The Appeal of Experience; The Dismay of Images: Cultural Appropriations of Suffering in Our

Times
Author(s): Arthur Kleinman and Joan Kleinman
Source: Daedalus, Vol. 125, No. 1, Social Suffering (Winter, 1996), pp. 1-23
Published by: The MIT Press on behalf of American Academy of Arts & Sciences
Stable URL: http://www.jstor.org/stable/20027351 .
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Arthur

and Joan Kleinman

Kleinman

The Appeal of Experience; The Dismay of

Images: Cultural Appropriations

of

Suffering inOur Times

ORIENTATION

is one

of the

existential
grounds
of human
experi
a
in
human
ence; it is a defining
quality,
limiting experience
It is also a master
conditions.1
subject of our mediatized
times.
of victims
of natural
disasters,
Images
conflict,
political

Suffering

the HIV
abuse,
pandemic,
of kinds,
domestic
and
crime,
abuse,
are
cameras
of destitution
the deep privations
Video
everywhere.
of pain and misfortune.
take us into the intimate details
are appropriated
to appeal emotionally
and
Images of suffering
to
to
both
audiences
and
local
Indeed,
morally
populations.
global
an important
As
those
part of the media.
images have become
forced

chronic

famine,
of dozens

migration,
illnesses

on

"infotainment"
mercialized;
and business
ences,

substance

they

the nightly
are taken up

news,
images
into processes

for gaining

market

Arthur Kleinman
isMaude
and Lillian Presley
man
of the Department
of Social Medicine,
Medical
and Professor
School;
of Anthropology
a sinologist,
Joan Kleinman,
Harvard
University.

is Research

are com

of global marketing
experi
appeal of human

The existential
competition.
to
their potential
mobilize
sentiment
popular
or offer
to witness
and even their capability

action,
now available

of victims

share.

Suffering,

and collective
testimony

are

"though

at a

Chair
Professor
of Medical
Anthropology,
at Harvard
and Professor
of Psychiatry
at Harvard
University.

Associate,

Medical

Anthropology

Program

at

Arthur Kleinman and Joan Kleinman

as

distance,"

the French

it, is routinely

presses

Luc

sociologist

Boltanski

in American

appropriated

ex

tellingly

culture,

popular

which is a leading edge of global popular culture.2 This globalization

is one of the more
signs of
troubling
suffering
era:
because
of the current
transformations
troubling

the

of

is being used as a commodity,

tation of suffering,
experience
distorted.
to avoid

It is important
talizing
timeless

suffering.
or spaceless

munities

inwhich

endowed
of

with

There

and

through

is being

essentializing,
is no single

universal

shape

experience

this cultural

remade,

cultural

represen
out, and

thinned

or sentimen
naturalizing,
to
is no
there
way
suffer;
to suffering.
are
com
There

suffering is devalued and others inwhich

it is

the utmost

The meanings
and modes
significance.
and
have been shown by historians
of suffering

the experience

to be greatly
diverse.3
Individuals
do not
alike
anthropologists
more
what
than
talk
about
suffer in the same way,
any
they live,
same
or
in
to
Pain
at
the
serious
is
ways.
stake,
problems
respond
even in the same commu
is perceived
and expressed
differently,
from the Nazi
death
Extreme
of
forms
suffering?survival
nity.4
or

camps

the Cambodian

catastrophe?are
of poverty
and
experiences
"ordinary"
as a social
can speak of suffering
We
to this essay:
that are relevant
1)
ways
rience shape individual
and
perceptions
are visible

tive modes
are

and

they
2) Social

taught
interactions

patterns

of how

sometimes
learned,
enter into an illness

not

same

the

as the

illness.5
experience
Collective
expressions.
to undergo
openly,

in at least

two

modes

of expe
collec
Those

and
troubles,
often
indirectly.
(for example,

experience

a family dealing with the dementia of amember with Alzheimer's

disease

or

a close

As

these

cancer).
take part,
Both

network

grieving

for a member

with
and

suggest,
relationships
examples
a central part, in the experience
sometimes
collective
of social
aspects
experience?its

terminal

interactions
of suffering.6
mode
and

to be reshaped
be shown
by the
of time and place. Cultural
represen
and its institutions,
community
by a moral
local differences?in
of suffering.
modes
Yet,

processes?can
intersubjective
distinctive
cultural meanings
tations,
elaborate

authorized
different

and, of course,
subjectivity?as
age group, class, ethnicity,
gender,
as
make
into local worlds
of
the
well
penetration
global processes
and complex.
influence
this social
partial

Cultural Appropriations

of Suffering in Our Times

It is this aspect of suffering that this essay addresses by way of

an analysis
of
to professional

that contribute
and political
processes
that have
of
processes
appropriations
suffering,
are experiences
uses
of
what
To
moral
implications.

important
suffering

the cultural

are

put? What

of

the consequences

those

cultural

prac

tices for understanding and responding to human problems? And

what
tions

are the more

implications
general
for human
experience,

of suffering

of the cultural
including

appropria
human
experi

ences of suffering?
PROFESSIONAL APPROPRIATIONS
PHOTOJOURNALISM

OF THE IMAGES OF SUFFERING:

AND PUBLIC HEALTH

Image I.

Source:

Kevin

Carter,

The New

York

Times,

26 March

1993.

1993

by Sygma.

This photograph won a Pulitzer Prize for The New York Times. In
the April 13, 1994 issue of the Times, there was a full-page
advertisement

taken

out

by

the Times9

owners

in recognition

of

Arthur Kleinman and Joan Kleinman

Prizes

the three Pulitzer

this award-winning

that

picture

itwon

that year. The Times

in the following
way:

described

York Times,
for Kevin Carter's
of a
photograph
a
vulture perching near
little girl in the Sudan who has collapsed
from hunger, a picture that became an icon of starvation.

To

The New

When
the famine

the photograph
that has once

the chaos

civil war

of

first appeared,
again resulted
in the

southern

a story of
it accompanied
from political
violence
and
Sudan.7 The Times3
self

account

fails to adequately
evoke the image's shocking
an
is hardly
than
she
infant; she is naked;
larger

congratulatory
effect. The child

over

in weakness

itwould
incapable,
no family, no one

and sickness,
is
No mother,
she
seem, of moving;
unprotected.
to prevent
is present
her from being attacked
bowed

appears

to starvation

or

the vulture,

by

eaten.

then

and

The

succumbing
being
image sug
is led
The reader again
gests that she has been abandoned.
Why?
to imagine various
in
scenarios
of suffering:
she has been lost
the

chaos of forced uprooting; her family has died; she has been
near

deserted
reader
war

in order

for her mother

image's
to know more.

success

death

children.

viable

to want

The

great

is this

Why
The

to hold
is that
innocent

on

to more

it causes
victim

the

of civil

and
unprotected?
danger
are
not
in
the
and
real
forces
of
evil
the
evil,
greater dangers
are
in
"natural world";
the
those
world,
including
they
political
or in government
in Khartoum.
in army uniforms
offices
nearby
a political
in the Sudan.8
Famine
has become
strategy
and

famine

vulture

embodies

but

has been
photograph
in
advertisements
duplicated
The

aid
This

reprinted many
for a number

times, and it has been

of nongovernmental

food
funds to provide
that are raising
agencies
sentiment
instance of the use of moral
is a classic
for social

support

One

cannot

Or,

succumbing
donation.

