If I’m being perfectly honest, the only knowledge I had of Partners in Health came from going to an Arcade Fire concert last year and having volunteers from Kanpe and PIH make impassioned pleas on their behalf. I knew very little about Haiti, except that it was the most destitute country in the Western hemisphere and very few people seemed bothered by that. One of the people who was — and is to this day — is Dr. Paul Farmer, who founded Partners in Health and its Haitian counterpart Zanmi Lastante in Cange, Haiti, in the mid-80s.
“Mountains Beyond Mountains” was, to me, the title of an Arcade Fire song, and that’s what prompted me to pick up Tracy Kidder’s book. Soon, I learned that the title actually refers to a Haitian proverb that refers to the continued obstacles along life’s path. For the poor of Haiti, there is always another obstacle, and indeed, the same can be said for those who have made it their life’s work to help them. Dr. Paul Farmer is one of those people, a man who obtained both an MD and a Ph.D in anthropology and has spent his life amongst the poorest in the world, trying to provide health care and adequate living conditions to improve the lives of those who need it the most.
Kidder can sometimes overpraise Farmer, but even trying to look at the situation objectively, there is much to admire in the dogged determination of Paul Farmer and his co-founders of Partners in Health. “No” is simply not a part of their vocabulary. When the World Health Organization and other international organizations were skeptical about Farmer’s plans to deal with multiple drug resistant tuberculosis (MDR), Farmer et al. did not accept the status quo and kept pushing for reductions in drug prices and changes in protocol. So too for the widely-held belief that HIV/AIDS could not be dealt with effectively in third-world countries. Farmer refused to accept this.
There are certainly organizations other than PIH making a huge difference in the most destitute nations in the world — Médecins sans Frontières/Doctors Without Borders (MSF) comes to mind — but much of the knowledge about how to treat people in these areas, and to do it with dignity, comes from the struggles of the employees and volunteers at Partners in Health.
Needless to say, I found this to be a revelatory book and one I highly recommend for those looking for examples of people willing to put their money and their time where their mouths are.