“朱门酒肉臭，路有冻死骨。”—— 杜甫
Roughly translated as: The wealthy and powerful have so much to eat that their food and drinks go bad. Outside their mansions, the corpses of the poor who died of hunger and cold pile up on the roadside (Du Fu, 755, Tang Dynasty).
Human suffering is no news. For thousands of years, individuals at the lower end of the socioeconomic spectrum have been unequally influenced by larger social force, be it political, economic, or institutional. All four books for this week painstakingly tease out how suffering is intricately produced at the intersection of multiple forces in which the poor and (thus) powerless are caught up, their life being crushed.
I’d like to give an example of mainland China that demonstrates how extreme suffering and tragedy are structurally produced. The case I present is the so-called AIDS village in China. The YouTube channel has a 5-min brief (and sarcastic, disrespectfully I’d say) of the tragedy. The documentary has an elaborate portray of the event. Unfortunately, I am not able to find one with English subtitles.
YouTube: https://www.youtube.com/watch?v=E4xQfGQCi9U
Documentary: http://jishi.cntv.cn/zhongguoaizibingshilu/videopage/
Long story short. Henan Province has always been one of the most impoverished areas in China. The local officials, in order to boost the economic development, encouraged the blood-selling industry, which, of course, would not be possible with the advancement of blood-drawing machines and growing demand for cheap blood in urban areas. The profit of selling blood, for rural residents, is much more than they can possibly make. As a result, it was not uncommon that the whole village would go together to sell their blood. However, private, unsanitary blood-drawing business took the opportunity for black-market blood-selling. They used the same machine without sterilizing. Consequently, so long as one person was HIV positive, the whole village would be likely infected.
The story gets more difficulty to narrate. Any attempt to present a neat storyline may invite problems. Indeed, as Kleinman et al. (1997) and Farmer (2001) point out, suffering is co-produced by so many social forces that it is almost impossible to pinpoint where exactly the sources of suffering are. In the case of AIDS village, the rural residents barely had any idea about HIV/AIDS. The local officials, in order to avoid responsibility, suppress the victims’ appeal for compensation and justice. Policies, bind them to the rural areas they were born and make it difficult for them to move to urban areas where HIV treatment is relatively more available. But it wouldn’t have mattered, since they do not have insurance. Even if they did, insurance sometimes only pays half as much for a rural resident as for an urbanite. I can keep listing reasons why these people have no other option but to rot their life away by AIDS in their villages.
This story is not concealed—or politically appropriated and silenced, as Kleinman & Kleinman phrase it. Journalists, humanitarians, researchers, and government officials frequented the villages when the story was first learned. Not much can be done. The more effective inhibitors for HIV/AIDS were available only in the West, not to mention that the rural farmers couldn’t even afford the less effective ones available in China. Why otherwise would they rush to sell their blood? To borrow Kelly Ray Knight’s concept of temporality, I’d say that these farmers have a “waiting” time, one that is fairly short, considering how quickly they would die from AIDS. And they did. And then we forgot about them. Their suffering is appropriated and consumed by those of us safely away from the tragedy. I wonder if people shed more tears for Titanic than their fellow Chinese in these villages.
While I think this would be justly called ethical indifference, what should we do, as anthropologists or public health scientists, if we found ourselves in a site like this? Faced such grave social inequalities and human suffering, how can we conduct research ethically? For anthropologists (medical anthropologists in particular) as well as public health scientists, this question weighs even heavier. When we are conducting research with our co-subjects, have we done what we can? The opinion that the anthropologist should remain an observer, leaving the field as it is, in my opinion, simply does not hold water when the issue she studies is on suffering. Does one’s research have a tangible impact on the co-subjects’ life in a very real way? And by real, I mean in ways that the informants consider significant to themselves too. In other words, does their life become any better because of one’s research?
A most common response would be, the value of research can very well manifest in the effect of “calling for attention.” I agree. There is only so much one single researcher can do, and in order to bring about societal changes, much more people need to be involved and contribute to the betterment of the world we live in. However, the question remains. Have you done what you can to make your co-subject’s life better in tangible way?
Let’s revisit the famous photo discussed in the chapter by Kleinman & Kleinman (1997).