The photograph
allow
did Carter

calls

for words

the vulture

it in some

sense

to answer

to get

thing to protect the child? What

taken? Was

at this picture without

the child and drive the vulture
look

to protect
something
as one aid agency puts it, to prevent
other children
from
a
inhuman
in the same heartlessly
way
by giving

to do

wanting
away.

action.

to refugees.
to mobilize

other

so close without

questions.

How

doing

some

did he do after the picture was

posed?

Inasmuch

as Kevin

Carter

Cultural Appropriations
to take

chose
point
rather

the time, minutes

is near death,

when

she

to save

than

Those

nonrelationship)

his death,
magazine

that may have been critical at this

to compose
an effective
picture
is he complicit?

ran an
for Kevin Carter, who
obituary
at age thirty-three.
That shocking
notice of
corre
Bill
the
Times9
Keller,
by
Johannesburg
as a longer article by Scott Mac
in Time
Leod

York

Times

suicide

written
as well

spondent,

to Carter's
(or
questions
particular
relationship
to the dying child were only intensified when,
on
a few months
after the Pulitzer
Prize announce

moral

1994,
July 29,
ment, The New
had committed

the child,

of Suffering in Our Times

on September

12,

Carter's

reported

how he took the photograph and what

clarifications

about

followed:9

.. .he wandered

into the open bush. He heard a soft, high-pitched

saw a tiny girl trying to make her way
and
to the
whimpering
to
a
center.
As
he
crouched
vulture
landed
her,
feeding
photograph
in view. Careful not to disturb the bird, he positioned
himself for
the best possible
later say he waited
about 20
image. He would
the
vulture
would
its
It
did
not, and
minutes,
wings.
hoping
spread
after he took his photographs,
he chased the bird away and watched
as the little girl resumed her struggle. Afterwards
he sat under a tree,
to God
lit a cigarette,
talked
and
.He kept saying he wanted
afterward...
The Times9

obituary
in which

ends with

cried. He was
depressed
to hug his daughter.10

a section

entitled

"The Horror

of

the Work,"
son "Always

that
father, observes
Jimmy Carter, Kevin's
carried around
the horror
of the work
he did."
Keller
the burden
that it was
of this "horror"
that may
implies
to suicide. The article by Scott Mac
have driven Carter
in
Leod
his

a very troubled
life, with
a messy
financial
brushes
divorce,
drug abuse,
problems,
deep
with
the police,
and was a manic-depressive.
We
also learn that he
had spent much
of his career photographing
repression
political
Time

shows

that Kevin

Carter

had

lived

and violence in South Africa, and that he had been deeply affected
of his best friend and coworker,
Ken Oosterbrock,
by the shooting
for whom,
he told friends,
he "should
taken the bullet."11
have
His
comes
suicide note, besides mentioning
these other problems,
back

to the theme

of the burden

vivid memories
starving
police,

of killings
and
or wounded
children,

of killer

executioners_"12

of horror:
and

"I am haunted
and

corpses
anger
of trigger-happy
madmen,

by the
.of
pain..
often

Arthur Kleinman and Joan Kleinman

From

to his

much

Leod we also learn that Carter had been present

men
of right-wing
in Bophuthatswana;
paramilitary
he had missed
the master
annoyance
image snapped

Scott Mac

at the execution

by his colleagues of a white mercenary pleading for his life before

that also was
being executed?a
picture
in Time
around
the globe.
The
article
aware of the photo journalist's
painfully

reprinted
reports
dilemma:

by newspapers
that Carter was

"I had to think visually,"

a shoot-out.
he said once, describing
"I
am zooming
on
a
in
tight shot of the dead guy and a splash of red.
into his khaki uniform
in a pool of blood in the sand. The
Going
a visual here. But
dead man's face is slightly grey. You are making
inside something
is screaming,
'My God.' But it is time to work.
Deal with the rest later_"13
writer
discovered
that some
ques
magazine's
journalists
Carter's
ethics:
"The man adjusting
his lens to take just the
frame of her suffering..
be a predator,
just as well
.might

Time
tioned
right
another
some

vulture

on

of Carter's

the girl."14
It is easy

the

friends

to moralize

scene."

Scott Mac

"wrondered

notes

Leod

aloud why

he had

that

even

not helped

success
professional
was a result of his failure to act humanely.
To balance
the account,
we need
to remember
that many
and
photographers
journalists
some of the more
this year covering
have
been killed
violent
about

how

Carter's

conflicts
the world.
around
"Hardly career advancement,"
political
Bill Kovach,
Curator
of Harvard's
Nieman
cautioned
Foundation,
to an earlier
in response
version
of this paper. Kevin
Carter's
career is as much
a story of courage
as it is a
and professionalism
tale of moral

failure. Moreover,
the photograph
he created
pro
to
act.
vided political
and
drove
Photo
testimony
journal
people
to a global humanitarian
contribute
effort
ists, like Kevin Carter,
to prevent
is a considerable
silence. That
contribution.
learned about
Having
an anonymously
public
part of close experience.
on

the

side

Carter's
icon
Kevin

suicide,

of

suffering
Carter
is transformed

of

the photograph
a classic example
the heart of darkness,

emplotted
as
Africa

with

becomes

a subject

in the

the prize-winning
at a distance,

cultural

from

a narrative,
a
of Joseph Conrad's
to

the

site of
story

his

social

story

image,
becomes
a name
is

that

of

depiction
Carter
horror.

photograph

helped

write
he had

infected

by being transformed,
to bear.

