I recently read Mountains Beyond Mountains by Tracy Kidder and believe that the practices of Dr. Paul Farmer, Dr. Jim Yong Kim, Ophelia Dahl, Tom White, and many others were effective at eraditcating disease, improving the environmental situation, alleviating extreme poverty and hunger, and improving general sanitaion and education worldwide. Because Dr. Paul Farmer’s story is not contained in any specific online article, I have included a Wikepedia summary of Mountains Beyond Mountains here: http://en.wikipedia.org/wiki/Mountains_Beyond_Mountains

Dr. Paul Farmer and his collegues focused on efforts ranging from development and the environment to politics and moral philosophy, therefore making it hard for me to focus on just one aspect of the global situations they touch upon. However, this is actually what made him so effective. He did not just try to tackle one aspect and leave it at that. He saw the whole situation and its interconnectivity – treating not only the symptom, but treating the “patient” as a whole. This seems particularly relevant given what we have been studying in class about, “diddling with the details” or making simple changes and how they in essence do nothing for the environmental situation. Dr. Paul Farmer took such vast, irrational, expensive, and supererrogatory actions that one wants to either look away or search Farmer meticulously for some fault. He changed what could be expected of someone – what should be expected from someone by setting a precedent previously unheard of. He went to Haiti, Peru, Siberia, Cuba, and many other countries to end the pandempic of infectious diseases there. While he was in country, he cleaned water supplies, provided education, health care, and job opportunities, distributed condoms and free TB, AIDS and HIV treatement, reconstructed or built living quarters, and worked with unrelenting effort until he had improved the lives and living situations of the people around him. 

As I said, Dr. Farmer saw all the connections. One could not be healthy unless their environment was healthy and that meant no war, no famine, sanitary conditions, and sustainable lifestyles. He did this all, but his greatest efforts are documented in Haiti and Peru. Once, in order to reduce infant mortality he brought out a team to devise a plan that would bring clean water to those living in Cange. They used the natural force of an underground river to pipe the fresh water up 800 feet into communal spigots in the town. He also created Zanmi Lasante, which was a hospital in Haiti unlike anything they had before. It had competent doctors, expensive and new medicines, modern equipment, sanitary premises, and didn’t charge for treatment if one couldn’t afford it. The hospital had women’s literacy and AIDS prevention programs, and created schools and jobs for locals. Dr. Farmer’s use of antiretroviral drugs and the occasional flying of patients out of Haiti to Boston was seen by many as ludicrous and certainly not cost effective. However, he largely argued against their views and felt strongly about his practice. Occasionally, he would take note about what he considered “appropriate technology.” He appreciated technology, scorned what he called the “Luddite trap” and felt new technology was the answer to many of today’s problems, much like Market Liberals. However, there were times he believed one should use the simplest technologies necessary for a job especially in poverty-stricken countries. This was because the technology of the Western world may actually not improve the situation of the bottom billion in the ways we would expect.

He turned his vision into a success story that touched so many parts of the world. However, the question remains whether his methodology could be replicated today and indefinitely. I believe his methodology could be replicated in most all parts of the world with success, but not without him and certainly not forever. Dr. Paul Farmer was a genius and perhaps a saint. Whether driven by his own fear of guilt or by an incredible genetic inclination to altruism, he was not a normal man by any means. I am not convinced that his actions would be replicable in the future mostly because I cannot think of anyone willing to replicate them as he had originally done. I like to believe there are people out there that could, that even I could if I put my mind to it, but I’d be a fool. The man was crazy incredible.

I am hopeful, reading about Dr. Farmer’s life, that changes can be made that have big and positive impacts on the lives of millions and their environment. However, as I mentioned before, unless the rest of the world is willing to take up the same path as Dr. Farmer, I think this hope is only temporary. He is one man changing the world, but I think the world and its increasing problems are changing faster. Despite Dr. Farmer’s faith in technology, he believed that capitalism was at the root of the problem and that the rich by nature take from the poor and exasperate their situation. He laid a golden track for many of us to follow and if we all had a brain, soul, and thick skin like his, maybe the world could change. But I can’t say I’ve seen any of his clones walking around.