Reflections on poverty, structural violence, and empowerment

In the past month I have spent quite a bit of time visiting the project villages. More often than not every morning I go out with the Mobile Health Team to meet with the Village Health Worker, to drink chai at her house and eat some of her delicious cooking, to see patients, and to meet with the women's groups and farmer's clubs to support them, offer advice, and give counsel. It's interesting how used I am to seeing very simple homes. Everyone lives in a single room with all of the cooking and sleeping supplies stacked up in a corner. I am no longer blown away by such poverty. I no longer think of their lives as wretched existences, but instead think about what made me believe this in the first place.

I think there is a considerable discourse in our society that discusses the horrendous lives of those who lack the same resources as we do. A paradigmatic example would be the Christian Children's Fund (I think) commercials that has an old white man with a big white beard kneeling next to a half-starved, dark-skinned, bloated-belly young child wearing rags and asking you for money. Only one dollar to give this kid all of the vaccines he needs. Only 10 dollars for food for the week. Only 50 dollars for schooling and supplies, etc.

While I think this is probably a good technique for obtaining funding – the greater the distance between our realities coupled with the increased purchasing power of my money the more likely I am to donate – I think it only captures a part of the reality. It misses the wonder and happiness in these children's lives, and, working within a charity model as opposed to a justice one, it also misses the structural factors for why such poverty continues to co-exist with incredible wealth.

In having actual interactions with these people, in seeing them sing, dance, eat good food, laugh, play, work, pray and live actual lives my understanding is shifting. The people are becoming real and the many joys and beauties in their lives are showing themselves. This process began last time I was in India when I visited a rural village and thought the banyan trees, wheat fields, and rivers to be some of the most beautiful sights of my life and started to wonder what makes these people's lives “so bad.” What is it about poverty that makes it such an important part of people's lives and our societal discourse on justice and morality?

I don't think it's just about material resources. Certainly that is an important part of the story but it's clear to me that it isn't the possessions of materials that automatically makes for a good life. These people can still have good lives, even if they live in one-room concrete and tin homes, cook over wooden fires, and have to spend all day traveling to market to sell their produce. Instead, I think it's about the central role poverty plays in structural violence. In short, structural violence says that diseases, suffering, and human rights violations are not produced randomly or by chance but instead are produced and determined by structures and therefore are distributed more to the lowers of the world. Poverty is the most important structure, though gender, race, education, caste, nationality and others play an important role as well. The point is that poverty doesn't automatically make life difficulty – there are many joys in these people's lives! - but that they are more likely to experience intense and overwhelming hardships and traumas and are less likely to have the resources to overcome them. I can see this in how people here in the villages have close family relations, abundant festivals, and great natural surroundings but not enough money to cover a drought or medical emergency.

I think the importance of this viewpoint of the understanding of poverty is important because how one defines the problem determines what solutions one seeks. This can be as simple as the give a man a fish or teach him to fish story: is the main problem his lack of a fish or his inability to acquire one for himself? I see it in the selective- vs. comprehensive- primary health care debate, as well as, in a different vein, in the psychiatry vs. psychology debate. Here, it relates to the role of structures in poverty. It isn't simply that people don't have resources and so giving them money is what is needed. Instead, it's more systematic, and structural change is required. Without question, economic concerns are central here but the approach should be different. What has been so successful about this project is not that they were able to funnel money into poor villager's lives but that they were able to take donations and make excellent use of them by combining them with people's participation to create a change in their world around them. The poverty of the area was addressed by setting up watershed projects that raised the water table and allowed for irrigation, better crops, and multiple yields. In this way the reality of these poor villagers' susceptibility to drought was reduced. Similarly, the poverty and low status of women is being addressed with self-help groups and micro-credit initiatives that extends credit to otherwise ignored populations so that they can work towards creating a better life for themselves. The main factor here is that this approach to overcoming poverty recognizes that it isn't just about materials but rather about marginalization, insecurity, and patriarchy, and that through empowerment rather than just a transfer of wealth then structural violence can be addressed.

Such are my thoughts on how to interact with the inequality around me.