Dr. Paul Farmer’s
Mission of Healing
Driven by faith and a commitment to social justice, this Harvard doctor
develops health-care clinics in the poorest parts of the world.
BY DONIS TRACY
D
PHOTO BY REBECCA E. ROLLINS/PARTNERS IN HEALTH
R. PAUL FARMER is a citizen of
the world.
For more than 30 years, this
medical doctor, Harvard professor, and founding member of
Partners in Health (PIH), an international aid
organization, has been a tireless advocate for
those who often don’t have a voice in society—the poor, the imprisoned, the marginalized.
Most days, he is traveling. He divides his
time between Harvard, where he heads the
department of global health and social medicine, and the world—visiting PIH programs,
tending to the sick, and raising funds to continue the PIH mission of providing quality
health care to the poorest of the poor in Haiti,
Peru, Russia, Mexico, Malawi, and the United
States.
Speaking to St. Anthony Messenger from
Miami International Airport as he waited to
catch a plane to Haiti, he says, “I guess I have
become Catholic with a small c. My mission
has always been to provide a preferential
option for the poor in health care.”
According to the organization’s mission
statement, “Partners in Health strives to
achieve two overarching goals: to bring the
benefits of modern medical science to those
most in need of them and to serve as an antidote to despair.
“When our patients are ill and have no
access to care, our team of health professionals,
scholars, and activists will do whatever it takes
Fr anciscanMedia.org
to make them well—just as we would do if a
member of our own families or we ourselves
were ill,” the statement continues.
An Unconventional Childhood
Farmer’s vocation to minister to the poor has
roots in his past. Born in 1959 in North Adams,
Massachusetts, a small town in the Berkshire
Mountains, the second of six children, his
upbringing was a bit unconventional.
“I was 10 years old the last time I lived in a
house,” he explains with a smile.
When he was 7, his family moved to Alabama, and later settled in northern Florida.
In Florida, Farmer’s father bought an old bus,
wired it for electricity, and converted it into a
mobile home, replacing the seats with bunk
beds. The family bounced around from one
trailer park to another until, a few years later,
his father moved the family into a houseboat,
mooring it in an undeveloped bayou, where
the family bathed in a creek and bought water
from the nearest town.
“My family and I, we lived in unorthodox
circumstances,” laughs Farmer. “I mean, I
assume everyone has lived on a bus, no?”
Looking back, Farmer believes his “experience of housing” growing up has helped him
to feel at home regardless of his circumstances.
After graduating with high honors from
Hernando High School in Brooksville, Florida,
Farmer received a full scholarship to attend
Duke University in North Carolina. That is
where his vocation to minister to the poor
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Confronting the Ebola Crisis
During a visit to Freetown,
Sierra Leone, in October
2014, Dr. Paul Farmer
talks with survivors of
Ebola about their experiences at holding and
treatment units when they
were ill.
PHOTO BY REBECCA E. ROLLINS/PARTNERS IN HEALTH
began to take shape. While studying at Duke,
Farmer met Sister Julianna DeWolf, a Belgian
nun working to improve the lives of migrant
workers in North Carolina.
Sister Julianna introduced Farmer to liberation theology, a branch of Christian theology
that sprang up in the 1950s and 1960s in
South America. It stresses the need for corporal
works of mercy, particularly for the poor and
underprivileged in society.
“Liberation theology is really very Gospelfocused,” explains Farmer. “It was what was
being talked about in the first years of the
Church.”
For Farmer, the concept was fascinating.
“I remember thinking, ‘This is not the
Catholicism I grew up with!’” he recalls. “Or
if it was, I must not have been paying attention
at CCD class. I didn’t even know what corporal
works of mercy were,” he adds, noting that
he was immediately drawn to deepen his faith,
something that surprised everyone around
him, including himself. “I was raised Catholic,”
he explains, “but, like a lot of people in the
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June 2015
United States and in Europe, it didn’t stick.”