But what

of Suffering in Our Times

Cultural Appropriations

more

than

affected,

by what

the horrors
by the little Sudanese
girl,
experienced
nor
name
a
a
The tension
local moral world?
neither

of

is given
is unrelieved.
the story of Carter's
of uncertainty
Only now, with
the
the
and
interfuses.
of
the
repr?senter
suicide,
suffering
represented
as
as
well
would
Professional
interpretations
representation
popular
the two: one a powerless
local victim,
the other
have us separate

who

a powerful
the account
of Carter's
Yet,
foreign
professional.15
a more
The
of the
suicide creates
reality.
complex
disintegration
us
a
vari
all. The theories
of
implicates
subject/object
dichotomy
ety of academic

may

professions

help

explain

how

Carter

got

us

into this situation of bringing the global into the local, but they fail
how we will

to explain

get ourselves

out of the moral

complexities

he has intensified for us by projecting the local into the global.16

are

We

the unsentimentalized
limits of the human
left only with
silence seemingly without
meaning,
possibly without
And
calls for images:
the mixture
still the world
of moral

condition?a
solace.

commerce

is here to stay.17
immense
it is
the
achievement,
photograph's
disputing
to
its moral
useful
and political
There
is,
assumptions.18
explore
Afri
for example,
the unstated
idea that this group of unnamed
failures

and global

Without

cans

or Dinka?)
cannot
their own. They
(are they Nuer
protect
as well as represented,
be protected,
others.
The image of
by
an
the subaltern
almost
neocolonial
of fail
up
conjures
ideology
and
ure, inadequacy,
fatalism,
passivity,
inevitability.19
Something

must

be done, and itmust

setting. The authorization

must

be done
of action

intervention,
aid, even foreign
enous absence,
an erasure of

but from outside

the local
an
for
through
appeal
foreign

soon,

an evocation
begins with
local voices
and acts.

of

indig

Suffering is presented as if it existed free of local people and

The

local worlds.

disasters,
illnesses,
other non-Western
the

of

image
Western
mode:

is alone.

and deaths

is not the way

that
This, of course,
are usually
or
in African
dealt with

in the West.
or, for that matter,
societies,
Yet,
an ideologically
is culturally
in
represented
it becomes
the experience
of a lone individual.20

famine

is to assume
that there are no local
step, naturally,
or programs.
That assumption
almost
leads
invariably
to the development
or
are
of regional
national
im
that
policies

The

next

child

institutions

Arthur Kleinman and Joan Kleinman

on local worlds.
or
When
those
localities
end up resisting
posed
not complying
to assist
with policies
and programs
that are meant
are
acts
or
such
then
labeled
irrational
self-destructive.
The
them,
is deemed

local world

incompetent,
too thoroughgoing
can do good, but

seem

This may
and mobilization

the complexity
seriously
institutions.
local
Moral
to other,
and

unspoken
about

else,
entertainment.
are

Papers
are advanced,

as we

has,

local

a critique. Clearly, witnessing

best when
they work
they take
situations
and work
through

also must
involve
witnessing
moral
and political
assumptions.
that
suffering,
especially
suffering

reading

where

of

or worse.

a form of
become
noted,
already
are part of our political
economy.
audience
programs
share, careers
gain

of trauma

Images
sold, television

and prizes are awarded

jobs are created,
of images of suffering. Kevin Carter won

appropriation
but his victory,

as itwas,

was

substantial

misery

(and probable death) of a nameless

side

of

the

is that

of

appropriation

of cultural
processes
globalization
across
One message
that comes
distance

Watching
exists some

have

Prize,

dubious

a sensitivity

for all the havoc

won

because

of the

little girl. That more

human
must

is what

the
through
the Pulitzer

in
misery
be addressed.

the

from a
suffering
we
are
some
society,

from

viewing

inWestern

status and
gain in moral
some of our organizations
while
and politically,
gain financially
we represent,
or appropriate,
remain where
those whom
they are,
surrounded
vultures.
This
of
suffer
moribund,
"consumption"
by
so
an
era
not
in
is
so-called
"disordered
of
very
ing
capitalism"
how

better

different

than

from
a higher

at

colonial

in each

involved
and

the

historical

child

globalization
ened human
Another

view
development?a
are
Both
forms of cultural

carries

commercial,
The point

appropriation

and

the

is that

the

image

and

programs

of

"modernization"

that have

financing),
in sub-Saharan
Africa.21

world's
the postmodern
serious
of
such
images

of

of the vulture

the brutal
including
as the dubious
cultural

entailments,
as well
of colonialism
recent

authorized

in
representation
are deeply
political

cultural

(of markets
problems
effect of

that

of

other.

genealogy
of the more

baggage

nomic

level

exploitation.
the
the moral,

which

society. We

view
that the savage
late nineteenth-century
of our own civiliza
lands justified the valuing

the

in pagan

barbarism
tion

this African

and

too often wors

and eco
political
forms of suffering

Cultural Appropriations
at a distance
overwhelmed
to see,

and

is that

the viewer.

desensitized

are

Viewers

is too much
of atrocities.
There
by the sheer number
to be too much
to do anything
about.
there appears
sense
can be
that
complex
epoch's dominating
problems

Thus, our
neither understood
of

it has

of Suffering in Our Times

nor

fixed works

images

with

to produce

of

suffering
and political
empathy,
despair.
iswhen
The appeal of experience

the massive

moral
we

globalization
exhaustion

fatigue,

see on television

of

a wounded

a threatening
accusa
crowd,
protesting
of a murderous
organiza
paramilitary
is when we are shown
that the man
images

surrounded
Haitian,
by
tions that he is a member
tion. The

of
dismay
are
and the crowd
themselves

surrounded

determine

participation
helps
The appeal of experience
and
in Kevin Carter's
photograph,

by photographers,
the direction
the event will

whose
take.22

the dismay
of images fuse together
in
and
the story of his suicide. The
a
is
transformation
of social life, a politi
photograph
professional
a
relevant
constructed
form
that
natural
rhetoric,
cally
ironically
izes experience.

As Michael

Shapiro

puts

it,

..
is the absence of presence, but because the real is
.representation
never wholly present to us?how
it is real for us is always mediated
some
lose something when
through
representational
practice?we
we think of representation
as mimetic. What we lose, in general, is
insight into the institutions and actions and episodes through which
the real has been fashioned, a fashioning
that has not been so much
a matter

of

immediate

acts

of

consciousness

by

persons

in everyday

life as it has been a historically

kind of imposition, now
developing
in
institutionalized
the
kinds
of meanings
largely
prevailing
deeply
inscribed on things, persons, and structures.23
This

cultural

of professional
and political
transformation
process
to the way we come to appreciate
human
and
problems
to prepare policy
That appreciation
and preparation
far
responses.
too often are part of the problem;
become
they
iatrogenic.
is crucial

PATHOLOGIZING
When
over

SOCIAL SUFFERING

those whose

to places
another
type

suffering
of refuge and

of

arrogation.24

is appropriated
by the media
submit
safety, they often must
Their

memories

(their

cross
to yet

intimately

10

Arthur Kleinman and Joan Kleinman

interior

of violation
images)
trauma
stories
then

These

capital, with
and achieve

are made
become

over
the

into

trauma
the

currency,

stories.
symbolic

resources
for physical
they enter exchanges
the status
of political
those
refugee.
Increasingly,
a
core
to
in
based
real
reduced
events,
stories,
yet

which

complicated
cultural
image

are used
of victimization
(a postmodern
hallmark),
to
in
rewrite
social
medical
by health
experience
professionals
a
terms. The person who
torture
first
becomes
victim,
undergoes
an image of innocence
someone who
cannot
and passivity,
repre
sent himself,

who

specifically

a patient

must

be represented.
Then
a
with
quintessential

a patient,
si?cle disorder

he becomes
fin de

stress disorder).25
to receive even mod
(i.e., posttraumatic
Indeed,
a sequential
est public
to undergo
it may
assistance
be necessary
one
from
transformation
who
who
suffers political
experiences,
terror

is a victim

to one who

sick, who
financial

has

a disease.

to one who
of political
violence
is
of the practical
and
political
the violated
them
transformations,

Because

of such
importance
selves may want,
and even seek out, the re-imaging
as well
tion so that they can obtain
the moral
ill. We

to

the

financial

kind of
ask, however,
a
victim
the transformation
of
cultural
of vio
process
underpins
a pathology?
to give
with
What
does
it mean
lence to someone
a pa
status
violence
social
of
those traumatized
the
by political

benefits

of

being

need

of their condi
as

what

in what

tient? And

does the imagery of victimization

way
an
individual
alter the experience?collective
of
pathology
as moral
as individual?so
that its lived meaning
and
memory,

perhaps
and
"paranoia,"

even

is lost and
resistance,
a "failure
to cope"?

