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  58. From the first chapter ‘Universal Declaration of Human Right’ that I read prior to the others, I felt that these articles from 1 to 30 are meaningful to define what is the human rights. I really focused on one word that is ‘everyone’. From the meaning of everyone, I can easily imagine that we all received the same dignity. However, there are many barriers to achieve same dignity for everyone in real world. From the Paul Farmer’s article, having the same dignity was not easy to achieve with living in poverty and lack of power.

    In ‘health inequalities and inequities’ article, the authors suggested three meanings of health inequalities prior to defining the meaning of health inequities (differences between individuals, groups, and groups occupying unequal positions in society). These groups are related each other and one group can affect on others easily. I guess this separation can help to anlyze what factors affect in different groups.

    In comparison to health inequalities, health inequities involve a moral and ethical dimension. So, value judgement should be achieved in the case of health inequities.
    There were two different insights of equity and justice. First ones are moral equality and basic freedom. Second one is role of social structure. In these inghts, Rawl and Sen have different approaches. Rawl’s approach is good-oriented framework, which argues that equal distrubution of resources and opportunities are needed for fairness and justice. Senss approach is capability-oriented framework, which more focuses on human development than economic development.
    I think that Rawl’s approach can be more used for developing countries because they alsolutely do not have resources. However, in developed countries, resources are almost equally distributed, a problem is difference between wealth and poor.

    Through the third article named ‘Pathologies of Power’, I encountered that this is the real world. I felt that every problem in third world starts with poor and lack of power. Nobody wants to have HIV/AIDS, nobody wants to die because he/she expresses their opinion. This is so sad. On the contrary, human rights abused through money and power. Somebody might say this is a fact of life toward to more advanced society. But I think this idea is already built in human rights abuse.
    How do we help people with poverty even in develpoed countries??

  59. Like most of you have pointed out, I found the Universal Declaration of Human Rights difficult to understand in terms of the words that were used to write it, and in some way, unrealistic or surreal. Looking through the articles of this declaration, I guess that these might be written with the best of the intentions, and/or to find a “balance” in the world in what is considered fair for everybody. But, what is considered fair? Is it something that someone with power could make a statement (or a declaration) about? It’s under this declaration of human rights that big nations “take control of the situation” and invade other countries looking for justice, equity and respect for human right, right? I don’t know, it seems subjective, and still surreal for me.

    In some way, I specifically agree with Jamir in asking why if there are human rights to be “respected”, there are also inequalities and disparities. I look at these rights like they are something that had to be stated so a country’s government when confronted about what is happening with the inequalities, they could say: “Hey there, I don’t know what’s happening, I did my part, and it’s written here (the declaration)”. Indeed, there are inequalities, but moreover, health and social disparities are becoming the worst burden a country could handle. Some might say it’s the lack of resources or the mal-distribution of them, but certainly, there’s something else that’s not being addressed yet. For instance, when Graham explains the three meanings of health inequalities (health differences between individuals, between population groups, and between groups occupying unequal positions in society), I can’t stop thinking about Krieger’s ecosocial theory and how important it’s to frame social and health disparities nowadays. The ecosocial theory takes in account how humans interact with other people from micro to macro levels in society, describing populations in terms of patterns of health, disease and well-being. Therefore, as we could learn in the film that we watched in class last Friday, social class and interactions between populations might influence individual behavior by finally affecting a human being health status.

    I can’t help it but feel disappointed and helpless when I see some kind of injustice or a situation that doesn’t seem fair for me. But once again, what is fair for me might not be fair for you; there’s a thin line, I guess. So when I read about suffering and structural violence, I then understood, but not comprehended, why such health and social disparities are happening, even though there are human rights that people could use to avoid this kind of oppression. There still too much to be done in order to find that fairness and equality that we are supposed to have “by default”…

  60. Where to begin?! These readings were frustrating to wrap my head around, not because of the complexity of the terms, but due to the focus on issues that are still prevalent in society. This could be because I started with reading the Universal Declaration and subsequently read the following two Chapters with those ideas in mind.

