On Suffering and Structural Violence: A View from Below
veryone knows that suffering exists. The question is howtodefineit.Giventhateachperson’spainhasa degreeofrealityforhimorherthatthepainofothers cansurelyneverapproach,iswidespreadagreementonthesub jectpossible?Almostallofuswouldagreethatprematureand painfulillness,torture,andrapeconstituteextremesuffering. Mostwouldalsoagreethatinsidiousassaultsondignity,suchas institutionalizedracismandsexism,alsocausegreatandunjust injury. Givenourconsensusonsomeofthemoreconspicuousforms ofsuffering,anumberofcorollaryquestionscometothefore. Canweidentifythosemostatriskofgreatsuffering?Among those whose suffering is not mortal, is it possible to identify thosemostlikelytosustainpermanentanddisablingdamage? Arecertain“event”assaults,suchastortureorrape,morelikely toleadtolatesequelaethanaresustainedandinsidioussuffer ing,suchasthepainbornofdeeppovertyorofracism?Under thislatterrubric,arecertainformsofdiscriminationdemonstra blymorenoxiousthanothers? Anthropologistswhotaketheseasresearchquestionsstudy bothindividualexperienceandthelargersocialmatrixinwhich it is embedded in order to see how various large-scale social forcescometobetranslatedintopersonaldistressanddisease. Bywhatmechanismsdosocialforcesrangingfrompovertyto racismbecomeembodied asindividualexperience?Thishasbeen thefocusofmostofmyownresearchinHaiti,wherepolitical andeconomicforceshavestructuredriskforAIDS,tuberculosis, and,indeed,mostotherinfectiousandparasiticdiseases.Social forcesatworktherehavealsostructuredriskformostformsof extremesuffering,fromhungertotortureandrape.