Guest post by Megan Hogikyan
To label Paul Farmer as a practitioner or theorist of any one field would be a disservice to the multi-faceted nature of his commentary and points of view. A self-described physician and medical anthropologist by training (Farmer 2001 , 2005), Farmer’s career experiences highlight his other important roles as an academic, humanitarian activist, diplomat, and voice of the poor. Evidence of each can be found when tracing the development of Farmer’s theories through analysis of selected works published since the 1990s. Depending on the function and audience of the work, and its place in his timeline of experience, each book highlights different concepts, practices, and forms of theory.
The categorization of Farmer’s writings into early, middle, and late periods helps to demonstrate the development and evolution of his core theories, how they build on each other, and how their progression is affected by each of his varied perspectives and audiences.
Analysis of selected works by Farmer traces the development of his main theories and arguments as they build on each other over time. Over the last two decades, Farmer’s central theories have evolved from studies of social suffering to practical analysis of political, social, and economic inequality and structural violence, and to pragmatic solidarity and the provision of tools of agency and targeted solutions to suffering stemming from tuberculosis (TB), HIV/AIDS, and poverty. The use of ethnography, local and international history, and the practice of actively bearing witness to violations of health as a human right facilitate what has become a collective, comprehensive approach and body of theory associated with Farmer. Consideration of his central concepts, writing style, and practical experiences serves to demonstrate how his unique approach came to be associated with the household name he is today.
1992-1996: The Early Years, Paul Farmer, Academic and Medical Anthropologist
Ethnographies and Analysis of Suffering
The early selected works of Farmer establish the core concepts and frameworks he uses in his writing moving forward. In these works, Farmer is structured in his writing style. Structured in this sense describes his use of distinct chapters and explicitly stated positions of analysis to address the central topic of the book. He approaches health issues from defined and disparate positions, separating biomedical and medical anthropological commentary and analysis. Always inclusive of elements from both disciplines in his writings, the structured approach here to providing ethnography, history, and epidemiological analysis in distinct chapters, later develops into a more free form, integrated writing style.
One of his earliest published books, the “revised and shortened dissertation” (Farmer 2006a : xiii) AIDS and Accusation: Haiti and the Geography of Blame illustrates foundational concepts of Farmer’s process. Farmer establishes the medical anthropological base for his future works by stating his intentions for the book to be “an attempt to constitute an interpretive anthropology of affliction based on complementary ethnographic, historical, epidemiologic and political-economic analyses” (Farmer 2006a : 13).
With a scholarly focus and the academic community as an audience, Farmer uses accepted medical anthropological theory, especially that of Arthur Kleinman, as the starting point for what will evolve into his distinctive contribution.
Farmer’s methodology in the study of suffering, and accusation as a manifestation thereof, is notably influenced by the belief in the importance of ethnography and positioned accounts of suffering and affliction associated with Kleinman, Farmer’s teacher and colleague. The application of Kleinman’s style of positioned accounts of ethnography is a clear focal point of Farmer’s early works (Farmer 2006a ). He uses ethnographic accounts of poor Haitians to better understand their suffering due to AIDS, what the consequential “stakes” (Farmer 2006a : 47) are for their physical, social, and economic well being.
Entire chapters devoted to the stories of Manno, Anita and Dieudonné (Farmer 2006a : 61-109), all native Haitians suffering from AIDS, are illustrative of the depth and quality of Farmer’s anthropological research. Each story of suffering serves as a microcosm, a manifestation of Haiti’s history and relations with the West, and of recent Western perceptions of Haiti as relates to the spread of AIDS. Comprehensive accounts of Western media, actions, and policies toward Haiti paralleled with local perception, sorcery, and understanding of the disease, flesh out Farmer’s anthropological narrative of suffering (Farmer 2006a ).
Reflecting back on this 1992 work, Farmer’s preface to the 2006 edition identifies and acknowledges the later progression of his approach from roots in the core concepts of AIDS and Accusation (Farmer 2006a ). One manifestation of this progression is seen when his dual role as a physician and anthropologist lends itself to a gradual transition from the distinctly Kleinman narratives of suffering, toward structural analysis and practical solutions to violations of health as a human right (Farmer 2006a : xiv). It is through the conflation of structural, macro-level analysis and individual stories of the poor and suffering, that Farmer’s training in medical anthropology informs his theories, aids in their development and evolution, and guides the functional purpose of his writings. He is able to apply critical anthropology to individual situations of suffering, and to recommend holistic actions to address the problems from all angles.
