1 – Democracy NOW!, 2014). He then defines these resources as not just the medical supplies themselves (stuff), but also the people who provide the care (staff) and the safe space in which they provide care (systems) (Film 5.1 – Democracy NOW!, 2014). This is just one example of “structural violence”.

The effects of structural violence can take many forms. For example, the Lee family in Anne Fadiman’s book “The Spirit Catches You and You Fall Down” had to endure great hardships when evacuating the devastating effects of political power struggles. One such hardship faced by the Hmong was the concentration of 42,858 inhabitants, 90% being Hmong, into a camp known as Ban Vinai (Fadiman, 1997: 179). According to a Catholic relief agency, “Like other poor urban communities, Ban Vinai has problems of inadequate health, overcrowding, welfare dependency, unemployment, substance abuse, prostitution, and anomie (suicide, abandonment, loneliness)” (Fadiman, 1997: 180). Living conditions such as those found in this refugee camp are perfect environments for diseases to “emerge”, and spread, because the occupants are malnourished, have weakened immune systems, are in unsanitary spaces and are within close proximity to each other.

In order to fight both the prevalence and spread of Ebola in the future, governments should educate their citizens about the signs and symptoms of the disease and even the existence in some cases (Quist-Arcton: 2014). For many, seeing is believing but some remain skeptical and believe their government is lying to them (Quist-Arcton: 2014). Rather than simply forcing the vulnerable people into quarantine or refugee camps with little to no explanations and resources, governments should instead work harder to create a unified front against the disease, which appeared to have been the case in the town of West Point (Quist-Arcton: 2014).

Another way to combat the spread of Ebola is to keep a closer eye on the environmental factors that contribute to the spread of Ebola, such as overcrowding, overpopulation, and deforestation. What is interesting about deforestation is that many people wouldn’t think that cutting down trees could lead to an Ebola outbreak, however, the suspected reservoir of Ebola (fruit bats) live in these forested areas. As encounters with the host increase, so does the likelihood of encountering Ebola (Beaubien: 2014).

Lastly, funeral and burial rites of the local population can also greatly contribute to the spread of Ebola (5.1. Hewelett, B.S. and B.). In one society, the bodies are washed and dressed shortly after death (5.1. Hewelett, B.S. and B.). Close family members and friends oftentimes lay or sleep near the body, and kissing or touching the body is commonplace, all of which lead to close contact with not only the deceased, but the disease as well (5.1. Hewelett, B.S. and B.). The bodies are then buried near the home for spiritual reasons, however, this practice also presents risks of contamination and contact with Ebola (5.1. Hewelett, B.S. and B.). In order to reduce this risk, international health teams and and local governmental agencies are encouraging the use of funerary teams that are specifically trained and appropriately geared to deal with the disease (5.1. Hewelett, B.S. and B.).

 

Farmer, Paul E., Bruce Nizeye, Sara Stulac, and Salmaan Keshavjee. “Structural Violence and Clinical Medicine.” PLoS Med. 3, no. 10 (October 24, 2006). Accessed August 5, 2016. doi:10.1371/journal.pmed.0030449.

3 thoughts on “W5: “Structural Violence” and the “Emerging” Disease

  1. I really enjoyed reading your post, and I think you did a great job answering the questions and doing your part to really give information regarding the way you think we can help to reduce widespread diseases around the world. As Americans, we are very blind to all of the terrible issues occurring around the world. As Dr. Farmer stated in his interview, Ebola is an extreme issue in Africa, yet we don’t hear much about it, but if it were to come to America, it would be handled EXTREMELY differently. If Ebola found its way to the US ( as it did a few years ago), it would be shut down immediately, with different treatments. Not only would the patients be put in a solo room, with doctors that were doing all they could to protect themselves while they were giving their patient the best possible treatment. Fortunately for Americans, we are lucky enough to live in a country with enough resources and money to treat these patients, not only with diseases such as Ebola, but any widespread disease that could make it’s way to the U.S. Structural violence, isn’t necessarily intentional, it is simply just how things work out due to money and the resources each country possesses. We can’t just magically give these developing countries enough money and resources to change their healthcare systems, but I think looking at ways to avoid these diseases should be much more important, and widely known. As an American, I don’t know exactly how to avoid Ebola, and I don’t know the signs, but I think there should be more information widely known around the world about how to avoid these serious illnesses and diseases. If we can’t cure Ebola and other diseases , we should do our best to teach people how they can protect themselves everyday.

  2. I really enjoyed reading your post, and I think you did a great job answering the questions and doing your part to really give information regarding the way you think we can help to reduce widespread diseases around the world. As Americans, we are very blind to all of the terrible issues occurring around the world. As Dr. Farmer stated in his interview, Ebola is an extreme issue in Africa, yet we don’t hear much about it, but if it were to come to America, it would be handled EXTREMELY differently. If Ebola found its way to the US ( as it did a few years ago), it would be shut down immediately, with different treatments. Not only would the patients be put in a solo hospital room, with doctors that were doing all they could to protect themselves while they were giving their patient the best possible treatment. Fortunately for Americans, we are lucky enough to live in a country with enough resources and money to treat these patients, not only with diseases such as Ebola, but any widespread disease that could make it’s way to the U.S. Structural violence, isn’t necessarily intentional, it is simply just how things work out due to money and the resources each country possesses. We can’t just magically give these developing countries enough money and resources to change their healthcare systems, but I think looking at ways to avoid these diseases should be much more important, and widely known. As an American, I don’t know exactly how to avoid Ebola, and I don’t know the signs, but I think there should be more information widely known around the world about how to avoid these serious illnesses and diseases. If we can’t cure Ebola and other diseases , we should do our best to teach people how they can protect themselves everyday.

  3. I agree with your stament saying we need to educate our citizens on signs and symptoms of Ebola. It is known that knowledge is power and wit the knowledge of what to look for in a disease can help defeat the spread of it. Also you are right when mentioning governments should create a unified front, they should work with their citizens and explain what is going on and give them the option of going and seeking treatment or going into quarantine instead of just forcing them. It is their health and if they don’t want to seek treatment then they should not be around those who do want to keep their health safe. Again with overpopulation it is a good idea to set a strict limit of how many people can live in a certain area and this would decrease the interaction of so many germs, which leads to disease. With the burial rituals even though it is religion and common practice to be around one who has recently passed it should not be allowed when they were known to have had the disease to stop the spreading of it. Or if one has passed there should be a certain time for the body to rest before it returns to the family to make sure the disease isn’t contractible anymore.

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