I first learned about Dr. Paul Farmer in college during a Public Health and Medical Ethics course. We read multiple excerpts from his various books along with the biography, Mountains Beyond Mountains, of this world-renowned figure in Global Health. His important contributions to medicine and people in poverty-stricken countries are innumerable. Dr. Farmer served as chair of the Department of Global Health and Social Medicine at Harvard Medical School, chief of the Division of Global Health Equity at Brigham and Women’s Hospital, and co-founded Partners in Health (PIH). His mission became one of the driving forces for my interest in a career in medicine. In fact, early in my medical education, I was mostly interested in specializing in Infectious Diseases and treating HIV patients. It was also my dream to provide medical care around the world in developing nations. Of course, life has a funny way of changing our directions and our plans, and I am very happy where I ended up with a career in Palliative Medicine. However, I still feel a draw to working internationally at some point in my life. Dr. Farmer was instrumental in this interest.
Dr. Farmer’s writings were the first to introduce me to the reality of social inequities in health care. I learned that tuberculosis is a disease of the poor; it is easily treatable, but the lack of resources for the impoverished makes this disease needlessly devastating. I had first-hand experience when that same Public Health and Medical Ethics course culminated in a service immersion trip to the Dominican Republic. Given the DR’s proximity to Haiti, where Dr. Farmer did a great deal of work, we had the opportunity to work directly with Haitian migrant workers. We visited a batey, or a makeshift rural community for migrants workers, where the homes were made out of corrugated tin, there was no electricity or running water, and communicable diseases were subsequently rampant. We learned that simple measures like teaching about hand washing was unhelpful when people lacked clean water to wash their hands in, much less soap. We also participated in a deworming service for the children of the community; we provided a dose of albendazole (anti-parasitic). We worked with community health care workers who visited people in their homes to assure they were adhering to their medication regimens. This is important in treating tuberculosis for the cocktail of medications must be taken for months to both eradicate the infection and prevent bacterial resistance.
This experience was life-changing for me in terms of how I view health care and its close relationship to social and healthcare inequities. This later prompted me to become interested in learning more about healthcare ethics, and in the Masters program I completed, we spent a heavy amount of time focused on disparities in health care which are a direct result of social disparities. This, in turn, impacts how I vote.
I owe a lot to Dr. Farmer, and I encourage anyone, even if not in the medical field, to pick up one of his books to learn about the how social inequities keep people in cycles of poor health and, as a result, a lack of upward social/financial mobility. Thank you to Dr. Farmer for your lifetime of service to those in need and for sharing your humanity and genius with the world.
To learn more:
Documentary: Bending the Arc
Books by and about Dr. Farmer: