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Paul Farmer, an American medical anthropologist and an assistant professor at Harvard Medical School, is recognized for his commendable contribution to the field of anthropology and also finding and developing a non-profit health organization that provides free treatments to patients, working largely in the third world countries. In one of his famous articles “On suffering andstructural violence: A view from below”, he has focused primarily on the physical and mental suffering experienced by an individual. The article narrates the story of two young Haitians who became the victims of social injustice and violence in Haiti and that ultimately became the source of their death. The article looks deeply into the everyday structural violence perpetrated by the social forces in Haiti and how the fate and lives of millions of people are affected and suffered by the violence and fierceness of these forces. The author also talks about the sufferings caused by the political violence committed by the authoritarian governments. The article has shed a light on the then ongoing situation in Haiti where oppression and violence was rampant and the Haitians had to live in extreme poverty with fear and under repression.
The author has conducted qualitative descriptive research by examining the case studies. He provides an account of the life stories of two young Haitians, Acephie and Chouchou, who became the victims of structural and political violence in Haiti. He has intensively analyzed the lives of these two Haitians and descriptively narrated the events occurred in their lives in a great detail. The author has related his research with different anthropological theories, for example he takes into account the feminist theory. His research shows that women are more vulnerable to violence than men. Though in many cases men are the target of political violence but the sufferings of women are much more commonplace.  Whether its domestic violence, rape or AIDS, women are more vulnerable to these issues than men.
The author has practiced Critical Medical Anthropology in his research in Haiti. Critical Medical Anthropology is a theoretical approach within medical anthropology that focuses on the political economy of the health and health care (Singer). It examines the influence of government policies and the economic system of a country on the health of the general population. The people of Haiti live in an extreme poverty and access to health care is quite expensive. Most of the Haitians are associated with agriculture from where they generate very low income. The government health services are in poor condition and lack basic health facilities. These have a direct impact on the population of local people. In the case of Acephie, she didn’t have the access to regular medical checkups, where she could gauge the performance of her health and ultimately she was diagnosed with AIDS. The lack of awareness is another issue which could be blamed on the governmental policies. Haitians were unaware of this deadly disease uptil early 1980’s. When Acephie got AIDS, people started blaming her for her past deeds and some suggested that it was the work of sorcery. The economic system of the country also forces the people to take such steps in their lives that could be harmful for them. The author writes that the harsh poverty drives thousands of women, mostly teen aged girls, to cities in search of better living condition, where none finds health security and they end up in aggravated health situation.
            Farmer has put great effort and detail into explaining the suffering of an individual. Through the narration of the life stories of Acephie and Chouchou, the two young Haitians, he has shown how violence traumatizes and dehumanizes the individual. Acephie was a young beautiful girl who became a victim of AIDS at a very young age. Haiti has one of the highest rates of HIV positive patients in the world. The author points out that structural violence have caused the death of Acephie. She was living a poor and miserable life in a remote Haitian village and that is why she was forced to marry an aged and already married man, the man from whom she got infected. She thought her economic conditions would improve after marrying him. Her social and economic condition made her think in such a way. All this could be attributed to the injustices of social forces. She was poor, uneducated and got sick because she was denied such basic facilities. In simple words she was a victim of structural violence. She went through an extreme period of suffering and agony after discovering about her disease. The mental pain was not only shared by her but also left a deep scar in her family’s life. Farmer writes that thousands of women in Haiti, like Acephie, who leave their houses in order to change their fate, falls prey to the unjust practices of social forces.
            Political freedom is a basic right that every individual should enjoy. But this very basic right was taken away from the people of Haiti by the autocratic regime of Haiti. After the military coup d’├ętat in 1991, when a democratic regime was overthrown by the country’s military, Haitians had to live in an extreme suppression. Thousands were perished by raising their voice against the military. Chouchou Louis was among those who spoke out for their right.   He was taken away by the soldiers when he accidentally expressed his remarks about the inhumane actions of the military. He was tortured for months and then thrown in a ditch to die. Farmer verbalizes the sufferings committed by the military and how physical torture is translated into mental pain. Through torture he received physical pain but the thought about his family that he left back at home would mentally disturb him.  The author says that thousands of Haitians were physically tortured but their sufferings were not heard or noticed by the international media. Those who survived the physical and mental torture became a victim of Post-Traumatic Stress Order, which is developed after exposure to the events that result in psychological trauma (Kato). Their grim past haunts them to this day. Their memory still flashes the horrors and crimes committed by the oppressors.   
            Many past literatures have covered the subject of individual suffering and pain. The author has used some of them in the article. Liberation theology is greatly concerned with the physical and mental suffering of a body. It was developed as a movement in 1950’s in Latin America and it could be described as an interpretation of Christian faith through the poor's suffering, their struggle and hope, and a critique of society and the Catholic faith and Christianity through the eyes of the poor (Hodgson). Liberation theologians have attempted to use social analysis to both explain and deplore human suffering. The author seconds the view of this movement and commends that they have greatly vocalized the plea and sufferings of the poor. Moreover, the author has effectively used the verses from different Holy books and other scriptures to describe the intensity of suffering, which has made the article quite sentimental and interesting to read. The author suggests that there should be more literature on the social and individual suffering because many people are unaware of the silent pain of many individuals.    
                             The author has raised the voice of those suffering bodies that is only encountered by the individual itself. The writer concludes that suffering through structural and political violence exists everywhere but some factors do not allow them to be reported in an intelligible manner. It is quite daring and difficult job for anthropologists to explain suffering because they haven’t gone through that period themselves and the one who experiences it personally can describe it more efficiently. The author says that gender inequality and racism are the major causes of social suffering. Women and minorities are more vulnerable to get suffer. Moreover, suffering shouldn’t be taken into cultural context but rather suffering is a universal concept. Everyone has the same level of feelings and sentiments and when they get hurt, the suffering caused is same for everyone. The author at the end suggests that we must identify those forces that are conspiring to promote suffering and we as a human should listen and vocalize the concerns and sufferings of individuals who are helpless and hopeless. 
Written By: Jawad Karim

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