Bioviolence And Structural Violence

The society we live in today experiences severe global inequality and a huge disparity between the rights accorded to all human beings. An increasing polarization between the rich and the poor and the commercialization of health has resulted in a diverse exploitation of individuals. Social structures inflict harm on the lower vulnerable sections of society in the form of physical, psychological, social, and economic damage. The pivotal cause factor for these avoidable structural inequalities is the unequal distribution of power. This phenomenon of structural violence inhabits our society in various forms. Living in today’s world where individuals are increasingly affected by infectious diseases, infertility, organ loss and nerve damage, it

is crucial and unavoidable to look at these epidemics as a form of structural violence that impairs the living health conditions of an individual.
Therefore, it becomes essential to first understand what we mean by the term structural violence. Structural violence has been defined as a form of violence where some social structure or social institution may harm people by preventing them from meeting their basic needs. This form of violence is greatly linked to social injustice and people who suffer from it cannot control the conditions that have caused their suffering. Focusing on structural violence within the context of health damage, it is important to define the term bioviolence as well. As put forth by Monir Moniruzzaman, bioviolence is an act of inflicting harm and intentional manipulation to exploit certain bodies as a means to an end (Moniruzzaman, p.72). Bioviolence is a vehicle to fulfill the medical need and desire of the affluent few, but at the cost of bodily harm to the deprived majority (Moniruzzaman, p.72. This paper describes structural violence, especially bioviolence, embodied in various forms.
Structural violence began in the Gulf region, especially in the UAE, with the Gulf War Syndrome. Mark Nichter argues that a lot more goes into the analyses of an illness. The way an illness is responded to in context over time is influenced by cultural values, economic circumstances and power relations (Nichter, 2002). The Gulf War Syndrome is a chronic multisymptom disorder affecting returned military veterans and civilian workers of the Gulf war. Research shows undoubtedly that a portion of the individuals who served in the Gulf feel their health to be significantly worse than the comparable health personnel (Kilshaw, 2006). However, there are other people that argue that GWS is not an illness, but is likely psychological in nature. Anthropology showed that GWS is neither physical nor psychological, but both; and also a social, cultural and personal phenomenon. The author Susie Kilshaw looks beyond the illness itself and investigates the wider context of the sufferers’ lives. In structural violence that goes unnoticed, one often fails to consider the damage produced at the individual level. The veterans whose psychopathology is now ignored, were helpful during the war; a form of structural violence that is indirect but still exists.
Migrant workers in the UAE and other GCC (Gulf Cooperation Council) countries are the leading victims of structural violence as they experience a violation of their human rights as well as physical and psychological damage. The article on human rights and health disparities for migrant workers in the UAE precisely summarizes the violation of human rights focusing on their health ramifications and disparities (Sonmez et al, 2011). Many migrant workers from African and Asian countries that are serving the country experience systematic exploitation and discrimination. One way is through the Kafala system which involves holding laborers’ passport to regulate their residency and employment, giving employers near total control over migrant workers’ living conditions and their very ability to return home (Sonmez et al, 2011). This Kafala system is a form of structural violence. Laborers’ options are not only constrained by this system but also by brutal work conditions and threat of several fines for quitting and jail or deporting for striking. Construction workers even risk severe exhaustion from lifting or carrying heavy materials in the heat for many hours. Workers experience wage exploitation and excessively long work hours, sleep and food deprivation, inadequate living conditions and verbal, physical and psychological abuse. Therefore, in this condition, the employers belong to the social institution that cause harm to a deprived majority which are the migrant workers – a direct form of structural violence.
The migrant workers not only experience this violence at their work place but are exposed to psychological health damage as well. This can be clearly explained using the ‘othering’ theory. Refugees and irregular migrants are positioned as the ‘other’ and are treated separate and distant from the host communities. This effectively creates a separation between ‘us’ and ‘them’. The authors therefore study how this phenomenon of ‘othering’ influences the way refugees and asylum seekers are perceived, how they perceive themselves, and ultimately how this affects public health at various levels (Grove and Zwi, 2005). The adoption of metaphors of threat, natural disaster, of invasion and of contagion in relation to these forced immigrants constructs them in a destructive light. Such ways promotes interaction with refugees and asylum seekers from a point of defense. By not focusing on individual lives and circumstances, but rather on mass movement, the ability to personalize the refugee ceases to exist. They are also seen as ‘uninvited’ and ‘imposing’ and they are perceived as needy, helpless and a drain of resources. In many different ways, the refugee populations are at health risks and have unique health needs. Instead, they are seen by the host country as a threat and consider them as ‘vectors of infection’. Their health needs are neglected and not attended to. Again, this is a clear form of structural violence in which the countries housing these forced migrants and asylum seekers have plentiful resources, but still cause harm to the immigrants by preventing them from meeting their basic health needs.
Not only do migrant workers experience severe injustice in the workforce due to bad working conditions, but the workers in UAE are exposed to environments that cause serious health problems as well. One important example is the effect of pesticides on the farmers and their children. Farmworkers and their children are regularly exposed to pesticides just by living near treated fields. Organophosphates (OPs) are some of the most toxic insecticides used today, that cause adverse effects to the human nervous system. In the study conducted on subjects selected from Al-Ain city, Dubai and Sharjah, exposure to cholinesterase inhibiting enzymes such as organophosphates was found to be a major health hazard for farm workers (Beshwari et al, 1999). The farmers exposed to pesticides showed more chronic and respiratory symptoms than the non-farmers. This exposure to pesticides with its damaging effects on farmers and their children’s health is another form of structural violence that often goes unnoticed.
Then there is the form of structural violence towards the migrant workers where the victims of detrimental and infectious diseases are deprived of the facilities they require. One of them is HIV, and Ayaz Qureshi’s paper examines the phenomenon of othering through the Pakistani immigrants who are HIV positive (Qureshi, 2013). The National AIDS Control program regards the Gulf migrants as a key risk factor for a HIV epidemic. Qureshi says that the labor sending countries like Pakistan are limited in their capacity to protect their citizens by their dependence on the remittances from the oil-rich GCC countries and where dynamics of controlling the labor market are shaped by the imperatives of a neoliberal global order. Tests are done in Pakistan and then in the UAE on arrival, to check for a patient with the disease. Confirmed as a HIV positive, migrant workers are banned from entering the GCC. Even if the workers are tested to be HIV positive during their working contract, they are immediately deported from the country. The people in charge of regulating health in the UAE have framed laws that in all ways protect their own country from epidemics of infectious diseases. However, this law and order system of the host country has been constructed in a manner that also negatively impacts HIV infected people physically and psychologically. Placing their own country’s security as their first priority, the law and order systems compromise the welfare of the workers, which are the vulnerable majority. This is therefore a unique case where even though the host countries may or may not have a role to play in the infection of the disease, they are engaged in a form of structural violence as they fail to provide the infected population with the necessary health facilities. In addition, they are forcibly deported from the country causing psychological harm as well.
However, the most extreme form of structural violence which is bioviolence and which springs as a result of injustices between the rich and poor is organ transplantation.