Advancing forward to a dualistic analysis at the systemic and individual levels, Farmer takes on two investigations in The Uses of Haiti (2006b ): “one examines the ‘large-scale’ forces that have determined, to no small extent, the nature of the current crisis” (Farmer 2006b : 43) of political upheaval and consequent health rights violations, examining economic and political forces historically over time. The other “seeks to discern these same large-scale forces at work in the experience of individual Haitians” (Farmer 2006b : 44), whom Farmer knows personally.
Looking at the development of historical forces overtime, Farmer details major events in Haitian history and their ties to U.S. foreign policy through the 1990s when this book was written (Farmer 2006b ). Analysis from the perspective of the poor, demonstrating influences of rich Westerners on the poor in Haiti, serves as context for the individual stories of suffering and political violence documented in later ethnographic accounts. Detailing the socio-political history of the Haitians suffering today, Farmer gives the broad anthropological context necessary to understand their individual perceptions of suffering.
The analysis of ethnographic content in The Uses of Haiti (Farmer 2006b ), specifically the stories of Yolande, Chouchou Louis, and Acéphie Joseph, demonstrates a progression from AIDS and Accusation (Farmer 2006a ), as Farmer’s stated “analytic and narrative task is to expose the mechanisms by which abstract and large-scale forces … become manifest in the lives of individuals” (Farmer 2006b : 215).
Farmer’s approach to studying individual suffering begins to take root in the cross-cutting examination of power structures, in this case the “political economy of brutality” (Farmer 2006b : 46) in Haiti and the contributing role of Western, especially American, foreign policy. Each story incorporates the following: an element of health, namely AIDS or injury sustained from physical abuse; local and national level political and social factors in Haiti; and international political and economic forces. Farmer always ties his analyses of these macro-level forces back to the abuse of the health of individuals. From the connection of these levels of analysis unfolds the constellation of causes of individual suffering illustrated through ethnography. Farmer conflates ethnography with analysis in this work, relating political, economic, and social structural realities to the course, severity, and nature of individual suffering.
Working to raise awareness about the significant roles played by structural forces in the health of the poor, Farmer contributes a medical anthropological voice to Women, Poverty, and AIDS: Sex, Drugs, and Structural Violence
Farmer defines structural violence as “historically given processes and forces that conspire to constrain individual agency” (Farmer et. al 2011 : 23), the central concept driving his analysis and recommendations. Farmer’s academic theory is complemented with literary analysis documenting the prevalent gaps in knowledge and practical considerations for pragmatic solidarity, what can be done to address situations of structural violence moving forward. The discussion is explicitly directed toward a broadly stated audience of scholars, healthcare professionals, social activists, and grant-seeking community-based organizations (Farmer et. al 2011 : xli), covering both theoretical and practically applicable fields.
Farmer’s contributions to Women, Poverty, and AIDS include the voices of the poor, speaking through ethnography. Although, in distinct contrast to AIDS and Accusation (Farmer 2006a ) and The Uses of Haiti (Farmer 2006b ), the stories of Darlene, Guylène, and Lata are centered around their common experiences with structural violence and HIV/AIDS, but in the disparate contexts of Harlem, rural Haiti, and rural India respectively (Farmer et. al 2011 ).
Farmer uses these stories to illustrate the forces of structural violence, constraining the agency of poor women and integrating inequality globally, and to note that while individual experiences may be different, all around the world the macro forces perpetuating inequality are what need to be addressed (Farmer et. al 2011 ). Using the common denominator of HIV/AIDS in women as the health element of this theory, Farmer et. al demonstrate the connections and fill the knowledge gap between structural forces and individual suffering. For example, by demonstrating that Lata; being born a girl in India was culturally “pre-destined” to a life of hard work, no school, abuse by her father, and significant vulnerability; had no other viable choice but to go with the man who promised to take her somewhere far away and to help her make a living — and thus became a sex-trafficking victim and HIV positive (Farmer et. al 2011 : 15-20). Such individual illustrations of structural violence bring a tangible anthropological element to the literary analysis of scholarly gaps in the study of these important issues, and augment the epidemiological and biomedical contributions of the other authors of Women, Poverty, and AIDS.
