Social Entrepreneur 1: Dr. Paul Farmer

Check out the book by the great Tracy Kidder, Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World, (Random House, 2004).

Farmer, a student of medical anthropology at Duke before attending Harvard medical School, claimed as a hero, German scientist Rudolf Virchow, known as the “Father of Pathology” and the founder of the field known as Social Medicine, which seeks to “understand how social and economic conditions impact health, disease and the practice of medicine,” as well as to “foster conditions in which this understanding can lead to a healthier society.”

As Farmer puts it in the book, “ Virchow had a comprehensive vision: pathology, social medicine, politics, anthropology.” (61)

For years Dr. Farmer has commuted between Harvard and Haiti, where he founded Partners in Health (PIH), forging connections between Haiti and resources in the US. Known as Dokte Paul throughout Haiti, he has improved rural health by teaching basic health practices as the best preventive medicine.

With this public health model, Farmer and his colleague, Jim Kim, have influenced changes in epidemiological protocol for global infectious diseases, in the World Health Organization (WHO) and the International Red Cross (IRC), as well as in the pharmaceutical industry.

Farmer was raised Roman Catholic. He has tenuous ties to organized religion, taking guidance from the example of Jesus. He has found an affinity with liberation theology, a movement arising out of Latin America in the 20th century. Farmer abbreviates the basics:

The “O for the P” is the preferential option for the poor in scripture, in the life of Jesus, in the witness of saints, e.g. monastics working among the Latin American poor (174).

The “H of G” is a hermeneutics of generosity, the discipline of giving others the benefit of the doubt, based on the imago dei, humanity created in God’s image. (215).

The village of Cange in Haiti is Dokte Paul’s base ops, a model of sustainability and replicability (256).

Farmer’s first response to the lousy health resources of the poor of the world was anger, but he says, “After a while I realized I could do just as good a job treating my patients without getting angry.” Kidder describes this passage away from anger, writing “I think he was transmuting anger into something that felt better, a dream of ending the disparities, at least the medical ones, that separated Boston and Cange” (261).

Farmer considers Cuban medicine exemplary and instructive for American as well as Haitian practices of social medicine. Cuba has twice as many doctors as the US and the most equitable distribution of medicine among the population, including the lowest HIV/AIDS infection rate in the world, according to WHO statistics (194).

Farmer is interested in a kind of universal triage. He says, “You should compare suffering. Which suffering is worse? Farmer points out that the word, triage, comes from the 14thc French, trier, meaning to pick or cull. There are two meanings. In battle, one attends first to those who may be saved. In peacetime, those in the gravest danger are to be treated first. Farmer connects this kind of triage to the O(ption) for the P(oor). (286)

Here are some choice Farmer quotes, culled from Kidder’s book by Kitty:

Medicine is social science, and politics is nothing but medicine on a large scale…

If disease is an expression of individual life under unfavorable conditions, then epidemics must be indications of massive disturbances of mass life…

The physicians are the natural attorneys of the poor, and the social problems should largely be solved by them…

My politics are those of prophylaxis, my opponents prefer those of palliation…

There have been fundamental shifts in what human beings feel is morally defensible, and what not…

We know things change all the time. Culture changes all the time. Advertising people force changes in culture all the time. Why can’t we do that? …

Equity is the only acceptable goal (261)…

It has been said that poverty is a social disease, as in the remark, “She died of Haiti.”

---

Possibly related posts: (automatically generated)

• August is Dr. Paul Farmer Appreciation Month (Yes, Dr. Paul Farmer!!!!)
• It’s Dr Paul Farmer Appreciation month at jitterbugging
• Dr. Farmer’s Remedy For World Health