    However, as I was reading the Declaration, I kept thinking how wonderful these ideas would be if they could ever come to fruition. As I continued reading it, it became increasingly evident that each one of these articles had a caveat or highlighted a flaw in its potential. There is such a distinct difference between the content of the Articles in this document and reality. On a daily basis people act in blatant disregard for the general concepts outlined and how this “violation” proliferates our society is where we see health disparities and inequalities arise.

    Kristie touched on a valid point with regard to Rawls theory surrounding primary social goods and how these are limited by one’s social position and the social structure which dictates outcomes. This becomes specifically evident when examining the Universal Declaration, Article 23 regarding the right to work and free choice of employment, again in Article 24, 25, and 26. These rights and liberties, opportunities and powers, income and wealth are limited by social influences.

    The chapter titled: Health Inequalities and inequities, highlighted a point that stuck out to me…where the term health inequity can be broken down into 3 categories: individual, population groups, and positions in society. I feel like these separate analyses are inherently linked to one another, so it is hard to look at an individual without understanding population and societal influences. For example, if you look at me as “Shana”, what about my role in the female population, how does that influence my health, and the fact that I have an education compared to others who do not…it all plays a role. So in my opinion it’s difficult to understand one aspect without the others.

  61. The value that I see in the Universal Declaration of Human Rights is that it sets up the guidelines for what rights all people should be entitled to. Of course, as many people have commented, these statements do not match the lived reality of the majority of the world. At the same time, I do think it is important to spell out what nations should strive towards. I had forgotten who the UN member organizations were, so I looked them up: http://www.unsceb.org/content/member-organizations. What strikes me in looking at this list is that many, if not most, of these organizations are funding and therefore dictating how international programs are carried out. Take the IMF (International Monetary Fund) for example. They lend money to countries in the global south, but this funding is not without strings. For example, lending policies can dictate what crops are grown and how, and who is responsible for the funds (men, most often). These contingencies can and have been detrimental to social structures and are in opposition to the Universal Declaration of Human Rights.

    Iesha brings up a good point about use of language, which is a point that is echoed in the reading about health inequalities and inequities. I agree that the Declaration of Human Rights is not written for low literacy populations, which in my mind, refutes the foundation of the document. In the Graham chapter, the author identifies what we talked about in class after watching the movie: that people are afraid of saying words like “racism.” Graham talks about how in the US in particular, research and policy opts for terms such as “disparities” versus “inequities,” when inequity is a much more appropriate term. I have used the term health disparities often, and before reading this chapter had thought about what the term implies but not what it glosses over.

    I have read this Farmer chapter before, and appreciated the opportunity to read again to gain new insights. The theory and concept of structural violence is critical to incorporate into the field of public health as a whole; however, it is often not discussed or pointedly addressed. In reading this article again, I am reminded to explore in more depth liberation theology. As Farmer states, it is “a theology that underlines connections” (p. 41), and it is these connections that need to be addressed in order to ensure that all people can access all of the rights as defined in the Universal Declaration of Human Rights. It is this point that is the most difficult for me. How is this done? It seems to me the only way this can truly happen is if the structure of power and powerlessness shifts on a global basis, although I don’t see that happening in my lifetime.

  62. If the constitution gives everyone rights, then why are there inequalities and disparities? It makes me question if people (especially minorities) know of these rights today. I have not read the Preamble or Constitution since grade school, so it was a bit of a refresher to go through it and this point. In grade school I remember thinking that “this is how the world works and this is how it is”, but now, it seems like that is what they say but it can be the opposite on so many of those issues. For example, how marriage was a right back then, but as of late, there has been so much debate and talk about gay marriage.

    And since I watched President Obama give his speech the other night, I can not forget to express Article 23: equal pay for equal work. These documents were written in 1987, and still there is debate about giving males and females the same pay for the same job. I do not know how this is even an issue, but then again, I have not been in a position to hire or negotiate raises either. My point being, from 1787 until now, this issue still exist. If inequalities and inequities are an issue today, will they ever seize to be an issue; I believe not.

