Structural Violence Term Analysis

I attempt to portray and analyze the lives and experiences of Macario and my other Triqui companions in order to understand better the social and symbolic context of suffering among migrant laborers. I hope that understanding the mechanisms by which certain classes of people become written off and social inequalities become taken for granted will play a part in undoing these very mechanisms and the structures of which they are part. It is my hope that those who read these pages will be moved in mutual humanity, such that representations of and policies toward migrant laborers become more humane, just, and responsive to migrant laborers as people themselves. The American public could begin to see Mexican migrant workers as fellow humans, skilled and hard workers, people treated unfairly with the odds against them. I hope these recognitions will change public opinion and employer and clinical practices, as well as policies related to economics, immigration, and labor. In addition, I hope this book will help anthropologists and other social scientists understand the ways in which perception, social hierarchy, and naturalization work more broadly.

Over the course of my fieldwork, many of my friends and family who visited me in the labor camp quickly blamed the farm management for the poor living and working conditions of berry pickers.
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The stark reality and precarious future of the farm serve as reminders that the situation is more complex. The corporatization of U.S. agriculture and the growth of international free markets squeeze growers such that they cannot easily imagine increasing the pay of the pickers or improving the labor camps without bankrupting the farm. In other words, many of the most powerful inputs into the suffering of farmworkers are structural, not willed by individual agents. In this case, structural violence is enacted by market rule and later channeled by international and domestic racism, classism, sexism, and anti-immigrant prejudice. However, structural violence is not just a simple, unidirectional phenomenon; rather macro social and economic structures produce vulnerability at every level of the farm hierarchy.

The suffering of Triqui migrant laborers is an embodiment of multiple forms of violence. The political violence of land wars has pushed them to live in inhospitable climates without easy access to water for crops. The structural violence of global neoliberal capitalism forces them to leave home and family members, suffer through a long and deadly desert border crossing, and search for a means to survive in a new land. The structural violence of labor hierarchies in the United States organized around ethnicity and citizenship positions them at the bottom, with the most dangerous and backbreaking occupations and the worst accommodations. Due to their location at the bottom of the pecking order, the undocumented Triqui migrant workers endure disproportionate injury and sickness.

Years later, Abelino still tells me that he has knee pain and that "doctors don't know anything" (los medicos no saben nada).
After considering in some detail the course of Abelino's interactions with health care institutions, this common statement makes more sense. Several assumptions were made along the way, from the absence of stomach problems to his first return to work being "light duty," from his ability to read English to his being paid as an hourly worker, from his incorrect picking as the cause of his injury to his faking of the pain, from the importance of "Objective" biotechnical tests to the disqualification of his words and experiences.

If health professionals responded to sickness by treating not only its current manifestations but also its social, economic, and political causes, we could create a realistically critical public health and a "liberation medicine." This latter term alludes to liberation theology, in which a reflective engagement with those who are poor and suffering leads to new ways of thinking and practicing theology in order to achieve social justice. While there is genuine need for the skills of narrowly trained, competent biomedical physicians, I am convinced this is not enough.
As shown by the health care experiences of Abelino, Crescencio, and Bernardo, medical skills practiced without recognition of the social structures causing sickness are doomed to address only the downstream, biological and behavioral inputs into disease. This leads to ineffective health care at best and complicit, injurious health care at worst.