As sad as it is infuriating, people living comfortably usually dismiss thoughts of poverty, disease, and war. Luckily, we are sometimes shocked out of emotional detachment and we think twice, maybe truly mournfully, about the helpless people we hear about in the news. Hopefully, most of us then proceed to question whether there is something we can do to stop injustice. Typically though, a kind of helpless anger and frustration force most of us back into numbness before we manage to answer that question. There are, however, a few strong-willed souls that actually sacrifice everything for the battle against human misery. One of these is Paul Farmer. His story, disclosed in a heartwarming and candid account by Tracy Kidder in Mountains Beyond Mountains: The Quest of Doctor Paul Farmer, A Man Who Could Cure The World, attempts to challenge its readers out of inaction.
“The problem is, if I don’t work this hard, someone will die who doesn’t have to,” Farmer explains. Working hard essentially consists of providing free treatment to the disease-ravaged poor with no access to necessary healthcare, obtaining funds for medicinal facilities and pharmaceuticals for third world countries, flying from one side of the globe to the other a few times a week to attend international healthcare policy meetings, and teaching medical anthropology at Harvard, among other things. The man never sleeps, but he still manages.
His mission in Haiti began in 1984, during the time he was attending Harvard Medical School. He would travel back and forth from Boston to Haiti, only returning to Harvard to take his exams. Despite his prolonged absences at Harvard, he obtained his M.D. and Ph.D. in 1990, along with a prize for his thesis. In Haiti, Farmer began by creating what he called a “first line of defense,” which included providing vaccinations, a safe water supply, and accumulating a group of certified personnel to diagnose patients. He also hoped to set up a clinic and eventually a hospital in Cange, a Haitian village.
Although Farmer’s projects for free healthcare in Haiti were ambitious to the point of seeming unrealistic to people involved in public health, he managed to initially obtain substantial funds from a wealthy donor. In 1987, Paul co-founded a charity organization called Partners In Health (PIH) though which he, fellow doctors, and volunteers collected financial needs and organized projects. He not only succeeded in advancing the treatment of tuberculosis, but also in fighting AIDS in the developing world. Farmer’s breakthrough concentrated on preventing AIDS rather than treating patients with the disease, since even those who undergo treatment can unintentionally spread the virus. Additionally, PIH undertook the mission of treating multiple drug resistant tuberculosis (MDR); the cure against this strain, mostly neglected by the international community because its devastating effects are limited to the third world and are extremely costly to cure, was extended into other countries ravaged by hunger and destitution.
It’s through intelligent planning, essential partnerships, unyielding determination, and most importantly, compassionate care for each of his patients, that Paul Farmer continues to save the lives of the poor around the world. From his perspective, “patients came first, prisoners second, and students third,” but, as Kidder notes, “this didn’t leave out much of humanity.”
In addition to working full time for the needs of the poor, Farmer donated all his MacArthur fellowship money as well as his salary as a Harvard professor to the savings of Partners In Health. “I feel ambivalent about selling my services in a world where some can’t buy them. You can feel ambivalent about that, because you should feel ambivalent,” Paul argues; and that is why he keeps scarcely any money for himself.
If asked how he can expect others to replicate what he’s accomplished in Haiti, as far as effective free treatment for the poor goes, Paul can’t help but smile and answer “Fuck you.” In other words, he would just tell the doctors to “dedicate themselves to patients, and especially to having an outcome-oriented view of TB,” instead of remaining distant and forgetful. After meeting an American doctor who also worked in Haiti for a year, Farmer realized the two of them had radically different perspectives, although their mission was supposedly the same. “Haiti was something he was seeing that he could leave and erase from his mind, and I was thinking, Could I do that? He was leaving Haiti, really leaving in body and mind, and I realized I was going to have trouble with that,” Paul points out. In a way, we can’t help but feel that Farmer is somewhat of a saint, as some patients call him, a man full of purely altruistic care and enduring dedication to his fellow human beings. Kidder thus paints the unforgettable portrait of a completely selfless human being and we as readers are impelled to take action.
Beyond the surface, we are not only presented with the urgency of Paul Farmer’s mission, but also with the need to abandon our ordinary cynical mindset in order to truly make a positive difference in the world. In his unrelentingly honest writing, Kidder clearly emphasizes positive thinking as an inestimably crucial first step toward improving the planet we inhabit. Furthermore, Farmer stands as proof that one man can perform what a majority determines impossible; idealism, to a certain extent, should not be looked down upon as naïve, but rather as an unparalleled quality to be strived for.
The man we read about in