For those of you who did not read Chapter One, here is a brief review: Taken in 1993, the journalist Kevin Carter captured a young child trying to make her way to the shelter. Not very far from her, a vulture was waiting to devour this soon-to-be-dead child. Carter took the picture, drove away the vulture, and left. This photo spawned controversy. While some admired the journalist’s sharp journalistic eye, some questioned his choice of taking the photo without saving the girl. A year later, Carter committed suicide.
Did Carter and his famous photo call for attention? Undoubtedly. It earned the New York Times a Pulitzer award for that. The world got to learn about the severity of the famine in Sudan and more intervention was created. But is it ethical on Carter’s side? Isn’t it just a form of appropriation of the little girl’s suffering so that the rest of the world, the wealthy ones in particular, can safely satisfy their voyeurism, secretly feel happy that it is not them dying from hunger, and perhaps even feel noble donating a meal’s worth of cash?
I cannot help but notice the similarity between this and anthropological work. We go to the field; we collect data; we come back and write ethnography. Our ethical connection with our informants, it seems, lasts only as long as a journal article or a monograph requires. After writing up, the worth of our informants’ suffering is also exhausted. Alas, prolonged engagement does not mean permanent engagement. One project does not get one tenured. For our informants, suffering may last until the end of their life. Indeed, for all the authors in these weeks’ readings, some of their informants did not even survive the ethnographic project. But for the anthropologist, for the rest of the world, their suffering has a fixed temporality, to borrow Kelly Ray Knight’s (2015) phrase. For many, their suffering, to put it in plain language, start from the first summer visit, and end with the dissertation field work.
Did Du Fu, I wonder, give food to the poor dying at the roadside? Did any of the anthropologists whose work we read manage to make however small an impact on their informants’ life? Putting bread on their table? Helping them get medical help? Anything other than watching and asking? Perhaps we should all ask ourselves, Have I done what I can? Does their life become better, in ways that they actually care?
Thank you Yifeng, for the stimulating discussion!
Your post makes me wonder: is structural inequality nothing but an ethical issue, and should it be studied as such in anthropology? While there is no doubt that inequality has an ethical dimension, I also think that anthropologists seem almost too ready to speak about inequality with unfounded righteousness, as if they themselves are the ultimate embodiment of social justice. Maybe I have become too sour and cynical over the years, but no, I don’t think our informants’ lives become any better or worse because of our works. Intellectual endeavors have become a luxury good, which way too often could not be translated into anything other than a pastime. Moreover, even if Du Fu had given the dying poor at the roadside a morsel of bread (I mean, steamed bun really), would anything change? Like Du Fu, maybe we could improve the living condition of a few people during our fieldwork, but then what?
On the other hand, perhaps we are approaching the issue of inequality all wrong: rather than investigating human suffering as the spectacles of miseries, maybe we should instead ask questions about social mobility instead. What hinders or allows individuals to move up the socio-economic ladder? Maybe by focusing on the potentialities of a given situation, we as anthropologists could make “real” contributions for alleviating social suffering.
Thanks for the post Troy! This comment from your post struck me: “considering how quickly they would die from AIDS. And they did. And then we forgot about them.” Forgetting seems to be a common phenomenon. People are initially compelled/motivated/fascinated by stories of tragedy and suffering. But, over time, their investment wanes. Here, I think, lies the critical difference between “calling” attention to suffering and “keeping” that attention. How long do people continue to care about the suffering of an “other” in a foreign place? How can we (as anthropologists, public health workers, activists, humanitarians) keep people’s attention and direct it in ways that alleviates suffering in meaningful and lasting ways? Do attempts to keep people’s attention simply reinforce the exploitation and appropriation of human misery?
