Newsletter: January 2002
Ann Miles and Fred Bloom Co-Contributing Editors
Structural Violence and the Assault on Human Rights
Paul Farmer (Harvard)
A growing number of medical anthropologists devote attention to structural violence. Just as everyone seems to have their own definition of “structure” and “violence,” the term itself causes epistemological jitters in our ranks. The term dates back at least to Johannes Galtung and also to the liberation theologians who used it to describe “sinful” social structures characterized by poverty and steep grades of social inequality (including race and gender inequality). In short, structural violence is the social machinery of oppression.
The degree to which people can fight back has been the subject of much anthropological inquiry. We’ve written about “weapons of the weak” (James Scott’s term), and some texts celebrate various forms of “resistance.” Romanticism aside, the impact of poverty and social marginalization is profound in many of the settings in which we work, including not only the slums and villages of the Third World (or whatever it’s called these days) but the cities of the US. In some of these settings there really is spirited resistance. Sometimes, however, the impact of resistance is less than we make it out to be. The degree to which agency is constrained correlates, if not always neatly, with the ability to resist marginalization and other forms of oppression.
Anthropologists have considered both anthropology and human rights, and the anthropology of human rights (P.J. Magnarella, E. Messer and T. Downing and G. Kushner, for example). Many anthropologists are interested in human rights, but these are not always the same ones interested in structural violence. Yet, surely the majority of human rights abuses, however defined, occur among those whose agency is most constrained by poverty, gender inequality, and racism.
That’s why the best places to understand the impact of structural violence are also places where human rights are violated most egregiously. These concerns come together in settings of explosive violence, usually directed against the poor. In Haiti, for example, it was impossible to study tuberculosis or AIDS without running into the terrible poverty that determined risk. It was impossible to follow the trajectories of patients and families and not learn of death squads, arrests, and beatings, to say nothing of hunger and privation. It is, in fact, jarring to read the work of scholars of Haiti who do not write explicitly of structural violence and the human-rights abuses it engenders. Others, such as Linda Green working in Guatemala and Leigh Binford in El Salvador, have had similar experiences.
Surely there is something that medical anthropologists can offer to the struggle for human rights. As a contextualizing discipline, anthropology could add the word social to rights. And, since the economic undergirding of social life is ever apparent we could add the world economic, too. But what are social and economic rights? Usually, these include the right to food, housing, education, health care, employment. By definition, these rights are violated daily in most places we work, and often opposed by those who wish to maintain their privilege. But why would the campaign for social and economic rights trigger ambivalence within the human-rights community? In mainstream rights discourse, social and economic rights are sometimes called “second-generation rights,” and accorded less importance than civil and political rights. Within the human-rights community, social and economic rights are the neglected stepchildren of human rights. There’s a subtext, of course. It’s hard enough to push for civil and political rights. To struggle for social and economic rights is “unrealistic.”
Medical anthropologists could offer a great deal to our understanding of such rights and why they are difficult, but necessary, to promote. The goal here is not theoretical but to contextualize the struggle for human rights and to understand the motivations of the strange bedfellows that crowd this social field (remember, Henry Kissinger was awarded a Nobel Peace Prize). Another task is to subject elite discourses, including our own and also legalistic discourses, to critical scrutiny. This exercise calls for resocializing analyses. Why would we promote certain rights (e.g., the right to vote) and not others (e.g. the right to health care, employment, housing)? Anthropological inquiry could help reveal why the idea of the right to food, housing, education, et cetera, runs counter to neoliberal thought, the hegemonic force of our times.
Anthropologists could also reveal the mechanisms by which structural violence begets, inevitably, human rights violations. This is not voyeurism, since too often the violence is “explained away” using concepts we’ve circulated. The term “culture” is the prime example. One chief mechanism of obfuscation is the conflation of cultural difference and structural violence. This occurs whenever violence, the product of transnationally structured inequalities, is attributed to local cultural patterns. So, in Haiti and Guatemala and El Salvador, undemocratic governments and their pals in the U.S. Department of State were quick to point to local “cultures of violence” to deflect attention from the real causes of rights violations. Who better to counter these fabrications than those who deal in culture for a living?
In closing, I’d like to pose some questions for anthropologists interested in human rights. Who is at risk of having rights violated? How might risk knowledge prevent abuses? How are rights violations structured by social inequalities? How often do rights discourses conflate cultural difference with structural violence? How do these discourses hide the dynamics of violations by refusing to consider structural violence, which would necessarily implicate the citizens of affluent countries such as our own? How does “routinization” of violations obscure the machinery of oppression? To what degree is social inequality itself pathogenic, and by what mechanisms?
Let us return to the bedrock of medical anthropology. Most of us study pathologies of one sort or another. We need dynamic understandings of the distribution of affliction, and so many of us are interested in quantitative fields such as epidemiology. But we are impatient with such approaches, since they are manifestly incapable of capturing the biosocial complexity we see at every turn. The distribution of suffering in the modern world is tied to structural violence, and firm analytic grasp of suffering—including human rights violations—will not be possible if we are unable to understand both structure and process. Such understanding is inevitably historical and social and material.
To submit to this column, contact Ann Miles at miles@wmich.edu.