Infections and Inequalities: The Modern Plagues
Infections and Inequalities: The Modern Plagues Books
- ISBN13: 9780520229136
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- Notes: Brand New from Publisher. No Remainder Mark.
Product Description
Paul Farmer has battled AIDS in rural Haiti and deadly strains of drug-resistant tuberculosis in the slums of Peru. A physician-anthropologist with more than fifteen years in the field, Farmer writes from the front lines of the war hostile to these modern plagues and shows why, even more than those of history, they target the poor. This “peculiarly modern inequality” that permeates AIDS, TB, malaria, and typhoid in the modern world, and that feeds emerging (or re-emerging) infectious diseases such as Ebola and cholera, is laid bare in Farmer’s harrowing tales of sickness and suffering.
Challenging the accepted methodologies of epidemiology and international health, he points out that most current explanatory strategies, from “cost-effectiveness” to patient “noncompliance,” inevitably lead to blaming the victims. In reality, larger forces, global as well as local, determine why some people are sick and others are shielded from risk. Yet this tender account is far from a hopeless inventory of insoluble problems. Farmer writes of what can be done in the face of seemingly overwhelming odds, by physicians determined to handle those in need. Infections and Inequalities weds meticulous scholarship with a passion for solutions–remedies for the plagues of the poor and the social maladies that have sustained them.
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By claiming “social reform,” Farmer contradicts his stance as an American citizen: Haiti has no money to support its own citizens, that’s why the US and others are doing Haiti’s job. But, the US has to care for its own citizens as well therefore has to first work on its own AIDS patients within its boundary. If the US does that as its social reform, Haiti aptly away dries up.
Irritating mistakes in some way got through inspection: PAligre Dam? PEligre? (P. 174) PuertO Plata? PueltA? (P. 119)
Rating: 3 / 5
Too long . Written with sientific dicipline & detail and weighed down by too much specialized medical language for the well loved reader . The idealism is admerable and the conclusion are justified but it speaks to the medical profession more than to the general broadcast . A slow diffucult book to read . Sombody else should write the same book for the well loved reader and for leaders in broadcast policy .
Rating: 3 / 5
Anyone in the broadcast health arena has heard (or even read) of Paul Farmer. The Harvard MD/PhD (Anthropolgy) is indeed a passionate and competant professional who has fresh drive and leads a commendable life in service to humanity. This book seems to be his most well loved work (at least on campus of major broadcast health colleges) and it deserves attention and analysis.
Farmer gives systematic treatment of HIV and TB etiology and prevalence in the US and Haiti. More significantly, how those diseases affect the poor in inequitable ways. Peppered with intimate anecdotes and cold analysis, the book brings hard thoughts with the nearness of the individual plight. He debunks myth of AIDS early history and establishes perspetive for the disease to be viewed/studied in light of the poor and the strucutral violence that (he deems) causes the propensity of the disease in the lower levels of society. He offers solutions and pleas for attention to these ‘new plagues’ so that the effects can be mitigated for the sake of all humanity.
There are some issues with that perspective. Of course every author brings inherent bias to the writing (either intentional or not), but Farmer makes no apology for his worldview and dismisses opinions of others who are even within the sientific community as he. John Stuart Mill (in “On Liberty”) would say that such an attitude is likened to assuming infallibility (which Farmer more or less accuses the attitude of the ‘rich’ toward the modern plagues). His neo-Marxist tendency absolutely undermines the state of the world and he therefore addresses his problems from a “the way it should be” approach. That is his prerogative, but taking such an attitude means that his thoughts will remain just that: thoughts. His lack of practicality limits a silent taint of militarism and that approach seldom attracts policy makers, even those on the left.
Farmer assumes that a preponderence of evidence precludes a serious analysis of private aganecy. No one would argue the conflict of structural violence and the inherent effects on private agency. Yet, the fact remains that it does exist and it at least needs to be addressed in a thorough matter in order to be a honest treatment of the theme matter.
Furthermore, he needed to address the distal factors (i.e etiology and biology of the diseases) with the proximate (i.e. socio-econimics, etc…) for the book to be of more interest to the lay person. Despite my reservations, it is still a fantastic book to get the reader “out of the box” and see AIDS and TB with the urgency it deserves. Yet, this type of book needs to be in the hands of the lay, and this recommendation would help.
Lastly, Farmer claims on several occasions a foundation of political economy in the analysis of his theme. He is a physician and anthropologist, and without the concurrent opinions of a political-economist to back up his claims, the thoughts therein are weak at best. His political-economic opinions may be in line with greats like Marx and Henry George, but he cannot assume the validity of his assumptions just by telling the readership he his resting on such evidence. Several other leading political-economic thoughts stand in direct challenger to his conclusions of goverment fixing all health problems to his liking.
All in all, it is hard not to be went by Farmer’s compelling treatment of such horrendous plagues on humanikind. Yet, passion does not everlastingly equal pragmatic and working solutions. Therefore, his work will hopefully inspire those who can take his passion to offer clear and viable solutions in the war on these plagues.
Michael Jewell, MPH
Rating: 2 / 5
This is a very thoughtful & readable book for those interested in the modern epidemics of tuberculosis and HIV infection. The highlights to me were the clinical vignettes from Haiti, Peru and the US. They certainly clearly exhibit the challenges faced by the impoverished victims of these diseases.
I do take exception to the lumping of the poor in New York City with the poor in the other locations. Their private agency is certainly much richer than that in the developing world. These “victims” do have access to care, medications, housing and other resources that those in Haiti and Peru simply do not have. Using heroin and other drugs is a private choice. Not seeking to pursue education and training available is a private choice. Choosing to participate in street violence is a private choice. Choosing to be on broadcast help from “cradle to grave” is a private choice. Certainly mental illness and other disabilities are not a private choice. Haitians and poor Peruvians would welcome such opportunities. We must dispel of this “victim” attitude when apt. It is clearly counterproductive, though is does keep liberal politicians in office.
Dr Farmer flirts with a “new world order” throughout this book. Let him not forget that his broadcast health efforts in Central Haiti would not be possible without the financial gifts of his wealthy benefactors in Massachussetts. Let him remember that the development of effectve HIV medications is not happening in “uncensored” countries but in those nations with the private money of those willing to take significant investment risks. In Chapter 10 he notes how the treatment of HIV patients with protease inhibitors in Europe is much less common than in the USA. May possibly this be because socialized medicine administrators have resolute that the cost of these drugs is not worth the lives saved?! Is this akin to the fact that cancer patients in these socialized countries will survive half as long as our loved ones here in the United States (that is until our current administration has their way…!)
Although repetitive and agenda-oriented this is certainly a worthwhile read. Life will never be “utopian” here on earth. I frequently ponder why I was given so much when others barely exist. I strive to live my life with the maxim “to whom much is given, much is expected” at my spiritual core. We can provide health care world-wide if it becomes a global priority. Meanwhile we can each do our part. We don’t have to live in a Marxist society to reach out to those in need.
Rating: 4 / 5
If you are interested in broadcast health and infectious diseases, this is a must read. Paul Farmer has a way of explaining things that just make sense and provides solutions that seem so simple…. if only it were that simple. There was small I may possibly disagree with in this book, Dr. Farmer is spot on. This read is worth the time.
Rating: 5 / 5