There

is an uncomfortable

unnecessary

correlation

irony here. There

between
the aesthetics

and Bosnia
temala, Rwanda,
are reported
in the news. We
and landmines.
off by mortars
terrorizing
into pieces,
details
of

populations,
blown up,

are dramatically
victims?their

trauma

appropriated
and sexual

by the
violence

is replaced

as the
as well
political

by "guilt,"

is an uncanny
and
in Gua
of murder

in which
those deaths
and the way
are shown close-ups
of limbs blown
at
In low intensity warfare
directed

are not just killed;

they are hacked
people
torn apart, burned,
and broken. And all the
the cultural
for us. Thus,
capital
displayed
their
their tragedy?is
scars,
wounds,
same
are

popular
commodified,

codes

through which
physical
sold in the cinema, mar

of Suffering in Our Times

Cultural Appropriations
keted
tract
other

11

as

to at
and used by tabloids
and novelists
pornography,
forms of trauma
readers.
from abroad
hold an
Spectacular
as
consume
our
well:
interest
and
deflect
significance
they

attention

from

The

aesthetization

at home.
misery
of child sexual abuse

routinized

is another

case

in point.

Appearing in The New York Times of April 9, 1993 was a picture

of a child prostitute in the red-light district of old Dhaka, Bangladesh.
a Lolita
bare-chested,
girl is shown
wearing
on her arms, ear
adult hairstyle,
many
bangles
a
and
necklace.
Behind
her
thin
small,
rings,
figure looms someone
to
one hand
who
be
her
appears
brothel-keeper,
grim, mustached,
The

prepubescent
smile, a tousled

near his groin. Behind

them are the filthy walls
of an alley; another
or a customer
stands off to one side. The accompanying
prostitute
on the World's
Chil
Scourge
a major
this picture
newspaper,
as child pornography.
would
The purpose
of the picture
qualify
and the accompanying
the degradation
of child
story is to expose
a
era
in
the
of
AIDS.
prostitution,
phenomenon
greatly
increasing
story is titled,
dren." Outside

"The
the

Sex Market:

context

of

But the picture

to
intention,

not entirely without

simultaneously
appeals, probably
a prurient
not enough
to
It
is
sensibility.
clearly
a
to
child's
recreate
for
the
needs
the
sale;
picture
body
picture
of sexual desire. Thus,
the media,
atmosphere
by the success of its
it seeks to criticize.
gets caught up in the very processes
artistry,
now turn to explore
a different
We
form of the transformation
In recent years, experts
of social suffering.
in international
health
and

social development,
for very appropriate
have sought
reasons,
new ways
to develop
of configuring
the human misery
that results
from chronic
disease
and disability.
Faced with
the problem
of
cases
numbers
of
of
chronic
heart
increasing
illness?diabetes,

cancer, asthma, depression,

disease,
schizophrenia?as
populations
to experience
live long enough
and other
diseases
degenerative

health conditions of later life, health professionals

rates
that mortality
and especially
ment,
have

sought

to represent
the distress,
disable
cost
the
of these conditions.
Therefore,
they
to construct
new metrics
to measure
the suffering

from chronic illness, which

called

have realized

are unable

These

"morbidity."
the burden
claim, to measure
can enable the just allocation

inmedical
metrics

can

of suffering
of resources

and public health argot is

be

the experts
applied,
in "objective"
terms that
to those most
in need.26

12

Arthur Kleinman and Joan Kleinman

One

metric

of

suffering
attention

has

recently
developed
and considerable

gained wide
describes
what
the World

Bank's

result
from

Bank

(DALYs). Table 1 shows the

to measure

the cost of suffering

the significant
of
percentage

of DALYs

of the application
illnesses globally.

the World

II
Image
support.27
mean
economists
by the

health

term Disability Adjusted Life Years

by

It emphasizes

loss in DALYs due to mental health problems. This finding, one

would

the case for giving mental

health
help make
trauma due to violence,
mental
sub
illnesses,
so
resources
can
that
be
greater
priority

should

suppose,

problems?suicide,
stance
abuse?higher

are
In fact, the cost of mental
health
problems
so
in
the
World
Bank
the
that
the
category
discretionary
placed by
a
state is not held
is
serious
for that burden.
This
responsible
in
fundamental
the
that
way
requires
change
suffering
problem
to them.

applied

from mental health problems is prioritized by theWorld Bank. But

here we
tation

ask a different

Image II. Disability

What

question:

and professional

kind
of

appropriation

of cultural

suffering

represen
is this?

Life Years

Adjusted

Bank's estimates of lost years of quality life hinges on the concept of

Adjusted Life Years (DALYs), which is a measure of the burden

The World
Disability

by specific
produced
of the disablements

it combines

diseases;
result

that

from

of the premature
deaths
and
impact
at a given
In taking
death
diseases.
age
the expectation
lost is evaluated
by using
the

those

into

of years of life
the number
account,
at that age to individuals
in low mortality
countries.
Years
of life
life remaining
a year
value
the life span; thus, most
do not have
the same value
people
throughout
a year
as worth
in the eighties
is worth.
in their twenties
three or four times what
of

This

is taken

evaluation

differential

into account

in the calculation.