Organ transplantation is one form that fits the definition of structural violence best as it is both exploitative and unethical. Organ commodification is seriously exploitative as organs are removed from the bodies of the poor by inflicting a novel form of bioviolence against them. In his article, Moniruzamman demonstrates how selling kidneys causes serious physical, psychological and social harm to the kidney sellers (Moniruzamman, 2012). Bioviolence is evident as it is not only the act of extracting organs from the physical body, but the whole process involved including deception and manipulation that play a role in exploitation of bodies. The narratives of the kidney sellers revealed how the wealthy buyers tricked the poor into selling their kidneys and how the poor were brutally deceived. The kidney sellers’ health deteriorated, their economic conditions worsened, and their social standing declined in a serious manner after they sold their kidneys. The author shows hat as the transplant industry flourishes, the structural violence against the poor becomes widely institutionalized. Kalindi Vora states that the invention of new transplant technologies and the constraints on South Asian workers creates a system where the lower economic classes live to support other people’s lives in the West (Vora, 2008). Nancy Scheper-Hughes also portrays how the lower sections of the society articulate their own ethical and political categories in the face of the consuming demands which value their bodies most when they can be claimed by the state as repositories of spare parts (Scheper-Hughes, 2000). For the transplant specialists, the organs of the poor is a commodity better used than wasted, while the organ can mean so much more to other people. Therefore we see that this bioviolence, particularly for the

extraction of organs, stems from the growth of the transplant industry and is closely linked to the suppression of the poor. It is structural injustice to the kidney sellers by the organ transplanters and a structural violence to the poor by the privileged few.
From all this, it is evident that the country’s health policy and their systems have to undergo change for this structural violence to be minimized if not ended. What the country needs is a health care reform that discusses major health policy creation or changes. The most evident and crucial change to be brought about is the consideration of the migrant workers while framing these health policies. Migrant workers should not only be entitled to proper working conditions and good salary, but also good care if they have been infected with a disease. Even if the workers who are infected with an infectious disease are sent back to their countries to safeguard the host country’s population, measures should be taken to ensure that the employers provide them with enough pay and facilities to treat themselves while in their home countries. In addition, the home countries of the migrant workers should also bring about a change in their policies where they take responsibility for a sick migrant worker that has been sent back from a GCC country. .
In the case of the illegal markets such as sex worker trade and organ transplantation, the issues could be challenging but have to be tackled. Trafficking of girls and women is illegal, a human rights violation and an extreme form of violence against women. A need to urge all governments, NGOs, and religious communities to focus on reducing the demand for victims of sex trafficking and prostitution is of utmost importance. With organ trafficking, there should be clearly defined codes of conduct for health care facilities and professionals’ roles in unregulated paid organ donation and transplants. Physicians and transplant surgeons should be held responsible to ensure that the organs they transplant were obtained upholding the highest standards of ethics.
With regards to the ill effects of pesticides, the handling of pesticides by the agricultural workers should be taken into consideration to ensure their safety. Employers should ensure that their employees have been trained on the basic concepts of pesticide safety. Employees need to be trained by qualified trainers and must have the opportunity to ask questions during the training session. The aim is to improve the training of health care providers in the recognition, diagnosis, treatment, and prevention of pesticide poisonings among those who work with pesticides directly and in areas where pesticide residues are present.
Acknowledging the structural violence present in the Gulf and around the world is only the first step. Structural violence encapsulates the various social and institutional failings that have real consequences in people’s lives. The word ‘violence’ rightly conveys the implication of the harm caused. As seen, the causes of this structural violence include poverty, income assets, vulnerability and powerlessness. However, the change necessary should not target the poor people, but the bigger institutions and governments that enable structural violence to take place.