Renewed in spirit, Farmer threw himself
into helping migrant workers, many of whom
were from Haiti. He began to forge bonds with
the Haitian people, bonds that helped shape
his vocation.
“By the time I graduated college, I knew
that I wanted to be a doctor to people who
were disadvantaged,” he says.
From Harvard to Haiti
He applied to Harvard Medical School, where
he began a joint degree program in medicine
and medical anthropology. Before he began
his studies at Harvard, he decided to spend
one year in Haiti, learning Creole, working in
public-health clinics, and learning about life
in the poorest country in the Western Hemisphere.
That was in 1983. What he found was a
place that cemented his calling. He began volunteering at a clinic in the country’s capital,
Port-au-Prince, and befriended Ophelia Dahl,
daughter of the late author Roald Dahl, who
St A n t h o n y M e s s e n g e r . o r g
E
VERY EBOLA DEATH is a reminder
of our failure of imagination,” Dr.
Paul Farmer says emphatically.
“Ebola has spread because of poor healthcare institutions—no staff, no space, and
no stuff.”
As the Ebola epidemic ravaged West
Africa, just as borders were being closed
to countries such as Sierra Leone and
Liberia, Farmer boarded an airplane at
Logan Airport in Boston to Liberia in
order to bring his innovative approach
to medicine to Grand Gedeh County,
one of the most rural provinces of
Liberia—where Ebola has wreaked havoc
on its citizens.
Together with Dr. Raj Panjabi, a Liberian-born physician who runs Last Mile
Health in Liberia, Farmer began a project
that created a top-notch medical treatment facility in Liberia.
“An Ebola sentence need not be a
death sentence,” he stresses, noting that
very few US personnel who have contracted the illness on American soil have
succumbed to its effects.
The idea came about when Farmer
realized that the current outbreak of
Ebola only has a 50-percent death rate—
which means that roughly half of those
“
infected with the disease are cured.
Farmer then wondered what would happen if the current outbreak of Ebola were
met with first-rate medical care. Currently,
medical facilities in the most affected
countries are fraught with problems—
lack of trained professionals, lack of medicine, even lack of clean water at times.
If these areas were to have access to
modern medicines, what would be the
outcome? he wondered.
He brought his idea to Dr. Jim Yong
Kim, cofounder of Partners in Health and
current president of the World Bank, who
met his idea with enthusiasm. Shortly
thereafter, George Soros’ Open Society
Foundations, a network which supplies
grants to projects aimed to shape public
policy throughout the world, pledged
$4 million to Farmer’s endeavor.
The result? A three-year project that
has created community-based, resultsdriven care facilities in Sierra Leone and
Liberia. Rather than quarantine healthy
family members with their sick relatives—
or take a “wait and see” approach to
suspicious, and also highly contagious,
patients—these facilities bring the best
of Western medicine to the impoverished
area.
Fr anciscanMedia.org
PHOTO BY MARK ROSENBERG
also was volunteering at a medical clinic in
the capital. Dahl would later become a founding member of PIH, playing an integral part
in the organization.
Farmer also met the Rev. Fritz Lafontant, a
Haitian Anglican priest who accompanied
Farmer into Haiti’s central plateau, the country’s poorest region. Lafontant had begun a
small school in the village of Cange, a town
that had been razed in order to build a hydroelectric dam. The residents had lost everything—their homes, their livelihoods, even
their dignity.
Farmer recalls, “To me, that was the definition of structural violence,” a term used in
liberation theology to refer to systematic ways
in which social structures harm or otherwise
disadvantage individuals.
“Say I’m seeing a woman with 10 children.
If this woman says, ‘Every day is a fight for
food and water,’ then, of course, it feels like a
violence to her,” he says. “It was important
for me to walk with these people, to live among
them, to really understand them.”
In order to fulfill his vision, more than
100 volunteer physicians, nurses, lab
technicians, and other health-care workers have been recruited. These medical
professionals not only treat the infirm,
but also train local residents with the
hope of creating a community-based
health-care facility similar to Zanmi Lasante in the Cange region of Haiti.