To measure

the

disability resulting from disease, each surviving year ismodified according to the
expected duration and severity of the disability. Duration is simply the years (or
fractions

thereof)

that

of

a given

disadvantage
For
death.
disease
and

of

disability

example,
the female

Source:
Income

the

expert

on

panels

the comparative
represents
Severity
to 1, for
from 0, for perfect
health,
at a severity
of 0.6,
and
rated blindness

lasts.

disability

handicap

a scale

have

system
reproductive
are combined.
In calculating

the age at which

(and

the

relative

at a severity
of 0.22.
the formula

DALYs,

Losses
takes

from

death

into account

the specific disease is acquired, the years of life expectancy

value

of

those

years),

et al., World
Robert Desjarlais
Countries
(New York: Oxford

and

Mental
University

the years

Health:
Press,

compromised
Problems
1995),

lost

by handicap.

and Priorities
295.

in Low

Table
Region,

1. Distribution
1990

of DALY

13

of Suffering in Our Times

Cultural Appropriations

Loss by Cause

and Demographic

(percent)

Sub
Saharan
Africa
Population(millions)5,267.0

510.0

Other
Asia &
Islands

China
850.0

Latin
America
& Carib
bean

Former
Socialist
Econo
mies of
Europe
346.0

1,134.0
40.1%

0%

36.0%

74.8%

4.6

6.2

1.3

Middle
Eastern
Crescent

0.2

11.3%

5.9

3.9

45.8%

71.3%

50.3%

48.6%

25.3%

13.0%

42.2%

51.0%

10.7

8.3

10.2

8.6%

10.8

100.0%\
1,362.0

100.0%
293.0

100.0%

100.0%

100.0%

100.0%

100.0%

292.0

201.0

177.0

103.0

144.0

100.0%

100.0%

1.8
286.0

Source:
Health

from World
Bank,
Adapted
(New York: Oxford
University

World
Press,

Development
1993), 27.

Report

1993:

Investing

in

14

Arthur Kleinman and Joan Kleinman

of suffering was constructed

by assigning
degrees
to years of life and types of disability.
The assumption
suffering
that values will be universal.
They will not vary across worlds
This metric

of
is
as

as China,
different
and North
India, sub-Saharan
Africa,
greatly
to
measures
America.
also be reducible
of economic
They will
cost. That expert panels
a severity of 0.6, while
rate blindness
with
are evaluated
at one third
female
system disorders
reproductive
is surely a cause for questioning
the severity
whether
bias
gender
one uneasy with
is present,
but more
it should make
the
generally
means
can
cost
which
evaluations
of
and
its
be
by
severity
validly
across different
standardized
social classes,
societies,
age cohorts,
and occupational
groups.
ethnicities,
genders,
The

an objective
to develop
indicator may
be important
choice concerning
of scarce resources
allocation
among
and programs.
should
the
(It certainly
support
policies

effort

for rational
different

of

importance

funding

mental

is presently used in theWorld

not

health

programs,

even

though

Bank's World Development

as it

Report

to this conclusion.)
to
But it is equally
important
are
what
the limits and the potential
of configur
question
dangers
as
an
economic
social
indicator.
The
and
moral
ing
suffering
it does

lead

to fit
in this essay cannot
issues we have raised
be made
political
to map
into this econometric
index. Likewise,
the index is unable
it assumes
and gender differences.
homo
cultural,
ethnic,
Indeed,
to illness experiences,
in the evaluation
and response
which
geneity
an enormous
amount
of anthropological,
belies
and
historical,
in each of these do
clinical
of substantial
evidence
differences
are privileged
over lay categories,
mains.28
Professional
categories
yet

the experience
Furthermore,

ing that suffering

tation of a thickly
social

in lay terms.
is expressed
focuses on the individual
sufferer, deny
is a social experience.
This terribly thin represen
of

illness

the index
human

condition

may
It can do

of

experience
suffering.
the apparatus
of cultural representation

which

in time

also

thin out

this by becoming
that creates societal

part

the
of

norms,

in turn shapes the social role and social behavior of the ill,

of families
and health-care
be the practices
pro
is changing
for
cultural
rhetoric,
example,
from the language
of caring to the language
of efficiency
and cost;
use this rhetoric
to
to hear patients
it is not surprising
themselves

and what
viders.

describe

should

The

American

their problems.

Thereby,

the illness

experience,

for some,

Cultural Appropriations
may

be transformed

from

15

of Suffering in Our Times

a consequential

moral

experience

is what

Czeslaw

into a

technical

inexpediency.
of experience
transmutation
a refugee
from political
violence,

merely
This

slow

himself

in taken-for-granted
grips with
tion in the popular
culture
that

cultural
infiltrate

Milosz,
to come
to

us

presses

of representa
processes
of
the ordinary
practices

living:
airs nature programs mainly for
every day, Public Television
animals of the
young people. About
fish,
lizards, coyotes,
spiders,
and so on. The technical excellence of
desert or of alpine meadows,
these pro
doesn't prevent me from considering
the photography
grams obscene. Because what they show offends our human, moral

Almost

understanding?not
only offends it, but subverts it, for the thesis of
it is
is: You see, that's how it isNature;
these programs
therefore,
we
a
are
to
of
the
evolu
and
we,
too,
Nature,
natural;
part
belong
tionary chain, and we have to accept the world as it is. If I turn off
indiffer
the television, horrified, disgusted by the images of mutual
ent devouring..
I am capable of picturing what
.is it because
this
into
translated
like when
those
millions
of
young
children,
with
impunity since they don't
cruelty of Nature? Or, without
looks

the life of human society? But the

minds, are they able to watch this
associate
the blind
anything with
are
it,
realizing
they being slowly

and systematically
by those masters
poisoned
also do not know what they are doing?29
DALYs

and

other

economic

indexes

of photography

of health

who

conditions

have

of course. We

need to formulate
health and
their appropriate
uses,
resources. We
to priorities
for limited
social policy with
respect
of illnesses
and their social conse
need valid economic
indexes
can be useful
in health-care
DALYs
reform
and public
quences.
as
not become,
indexes
should
economic
health
Yet,
planning.
in much
in
of the recent debate on health-care
reform
they seemed
States, the only authorized
and programs.
These economic

the United
policy
mented

by narratives,
even
to the complex,
sent this other
side,
leaves

out most

construction
measures

need

ethnographies,

and social

contradictory,
the economistic

human

of what

is at stake

histories

side of

measurement
for peoples

of suffering
for
to be comple
that speak
suffering. Ab
of

globally.

suffering

16

Arthur Kleinman and Joan Kleinman

ABSENT

IMAGES: THE POLITICAL RHETORIC OF OPPRESSION

to balance
is necessary
the account
of the globalization
of
a
commercial
and professional
with
different
and
images
vastly
even more
cultural process
of appropriation:
the totali
dangerous
tarian state's erasure of social experiences
of suffering
the
through
It

of images. Here
the possibility
of moral
suppression
appeal through
of
is
it is their absence
human
and
that
images
misery
prevented,
is the source of existential
dismay.
Such
to 1961.

is the case with

the massive

story was

This

not

reported

in China

starvation

at the time even

from
though

1959
more

than thirty million Chinese died in the aftermath of the ruinous

the Great

of

policies

the perverse
effect of Mao's
Forward,
on peas
immediate
industrialization
forcing
most
of this, the world's
famine, were
devastating

dream

impossible
ants. Accounts

Leap

of

no
totally
suppressed;
dead were
published.
An
team

stories

or pictures

of

internal report on the famine was made

for the Central
Committee
of the Chinese

It was

on a detailed

the

starving

or

the

by an investigating
Communist
Party.

of an extremely
poor region of
Anwei
Province
that was particularly
affected.
The report
brutally
a
statement
includes
Wei
this numbing
local
peasant
Wu-ji,
by
leader from Anwei:
based

survey

now only
in our commune,
there were 5,000 people
Originally
we
not
remain.
When
the
invaded
did
lose this
3,200
Japanese
we
save
at
least
could
ourselves
This
many:
year
by running away!
there's no escape. We die shut up in our own houses. Of my 6
5 are already dead, and I am left to starve, and I'll
family members,
not be able to stave off death for long.30

Wei Wu-ji

continued:

that cases of
Springs County
reported
Jia-feng from West
were
meat
discovered.
human
eating
Zhang Sheng-jiu said, "Only
an evil man could do such a thing!" Wang
Jia-feng said, "In 1960,
ten of them died last year. My son
there were 20 in our household,

Wang

told his mother

Til

die of hunger

in a few days.'"

