As the end of the semester approaches, I finish up my column “Looking for Life, Destroying Life.” The title, as mentioned in my first column, originates from a famous Haitian proverb. It refers to a woman selling mangoes to make a living. In doing so, she falls off her mango truck and dies. When poor people seek out life, amidst terrible odds, their pursuits are futile, even destroyed.
I first came across this idea in Tracy Kidder’s book, “Mountains Beyond Mountains” (2003), which follows the career of Paul Farmer, a doctor seeking to address multi-drug resistant tuberculosis in remote Haiti. Farmer himself is a protagonist with a deep-seated compassion for the poor and desperate, believing that all humans are of equal value regardless of their birthplace. As I initially ventured through the biography, I felt ambivalent towards Farmer. While I appreciated his ardent support of struggling, sick Haitians, I could not help but feel like his mission was impractical, and quite frankly, unattainable.
Farmer would walk four hours up hills and rough terrain to ensure that one of his patients was compliant with the strict regimen of antibiotics required to cure multidrug resistant tuberculosis. As I read this, it initially struck me as naïve and the thought crept into my mind: Does he seriously think he can save an entire country one-by-one, or does he just have a god complex?
To my 18-year-old self, Farmer seemed like the ultimate idealist. Now, having worked abroad and delved deeper into my public health curriculum, my perspective has shifted slightly. Farmer’s undying fervor to help the poor and sick points to the very essence of global health and medicine. Farmer’s favorite quote even reads, “Physicians are the natural attorneys of the poor, and the social problems should largely be solved by them.”
As I wrap up this column, I want you to understand the relationship between Farmer’s mission and the title of Kidder’s book. In global health, we face enormous problems, mountains even. And beyond those mountains are even greater mountains.
To address human health, we need to build toilets, we need to end poverty, we need to feed children, we need to stop gender violence, we need to provide clean water; the list goes on and on.
Farmer is an anomaly. He dedicated his entire life to global health. In fact, the Brigham and Women’s Hospital, where he completed his residency, let him spend half his clinical hours in Haiti because he was adamant on addressing the need there.
For a regular person, like you and me, it is hard not to become discouraged by the number and scope of problems that exist in global health. But Kidder puts it rather eloquently: “if the poor have to wait for a lot of people like Paul [Farmer] to come along before they get good health care, they are totally fucked.” My point is, we can’t wait for that one in seven billion. We need to care because if we don’t, lots of people are going to be “totally fucked.”