1. The article cites the previous successes of HIV/AIDS treatment studies that were applied in both Hati, Baltimore, and Boston.
2. The article describes the conditions of poverty in Rawanda and how the PIH model was applied there. It cites its successes and failures.
3. The article describes possible ways to incorporate structural interventions into medicine and public health practices
Based on the references, the information for this article was drawn from various medical sources, as well as some historical and anthropological reports.
This article argues that many of the root causes of disease are based on social inequality and structural violance, citing factors such as environmental conditions, racism, pollution, housing conditions, poverty, infrastructure, and access to food, water, and healthcare. It presents the case that if clinicians take these factors into account, programs can be put into effect which, even in the poorest of rural communities, could help to mitigate disease transmission.
Based on the available sources, I was unable to determine if this article was discussed or cited elsewhere.
The article was written by Paul E. Farmer, and his colleaues at Partners in Health, Bruce Nizeye, Sara Stulac, and Salmaan Keshavjee. Dr. Farmer is a physician-anthropologist, and is one of the founders of Partners in Health. He and his global colleauges have worked extensively on community-based treatment strategies and have implimented them in poor and rural areas both in the US and abroad. He and his colleauges have written extensively on both health and human rights, and about how social inequalities effect the distribution and outcome of infectious diseases. His work, and the work of his team has been published in various journals such as the Bulletin of the World Health Organization, The Lancet, the New England Journal of Medicine, Clinical Infectious Diseases, and Social Science and Medicine.
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Emergency response is not addressed in this article. It focusses on long term care and the prevention of disease on the public health level.
Data for this article was gathered from previous studies done by health organizations in Boston, Baltimore, Hati, and Rawanda. He also references peer reviewed publications for more background information, and recent work by the PIH in Rawanda.
"In this article, we describe examples of structural violance upon people living with HIV in the US and Rawanda. In both cases, we show that it is possible to address structural violance through structural interventions."
"Susceptabiliy to infection [by HIV/AIDs] and poor outcomes is aggrivated by social factors such as poverty, gender inequality, and raceism."
"by insisting that our services be delivered equitably, even physicians who work on the distal interventions characteristic of clinical medicine have much to contribute to reducing the toll of structural violance."
Some additional points to research to forward understanding of emergency response would be:
-Structural Violance
-Societal factors influencing public health
-nationalized health insurance.