Preferential Health Care for the Poor

In 7^th grade, my first research paper assignment focused on the work of Doctors Without Borders, an organization that delivers emergency medical aid to people affected by conflict, epidemics, disasters or exclusion from health care in nations with the greatest amount of need. When I entered high school, I became particularly fascinated with the work of doctor and anthropologist Paul Farmer, who founded the organization Partners in Health (PIH). This organization differs from many of the ones already in existence that may exhibit principles of “volun-tourism.” Instead, PIH provides preferential options for the poor by establishing lasting partnerships with sister organizations in that country.

Dr. Farmer is an anthropologist and physician who has intensely served in the health care field throughout his career. He was named a University Professor at Harvard University, which is the highest honors for a faculty member, won the Anthropological Association’s Margaret Mead Award, and currently serves as an attending physician at Brigham and Women’s Hospital.

 Farmer came from a rather humble background: he was one of six children and his childhood was characterized by frequent moves between trailer parks. One of his most notable childhood homes was a converted school bus, complete with bunk beds and electricity. Despite this unconventional upbringings, the elder Farmers encouraged their children to take an interest with the wider world around them. Farmer was an excellent student and received a full scholarship to Duke University to study medical anthropology. During his undergraduate career, Farmer studied in Paris under Claude Levi-Strauss, one of the founding fathers of the field. He easily became fluent in French and had a natural inclination to learn languages.

Farmer was shaped by the global climate around him, his education, as well as his religious upbringing. After completing his undergrad, he completed a two year fellowship at University of Pittsburgh. He went on to apply to Harvard’s dual MD/PhD program for medicine and medical anthropology. In the meantime, he arranged to spend a year working in Haiti’s public health clinics. There, in the desolately poor town of Cange, farmer built his first clinic which would open its doors to anyone regardless of their ability to pay. He was firm on providing access to health care, which he viewed as a fundamental human right, as well as employing local health workers to uphold cultural practices. This integration of anthropology and medicine was revolutionary in the world of public health care.

While working in Cange, Farmer was accepted into Harvard Medical School’s dual degree program. Throughout the course of his studies, Farmer would commute between Cambridge and Cange with his study materials in tow. In his eyes, the experience he was getting in Haiti was much more applicable than anything he could learn in the classroom. Even in the face of the commute, he maintained some of the highest grades in his class. Nancy Andreasan’s article, "Secrets of the Creative Brain" states that many creatives are autodidacts: “they like to teach themselves, rather than be spoon-fed information or knowledge in standard educational settings.” Farmer’s refusal to conform to the standard lifestyle required by medical school reflects this creative and intelligent nature.

Harvard’s website states the following about Farmer’s work:

“With PIH over the past twenty-six years, Dr. Farmer has led colleagues working in twelve sites throughout Haiti and twelve additional countries around the globe. For more than a decade, the Department of Global Health and Social Medicine has integrated research and teaching programs with PIH service activities, establishing direct feedbacks between clinical interventions and biosocial analyses. The work has become a model for health care for poor communities worldwide and provides the basis for developing a science of global health delivery implementation.” (Harvard.edu)

Farmer has (almost) single-handedly revolutionized global public health care. His methods for combating the effects of HIV and AIDs have been adopted by the World Health Organization, who have implemented them in over 30 countries. He executed an extensive method of therapy to treat Multi-drug Resistant Tuberculosis in Haiti, which then spread to Peru and Russia. His treatment course achieved an 80% cure rate, which is higher than that in the U.S. PIH has received funding from the Gates Foundation, World Health Organization, William J. Clinton Foundation, as well as Global Fund. Currently, PIH has operating locations in Haiti, Lesotho, Rwanda, Malawi, Mexico, Russia, Peru, the Navajo Nation, Liberia, and Sierra Leone.

I believe that Farmer exhibits many of the characteristics of an eminent creative. His motivations are split between both extrinsic and intrinsic – he is extremely self-critical in his pursuit of achieving a preferential option for the poor. J. Jason van Steenburgh’s article on insight strongly relates to Farmer’s achievements: he was able to come up with a new solution in order provide a preferential option for the poor that always seemed obviously correct. In order to encourage the rural inhabitants of Haiti to take their medicine, it was important to relate to their cultural beliefs; he saw the solution “in a new light.” His self-criticisms and blunt attitude reflects his insightful nature.

Paul Farmer has transformed how western medicine is applied on a global scale – representing an integration of cultural relativity and medical practices. His creation, Partner’s in Health, has brought modern medicine to those who need it most. If his organization continues to expand, he may live up to his reputation as the man who will cure the world.  

Sources:

http://ghsm.hms.harvard.edu/person/faculty/paul-farmer

http://www.pih.org/pages/our-mission

https://www.foreignaffairs.com/articles/2013-12-12/rethinking-foreign-aid

http://www.achievement.org/autodoc/page/far1bio-1

http://www.britannica.com/biography/Paul-Farmer