Structural violence

The entrenchment of the norm coincides with this appropriation by the individual: disciplinary power works by means of a dual imperative of conformity and creativity 6. In spite of the availability of significant resources to treat complications of HIV infection in Africa, almost all patients enrolled on ART live in cities or towns.

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This model, with conventional clinic-based distal services complemented by home-based more proximal care, is deemed by some to be the world's most effective way of removing structural barriers to quality care for AIDS and other chronic diseases.

Thought Experiment 3: Imagine that an individual or a small group of people works tirelessly and effectively to demand great changes on your behalf, while also writing articles that explain your problems and what you need.

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Does our clinical practice acknowledge what we already know—namely, that social and environmental forces will limit the effectiveness of our treatments? The early chiefdoms were not states, obviously; still, they were established on a similar basis—an inversely proportional relationship between security and resources, on the one hand, and liberty, on the other.

Using this model, we currently provide daily supervised ART to more than 2, patients in rural Haiti. As noted, structural forces account for most if not all epidemic diseases e. That being said, Foucault at times describes his oeuvre as pessimist activism.

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Because of contact with patients, physicians readily appreciate that large-scale social forces—racism, gender inequality, poverty, political violence and war, and sometimes the very policies that address them—often determine who falls ill and who has access to care. Is this an example of violence according to Galtung? What circumstances or factors might be important in shaping how you regard these efforts and these writings? The connection, distinction and interaction of kinds of violence enable the peace researcher to approach conflicts on their roots rather than solely on their visible effects. Structural violence, a term coined by Johan Galtung and by liberation theologians during the s, describes social structures—economic, political, legal, religious, and cultural—that stop individuals, groups, and societies from reaching their full potential [ 57 ]. Most microbes mutate when challenged with antibiotics; the rate of mutation may be hastened by imprudent use of antibiotics or by inadequate or interrupted therapy [ 40 , 41 ]. In his book Pathologies of Power, Farmer writes: The abuse of the concept of cultural specificity is particularly insidious in discussions of suffering in general and of human rights abuses specifically: cultural difference, verging on a cultural determinism, is one of several forms of essentialism used to explain away assaults on dignity and suffering. His work emerges from the intersections of public health and human rights, and he is the Kolokotrones University Professor of Global Health and Social Medicine at Harvard University. Medical professionals have to ignore the social determinants that alter access to care, and as a result, medical interventions are significantly less effective in low-income countries. Yet it has long been clear that many medical and public health interventions will fail if we are unable to understand the social determinants of disease [ 17 , 18 ].
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Foucault and Galtung on structural violence