As he gains experience and continues to write, Farmer moves away from his initial academic focus, maintaining key concepts but gearing the message to an increasingly broader audience. The use of ethnography, history, and structural analyses are central themes built upon in later books, amplified by additional years of experience, ethnographic accounts, political and social events guiding the themes of later works toward awareness-raising and public education (Farmer 2001 , 2005, 2011). But first, Farmer augments his basic framework for structural analyses with tools from both biomedicine and medical anthropology, rendering an integrated approach informed by complementary in-depth analysis of suffering and pragmatic treatment solutions at both the individual and systemic levels.
1999-2003: The Middle Years: Physician and Medical Anthropologist
Inequality and Structural Violence: Health as a Human Right
Moving into the middle years of Farmer’s theoretical development, his writings are less rigidly framed than his earliest works. Speaking to broader audiences, Farmer incorporates and juxtaposes history and ethnography with biomedical statistics to tell the stories of the poor. Key points of analysis are embedded in ethnographic demonstrations of the validity and saliency of Farmer’s approach to addressing inequality and structural violence experienced by the poor.
Farmer advances the concepts of inequality and structural violence to a new level of analytical detail in his 1999 work, Infections and Inequalities: The Modern Plagues. He again highlights the specific plight of women as pertains to inequality (Farmer 2011 , 2001 ), the exaggerated agency of poor patients (Farmer 2011 , 2001 , 2005), and the different perceptions of disease from the individual to those of international aid sponsor countries (Farmer 2006a , 2006b , 2011 , 2001 ).
Here Farmer also documents his struggle in reconciling medical anthropology and biomedicine (Farmer 2001 ). Speaking to challenges of addressing sorcery as the perceived cause of TB in a village in rural Haiti, recognizing it as a method of rationalizing suffering, Farmer purports that “the anthropologist within me is perfectly satisfied to analyze such explanations, but to a physician it is nothing less than punishing to see preventable or treatable pathologies chalked up to village-level squabbles. The doctor in me insists that no one should die of tuberculosis today; it’s completely curable” (Farmer 2001 : 3).
The dualistic theme of anthropologist-physician carries throughout the book as Farmer the anthropologist uses ethnographic evidence and analysis of local, national, and international structural forces to show the reader how these embedded inequalities result in diminished patient agency and the unwillingness of the international health aid system to provide the basic inputs needed to treat TB, a curable disease (Farmer 2001 ).
Farmer’s comprehensive style incorporates perspectives from the international business, profit-seeking mindset of pharmaceutical companies (Farmer 2001: 243), to the tired unwillingness of patients with multidrug-resistant tuberculosis (MDRTB) to seek treatment after years of poor interactions with the disparate health providers in Haiti (Farmer 2001 ). Simultaneously, Farmer the clinician assesses and demonstrates with personal success stories, that poor patients with MDRTB are not untreatable, as the many hospitals and international medical aid groups would have them termed; rather the system of structural violence and social, political, and economic inequality has defined them in this way (Farmer 2001 : 34).
The constellation of problems resultant of structural violence are illustrated by Farmer in detailed anthropological assessment of inequality, suffering, and the observed effects of poverty and larger structural forces on the incidence and experience of poor Haitians suffering from TB, MDRTB, and HIV/AIDS. To address the issues caused by structural violence, specifically TB in this case, Farmer advocates for pragmatic solidarity, the “increased funding for tuberculosis control and treatment … making therapy available in a systematic and committed way” (Farmer 2001 : 208). Pragmatic solidarity rises from his biomedical conviction that prevention and treatment need to happen, and they need to be directed toward the most vulnerable populations, namely the poor (Farmer 2001 : 208).
Pragmatic solidarity focuses on biomedical solutions to prevention and treatment of disease but it stems from Farmer’s anthropological work as documented in the ethnographies of the poor patients he works with directly. Farmer demonstrates that active identification of the systemic, structural obstacles to getting necessary drugs to the sick and poor, but also understanding the unique suffering of the individual, both influence a person’s ability or willingness to seek and follow treatment or preventive measures.