This discussion reminded me of an article by Nancy Waxler called “Learning to be a leper.” In the article, Waxler examines how organizations that treat leprosy inadvertently perpetuate stigma relating to the disease. Waxler notes: “Leprosy organizations, like many medical foundations, are dependent on public donation of funds [. . .] funds may be contributed more generously if such organizations confirm popular beliefs by medical and social science.” In the case of leprosy, allowing myths and stereotypes about leprosy as untreatable and highly contagious is advantageous for aid organizations because these conceptions help funding efforts. Humanitarian aid organizations are invested in their own survival. Thus, “once organizations are established, they tend to perpetuate themselves.” In a competitive aid market, maintaining the stigma around leprosy helps leprosy organizations gather more resources to treat those with leprosy: “leprosy foundations may, to sustain themselves, find it necessary to allude to the idea of threat and to support the community in its willingness to stigmatize.” Yes, the appropriation of those with leprosy does result in more healthcare for them, but what negative outcomes does this refusal to repudiate myths about suffering have?
Great blog post, Yifeng! Your questions echo a lot of my own concerns. As you mentioned, in both anthropology and public health, we as professionals insert ourselves into our informants’ environments of suffering. But, inevitably, as our academic work draws to a close so does our involvement. I suppose I never really felt uncomfortable with that idea until our recent class decisions. By acknowledging suffering, and making it the subject of our work, what are we really doing? Yes, we sometimes draw attention to a cause, but that is often the end of the story. In that way, are we as researchers really just glorifying appropriation? Also, I do think Yuezhu’s comment about researchers’ holier-than-thou approach to social injustice is spot on. It almost seems that by occupying this partially removed, partially involved space in order to document suffering we assume an air of righteousness, as if by calling attention to horrific social inequalities we are somehow better than everyone else. I wonder about the ethics of that, as well.
On a more optimistic note, maybe our role in our informants’ lives is less active, and more passive, in that we offer them a space to share their stories. Obviously, that’s not enough to mitigate the challenging circumstances of their realities – but it is an avenue that which the poor and powerless are often denied. By giving a voice to sufferers, I like to think that we are perhaps doing more than just calling attention to a problem, but are helping to shape it, personalize it, and make it relatable across all social contexts and situations.
Thanks for the post Troy! I think the comments about the ethical concerns for fieldwork are particularly important to consider. The idea of what can you do when faced with everyday realities of immense suffering can be extremely overwhelming. One of the strategies I found most useful in my work in public health was that it was necessary to redefine what one considered as success in making things better. If one person is still alive because you were able to help them, but many others die, is that still success?
Additionally, suffering surrounds us everyday in our own lives, and not just in the field. The news is filled with images of suffering from around the world and people, and people are homeless and in need of assistance throughout the U.S. How do we deal with the everydayness of this suffering? Are we more apt to ignore it because of its familiarity, rather than the sensationalized suffering of others in extreme poverty? Does this mean that we are in agreement with Farmer’s understanding of structural violence from liberation theology, where the poorest of the poor are more deserving of our help than others, because they suffer the most?
Hi Troy,
Thanks for the post!
The fixed temporality of suffering is the mechanism that allows us, as humans, to resume living our own lives for ourselves. Otherwise, I imagine at least two possible directions for a person that internalizes their relationship to the vast varieties of suffering that occur perpetually in the world: (1) an insatiable guilt would paralyze and consume the body; or (2) a reinvigorated sense of activism and desire to be on the frontiers of whatever issue in a fervent display for social change. Although this may be viewed as narcissistic, to put our own individual well-being before the suffering of other individuals or groups, but I think that we do this to reconcile with the boundaries of imagination and possibility. Maybe as scholars we could do more to make an impact on our informants’ life but just like your question asks “have I done what I can” we can also ask ourselves “why are we doing this”, “how can our efforts be sustained”, and “is this what they want”? Otherwise we come across problems of neocolonialism and dependency.
Thanks for your post. There are extreme ethical dilemmas with anthropological work, I agree. For the sake of making more known a particular experience of suffering (and maybe getting a full time job) we extract stories from people living in very marginal conditions.
I personally do not know how to deal with this. I truly think of my work as extraction. I may provide a temporary amusement to an informant, as I listen to their stories. I may be able to buy an informant lunch or a coffee. For the clinicians I work with, maybe I can translate some documents for them. Or maybe I can speak a little english with them. But in no ways can I do anything to alleviate the structural suffering that someone, whether a drug addict or a clinician, faces living in an isolated post-sanctioned country in which almost everyone is suffering from economic violence, and the way that violence bleeds into other aspects of social life.
