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Working Notes Towards Week 12 (Nov 22): Points of Contact ORIGINAL/COPY

bringing us into this space-->
"Origin of Love" from Hedwig and the Angry Itch (from KimK's second web event) and/or
"symphonies of science and diffraction" (from Gavi and chelseam)?

Haiti Women and Girls Vulnerable to Sexual Violence

"unless we agree that the world should not be the way it is … there is no point of contact,
because the world that is satisfying to us is the same world that is utterly devastating to them"
(Juan Segundo, qted. by Paul Farmer, Pathologies of Power, p. 157)

I. coursekeeping

beginning where we ended: the trigger event of "Over It" --> not being over it....

what we understood to be happening, in class and on-line:
not re-traumatizing, but creating space to re-visit in any way--
here, on-line, conferences, e-mail...

talk about the talking: how do others feel about that? consensus? allow time?
paradox of conversation re: comfort/discomfort

* AmyMay: I would suggest a "trigger warning" before bringing up such a personal issue in class.  This would allow people to decide in advance if the topic is something they are prepared to discuss openly in the presence of others. Personally, these are issues I want to talk about, and that I want other people to talk about.  It was very powerful for me to hear things that I feel deeply personally about come from many of the people in our class (in the "in response to __ we propose __" portion).  It was one of the few times I've felt truely understood, like my voice was being heard without me having to try to find the words.  Many of you got it.  That means more to me than I could ever say.  Though it was emotionally exhausting, by the end I felt we were bodies in alliance.

* Kaye: i too have been thinking a lot about tues night's class and wonder if trigger event warnings would have prevented the powerful learning that took place. do we need to meet each other in our precarity if we are to have real conversations and relationships. if people knew it what we were going to do, they might not have come to class or have built up their defenses so only part of them was there.

also, about "appearing": the differences between how embodied appearances in communities like our class and virtual appearances on Serendip are experienced.  Speaking your words out loud in front of people who are looking at you and whom you are looking at has a different emotional valence that posting the same words on-line.

***what about linking this to Galeano's "Celebration of the Human Voice/2" on p. 23 of Farmer?

* S. Yaeger: What surprised me was that last night's call for litanies and group discussions actually compelled me to be louder and more assertive. I think the reason for that is multi-fold.  First, though we haven't designated our classroom a "safe space" in the way that support groups name spaces, there is a general atmosphere of seeking to understand that makes the space safe, at least to me.  The fact that we have all come to a class like this and are working at chipping away our understandings of sex, gender, biology, and even physics together makes it much easier to imagine that we are also working at understanding one another. Second, the format of creating a litany by distilling our complex reactions to the piece down to a few words made it feel much less like I was being asked to expose myself forever, and more like I was being allowed to expose a fleeting, though resonating request.  Finally, in hearing the lines being called out and allowed to sink in, I felt very much a part of a larger whole, for the first time this semester.

* jfwright: the way in which Barad embodies the electron is a pretty decent representation of the way I feel about the Right to Appear as it relates to gender non-normative and intersex victims of rape and sexual assault.

* Gavi's response to Kaye's question re: quantum integrity: Maybe, the idea that we do not have an overarching framework of integrity (as consistency) can free us to constantly question the lives and narratives we have constructed and reconstructed and, in doing so, let us attempt to find a maximized goodness for our selves and for other people (social justice work).

going on

Judith Butler occupying Wall Street....and Bryn Mawr

II. Butler's last lecture

III. Paul Farmer on the pathologies of power

especially striking to me is
1) the question of the relation of gender and class--his saying that the "class-oppressed" are the infrastructural expression of oppression, while other marginalized groups (blacks, indigenous peoples, women) represent "superstructural" expressions, but also

I think this is key--let's try to focus on how all of this relates to gender/sexuality--while also highlighting connections to other modes of oppression (and notice that he didn't include people with disabilities in his list of marginalized groups.)