Addressing individual and systemic level forces, as detailed in Pathologies of Power: Health, Human Rights, and the New War on the Poor (Farmer 2005) Farmer explores the “struggle for social and economic rights” (Farmer 2005: xxiv) in the context of health as a human right. In the chronology of the selected works examined here, Pathologies of Power is a pivotal work in which Farmer combines his well-developed theories and experiences as a medical anthropologist and physician to create a platform for a distinctly human rights activist role. In his own words, “this book is a physician-anthropologist’s effort to reveal the ways in which the most basic right—the right to survive—is trampled in an age of great affluence, and it argues that the matter should be considered the most pressing one of our times” (Farmer 2005: 6).
Always an advocate for the poor, Farmer identifies, demonstrates, and advocates for solutions to the gross violations of the rights of the world’s poor, arguing, “human rights abuses are best understood (that is, most accurately and comprehensively grasped) from the point of view of the poor” (Farmer 2005: 17). Framing such violations as anything but accidental, Farmer argues them to be “symptoms of deeper pathologies of power” and “linked intimately to the social conditions that so often determine who will suffer abuse and who will be shielded from harm” (Farmer 2005: 7). This framework conflates the concepts of structural violence, inequality, bearing witness to the suffering of the poor, and of pragmatic solidarity as part of the solution.
In the role of human rights advocate and activist, Farmer adds the voices of the poor and afflicted to human rights literature; accounting for, and addressing solutions to, the multitude of contributing factors to violations of the health and human rights of the poor, creating “a searching analysis of the mechanisms and conditions that generate these violations” (Farmer 2005: 11).
In Pathologies of Power (2005), Farmer geographically and analytically broadens the scope and application of his core concepts. Geographically, the concept of bearing witness includes rights violations of the poor around the world. Analytically, his base of systemic analysis is expanded with a combination of ethnography and theoretical analysis of socio-economic and political forces. Farmer takes specific cases of physical injury, TB, and HIV/AIDS in Haiti, Guantánamo, Chiapas, and Siberia to demonstrate and analyze the “pathogenic role of inequity” (Farmer 2005: 20) in perpetuating human rights violations as related to health. His dualistic analysis operates as a channel for voices of the poor and as educated advocacy from an understanding of the international forces influencing these situations. In this way, bearing witness becomes more than a reporting of stories of the poor and afflicted.
Demonstrative of this progression in his approach, the stories of Acéphie Joseph and Chouchou Louis’s, readdressed here from an initial recording in AIDS and Accusation (Farmer 2006a), show the dynamic roles of social, political, and economic inequalities in defining the gaps and unaddressed issues of a greater health and human rights agenda. By drawing on the varied experiences of the rural poor in Haiti, Haitian refugees in Guantánamo, poor farm workers or campesinos in Chiapas, and inmates in Siberian prisons, Farmer translates individual experiences of violations of the right to health from the perspective of the poor to a framework for problem solving. He creates a global agenda for addressing inequalities underlying major health issues with the best interests of the poor at the center. Farmer argues for change in how the problems of the poor are identified and a fundamental readjustment of the health and human rights agenda toward the notion of “preferential treatment for the poor” (Farmer 2005).
Adding depth to his framework for the human rights agenda this work also serves “as a contribution to a critical anthropology of structural violence” (Farmer 2005:28). Farmer utilizes liberation theology, the idea that “genuine change will be most often rooted in small communities of poor people” (Farmer 2005: 140), to further a critical, theoretical examination of structural violence and how best to ensure the provision of pragmatic solidarity as part of a human rights health agenda. Adding agency and culture to his analysis of medicine, health, and the crosscutting effects of poverty, Farmer addresses perceived “noncompliance” (Farmer 2005: 147) of poor patients and the effects of prison culture on TB treatment (Farmer 2005: 179), thus bringing social, anthropological elements to a developing body of critical theory.
Discussion of the commodification of medicine (Farmer 2005: 152) and the negative consequences for the health, and access to treatment of the poor, demonstrate a critical anthropological analysis of economic determinants of structural violence. As a contribution to the critical anthropology of structural violence, Farmer demonstrates the necessity of being critical from all angles, and of considering the many manifestations of structural violence, all from the perspective of the poor and afflicted. As a road map for the health and human rights agenda moving forward (Farmer 2005: 238-246), Farmer bundles ethnographic lessons with critical anthropology to lay out a holistic approach to guide future actions of physicians, policy makers, individuals, governments, scholars, and the private sector in redefining and acting on health as a human right of poor.
