Structural Violence and Bioethics
Structural violence is defined as “violence exerted systematically – that is, indirectly – by everyone who belongs to a certain social order… in short, the concept of structural violence is intended to inform the study of the social machinery of oppression” . The important thing to note about structural violence is that it is present in many forms and is all around us, whether in the United States or Sudan.
For instance, structural violence plays a role in the existence of food deserts all across the United States. The need to travel longer distances to access healthy food choices places an unfair burden upon the 23.5 million people living in these areas, half of whom are low-income families .
This past spring break, I went on a surgical mission with a medical organization travelling to Sudan. With a little over a dozen volunteers flying from all over North America including surgeons, anesthesiologists, and assistants, we devoted the next week of our lives to visiting a clinic in Khartoum where we performed approximately 130 cleft lip operations within a seven-day span.
Our first day in Khartoum we went to the clinic in which we would be performing surgeries to set up. While we made use of some pieces of equipment already there, most of the supplies we used during the trip were brought over by our group members; each volunteer taking 1-2 pieces as luggage. We spent the next few hours organizing various equipment from needles to diapers and children’s hospital gowns. Leaving our perfectly set up clinic made us feel prepared for the hecticness that would undoubtedly ensue the next morning when the clinic opened.
Despite the quick-paced environment of a medical setting, I had the opportunity to chat with plenty of our pediatric patients’ parents during downtime. It was easy to talk with parents since they would come to me to express concerns about their child’s appointment or to ask specifics about the operation. I was particularly approachable considering I was one of two Arabic speakers in the group. Serving as a translator during doctor-patient interactions, parents whose children had come out of the OR a day ago shared with us how the child had been feeling and whether they'd had any of the expected symptoms explained to them the day of the operation.
All in all, 130 families visited the clinic during our trip. Of these 130 families, a majority, if not all, traveled miles from their homes for their appointments. In fact, most spent the night right outside the clinic, creating their own shelters and using old cardboard boxes to sleep on at night. This was due to the fact that it was nearly impossible to travel the great distance between their homes and the clinic for their same-day appointment.
Because the government lacks the ability to provide citizens with adequate healthcare resources, families are left with the burden of compromise, resulting in healthcare becoming a luxury, as opposed to a necessity. The fact that families need to travel many miles in order to seek out basic health necessities exemplifies that these families, like so many others around the globe, are dealing with structural violence.
Farmer, Paul. Partner to the Poor: A Paul Farmer Reader. University of California Press, 2010.
DoSomething.org. (n.d.). 11 Facts About Food Deserts.