Health at the Margins: Paul Farmer, Haiti, and the Transnational Disciplining of Bodies

Abstract

This paper reexamines the ethnographic work of Paul Farmer in Haiti from the theoretical perspective of the margins (Das and Poole 2004). I will argue that the disciplining of Haiti as a margin on the macro, transnational level though development causes violence, which, in addition to being structured, is inscribed upon the bodies of individuals who live at the margins. I will demonstrate how violence can be tracked from the macro factors, like transnational economic inequality, down to their inscription on individual human bodies. I will use various theoretical perspectives, including the anthropology of the state, to show that Haiti represented an unruly margin and was disciplined through development efforts, like the building of a hydroelectric dam in the Haitian community in which Farmer works. I will use the same theoretical lens to further show that because the margins must be disciplined, they necessarily entail and are even constituted by violence. This violence manifests in two distinct forms, structural violence and physical suffering that is inscribed upon human bodies. Farmer discusses at length the role of structural violence, or increased risk, in the atrocious health outcomes in rural Haiti. This form of violence is less visible than the physical suffering of human bodies that occurs at the iterative and intersecting margins of Haitian society, which I illustrate through Farmers ethnographic example. Lastly, I suggest that through a service-oriented method and the act of witnessing violence in the ethnographic context, anthropology can take steps to ameliorate suffering.