2011-Present: The Later Years: Paul Farmer, Diplomat and Activist Advocate
Bearing Witness and the Provision of Pragmatic Solidarity
The development of Paul Farmer’s theories, conceptual and practical approaches to addressing the health of the poor, has progressed over time in a variety of ways.
- First, the dominant role of the author and his stated or unstated choice of authorial position transitioned from being that of a medical anthropology scholar and academician, to the inclusion of a more biomedical, physician role, to that of advocate and activist. All of these roles and others, including historian and humanitarian, are significant to the comprehensive and unique nature of the body of practical and conceptual theory attributed to Paul Farmer today.
- Secondly, contributing in a similar fashion is the multitude of analytic forms Farmer incorporates in his writings. These include his use of ethnography, history, structural analysis, anthropological and biomedical frameworks. Each serves as a vehicle of observation, analysis, interpretation and practical action.
- Finally, Farmer’s ability to draw on personal experiences around the world fleshes out his arguments with individual stories of the poor, and allows his approach to develop to be a global commentary on the health of the world’s poor.
The diverse and holistic nature of Farmer’s writing in these works allows for the development of an almost ‘Pocket Paul Farmer’ body of theory and applicable pragmatism to improving the health and healthcare access of the world’s poor. By writing for such diverse audiences, but always including elements central to his approach, the ‘Pocket Paul Farmer’ working theory and comprehensive approach is incorporated into individual books (Farmer 2001 , 2005), giving the average, wayward reader insight into the breadth and depth of his unique approach to health problems plaguing the poor.
In his most recent book, Haiti After the Earthquake (Farmer 2011), Farmer continues his awareness-raising advocate role, bearing witness to, and analyzing structural influences and causes of the suffering of the poor. But unlike with many of his other works the catalyst for writing this book was a devastating internationally recognized natural disaster. True to form, Farmer highlights his perceived responsibility to give voice to the victims of the earthquake and to provide analysis of the underlying causes of such immense suffering surrounding the “acute-on-chronic” (Farmer 2011: 3) event of the January 4, 2011 earthquake in Haiti.
A detailed account of the earthquake and its aftermath serves as witnessed testimony to the acute nature of the health crisis experienced by Haiti’s poor. The “history of the chronic ailment” (Farmer 2011: 23) affecting the health of Haiti’s impoverished populations creates a second, historical dimension of analysis to the “acute-on-chronic” problem central to this book. Finally, an examination of “the tension between praxis and policy: the struggle between direct service, which is what doctors are supposed to provide, and policy, which is what politicians and legislators are supposed to formulate with, in theory, the guidance of the citizenry they represent” (Farmer 2011: 23) outlines the somewhat new and nuanced role of the author as a physician and diplomat. This “tension” is embodied in Farmer as he writes of his conscious struggle between the desire to give direct medical aid to help the injured and suffering, and the recognition that his expertise can be effectively applied to identifying and securing life saving aid for those people.
What could simply be an observational eye-witness account of how the aftermath of the earthquake unfolded, this work moves from bearing witness to the resultant health and human rights crises; to in-depth analysis of structural factors shaping the emergency and long-term responses at all levels; to identified mistakes that can be corrected in the future.
Parallel to these themes, the role of the author is somewhat transformed when he is writing from the role of diplomat for the first time, more specifically as the UN Deputy Special Envoy for Haiti (Farmer 2011). The core of Farmer’s account, approach, and analysis does not deviate from all he has built up to this point. A history of the international, national, and local forces that influenced the condition of Haiti’s poor after the earthquake (Farmer 2011: 121-148), along with ethnographic accounts of victims, physicians, humanitarian workers, and relevant, detailed analysis of health and structural issues impeding the recovery process (Farmer 2011) are all included in this comprehensive book.
From the position of diplomat, however, Farmer is at times forced to work through the problems plaguing Haiti within the confines of a diplomatic role. “… I felt out of place on the UN dais sitting behind President Clinton. At least … the others were real diplomats. But what was I doing sitting in a meeting when medical needs were great?” (Farmer 2011: 61). Forever juggling his responsibilities as a physician with his anthropological training, and now a diplomatic role, Farmer openly struggles with this dilemma especially when not present in Haiti immediately following the earthquake.