    I feel that we need to remember who wrote these “rights” and laws. For the sake of understanding how their views impact the rest of the culture. The people who were in a chamber in Philly were most likely all in a privileged position, so of course, they would create a declaration in which best suited them personally. The way they make it sound while reading it is that everyone is equal and should be treated that way, but of course in today’s society (and most likely back then as well), it is not.

    Just my personal opinion, all of these old historic documents need to be re-written. Now I do not think that they are any time soon, but I feel that it is ridiculous that we are living in a completely different country than the one that was here when these documents were written. How can we live and keep progressing as a nation if we have rules (or rights) of the past. It would be nice if there was a re-set button on a Nation, wouldn’t it?

  63. Something about the order in which I did these readings seems significant – Graham’s chapter touched on the political weight of acknowledging the classifiable inequalities that dot our (and many other nation’s) populations, which is so essential in the way that disparities are presented. Morals equalities and definitions of power, control and freedom collided with the expansion of what social structures do to enforce or push those boundaries. Rawls description of “people’s starting places and chances in life” (p.16) meets Sen’s exploration of power and the determinants that power mark or take away from our respective lives. In moving from this reading to the Paul Farmer piece (which I’ve read before and which consistently moves me in the most visceral way) I was struck by use of poetry and the weight of the structural shifts caused in the lives of families by the displacement of those experiencing flooding, the so-called “water refugees” (Farmer, p. 34). The idea of embodying an experience is brought home for me by that example and by the Bertolt Brecht poem “ It is the same cause that wears out our bodies, our clothes”, in that the disparities are a part of a complicated history (Farmer, p. 30, 39). The wear and tear on the lives, the structures that make the experiences of those displaced by the dam, by political strife and the silencing of those histories in so many ways is the critical part of health disparities that I found to be missing from the Graham chapter.

    In transitioning to the Universal Declaration of Human Rights my experience was similar to that reflected by my peers in the blogs posts; some sort of exhaustion and disbelief. It sounds so good, yet while I’m sitting at my table – the murmur of NPR in the background – I wonder about the Patriot Act, the statement that was just read from Guantanamo and so on. As the inequalities of the day are shared on the radio I find I harbor a little bit of contempt towards how chipper article 19 seems, how basic article 25 should be. I know that this publication is about an ideal, something to strive for and that it’s existence is important – a narrative of agreement and awareness in its own rite. In reflecting back to the Farmer chapter and the way he writes about history and the future I am reminded of a powerful performance I saw while at a conference in Texas last fall. The woman performing calls on history (on her right to nationality via article 15) and talks about cycles of violence and the ways in which this is “not a tradition” though absolutely a pattern (http://www.youtube.com/watch?v=Mg2Jjam0p-U). By framing the rape of native women as an act of structural violence across history she calls for change, illustrating the ways in which colonialism, land/body sovereignty and sexual violence are all interconnected, thus perpetuating a dreadful and entangled spiral. In comparing the readings, and my own emotional response to each of them I feel very aware of the role of history and the importance of acknowledging it as we try to untangle current manifestations of disparities and the ways in which we hope that rights can become realities.

