The Globalization Reader, 5th Edition

18 An Anthropology of Structural Violence

Paul Farmer

The ethnographically visible, central Haiti, September 2000: Most hospitals in the region are empty. This is not because of a local lack of treatable pathology; rather, patients have no money to pay for such care. One hospital – situated in a squatter settlement just 8 kilometers from a hydroelectric dam that decades ago flooded a fertile valley – is crowded. Medicines and laboratory studies are free. Every bed is filled, and the courtyard in front of the clinic is mobbed with patients waiting to be seen. Over a hundred have slept on the grounds the night before and are struggling to smooth out wrinkles in hand-me-down dresses or pants or shirts; hats are being adjusted, and some are massaging painful cricks in the neck. The queue of those waiting to have a new medical record created is long, snaking toward the infectious-disease clinic I am hoping to reach. First, however, it is better to scan the crowd for those who should be seen immediately.

Less ethnographically visible is the fact that Haiti is under democratic rule. For the first time in almost two centuries, democratic elections are planned and could result in a historic precedent: President René Préval, elected some years earlier, could actually survive his presidency to transfer power to another democratically elected president. If Préval succeeds, he will be the first president in Haitian history ever to serve out his mandate, not a day more, not a day less. ...