And

indeed he

did.31
The
Wudian

report

also

County,

includes

a graphic

Shanwang

Brigade:

image

by Li Qin-ming,

from

17

of Suffering in Our Times

Cultural Appropriations

to deliver 58,000
In 1959, we were prescheduled
jin of grain to the
we only turned
were
hence
but
harvested,
State,
jin
only 35,000
commune.
over 33,000
We really
the
left
for
which
2,000
jin
jin,
eat hemp leaves, anything
to eat. The peasants
have nothing
they
can possibly eat. In my last report after Iwrote,
"We have nothing
to remove my name from the
to eat," the Party told me they wanted
a
Out
of
Roster.
of
280, 170 died. In our family
Party
population
us
of five, four of
have died leaving only myself.
Should I say that
I'm not broken hearted?32
Chen

Zhang-yu,
terrible
image:

this

from Guanyu

offered

County,

the investigators

Last

of cannibalism
spring the phenomenon
appeared. Since Com
could not come up with
of
rade Chao Wu-chu
any good ways
out
to
the
order
he
those
who
it,
put
prohibiting
secretly imprison
to be at death's door to combat the rumors. He
imprisoned 63 people from the entire country. Thirty-three

seemed

secretly
died in

prison.33

The official report is thorough and detailed. It is classified neibu,

use

restricted

only.

To

it is to reveal

distribute

state

secrets.

Pre

sented publicly itwould have been, especially if it had been pub

lished in the 1960s, a fundamental critique of the Great Leap, and
a moral and political delegitimation of the Chinese Communist
claim

to have

the life of poor peasants.

Even
improved
as
is
it
silence
The
official
dangerous.
regard
today
It prevents
another
form of appropriation.
It
public witnessing.
an act of political
resistance
forges a secret history,
through
keep
state rules
of things denied.34 The totalitarian
ing alive the memory

Party's

the authorities

by

collective
and

suffering,
The
absent
public

silence

is also
image
is perhaps more

images of
delimit
appropriation

by public

the

by denying
forgetting,
a culture
thus creates
a

form

collective

experience

of

terror.

of
of

appropriation;
political
than being overwhelmed
terrifying
Taken
the two modes
of
together

atrocity.
the extremes

in this cultural

process.35

CODA
Our

of appropriations
critique
mean
that no appropriations

of suffering
are valid. To

does

not

that would

be

that do harm
conclude

18

Arthur Kleinman and Joan Kleinman

to undermine
be much
would
human
humane

to respond
to human
we
than the problem

any attempt
destructive

more

social

paralyze

action.

suffering

must

We

to

in order

draw

upon
needs

human

identify

It would
misery.
it
have identified;

responses.
to do so,

Yet,
sure
make

images of
and to craft

we

to develop
valid appropriations,
the biases of commercial
emphasis

that

the

must

first

on profit-mak
and the narrow

of political
ing, the partisan
agendas
ideologies,
are
technical
interests
that serve primarily
groups
professional
understood
and their influence
controlled.
The first action,
then, is
on
critical
self-reflection
the purposes
of policies
and the effects of
We
take that to be a core component
of programs
of
programs.
a
more
to
in the professions.
action
is
ethics
difficult
lift
Perhaps
the veil on the taken-for-granted
cultural
within
which
processes
no matter
and programs,
policies
and
inevitably,
usually
unintentionally,
The
idea that the first impulse of social
those

should

be

to historicize

the
of

issue before

action

are
intended,
and exploited.

up
and health-policy
experts
them and to critique
the

at hand

the grain of
goes against
a
is
chief
of our
Nonetheless,
practice.
implication
The starting point of policymakers
and program
builders
analysis.
that they can (and often unwillingly
needs to be the understanding
in the
lies latent
for harm
that potential
do) do harm. Because
cultural

mechanisms

well

how
taken

current

that

institutional
human

Humanizing

that

have

that work

problems,

professionals,
latent
those

focusing

structures

"experts"
institutional

been

behind

must

authorized
even

the

to respond
to
intentioned
best

be held

effects

responsible
can be controlled.

the level at which

interventions

to define

are organized

on the interpersonal
and evaluation
planning
context
of action. This
the local, ethnographic
at
is
for participants
with
what
stake
engagement

suffering,
not only
local worlds,

but

those

local

how
means

space

of

requires
in those

(not merely
and
process
assessing
developing
experts)
from the ground
Such policy-making
up can only suc
programs.
are more
if these local worlds
ceed, however,
projected
effectively
on human
discourses
into national
and international
problems.
national

bringing
into the

participants

of

to the globalization
the necessary
(This may represent
complement
the
it
be
called
should
of local images. Perhaps
representa
global
a reformulation
tion of local contexts.)
To do so requires
of the

Cultural Appropriations
indexes

and

instruments

of Suffering in Our Times

of policy.

Those

tools

analytic

19
to

need

authorize deeper depictions of the local (including how the glo

into the lo
markets,
displacement,
technology?enters
those methodologies
of policy must
the
existen
engage
to reframe
tial side of social life. How
the language of policies
and
so
are
to relate to
that large-scale
social forces
made
programs
and
will
local
engage
biography
history
require
interdisciplinary
bal?e.g.,
cal). And

ments

that bring

alternative

perspectives
the health
sciences

social

and
sciences,
is to
The
goal
of
purposes
practice.

reconstruct

lems.

