Analyze

This film focuses on the environmental and social problem of having large gas (lethal) plants near cities or other populated areas where people can be harmed. Environmentally these gasses are no good because they are emitted into the air and are very soluble in the water which leads to ocean acidification. Ocean acidification makes it so that the ocean has a lower pH level, this can harm marine wildlife. Socially, the gas is toxic to people and as seen in the Bhopal tragedy, it can kill people or severely alter their lives. This could be seen through the immediate deaths of civilians, deformities of children born after the incident, and the families affected even years after hoping for justice.

From watching the video, I feel affected emotionally because it was definitely hard to watch so many people die, especially the innocent children. It is a hard pill to swallow to watch the lives of so many people taken away from them so unexpectedly in their own homes. I feel affected by seeing the photo of the unknown child because it was hauntingly touching as it was for so many people that advocated for justice after this tragedy. It was also really daunting seeing so many people being buried and burned in mass because they were not granted the ability to be respectfully honored for their death which I think is something very valuable. Intellectually I think that this film made me think about how this tragedy could have been possibly prevented if the plant had been maintained and checked up on regularly or if the plant wasn’t so close to a whole city in the first place. And I also feel gratitude to those who are still advocating for justice for the victims and trying to get people with government power to make that change.

The authors are Paul E. Farmer, Bruce Nizeye, Sara Stulac, and Salmaan Keshavjee. All of the authors are involved with the nonprofit organization Partners in Health in some capacity, with experience working with rural or poverty stricken areas. Paul E Farmer, the primary author of the article is a medical doctor also working for the United Nations who has published many other articles on similar topics.

The main argument is that susceptibility to certain diseases is not only determined by biology but also social conditions, leading to a disproportionate disease rate among the poor, and minority groups without access to medical services. The author shows that addressing these social conditions leads to a decrease in disease when combining treatment and prevention plans.

The argument is supported through a combination of historical information including rates of AIDS in the early 1990’s and a study done in Baltimore in an effort to reduce AIDS rates in African Americans, who were more likely to be in poverty, by addressing monetary barriers to heath care. Two more recent cases are also used to support the main argument, implementing a method created by the Partners in Health to prevent transmission and provide AIDS care in rural Haiti and rural Rwanda. Throughout the article references were made to the current medical professional’s dilemma, where they are in a position to see the social inequalities contributing to disease rates but not trained to report or change common social contributing factors. This makes the article more relatable to the reader that may have experience in the medical field which elps to support the argument.

“Pioneers of modern public health during the nineteenth century, such as Rudolph Virchow, understood that epidemic disease and dismal life expectancies were tightly linked to social conditions [55,56].” (Farmer 5)

“…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.” (Farmer 1)

“In an attempt to address these ethnic disparities in care, researchers and clinicians in Baltimore reported how racism and poverty— forms of structural violence, though they did not use these specific terms—were embodied [33,34] as excess mortality among African Americans without insurance.” (Farmer 2)

Data collected from a study done in Baltimore in the 1990’s, including statistics and observations is used to support the main argument. The methods used in Haiti and Rwanda as well as the results from implementing those methods are also used as examples for the claim that social conditions greatly impact disease susceptibility.

Emergency response is addressed in terms of both long term response and future emergency prevention. The method used by the PIH in both Haiti and Rwanda were implemented in response to high rates of disease in those places, showing that an emergency can occur gradually and the response may require creating a permanent system. Prevention is also discussed as a portion of emergency response, that it is important not only to deal with emergencies as they occur but also to identify the causes and change the system to prevent the same emergency in the future.

The article has primarily been referenced in later works by Paul E. Farmer who has written several other papers and articles on both the medical state of Haiti and Rwanda as well as structural violence in many capacities. The article was initially published in 2006 and has since been published in journals, books, as well as open online collections for use by the sts community.