Perhaps then, we should think more about the issues we are focusing on? We should think more closely not just about how we are reflexive in our ethnographies, but what these ethnographies do when they travel. How do the voices of the suffering get lost as we assimilate them into our academic ideology and jargon, always changing them and appropriating their pain to make points that they may never have cared to make. For this reason, maybe we should return to Spivack’s text “Can the Subaltern Speak” for provocation about what happens when subaltern voices are made into academic stories.
Hi Parsa, thanks for your reply. I too feel the kind of powerlessness when you say there’s really not much an individual can do about structural violence. I don’t have a solution either. And probably this is why I cling on Marxism so much. Not that I can’t see the vision put forth by Marx and Engels is hard, if at all possible, to carry out, but at least it touches on what I perceive as the fundamental source of suffering on human beings. To me, at least I can say therein lies the problem. How to solve it? I don’t know. Because suffering is structural, the structure has to change. Should we start with one particular institution and work our way to others? I think not. All these institutions are interrelated and their relations with each other are also part of the powerful web that individuals are caught on. Seen in this vein, it seems only some kind of destructive power can destroy the “darkness,” for a lack of better terms, once and for all. Alas, even a Marxist can probably tell how vague and perhaps unrealistic this sounds.
Thanks Troy for the post. I appreciate how much you were able to tie in to the post. I agree with you on many levels about what it means for academics to think about suffering. I think what makes this topic in particular difficult is that by the nature of our work (especially those of us who are anthropologists) are engaged in social and political critiques which often also end up being ethical critiques.
When it comes to a topic like suffering it seems like the stakes are that much higher and it is hard for us to find ways to confront suffering in a tangible way. In particular, because it is such a moral issue and also because it seems so hard to pinpoint the sources of suffering as you referenced, it seems difficult to think about how critique serves the ending of that suffering. It makes sense when we can critique racism or capitalism because then our critique has a clearer target (even if still abstract target), and we can at least think of our work as having some significance. I think this is why writing about suffering can seem particularly moralizing. Even with as much self-reflexive thinking that Anthropology has a field does, it is I think harder to malign people for not doing enough about global suffering without doing something tangible yourself, It is perhaps this reason that Farmer, who is a practicing physician and activist of sorts feels so comfortable laying out his demands to confidently.
This was a really interesting and thought provoking post, Troy!
You raised very important ethical considerations that were prevalent in the readings, and one of the most important considerations in medical anthropology and public health research. I don’t know that we should be asking ourselves, “have we done everything we can?” Yes, we work in a field where we have personal contact with unimaginable suffering, and our work should be designed to help mitigate that suffering, either directly or indirectly. Without that purpose, our work would be voyeuristic and unethical. However, before we ask ourselves “have we done everything we can?”, we should be asking ourselves, “What is the purpose of my work? How can my role as a researcher cause the most benefit to the populations I work with?” As researchers, our job is to observe, to analyze, and to make suggestions. While we may make a positive impact (however temporary) on the lives of those we interact with through our field work, the goal of our research is to make a positive impact on these populations through our research and publications. Those publications guide the work of politicians, policy makers, aid workers, program coordinators, and the various other entities that work to alleviate the suffering of others. In the role of researcher, we are not policy makers, we are not program builders, and we are not aid workers. We can take those roles as well, but there are individuals that have much more training and experience to take on those roles than we do. So, instead of asking “have I done everything I can?”, I propose we ask “Given my personal resources, have I used my personal abilities to make the largest impact I can?”
Hi Lacey, I agree with you that probably as a researcher, what is most powerful is our research that has the potential to reach a larger audience. My original post is, of course, radical for provocative reasons. But I do have a concern that what you raised is used by many as an excuse not to take action while they can. For example, simply because taking a picture of a dying girl and posting it on NYT can have a larger impact doesn’t exempt us from actually helping that specific girl, that very human being suffering right in front of our eyes. We are researchers, but first and foremost human beings as well. What I lament most is the indifference not just among researchers, but the general public as a whole, a lot of whom see their role as by-standers or “the person who watches some world news on Friday night before going out.”