Ultimately,

we will

globalization,
commodification

such
uses

pornographic
to violence
relation
that has

attracted

the

of

serious

attention

the even more

issue would

first

and narrative

graphic,

to engage
the more
the commercialization

experiences

Regarding
social experience

of how

the object

of degradation.36
in the streets and

scholars.37

ominous
of
and

atrocity
Violence

fundamental

is being transformed
seem
to be to develop
studies

suffering,
and

abuse,

alters

cultural

the
the

question

in untoward

historical,
a more
powerful

that provide

disordered

of

aspects

in the media,
and its
in homes,
is already a subject
from communities
and from

derstanding of the cultural processes

of

the humanities,
the
on human
prob
of inquiry
and the

have
as

of

from

to bear

through which
the

ways,
ethno
un

the global

connections

between
capitalism
so
and
that
moral
for
experience
subjectivity,
sensibility,
or
becomes
diminishes
different:
example,
something
frighteningly
from
and ac
promiscuous,
gratuitous,
unhinged
responsibility
regime
collective

tion.38 There
plated.
social

is a terrible

The

transformation
as shifts
experience

to be contem
legacy here that needs
is as much
of epochs
in
about changes
in social structures
and cultural
repre

are
the three sites of social
transformation
indeed,
Out
of
their
too
transmutes.
inseparable.
triangulation,
subjectivity
current
The
transformation
we
is no different;
see
yet perhaps
more
turn
the
we
hazards
of
are
the historical
now
that
clearly
sentations;

undertaking.
Perhaps
existential
conditions
dangers

of civilizational

all along we
as an ultimate

have

been wrong

constraint

limiting

to consider
the moral

change.

At the end of this century it has for the first time become possible to
see what a world may be like in which
the past, including the past

20

Arthur Kleinman and Joan Kleinman

in the present, has lost its role, in which

the old maps and
which guided human beings, singly and collectively,
through
the
longer represent the landscape through which we move,
which we sail. Inwhich we do not know where our journey is
us,

or

even

to

ought

take

charts
life no
sea on
taking

us.39

ENDNOTES
is drawn
1This essay
from a larger project
to read Arthur
may wish
fering. Readers

concerning
Kleinman

ing and its Professional Transformation,"

(3) (1991): 275-301; Arthur Kleinman,
DelVecchio

Good

et al.,

Pain

eds.,

the
and

social

experience

Joan Kleinman,

of

suf

"Suffer

Culture, Medicine and Psychiatry 15

inMary-Jo
"Pain and Resistance,"

as Human

Experience:

Per

Anthropological

spectives (Berkeley, Calif.: University of California Press, 1991), 169-97;

Arthur Kleinman et al, "The Social Course of Epilepsy inChina," Social Science
and Medicine 40 (10) (1995): 1319-330; Arthur Kleinman and Joan Kleinman,
"How Bodies Remember: Social Memory and Bodily Experience of Criticism,
and Delegitimation

Resistance,

China's

following

Cultural

Revolution,"

New

Literary History 25 (1994): 707-23; and Arthur Kleinman, Writing at theMar

gin: Discourse Between Anthropology and Medicine (Berkeley, Calif.: Univer
sity of California Press, 1995).
2Luc Boltanski, La Souffrance a Distance
3On

the heterogeneity

of meanings

(Paris:Metailie,
of

and modes

Bowker, Problems of Suffering in Religions

suffering,

1993).
for example,

see,

of the World

John

(Cambridge: Cam

to Suffering,"
"Moral
Orientations
Das,
Press,
1970); Veena
bridge University
in L. C. Chen, N. Ware,
and A. Kleinman,
and Social Change
eds., Health
(Cam
Harvard
Arthur
The
Press,
1994),
139-67;
Kleinman,
University
bridge, Mass.:
Illness Narratives:
and Human
Basic
(New York:
Experience
Suffering,
Healing
Books,

1988);

Arthur

Kleinman

and Byron

Good,

eds.,

Culture

and Depression:

Studies in the Anthropology and Cross-Cultural Psychiatry of Affect and Disor

der (Berkeley, Calif.: University of California Press, 1985); Paul Farmer, AIDS
and Accusation: The Geography of Blame inHaiti (Berkeley, Calif.: University
of California Press, 1992); T. N. Madan, "Living and Dying," inT. N. Madan,
ed., Non-renunciation

Themes

and

Interpretations

of Hindu

Culture

(New

Delhi: Oxford University Press, 1987), 118-41; Phillipe Ari?s, The Hour of Our
Death, trans. Helen Wever (New York: Knopf, 1981); Piero Camporesi, Bread
of Dreams: Food and Fantasy inEarly Modern Europe, trans. David Gentilcore
University of Chicago Press, 1989); Carlos Ginzburg, The Cheese
(Chicago, 111.:
and the Worms: The Cosmos of a Sixteenth-Century Miller, trans. John and
Anne Tedeschi (New York: Penguin Books, 1980); IvanMorris, The Nobility of
Failure: Tragic Heroes in theHistory of Japan (New York: New American Li
brary, 1976); and Ann F. Thurston, Enemies of the People: The Ordeals of the
Intellectuals in China's Great Cultural Revolution (New York: Knopf, 1987).
4See DelVecchio

Good

et al.,

eds.,

Pain

as Human

Experience:

Anthropological

Perspectives, David Morris, The Culture of Pain (Berkeley, Calif.: University of

21

of Suffering in Our Times

Cultural Appropriations

California Press, 1991); and Elaine Scarry, The Body in Pain (New York: Ox
ford University Press, 1985).
The
Testimonies:
Holocaust
Langer,
Yale University
Press,
1993); Nancy

5Lawrence
Conn.:

Ruins

(New Haven,
Death
Without

of Memory

Sheper-Hughes,

Weeping: The Violence of Everyday Life inBrazil (Berkeley, Calif.: University of

California Press, 1993); and Pierre Bourdieu, ed., La Misere du Monde (Paris:
Editions du Seuil, 1993).
6Kleinman

and Kleinman,

its Professional

and

"Suffering

7TheNew York Times, 26 March

Transformations."

1993, A3.

8JeanDreze and Amartya Sen,Hunger and Public Action

not

disorder,

political

show

1991),

Press,

versity

that

crop

in sub-Saharan

famines

failure

(New York: Oxford Uni

occur

Africa

as a result

of

se.

per

9BillKeller, "Kevin Carter, a Pulitzer Winner for Sudan Photo, isDead at 33," The
New York Times, 29 July 1994, 138; Scott Mac Leod, "The Life and Death of
Kevin

Time,

Carter,"

12 September

70-73.

1994,

"Time; 12 September 1994, 72.

nIbid.,

73.

12Ibid.
13Ibid.
14Ibid.

15Forthis view of the "taking" of victimized social subjects by the more powerful
"a privileged

photographer,

observer"?the

of power"

"eyes

idea?see

W.

J. T.

Mitchell, Picture Theory (Chicago, 111.:

University of Chicago Press, 1994), 288,
324, 365, 420-21. Mitchell also introduces the fundamental moral issue of the
between

relationship
16On the dilemmas

for cultural

in the Global

tions

Ecumene,"

standing Translation
1993),

See

responsibility.

Ibid.,

421-25.

see Ulf Hannerz,

of globalization,
analysis
in Gisli Palsson,
Boundaries:
ed., Beyond

Discourse

and Anthropological

and Ulf Hannerz,

41-57;

and

representation

"When

Under

(Providence: BERG,

is Everywhere:

Culture

"Media

on

Reflections

a Favorite Concept," Ethnos 58 (1993): 95-111.