  64. From Rohina: Going through the Chapter-1, Universal Declaration of Human Rights prior to the rest of readings this week helped me to establish a foundation in mind when we talk about “rights”, “justice” and “inequalities” from the public health point of view. Doubtlessly most of the articles of the declaration are known to us these days since our attention is often times drawn to human rights pertaining topics in daily news and media discussions. For sure, the status is more of value when you are coming from a war-torn country where you routinely witness that how human’s basic rights/needs, which health is on top of it, are ignored.
    I believe that every single article of the declaration has been developed very thoughtfully that perceives all human beings equally as it is expected and all nations deserve it. However, what frustrates me is observing that such declaration remains merely as series of decent words on a piece of paper which is not executed by many states around the globe. As Iesha touched on it this devalue the discussion on “human rights” and even the declaration. The declaration is admitted by many countries but it is still simply disputable that how to ensure a strong global commitment to help nations to secure the absolute rights of its individuals as stated in the declaration. How to stop women’s death in a post-conflict country like mine because of inaccessibility to primary health care? All nations have the right to live in a secured circumstance where they are ensured of having access to their rights, but we observe that lack of any follow up mechanism to support/keep track of the declaration (e.g. punishment) has diminished the significance of it.
    On page-10 of the Unequal Lives the author states that “…the poorer health among older than among younger adults is more likely to be seen as a biological inevitability than as a social justice”, but I think we need to be cautious when we classify people’s health status based on their age. Because people’s health is hugely depending on the way they grow up and their life style which is affected by various factors rather just their age. For instance there are older people who have had a very healthy life throughout their life but at the end they are victim of social injustice in their society which affects their health – this might again be an example of developing countries where people’s life period undergoes with social, political and economic instabilities.
    In page-13 of aforementioned chapter Daniels concludes that it is just in an ideal society where the health access is distributed equally – which is true. We notice that in developed countries like northern American and European countries social structure considerably affects people’s access to health care services. Availability of resources is not I guess an issue in industrial countries but what contributes to the health inequalities is the way societies are structured.
    The examples included in The Pathologies of Power are quite indication of nations where politics stays before people’s health/life. Acephie’s and other stories impressed me in a way not to count too much on the effectiveness of declaration of human rights that I had read first today. That is political violence which mainly jeopardizes individuals and group of individuals’ access to their “right” and to a “just” society.

  65. I had similar thoughts to Iesha and Kristie on the Declaration of Human Rights- how nice it would be if these articles actually happened! As Iesha mentioned, what about equal pay and as Kristie brought up, The Patriot Act? It does feel a little deflating to read these aspirations and then to think about the state of the world and the struggles for so many in it. Iesha’s quote from Katherine Cross was great (thank you, Iesha!), and I appreciate the question of what is a right, especially if you don’t really have the ability to access your right.

    The explanation of health inequities as “health inequalities which are ‘politically, socially, and economically unacceptable’ ” (p.10) was helpful in situating the discussion on what is included in fairness and justice. Although Rawls and Sen take different stances on moral equality, Graham explains that together, they highlight that “unjust and unfair societies are those whose structures and institutions advance the freedoms of some to have, to and achieve at the cost of the freedom of others” (p. 18). With difference in health being unjust when they are a result of differences in basic freedoms (capabilities or goods).

    The chapter by Paul Farmer is one that I have read a few times in my undergraduate anthropology classes. One thing that came to mind while reading this chapter was our discussion in class about the last film we watched and how there was not mention of political agendas, capitalism, etc. whereas Farmer is very clear in his descriptions of structural violence that political violence and economic agendas are contributors. What this chapter does for me, is makes the theoretical discussions of inequality and injustice very, very real. As Farmer says…”the ‘texture’ of dire affliction is better felt in the gritty details of biography” (pg. 31).

  66. I got a headache just trying to read the first page of the Chapter one of Public Health and Social Justice. While I was reading the first page I had to stop and look up a few words. Once I got to the article of the documents it was easier for me to read and understand. My first reaction after reading the document is why would someone create a Human Rights document with that kind of language. These rights listed in the document are rights that apply to all humans so why put it in a language is almost impossible to read unless you have a law degree. As I continued to read the Universal Declaration of Human Rights and the other two other readings I kept asking myself what does it mean to have a right? What does it mean to have a right and no access? These readings reminded me of an amazing person I met at the CLPP Conference named Katherine Cross. Katherine at the time was working at the Sylvia Rivera Law Project. The Sylvia Rivera Law Project is located in New York City and is a non-profit that provides free services to low in low trans people and trans people of color. In the speech Katherine say:

