Lecture 9: Structural Violence

Who was Paul Farmer?

• physician and medical anthropologist

• founder of Partners in Health

• wrote many famous books and papers, particularly looking at structural violence and social determinants of health

Who is Acephie?

• pysdonym for a real patient Farmer treated

• from his paper On Suffering and Structural Violence: A View from Below

• represents the impact of how structural violence can be caused by significant changes in environment

What happened to the Haitian people?

• People used to make ends meet in Haiti → built Peligire river dam → village flooded → citizens forced to move upstream → CHANGED ECONOMY → diseases, lack of food, low income → tried to produce crops/sell differently

CHANGE IN ECOLOGY = CHANGE IN RELATIONSHIPS = CHANGE IN HEALTH

What specifically happened to Acephie?

• Acephie ended up in a relationship with a solider who was with many women, but she stayed because he was economically supporting her and her family

• She likely caught HIV from him (new people moving in and out of a area brought diseases that rural people wouldn’t typically be exposed to!)

• She then went to move to the city so she could make more money to support her family; There, she got married to a truck driver

• The HIV progressed to AIDS

• She still had a child

• Acephie ended up dying

Who is Choucho and what is his story?

• psydonym for someone Farmer met in Haiti during the political violence era

• from his paper On Suffering and Structural Violence: A View from Below

• represents the impact of how structural violence can be caused by significant changes in environment

• Choucho had made a harmless comment about the state; a solider had overheard him and tortured him to death

• In this case, Choucho’s life was significantly altered due to the changing politicial landscape

What is structural violence?

• The impact of social inequalities on health

• Social structures (ex. economic, political, legal, religious, and cultural) that stops individuals, groups, and societies from reaching their full potential

• the STRUCTURE OF SOCIETY = FORM OF VIOLENCE

• linked very closely to social injustice and the social machinery of opression

Who coined the term “structural violence?”

• Johan Galtung and libertarian theoligans in the 1960s

What does structural violence say about people with less power?

• more likely to become ill and die

What covers up structural violence?

• cultural explanations for health disparities

What are the two types of poverty? Describe them

1. Absolute Poverty: people not having enough money for food, shelter, and basic necesities, deeply impacting health (1 billion + people live in extreme poverty)

2. Relative Poverty: people’s needs for survival are BARELY met

What is the socioeconomic gradient?

As poverity increases, life expecetnacy decreases

Why is Structural Violence difficult to describe?

1. Exotification of suffering (stories that have less common with our own lives seem distance and less powerful to us)

2. Sheer weight (too violent/graphic) of suffering

3. The dynamics and distributions of suffering are poorly understood

What are the problems with the way anthropology has studied structural violence?

1. Anthropology has studied down steep gradients of power (focusing on extremes and loosing sight of stuff that occurs right in front of you)

2. Anthropology has confused structural violence with cultural differences (hits important to remember that poverty does not equal culture; decisions are made in response to living in poverty)

Seth Holmes

• physician and medical anthropology professor at UC Berkley

• Wrote the famous book Fresh Fruit, Broken Bodies: Migrant Workers in the United States (specifically focused on hierachies of ethnicity and citizenship)

• Major work in the Society for Humanities, Social Sciencies, and Medicine

Describe Structural Violence in Farmwork

• agricultural labor hierachy produces suffering and illness, specifically among berry pickers (exploitave economic systems harm health!)

• structural violence becomes naturalized (normalized) via perceived bodily differences (such as believing some individuals had better phyisical features to do farm work, thus justifying the hard and cruel work they had to go through)

Describe the hierachy of the people on the farm in Holme’s book Oxacans like to Work Bent Over (bent over refers to the position of their hard farm work) 

1. Executives: have to balance all work but are well off; have generational wealth

2. Crop Managers: deal with who goes where, what gets planted, and how to plant

3. Workers: live in labor camps and are distinguished by where they live and the work they do, and their citizenship status

• As you go down the hierachy, treatment and conditions worsen. Tihis is correlated with citizenship status and US residence

• You can move up the ladder, but there are some limits due to the descriptions of each role

What are the 3 types of workers?

1. Supervisers: See how much picking happens, check quota; nice living conditions; educated and citizens

2. Apple & Rasberry Pickers: No heating but have a roof; Apple pickers =highest paid; Rasberry Pickers sit in a machine and do work; undocumented workers from Central and North Mexico

3. Strawberry & Blueberry Pickers: poor housing; work bent over in fields with extreme phyiscal labor; no breaks and contious work needed for money; undocumented indigenous Mexicans (Triqui)

Who are two specific people Holmes brings up in Oxacans like to Work Bent Over? Describe their stories. What do these case studies show?

1. Abelino: suffered from reoccuring knee pain and goes to the clinic; told to take rest and ice the knee, but he is unable to get time off and access medical care, and unable to get an easier job to make it less harsh on his knee

2. Crescenio: has severe headaches; clinician says he needs to see a therapist and is a perpetrator of physical/domestic abuse

These case studies show how certain factors in lives, specifically work, can impact their physical and psyschosocial conditions.

What is the role of the Holmes?

• very complicated and diverse

How did Holmes conduct his work?

• participant observation

• berry picked twice and it was very painful

• even migrated with the workers

• he was treated differently due to his outside status, but some eventually accepted him

• talked to children and families of berry pickers

• lived with the pickers for 1+ years

What challenges did Holme’s Encounter?

• the community saw him as an executive rather than own people

• he was not accepted immediately

• hard to get to know people and situation

What is symbolic violence and who is associated this term?

• It is the naturalization and internalization of social asymetries, which leads to the complicity and internalization of the dominated

• We perceive the social world through lenses issues forth from that social world (thus, we recognize the issues of the social world as natural)

• Thus, the inequalities compromising the social world are made invisible, taken for granted, and normal for ALL involved

• Pierce Bodieu is associated with his work in this field

How is symbolic violence applicable to the farm workers Holmes describes?

• Symbolic violence causes perpetrators, outsiders, AND VICTIMS to see unjust positions are normal

• Thus, farmers started to see themselves has immune to the horrendous labor and pesticide exposure because they had internalized the societal view that they were built for this strenous labor

What is pragmatic solidarity and who coined it?

• It is a call to join the struggles of oppressed people instead of working solely as disconnected “experts”

• It is identifying structural violence and finding things you can do to help, such as teaching english, etc.