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The Consumption of the Poor

Tuberculosis in the 21st Century

Paul E. Farmer

Harvard University, Boston, USA

In an era in which we have effective therapies, why has tuberculosis remained the leading infectious cause of young adult deaths in much of the world? This article argues that in order to answer such a question, we must explore not only the life experiences of those sick with tuberculosis, but also the larger social contexts in which they become infected, fall ill, and meet with a series of therapeutic misadventures leading to complications, ongoing transmission to others and, often enough, death. The `ethnographically visible' is only part of the story, since the experiences and commentaries of the sick and their providers must be embedded in broader analyses informed by history, political economy, epidemiology and a sociology of knowledge. Such an analysis brings into relief not only cultural specificity but also jarring similarities: living with both poverty and tuberculosis means poor outcomes whether you live in rural Haiti, urban Peru or the inner-city United States.

Key Words: tuberculosis • suffering • epidemics • social inequality • poverty • pragmatic solidarity • Haiti • Peru • United States

Ethnography, Vol. 1, No. 2, 183-216 (2000)
DOI: 10.1177/14661380022230732


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