2) his critique of the current ironic state of bioethics, which focuses largely on the problems posed by "too much medical care....cases in which care is painful, expensive, and prolonged well beyond the point of efficacy. This is termed 'medical futility'.... I can't help but make connections between the surfeit on one side ... and the paucity on the other .... in the hospital we are asked to address the 'quandary ethics' of individual patients....[while] millions are denied the chance to become patients and to have an 'individual focus' trained on them .... problems of poverty and racism and a lack of national health insurance figure only rarely in a  literature dominated by endless discussions of brain death, organ transplantation, xeno-transplantation, and care at the end of life. When the end of life comes early ... the scandal is immeasurably greater, but silence reigns in the medial ethics literature ... ethicists are capable of endlessly rehashing the perils of too much care, while each year millions die what the Haitians cal 'stupid deaths'.... 'the care of individuals is at the center of health care delivery but must be viewed and practiced within the overall context of continuing work to generate the greatest possible health gains for groups and populations'" (203-205).

this should give real point, poignancy and a turn of the screw to our discussions about abortion,
sex selection, reduction of twins, etc. talk about an surfeit, individualism, and an excess of care

Anne's Reading Notes

Amartya Sen, Forward:
structural violence
methods of terse  definition ("make believe exactness") and exemplification:
many case studies of power inequities
asymmetry of power-> quiet brutality
stop whistling, start thinking…

Galeano's "nobodies," Mitchell's "little people"--

I'd like to read these out loud in classAlso, there's an interesting article from the Phila Inquirer about the GINI index and little/big people.  (See attached:  Satullo "The Wealth Gap Parade")

also, Chris Jordan's book, Running the Numbers (the prison uniform panels)

****cf. gender-sensitivity workshop in Guatemala,

seeking to change mentality of victims of genocide,
w/ mental health project to exhume the dead
neoliberal market forces don't serve his patients;

*****liberal political agenda doesn't include the powerless
basic right to survive trampled in age of affluence
(definition of a liberal: belief that bad things result from accidents)

****human rights violations not accidental or random, but symptoms of deeper pathologies of power, social conditions

****poverty major source of "unfreedom"
need to cross line from pure principles (of civic, legal, political rights) to social & economic ones: meeting urgent needs
neutral "terrorism of money"

****Brecht: stream termed violent, not the banks that hem it in
concept of structural violence:  p17 "social and economic inequities that determine who will be at risk for assaults and who will be shielded from them"  connect back with Welch??  (I really wish I could change the color of my comments to make them more distinguishable from yours.  Is this something that Ann could add to Serendip? or is it there and I haven't learned to use it yet?)

development and aid set stage for genocide in Rwanda
"averted gaze" of anthropologists
human rights too theoretical and legal; need to focus on health
equity central challenge for future of medicine

p19 "PoP suggests that a broad biosocial approach, when anchored in careful examination of specific cases, permits a critical reassessment of conventional views of human rights."  I think this links nicely to what we're asking them to do for Webevent 3?  (also see p42-43)

Part I: Bearing Witness
****clear conscience as animal-like (buzzard, piranha, rattlesnake)

interesting in terms of what people have posted about anthromorphizing and animalmorphizing

listening, interpreting the silent suffering of the poor
degree of injury unrelated to volume of complaint

*****bearing witness might respect the silence, avoid disrespectful rooting

design some experience of silence or refer back to last Tues' class?

all accounts partial, and eyewitnesses
pragmatic solidarity instead of reporting
superstition of cultural immersion necessary for knowing

*****to get beyond first silence: compassion and solidarity
*****bearing witness on behalf of others: to break the second silence

attempt to explain the presence of pain, affliction, and evil -- an exercise in theodicy

Chapter 1: On Suffering and Structural Violence
by what mechanisms do social forces become embodied as individual experience?
Haiti a living laboratory for the study of affliction
experience of suffering not conveyed by statistics; stories not anecdotal

p.31  "But the experience of suffering, it's often noted, is not effectively conveyed by statistics or graphs."  potential link to the reports from the UN and the WEF.

how representative the 2 stories of dying from AIDS and political violence?
cf. making sense and explaining it
social and economic forces dictate life choices, limit agency

****liberation theology uses social analysis to de/explore human suffering

****analysis must be geographically broad, historically deep (see above for link to Web event 3)

analytic traps: economic reductionism, axes of gender, race/ethnicity, class, immigrant/refugee status, sexual preference

*****conflation of structural violence and cultural difference (=reflexive cultural relativism)

this could be a great place to come back to leamirella's postings on wanting more of a global perspective

illusory cultural "equality"; abuse of cultural specificity, cultural determinism;

*****"culture" only furnishes an alibi for suffering (p49)

no single axis fully defines increased risk, but insist on primacy of the economic
world's poor chief sufferers of structural violence:
are both more likely to suffer, and not to have it noticed

p50  "We are aware that another gigantic wall is being constructed in the Third World, to hide the relaity of the poor majorities.  As wall between the rich and poor is being built, so that poverty does not annoy the powerful and the poor are aboliged to die in the silence of history" (Pablo Richard)

Part II: One Physician's Perspective
analytic perspective: from 1 vantage point, humbled by the suffering of the poor
pragmatic solidarity of medicine

p137  "Those who consider themselves stringent about matters such as 'theory' and 'analysis' may well find these essays insufficient."

