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This work focuses on HIV and tuberculosis infection through the lenses of both anthropology and medical practice. Farmer, qualified in both, examines the impact of these infectious diseases particularly in Haiti, but also in the United States and South America. The author particularly examines the relationships between increasing global inequality and infection. Drawing on case studies of his patients, what is particularly interesting is his distinction between "culture" and "structural violence", and he argues that the two have often been conflated. Structural violence is the means by which people are disenfranchised and have extremely limited life choices by virtue of colour, nationality, wealth and gender. Thus there are powerful social forces at work, which determine one's health outcomes. The author demonstrates how both TB and HIV are diseases of poverty, and explanations of their increased emergence in the world - such as culture (voodoo, reliance on herbal remedies), patient non-compliance and so on - are in fact the result of inequality, poverty and inaction on the part of the powerful world. This work examines the lives and case studies of people who have been so dramatically affected by the HIV and TB pandemics, and whose choices have been so restricted by their poverty and lack of access to medical care. This is an important book that places biomedical science within its social context, and asks important questions not only about the distribution of wealth in the world, but also about the distribution of health care and medical intervention in the treatment of HIV and TB. The dramatic affect of racism and unequal power relations between the genders is underlined. This is important reading for those interested in HIV or TB and its relationships to poverty and development.
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