Co-founder of his own NGO, Partners in Health, Farmer understands the necessity of government funding and international aid for relief and development work, and as such can come to terms with parts of his new role (Farmer 2011: 149-187). The acuteness of his interactions with the international aid, relief and development communities from the earthquake to the cholera outbreak and beyond, open his discussion to structural analysis of these communities as players in the health and human rights of Haiti’s poor.
With this new, added dimension, Farmer uses his analysis to “advance a process of discernment” to find “hopeful and relevant examples of building back better” (Farmer 2011: 217). By taking into account detailed analysis of such macro-level structural forces, Farmer is able to extrapolate what he encounters as a physician working in the relief tents to what he can do as a diplomat speaking at UN meetings (Farmer 2011: 59) to most efficiently effect positive results for the poor and suffering.
As seen in some of his other works (Farmer 2001 , 2005) Haiti After the Earthquake (2011) incorporates all the essential elements of the ‘Pocket Paul Farmer’ approach, and once again takes it a step further. After more than 20 years of writing and publishing at this point, Farmer has moved away from writing for highly academic, scholarly audiences, including erudite analyses in the style of scholars of the field (Farmer 2006a ). Rather, having developed his own unique combination of theories, approaches, and style, his writings are geared more toward the general public and civil society. As a microcosm of the purpose behind his writings, Farmer has moved into the realm of pragmatic solidarity; providing the reader with the tools of understanding and analysis to be fully educated on all dimensions of the problems, and thus move toward more effective and efficient solutions for consideration and action.
With more than 20 years of experience working and writing as an advocate for the health of the poor, Paul Farmer has truly evolved; playing many different roles, building on his collective experiences, and developing an integrated and holistic approach to addressing health issues of the poor.
Analysis of selected major works by Farmer demonstrates his constantly shifting roles; that of physician, medical anthropologist, activist and advocate, historian, diplomat, and above all voice of the poor; and the myriad of perspectives and levels of analysis these bring to his interpretive and often prescriptive approach. Parallel to these dynamic roles, various elements of Farmer’s body of theory and practical applications are more prevalent at different points. As discussed here, these major themes are structural violence, bearing witness, the provision of pragmatic solidarity, inequality, health as a human right, the use of voices and ethnography, emphasis on history, individual human agency, and the study of suffering.
From his earliest major works (Farmer 2006a ) to his most recent (Farmer 2011), these core concepts become part of the standard ‘Pocket Paul Farmer’ package. Depending on the circumstances of his writing, and the identified audience of the work, Farmer brings each of these themes to bear on his account and analysis, gearing interpretation toward the ultimate end goal of finding the right solutions to relieve the suffering of today’s poor. Perhaps too comprehensive to define in a single sentence, the culmination of Farmer’s theoretical, practical and very personal evolution thus far in advocating and working toward preferential treatment for the poor is the ‘Pocket Paul Farmer’ platform.
It is a body of practically applicable theory, informed by individual and structural analyses, written for a broad audience with the purpose of raising social awareness and driving healthcare and health policy toward preferential treatment for the poor. Over the course of the evolution examined here, Farmer translates his years of holistic analytical findings into practical concepts and actions to be taken by society at all levels. He makes the potential for real change in the approach to healthcare of the poor defined and accessible to everyone, from students to doctors to
If he continues on this trajectory of theory and approach, Farmer will advance his writings in a style that speaks to the general public as well as students, academics, and professionals alike. Always using his holistic style of analysis, incorporating ethnography and relevant history of the issue, an increasingly activist and diplomatic theme will continue to develop. Perpetual reassessment of the issues plaguing the poor will remain, but the established academic and scholarly core of his analytical style has become constant and a base for advocacy and activism. Now a household name, Paul Farmer has much more to show the public, and as he continues to apply and share his expertise, perhaps the scholars, practitioners, activists and aid workers of today will take note and succeed in effecting deep rooted and lasting change in the lives of the world’s poor.
The content posted here is a revised version of a paper the author originally wrote for a medical anthropology seminar taught by Professor Barbara Miller in the spring of 2012 at the George Washington University.
Megan Hogikyan attained her B.A. from the Elliott School of International Affairs at the George Washington University, where she graduated Summa Cum Laude with a major in international affairs, concentrating in international development, and a minor in French. Megan currently works for an international nonprofit organization in Washington, D.C. In her spare time, she enjoys playing tennis and exploring the city.