    Just what is a right? You see there is something about rights… We believe a right is something you can touch, can taste, can live and breathe. It is something tactile. Material with a size and a shape that is known and something that is more than a phantom of a whisper of a thought on parchment. A right is the recognition of your humanity… Rights require justice to be in order to be exercised in order to be something more then just theoretical. If a women has a right to reproductive choice but cannot afford it then for all practical intends and purpose she has no right to reproductive choice. That is reality…

    There is something about this speech that stuck with me. I remember listening to Katherine speak and being astonished. What does it mean to have the rights listed in the Universal Declaration of Humans Rights. Article 16 section 1 of the Universal Declaration of Humans Rights states every human regardless of race, nationality, and religion has the right marry and have a family. What does this mean to families have their children taken away by government agencies because they were deemed unfit to be good parents. Article 23 section 2 states that every human has the right be paid equal for equal work without discrimination. What does this right mean in a great nation like the United States that pays women less than men? Having laws and rights does not mean that the problem will be resolved. Rights do not mean access. There are many examples where rights and/or laws were put into place but because of lack of access these rights are not accessible to everyone. Rawl believe that by giving people rights and resources they will be equal. Sen gives an example of two people with the same rights and different circumstances and explains how even though they have the same rights their situations and different and so is the outcome. Having rights and laws is not enough to changes the health disparities or inequalities.

  67. Universal Declaration- I understand that the Universal Declaration of Human rights are goals that countries and peoples of these countries are working towards. But there are so many violations of these articles with seemingly no punishment. For example, I do not know if Syria is part of the UN, but it seems that there is clear evidence that the government has violated nearly all of the articles- yet everyone (countries that could help) is sitting by and waiting. In our own country articles 7- 11 seem to have been clearly violated concerning the rights of the terrorists involved in 9/11 and activities there after. On top of this the US seems to have violated the rights of every US citizen under article 12, with the Patriot act and the “listening in” on phones. Under article 15 – Haitians/Dominicans are being forced from their country -the Dominican Rep. with the government telling them to leave or face arrest, regardless of where they were born. What about the Syrian refugees or refugees in general? Articles 17,16, 19, 21, 23, 24, 25 & 26 are fantastic if you are male – but many countries all over the world violate these articles concerning the rights of women and children everyday.
    How do we as a people and citizen of the world work harder to make these articles a reality for everyone? How serious are these articles taken by our leaders? Why is more not being done to punish violators?

    Unequal lives – Rawls theory is interesting because the primary social goods (rights and liberties, opportunities and powers, and income and wealth) that he speaks of ARE limited from the start by ones social position and thus by the social structure. For example, those of us that were born in the US, are from the start better off in all of these social goods, versus someone born in a developing or war torn country. Also that those born into a wealthier family here in the US vs a poor family in the US, have more social goods. I would argue that Sens critique of the social structure with the capabilities approach and his substantive freedoms is an extension of Rawls theory. I say this because the social structures must have the flexibility and strength to permit one to choose ones way of life and do the things one values. In other words if the social structure says that you are not going to be given the opportunities or rights or income- it will be very difficult for you to achieve anything.

    If we look at Paul Farmers article/book – he seems to backup Sens – but takes it further stating that the social structures caused the violence toward the people of Haiti. My questions are: how do we begin to stop this structural violence or can we stop this? Is structural violence part of the equation- must it exist for the powerful to stay in power? For a country to move forward? No matter how we look at things, a fact of life is that we are always going to have people who are leaders and people who are not leaders. Control is part of this equation -whether it is control through laws and policies, or control through violence. The US did not get to the point were we are in history because we were nice to people- we killed off many of the Native Americans among others. Is oppression necessary to succeed?

  68. Hyungsoon Ahn(Soon)

    I had no time to tell about Jamir’s idea. I just want to add my thought on Jamir’s.
    He talked about ‘mindset’ and I agree that it is related to someone’s health status.
    Additionally, mindset is easily linked with where people live, their income level, and education level. People look as trying to compare with upper levels(wealthy people). It probably makes stress which influence on our immune system. I think the gap between rich and poor is the big problem in this country. 1% rich > 90% poor…..this is huge.

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