I critique market-based medicine not because I haven’t seen its heights but because I’ve seen its depths.
Since I do not believe that there should be different recommendations for people living in the Bronx and people living in Manhattan, I am uncomfortable making different recommendations for my patients in Boston and in Haiti.
I’ve been asked a lot for my view on American health care. Well, ‘it would be a good idea,’ to quote Gandhi.
I think, sometimes, that I’m going nuts, and that perhaps there is something good about blocking clean water for those who have none, making sure that illiterate children remain so, and preventing the resuscitation of the public health sector in the country most in need of it. Lunacy is what it is.
Again, conventional Catholicism does not much appeal to me.
At the same time, it is obvious that clinicians in Haiti are faced with different, and, in fact, greater, challenges when attempting to treat complications of HIV disease.
I would say that, intellectually, Catholicism had no more impact on me than did social theory.
I think that looking forward it’s easy to imagine more constructive help for Haiti.
In an age of explosive development in the realm of medical technology, it is unnerving to find that the discoveries of Salk, Sabin, and even Pasteur remain irrelevant to much of humanity.
The thing about rights is that in the end you can’t prove what should be considered a right.
The world is full of miserable places. One way of living comfortably is not to think about them or, when you do, to send money.
You can’t have public health without working with the public sector. You can’t have public education without working with the public sector in education.
Haiti is always talking about decentralization and nothing has been so obvious, perhaps a weakness, as the centralized nature of Haitian society as being revealed by the earthquake. I mean, they lost all these medical training programs because they didn’t have them anywhere else.
But as for activism, my parents did what they could, given the constraints, but were never involved in the causes I think of when I think of activists.
If you look just at the decades after 1934, you know it’s hard to point to really inspired and positive support from outside of Haiti, to Haiti, and much easier to point to either small-minded or downright mean-spirited policies.
Human rights violations are not accidents; they are not random in distribution or effect. Rights violations are, rather, symptoms of deeper pathologies of power and are linked intimately to the social conditions that so often determine who will suffer abuse and who will be shielded from harm.
Laws are not science; they are normative ideology and are thus tightly tied to power. Biomedicine and public health, though also vulnerable to being deformed by ideology, serve different imperatives, ask different questions. They do not ask whether an event or a process violates an existing rule; they ask whether that event or process has ill effects on a patient or a population.
The current human rights movement in Africa – with the possible exception of the women’s rights movement and faith-based social justice initiatives – appears almost by design to exclude the participation of the people whose welfare it purports to advance.′ – Chidi Anselm Odinkalu.
Rights violations are, rather, symptoms of deeper pathologies of power and are linked intimately to the social conditions that so often determine who will suffer abuse and who will be shielded from harm. If assaults on dignity are anything but random in distribution or course, whose interests are served by the suggestion that they are haphazard?
As Phillipe Bourgois notes, paraphrasing a warning issued by Laura Nader years ago: “Don’t study the poor and powerless, because everything you say about them will be used against them.” I hope to have avoided lurid recountings that serve little other purpose than to show, as anthropologists love to do, that I was there.