Over the last few years, the town of La Oroya, in Perú’s central Andes has received significant international attention due to the alarming number of children suffering from high levels of lead poisoning as a result of pollution from the town’s smelter. Paradoxically, instead of collectively unifying voices to claim the protection of their health and environment, a significant portion of members of this community opted to minimize the problem with the purpose of defending job opportunities at the smelter.This dissertation examines the deep structural causes that have placed residents of this community in the difficult position of having to sacrifice their human right to health in order to preserve their right to work at the smelter. I argue that the La Oroya community acquiesced in forfeiting their own rights because they have been historically trapped in a “context of systemic unfreedom.” This is a historically formed and politically and economically reproduced context of human rights abuses, a context that affects the overall well-being of individuals and communities, and diminishes their ability to challenge such abuses and transform their realities. To assess the exact contours and components of the context of systemic unfreedom in La Oroya, and respond to the question of how this context has encouraged the trade-offs of health for work, I have designed a “capability-oriented model of human rights.” Conceptually, this model builds upon structural approaches to human rights proposed by authors such as Paul Farmer, Tony Evans and Mark Goodale. It also adopts Séverine Deneuline’s relational-political interpretation of the capability approach pioneered by Amartya Sen. Methodologically, a salient feature of my model is its incorporation of voices of affected community members as an important source of knowledge. Results of this study show the extent to which the context of systemic unfreedom in La Oroya has been sustained by the interconnection of a constellation of factors: environmental (historical pollution); institutional (economic dependency, the state’s leniency in enforcing the smelter company’s environmental obligations, the extraction-based model of economic development in Perú, the institutional fragility of the human rights discourse); social (migration, loss of collective identity, socio-economic and gender inequalities, uncertainty about pollution, limited access to information, assignment of responsibility for pollution-based illness to individuals, stigma against the poor); and personal (individual values and needs, characteristics of individual identity). These factors have converged over time and intersected at the macro, meso and micro levels, trapping residents from La Oroya in a vicious cycle of disadvantage. I conclude by suggesting that, in order to effectively address “systemic unfreedom” in this smelter town, both short-term and long-term solutions are required. That is, in addition to promoting the completion of proposed environmental mitigation and soil remediation plans in La Oroya, I offer suggestions towards reversing entrenched socio-economic and gender inequalities and reconstituting a collective community identity. Fundamentally, the ultimate goal of structural transformation in La Oroya requires addressing current patterns of power, economic dependency, and domination, thus fostering changes in the state’s vision of development. / Graduate / 2016-04-30