17StanleyCavell writes
it is incapable

because

that philosophical
of decisively

is ultimately disappointing

knowledge
out

sorting

such

"ordinary"

com

human

plexities. Stanley Cavell, In Quest of the Ordinary (Chicago, 111.:

University of
Chicago Press, 1988), 88, 147, 149; he goes on to assert, in Stanley Cavell, A
Pitch of Philosophy (Cambridge, Mass.: Harvard University Press, 1994), 116,
"the world
that

calls

the world,

an intuition
for words,
that words
to be
is to be answered,
experienced,

are, Iwill
say, world-bound,
that this is what words

are

for."
18The analysis

Robert

that

follows

in Arthur

in this
Kleinman

section

on materials,

draws

and Robert

and

contains

several

and
Culture
"Violence,
at the Margin,
in Arthur
of Trauma,"
Kleinman,
8;
Writing
chap.
and Arthur
"Violence
and Demoralization
in the
Kleinman,
Desjarlais

paragraphs,
the Politics

New World Disorder," Anthropology

Desjarl?is,

Today

10 (5) (1994): 9-12; and Arthur

22

Arthur Kleinman and Joan Kleinman

Kleinman

and

Robert

"Ni

Desjarlais,

ni

patients

victimes:

Pour

une

en sciences

ethnographie de la violence politique," ACTES De La Recherche

104 (1994): 56-63.
sociales (ISSN 0355-5322)

19Compare the cover picture of The Economist of 23 July 1994, which, in themidst
of the Rwandan crisis, is of a frightened Rwandan child. The picture is entitled
"Helpless."
20On

the uses

cultural

of personification

Hebrew Literature
21
See

on

the chapter

of collective
see Alan

representation,

catastrophe
Hurban:

Mintz,

in the Western

tradition

of

to Catastrophe

Response

in

(New York: Columbia University Press, 1984).

social

global

change

in Robert

et al., World

Desjarlais

Mental

Health: Problems and Priorities in Low-Income Countries (New York: Oxford

University Press, 1995), for a discussion of how theWorld Bank and the Interna
tional Monetary
has worsened

Fund's
the

health

shows how the end of the Cold War

have
changes
or to constrain

worked

often

health

of

program
rigorously-applied
in sub-Saharan
of women

and

social

social

and mental
to those

responses

policy

22SeeAlex Webb and David C. Unger,

Magazine, 23 October 1994, 50-53.

restructuring
volume
also

This

and other global, political, and economic

to worsen

either

economic

Africa.

health

The New

"Taking Haiti,"

problems

problems.

York Times

23Michael J. Shapiro, The Politics of Representation: Writing Practices in Biogra

phy, Photography, and Policy Analysis (Madison, Wis.: University ofWisconsin
Press,
24The

xii.

1988),

section

following

25SeeAllan Young,

on materials

draws
Culture

"Violence,

Desjarlais,

and

The Harmony

in Arthur

the Politics

and

Kleinman

Robert

of Trauma."

of Illusion: An Ethnography

of Traumatic

Princeton
and Allan
Press,
N.J.:
University
forthcoming);
in this
issue of
of Traumatic
and the Origins
Memory,"
Young,
"Suffering
of people who
have experienced
Recent
of populations
Dcedalus.
surveys
politi
25 and 75 percent
that between
cal violence
report
experience
posttraumatic
on violence
et al, World
stress disorder.
in Desjarlais
Mental
See the chapter
(Princeton,

Memory

Health:

and

Problems

26ArthurKleinman,
Ware,

Priorities

in Low-Income

"A Critique of Objectivity

eds., Health

and Kleinman,

and

Social

27SeeWorld Bank, World Development Report

York: Oxford University Press, 1993).

Countries.

in International Health,"

in Chen,

Change.

1993: Investing inHealth

(New

28See, for example, Sheila Rothman, Living in the Shadow of Death: Tuberculosis
and the Social Experience of Illness inAmerica (New York: Basic Books, 1994);
andMorris, The Culture of Pain.
29Czeslaw

Milosz,

of Books,
30Central

Committee,

Yang County,
31Ibid.

"The

11 August

State

of Nature:

Notes

from

a Diary,"

New

York

Review

1994, 41.

Chinese

Communist

1961, 188-91.

Party,

Internal

Report,

Annals

for Feng

23

of Suffering in Our Times

Cultural Appropriations
32Ibid.
33Ibid.
34See James

C.

Scott,

Domination

the Arts

and

of Resistance

Yale University Press, 1992); and Rubie Watson,

sition

State

Under

American

Research

35It is not

the

only

An

Socialism:

in Rubie

Introduction,"

Press,

ed., Memory,

School of

1-20.

1994),
state

totalitarian

Watson,

(Santa Fe, N.Mex.:

Under State Socialism

and Opposition

History

Conn.:

(New Haven,

"Memory, History and Oppo

use

that makes

of

of

the weight

of

silence,

course. In the Gulf War, the US media often disregarded Iraqi casualties on the
battlefield, and told the story largely from the American perspective, in spite of
the

that

fact

there were

Western

dozen

several

36IanPalmer, a British military psychiatrist

to have

Times

York
among
ists_"

Westerners
"Western

York

agencies,
7 November

Times,

visitors

in Rwanda,
with

fascination

relief

here?the

The New

tinues:

"A

said:

is reported in The New

has

death
A4.

The

created

Nations

the United

1994,
tour massacre

regularly

in Baghdad.

journalists

and

Times'

sites where

voyeurism
the journal
con
reporter
are

bodies

rotting

and still unburied. Visiting diplomats have driven for hours to see bodies washed
up in the eddies of the Akagera River on the Tanzanian border." Ibid. This deep
voyeuristic

ening

be another

may

sensibility

side of

the cultural

process

we

have

identified.
37With

Motives,"
of

fense

still

there

picture,

are

registers

limits

put
by the responses,
in which
campaign
advertising
an oil-soaked
a war
cemetery,
of a Croatian

terms,

to sell clothing.

soldier

uses

to which

in Germany

report on violence
issue of cultural

are used,

even
in a strange paradox
"Benetton
Touches

Nash,

The New York Times, 2 February 1995, Dl,

and

atroci

representa

can
images of suffering
to Benetton's
provocative

especially,
with
of bodies
tattooed
pictures
labor in South America,
bird, child

See Nathaniel

"Moral

Harwood,

1994, A25, which offers a de

of

to the commercial

is shown

uniform

Richard

for example,

who
journalists
of the moral
complexity

motivation
the

see,

Post, 21 November

The Washington
the ethical

ties, yet
tion.
38That

to the Carter

relation

"HIV-positive,"
and the bloody
by postmodern
a Raw Nerve,"

18.

39EricHobsbawm, The Age of Extremes: A History

(New York: Pantheon, 1994), 16.

of the World,

1914-1991

be