Module 2: What Are the Contributing Factors to Poverty’s Pervasiveness?

How is it that a society allows such a paucity of capabilities to develop? What are the social, political, economic, environmental, and cultural contributions to such a dearth of choice and freedom?

Dr. Paul Farmer—physician and anthropologist who co-founded Partners in Health, a non-profit working all over the world to provide “a preferential option for the poor in health care”—has publicized in several of his books (Pathologies of Power and Infections and Inequalities, for example) his viewpoint on why poverty exists.(1) Farmer blames “structural violence,” which he defines as the “large-scale social forces—racism, gender inequality, poverty, political violence and war, and sometimes the very policies that address them—that often determine who falls ill and who has access to care.”(2)

“Structural violence, a term coined by Johan Galtung and by liberation theologians during the 1960s, describes social structures—economic, political, legal, religious, and cultural—that stop individuals, groups, and societies from reaching their full potential. In its general usage, the word violence often conveys a physical image; however, according to Galtung, it is the ‘avoidable impairment of fundamental human needs or … the impairment of human life, which lowers the actual degree to which someone is able to meet their needs below that which would otherwise be possible.’ Structural violence is often embedded in longstanding ‘ubiquitous social structures, normalized by stable institutions and regular experience.’ Because they seem so ordinary in our ways of understanding the world, they appear almost invisible … The idea of structural violence is linked very closely to social injustice and the social machinery of oppression.”(3)

To put this concept of “structural violence” in context, Farmer offers several examples in his book Pathologies of Power. The following example is in reference to the Guatemala Civil War, the longest civil war in Latin American history in which the government killed hundreds of thousands of civilians and grassroots revolutionaries and committed egregious human rights violations against indigenous groups like the Maya.

“To study Mayan widows without exploring the mechanisms that transformed them from wives to widows would be to miss the opportunity to reveal the inner workings of structural violence … This machinery is transnational as much as it is local. It has a history. And yet I have sat through conferences in which the fate of Mayan orphans is discussed at great length with no mention of what happened to their parents. Indeed, a focus on atomistic cultural specificities is usually the order of the day.”(4)

For an even more poignant understanding of the contours of “structural violence,” please read this chapter of Pathologies of Power entitled “Suffering and Structural Violence: A View From Below.”

As you can see, systemic structural inequalities give shape to the local manifestations of poverty and oppression. These are the inequities that Sen and Nussbaum discuss, the disparities that contribute to capability deprivation and jeopardized autonomy.


(1) “Partners In Health.” Accessed on 1 June 2010.

(2) Farmer, P., Keshavjee, S., Nizeye, B., and Stulac, S. “Structural Violence and Clinical Medicine.” PLOS Medicine. (24 October 2006). Accessed on 1 June 2010.

(3) Ibid.

(4) Farmer, P. Pathologies of Power. (University of California Press, 2004): 13.