By training local residents to effectively
treat illnesses, the face of medicine may
be forever changed in West Africa, not
just for the current outbreak, but for any
future illnesses that may befall the country.
In addition to creating the health-care
facilities, Farmer has appealed to the
entire world with a series of YouTube
videos that appealed to the world to get
involved in order to “stop this epidemic.”
“This illness is taking lives because
there is a failure to see that the lives of
these people, when they fall ill, are just
as important as the lives of the people
in our families,” he says passionately.
“Who is my neighbor? It can be a
complete stranger in need. This is why
the notion of the preferential option for
the poor and needy is a very, very, very
powerful one.”
Seeing the abject poverty of the people,
frustrated by the lack of medical supplies and
lack of hope for change, Farmer knew something had to be done. He resolved to build a
health-care clinic in Cange that would treat
people, regardless of their ability to pay.
Returning to Cambridge to enroll at Harvard
“The idea that some lives
matter less is the root of
all that’s wrong with the
world,” says Farmer, seen
here examining a patient
at a clinic in Haiti.
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Medical School, Farmer realized Haiti was calling him back. For the next three years, Farmer
divided his time between Cange and Cambridge, spending as much time as possible
ministering to the poor.
Partners in Health
tal
Digi as
Extr
Farmer’s dream began to take shape during
his first year in medical school. Project Bread,
a charitable organization whose mission is to
end hunger, agreed to provide funding for a
bakery to be built in Cange. With the bakery
in place, Farmer, together with Dahl and
Lafontant, opened Zanmi Lasante—Haitian
Creole for “Partners in Health”—a community-based health organization.
In order to create the health-care facility of
his dreams, Farmer needed funding. Still a
medical school student, Farmer
was not sure where to turn.
Click here for more on Dr.
Two years later, God interPaul Farmer and his work.
vened. Tom White, owner of
J.F. White Construction Company, contacted Farmer after
reading an article about Zanmi
Lasante. White traveled to
Cange with Farmer. What he saw fascinated
him, and he agreed to provide as much funding
as necessary to create a functional clinic with
a working lab, access to medicine, and properly
trained staff.
Farmer’s dream had come true.
That all was threatened in 1986, when Haitian leader Francois “Baby Doc” Duvalier was
overthrown. With the country in chaos,
poverty in the central plateau was exacerbated.
Seeing the instability in Haiti, Farmer realized
he needed to find a way to secure Zanmi Lasante. In 1987, Farmer returned to Boston, gathered some of his closest friends—Ophelia Dahl,
Tom White, fellow Harvard medical student
Jim Yong Kim and former Duke classmate Todd
McCormack—and founded Partners in Health.
By 1990, what had begun as a small healthcare clinic in Cange had become a hospital,
with a nursing school, blood bank, and operating room. Hundreds of thousands of Haitian
residents, regardless of their ability to pay,
were flocking to the hospital not only for medical assistance, but also for social services—
food, water, job training. Infectious diseases
such as tuberculosis were being successfully
treated.
Zanmi Lasante was a success.
A Prescription for World Health
Where some people might rest after turning
around the lives of hundreds of thousands of
people in the poorest country in the Western
Hemisphere, Farmer realized that his calling
was not limited to Haiti. “I look back now
and think, ‘We really pushed ourselves hard
back when we started,’” says Farmer with a
smile. “All of us, we really knew we could do
something.”
Partners in Health next turned its attention
to drug-resistant tuberculosis, a growing problem that had led to thousands of lives lost.
Oftentimes, drug-resistant tuberculosis emerges
in developing countries when antibiotics are
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June 2015
PHOTOS BY REBECCA E. ROLLINS/PARTNERS IN HEALTH
Dr. Farmer does clinical
rounds at Botsabelo
Hospital along with local
and visiting clinicians.
