- The Washington Times - Monday, October 6, 2003


Tracy Kidder

Random House $25.95, 317pages

When Margaret Meade said that “a smallgroupof thoughtful, committed citizens can change the world,” she was talking about people like Paul Farmer and his Cambridge, Mass.-based Partners in Health (PIH)organization.

It is fairly safe to say that no single individual or organization has done more to bring health care to the world’s most destitute in Haiti, Peru and Russia — and through his diplomatic efforts of counseling, educating, persuading, chastising and ultimately mobilizing the international health agencies to the rest of the world.

Economist Jeffrey Sachs once called Dr. Farmer’s clinics and program the model to be duplicated by the Global Fund to Fight AIDS, Tuberculosis and Malaria to reach the world’s poorest and sickest. Characteristically, Dr. Farmer dismissed the comment as faint praise, saying if his little program is the model, it only underscores how much more needs to be done.

Dr. Farmer’s odyssey is chronicled in “Mountain Beyond Mountains,” Tracy Kidder’s thoughtful and inspiring biography of a poor boy, raised in Alabama and Florida, in a converted school bus. It was poor, but according to Dr. Farmer, never deprived.

Influenced by a kind of lapsed-Catholic social responsibility and the sense of good and evil found in books like “Lord of the Rings,” he became valedictorian of his high school and earned a full scholarship at Duke. During a short preppy-phase, he joined and then quit an all-white fraternity. As was popular, he read “liberation theology” and he came under the influence of a long-dead German, Rudolf Virchow, a man with a “comprehensive vision” who founded hospitals and nursing schools, sewage systems, and made important contributions in oncology and parasitology.

“Medical education does not exist to provide students with a way to make a living, but to ensure the health of the community,” Virchow wrote. Even today, Dr. Farmer calls Virchow his “model.”

In 1983, during his first year at Harvard Medical School, Dr. Farmer traveled to Haiti and with 18-year-old Ophelia Dahl began working at a medical clinic in Cange, Haiti, serving an area with death and disease rates among the highest in the world. Dr. Farmer met patients with diseases no longer taught at Harvard. They came on donkeys and he trekked over mountains to minister to them. He still does. It was during this time that Haiti’s first HIV/AIDs patients were diagnosed.

On trips back and forth between classes in Massachusetts and the clinic, he was consumed by bringing better equipment, drugs and expertise to these poor Haitians, sometimes swiping a microscope or a bag full of drugs to take to Haiti. He justified his thievery. “We were just helping them [the doctors at Harvard] not to go to Hell,” he told Mr. Kidder. In 1987, he and several others founded Partners in Health, which now runs general health and HIV/AIDS clinics in Haiti and resistant TB programs in Peru and Russia. And he has become one of the world’s most prominent spokesmen for the poor and health care.

The book takes its name from a Haitian proverb, “Beyond the mountains, there are more mountains,” meaning after solving one problem, you move on and solve another, which is the essence of Dr. Farmer’s work.

The Dr. Farmer that Mr. Kidder portrays is intelligent, moral, driven, relentless, demanding and uncompromising in the pursuit of health care for the least fortunate. But the very qualities that allowed him to accomplish so much as a doctor and influence the international medical community, can also make him difficult as an individual.

After several years of an off-and-on-again relationship, Dr. Farmer asked Miss Dahl to marry him. While professing love, she turned him down, declaring that she couldn’t be married to a saint. She still runs the PIH office in Cambridge.

Dr. Farmer has overlooked Cuba’s dismal human rights record, in favor of noting that Cuba is proof that government can provide health care for the poor. “If I could turn Haiti into Cuba, I’d do it in a minute,” he said.

At the bottom of Dr. Farmer’s philosophy and view of the world is health as a birthright — everything else is secondary.

“Clean water and health care and school and food and tin roofs and cement floors, all these things should constitute a set of basics that people must have as birthrights,” he said.

“Doctoring is the ultimate source of his strength,” writes Mr. Kidder. “This person is sick. I am a doctor.” That singular vision has been his guide, to the sacrifice of almost everything else, proving Margaret Meade right — one man can change the world.

Tom Carter is a reporter on the foreign desk of The Washington TImes.

Sign up for Daily Newsletters

Manage Newsletters

Copyright © 2020 The Washington Times, LLC. Click here for reprint permission.

Please read our comment policy before commenting.


Click to Read More and View Comments

Click to Hide