Global Health in Times of Violence

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​      Authors: Barbara Rylko-Bauer, Linda Witheford, Paul Farmer, Philippe Bourgois, Didier Fassin, H.K. Haggenhougen,             Carolyn Nordstrom, James Quesada, Merril Singer
     Editors: Barbara Rylko-Bauer, Linda Witheford and Paul Farmer
     Santa Fe, United States of America, SAR Press, 2009
     304 p, Paperback
     EUR 28.12
     ISBN: 978-19346-9114-4
 
         


         Global Health In Times of Violence, written in 2009, is a book edited by Barbara Rylko-Bauer, Linda Witheford and Paul Farmer. Its eleven chapters revolve around the impacts of different types of violence in population development and health, resulting from a combination of powerful ethnographic studies from renown anthropologists. It takes us on a journey around the world and shows us that violence can be everywhere, even if we do not recognize it.
 
          The first chapter, written by the book editors, is named “Prologue: Coming to Terms with Global Violence and Health”, and addresses violence, its manifestations, causes and consequences. It concerns the normalization of violence and its nefarious consequences, particularly on the poorest and marginalized people, and states the importance of increasing violence visibility as a mean to fight against it. It recognizes violence as a global health problem and reinforces the importance of health care in mitigating suffering.
               
        In chapter three, “Landmine Boy and the Tomorrow of Violence”, Paul Farmer presents the story of two Rwandan boys picked by a landmine while farming cows, in 2006. Although they did not die, they were severely injured. This story exemplifies how the violence from the past echoes in the future – the landmine, and the poverty that leads those two boys to work instead of going to school, are direct consequences of past violence, and are themselves violence. But the author goes far beyond and unveils all that lead to this unfortunate incident in 2006. This narrative begins with the Belgian colonization of Rwanda and the segregation of Hutus promoted by the colonizers, followed then by the independence of Rwanda and the interference by the French in Rwandan internal affairs. Hate and conflict escalated between Hutus and Tutsis, leading to the Rwandan genocide in 1994 which had grievous consequences, such as suffering, death, poverty and mental illness. The writer also explores the weapon responsible for mutilating these kids – the landmine, designed to look like a toy - and other warlike artifacts. The profits of selling them make wars appetizing for many countries and nearly impossible to end.
               
           Chapter five, “Failure to Protect, Failure to Provide: Refugee Reproductive Rights”, by Linda Whiteford, is a raw portrait of the failure to protect women’s rights in refugee camps. It tell us about the normalization of rape in these places and the stigma that women carry after being raped (many are shamed and ignored by camp administrators and even by their own families). It also describes the lack of protection of women’s health – the inexistence of emergency contraception or abortive pills for these women, and the absence of health care, which leads to the spread of sexually transmitted infections. In addition, this chapter focus on the intricate network of refugee camps funding, giving the example of the USA conservative policy and the cutting of funding to refugee camps that provided emergency contraceptives to women.

           In chapter ten, “Medicine in the Political Economy of Brutality: Reflections from the Holocaust and Beyond”, Barbara Rylko-Bauer reports the major role of Nazi doctors in supporting the ideologic regime brutality against Jewish, Gypsy and other ethnicities, considered by them as inferior, with pseudoscientific facts and heinous acts such as involuntary mass sterilization, scientific experiments, the murder of the mentally and physically disabled and the collaboration in concentration camps, namely in gas chamber’s killings. The author made a parallel between these doctors and her mother, a Polish medical doctor and prisoner that worked in concentration camps hospitals. She describes her mother’s struggle to survive and to give a proper treatment for those in need, in spite of the hospital’s terrible conditions – the lack of space and hygiene, often with more than one patient per bed and the shortage of healthcare staff and medicines available – and the impotence and guilt she felt by not being able to perform her medical duty. This chapter also compares Nazi doctors and the USA military doctors and the psychologists responsible for the torture and death of war prisoners, stating that, even though seventy years had gone by since World War II, the Hippocratic oath continued to be broken, and atrocities were still being perpetrated by the ones who had vowed to protect the health and wellbeing of their patients.
 
            In the last chapter, “Epilogue: Global Health in Times of Violence – Finding Hope”, editors state that, although we are surrounded by violence, there is still hope for a better world and emphasize that the first step is to acknowledge and expose that violence is present in our daily life. They advocate for the victim’s rights, not forgetting that many times the perpetrator is also a victim.
 
            In conclusion, Global Health in Times of Violence shows the importance of narrative and ethnographic studies in the understanding of the phenomenon of violence, its manifestations, causes, and consequences. At the same time, it humanizes the thematic, making it easier for the message to reach the audience. The main message of this book is that violence is a global health problem, ubiquitous, most of the time unrecognized. It is up to us, health professionals in particular, to recognize and expose violent patterns, advocate for victim’s rights and in, in this way, improve populations’ health.
 
 
Autoria Joana Carvalho
Edição Filipa Gomes

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