 "Curiosity about the object of knowledge and the willingness and openness to engage theoretical readings and discussions is fundamental.  However, I am not suggesting an over-celebration of theory.  We must not negate practice for the sake of theory.  To do so would reduce theory to pure verbalism or intellectualism.  By the same token, to negate theory for the sake of practice, as in the use of dialogue as conversation, is to run the risk of losing oneself in the disconnectedness of practice.  It is for this reason that I never advocate either a theoretic elitism or practice ungrounded in theory, but the unity between theory and practice.  In order to achieve this unity, one must have an epistemological curiosity..." (Paulo Freire and Donaldo Macedo, 1995.  "A Dialogue:  Culture, Language and Race", Harvard Educational Review 65 (3): 382.)

Chapter 5: Health, Healing and Social Justice
re-define my neighbor as the one I must go out to look for

****also read outloud the quotes by Gutierrez and Sobrino at beginning of chapter?

the poor the by-product of a system we must re-build

****poverty an evil injustice: preferential option for them, against it

how does this connect with the Occupy movement?

****change rooted in small, poor communities: observe, judge, act

*****Freire's process of conscientization:
process of understanding how social structures cause injustice
majority of premature deaths are "stupid"
people living in poverty are experts on structural violence
only correct way to love the poor: struggle for their liberation=physical survival
prevent, treat, cure illness=pragmatic solidarity, diminishing hardship

*****(ex: t.b.--treat the sick while working to eradicate poverty)

p149--"cognitivist-personalistic pole that emphasized individual patient agancy (...) and a structural pole that emphasized patients' poverty"

p151--"analysis of the problem can lead researchers to focus on the patients' shortcomings...or...on the conditions that structure people's risk..."  (reconnect with Welch and the importance of having theory to guide analysis)

Lillian Hall's comment that Nicaragua is not a poor country, but an impoverished one?

received wisdom focuses on biological, cultural, psychological causes ("noncompliance"):
but outcomes are related to quality of program, not quality of ideas re: disease
the most important variables are related to economic factors;
removing structural barriers to compliance dramatically improved outcomes
flabby moral relevance=belief in broad menu of approaches to delivering effective health care--not true
commodification of medicine inevitably punishes the vulnerable
begin w/ perspective of health as fundamental human right, not good and service to be purchased
social democracies share a mania for border control
the problem is with the world, even though it may be manifest in the patient
truth is to be found in the perspective of those who suffer unjust privation,
must be in tune w/ those undergoing social misery
medicine has much to learn by reflecting on lives of the oppressed:
how is suffering explained and addressed?
three approaches: charity, development, and social justice
1. views those needing charity as inferior;
perpetuates injustice to continue opportunity to express "generosity';
Freire: unjust social order a permanent fount of generosity;
"true generosity consists in fighting to destroy the causes which nourish false charity"
resurgence of charity symptom and cause of inequality;
yet charity has a place in medicine: responding to underserved populations,
while attending to causes of excess suffering, and
recognizing that the homeless poor are more deserving of good care
2. regarding progress and development as natural processes
does not result in progress for the poor
liberal views place the problem w/ the poor, who reject modernity
developmentalism/reformism: erroneous view of poverty, vs.
"dialectical" explanation: growth of poverty dependent on growth of wealth--
internal to and natural product of linear, inevitable process;
cf. "liberation": a break w/ the present order, w/
"health transition model": belief that deaths from t.b., violence will cease to occur:
ppl. will live longer & deaths occur later, caused by heart disease and cancer;
masks interclass differences within a particular country: no health transition for the poor
from the vantage point of service to the poor,
outcome gap between rich, poor has continued to grow w/ development
3. people who work for social justice see the world as deeply flawed
conditions of the poor result of human-made structural violence
"unless we agree that the world should not be the way it is…there is no point of contact,
because the world that is satisfying to us is the same world that is utterly devastating to them"
privileged people, implicated in structural violence, feel indignation, humility, penitence--
critical to effective social justice work: not development, but redistribution of fruits of science & technology
what happens to the poor never divorced from actions of the powerful;
control of lives is related to political, legal structures in which lives are enmeshed
we are called to ink locally and globally and respond to both levels
declare health & health care to be human right, join forces to protect the rights &  dignity of the poor

IV.  the global reports

what about printing out some of the WEF summaries of selected countries to seed more specific discussion of the differences?