The group evaluates the
case of a young man who,
among other afflictions,
lost his hearing as a
result of tuberculosis and
multi-drug-resistant
tuberculosis.
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misused. Using an innovative approach, Farmer
had successfully treated many such cases at
Zanmi Lasante, and had received the MacArthur
Foundation “Genius Grant”—worth over
$200,000—that he used to start a PIH research
program called the Institute for Health and
Social Justice.
Farmer traveled to Lima, Peru, to a shantytown called Carabayllo, where he founded
Socios en Salud—Spanish for “Partners in
Health.” The success rate was over 80 percent.
He also went to Russia, to a prison where most
of the inmates had drug-resistant tuberculosis.
But he never forgot Zanmi Lasante, returning
as often as he could to treat patients and live
among the Haitian people he loves.
“There’s really a lost art of caregiving,” he
says. “We just don’t do enough caregiving in
medicine anymore. That’s what the corporal
works of mercy are all about. Just think about
it—the early years of the Church, that’s when
hospitality and nursing started.”
In 1996, Farmer married Didi Bertrand, a
Haitian-born medical anthropologist. Two
years later, their first child, Catherine, was
born. Becoming a family man did not slow
Farmer down, though. He continued to serve
the poor, flying between PIH sites as often as
ever.
An Ongoing Mission
By the mid-2000s, Partners in Health turned
its attention to another medical issue affecting
hundreds of thousands—AIDS. In Zanmi Lasante, Farmer had been able to secure enough
medicine to better the lives of thousands of
HIV-infected patients. In 2002, Zanmi Lasante
received funding from the Global Fund to
fight AIDS, tuberculosis, and malaria.
A few years later, PIH expanded to sub-Saharan Africa, opening HIV treatment facilities
in rural Rwanda, Lesotho, and Malawi.
Through it all, Farmer never lost his sense
of mission.
“Liberation theology is about taking care
of each other and walking with one another,”
he says. “That was exactly what I was called
to do. It shouldn’t have to be a nightmare for
people in the 21st century to find medical
care for themselves and their children.
“We are still involved almost 30 years later
because we still believe in this mission,” Farmer
continues, noting that PIH has been able to
influence public policies throughout the world.
The organization has brought its model of
treating the underprivileged to many nations
through institutions such as the World Health
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Often, it takes a bit of digging to find the cause of a
patient’s illness, as was
the case with 51-year-old
Rose Kaliwo. Eventually,
Dr. Farmer and clinicians
at Neno District Hospital
were able to diagnosis her
accurately and get her
back on her feet.
Organization and the World Bank, whose current president is PIH cofounder Dr. Jim Yong
Kim.
“The mission of Partners in Health is so
important,” Farmer says emphatically. “It’s
going to continue as long as we bring people
in.”
Today, Farmer spends much of his time
doing just that: looking to the next generation
of PIH physicians.
“Dragging people into this work is one of
the most exciting things I have done,” he
laughs. Then the 55-year-old adds, more seriously, “Finding ways to get the young people
involved has taken up a large portion of my
time now.”
Farmer is impressed with many of the young
people he meets, noting that their level of
commitment to the mission of PIH is aweinspiring. “I don’t remember feeling that committed when I was 16,” he says, “and yet there
are so many young people today that are.”
Seeing the young people embrace the mission of PIH, Farmer is optimistic about the
future.
“The mission of Partners in Health is so
important, it’s going to continue as long as
there’s a reason to focus our attention on people who are marginalized, sick, or poor,” he
says. “It won’t be easy. It’s not like we have it
all worked out. But social justice is not going
to go out of style.
“If these ideas are as vibrant now as they
were 2,000 years ago, then, as the kids say, ‘Do
the math.’ How can I not be optimistic?” A
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Donis Tracy is a Catholic freelance journalist who lives and
works in the Boston area. She is a frequent contributor to
The Pilot, newspaper of the Archdiocese of Boston.
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