Partner to the Poor: A Paul Farmer Reader
Paul Farmer, Haun Saussy
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models are “notions about an episode of sickness and its treatment that are employed by all those engaged in the clinical process” (Patients and Healers in the Context of Culture, p. 205). Formulated for each illness episode, EMs attempt to answer questions of etiology, type of symptoms and their onset, pathophysiology, the course of the sickness, and treatment. The methodology, when used in an open-ended way, has proven no less useful when the disorder is perceived as social or psychological in
especially those with histories of repeated exposure to cytomegalovirus. 38. It is not my intention to suggest that homosexuality is more stigmatized in Haiti than in other parts of Latin America. In fact, some ethnographic studies suggest the opposite; see Murray, “A Note on Haitian Tolerance of Homosexuality.” It is nonetheless true that homosexuality remains stigmatized among Haitians, wherever they live. 39. Pape and Johnson, “Epidemiology of AIDS in the Caribbean,” p. 36. 40. Ibid., p. 32.
the health of the poor, cheers were not forthcoming. These parties greeted the use of ARVs in places like rural Haiti or Africa with skepticism—deeming such projects wasteful and neither “sustainable” nor “cost-effective” in the paradigms of our day—and sometimes even derided the treatment programs as irresponsible. I am still struck, some twenty years after I learned to listen to patients and to people living in poverty, that such criticisms come not from the intended beneficiaries but rather
that the term “myths and mystifications” appears in more than one of the chapters in this book. But the converse view—that because poverty is the root cause of these epidemics, poverty reduction should be our sole focus in public health—is not adequate either. I have termed this view the “Luddite trap.” It amounts to throwing one’s hands up in the face of an unbeatable (indeed, almost incomprehensible) “sea of Introduction to Part 2 153 troubles.” If the cultural models are too
connection between international shipping practices and the spread of cholera from Asia to South America and elsewhere in the hemisphere? 14 How is genocide in Rwanda related to cholera in Zaïre? 15 The study of anything said to be “emerging” tends to be dynamic. But the very notion of emergence in heterogeneous populations poses analytical questions that are rarely tackled, even in modern epidemiology, which, as Anthony McMichael argues, “assigns a primary importance to studying interindividual