Malorie Webb

HPEB 470 Response 1

Paul Farmer is a successful physician that spends a few months of the year with the
infectious disease department at Harvard medical school, and the rest of the year in Haiti treating
patients. He donates his own salary to the work he does in Haiti and does everything he can to
get the best care possible for his patients. Farmer writes books about the work he does in Haiti as
well as teaches classes and gives lectures, all in an effort to raise money and drugs for his
patients. Farmer also has a Haitian family, who relocated to Paris. Farmer prioritizes his patients
and only sees his wife and daughter for a few months of the year, but he saves hundreds of lives
because of it. The author follows Farmer throughout the years from America to Haiti and writes
about the differences in resources, hospitals, and culture of the two countries. Paul Farmer, “the
poor people’s doctor,” is determined to make as much of a difference as he can in Haiti, treating
diseases such as tuberculosis and HIV with whatever minimal resources are available to him.
The best way to demonstrate Farmer’s values is to highlight two of his patients, one from
Boston and one from Haiti. In the reading, Joe, a thirty-five-year-old patient diagnosed with
HIV, is brought to Farmer because his doctors believe he may have developed tuberculosis. All
Farmer was obligated to do as an infectious disease specialist was to look at the X-ray, see the
patient, and make a diagnosis. But Farmer sits with Joe, talking to him about more than just his
disease and making Joe feel important. After learning that Joe wished he could find a homeless
shelter where he could regularly take his medicine and drink some beer, Farmer took it upon
himself to find Joe a place to stay. Farmer is able to make his patients at Brigham love him. He
carries these values over into how he treats his patients in Haiti as well. He takes an interest in
his patients’ dreams and does more than just treat them with medicine and send them off. He
found a blind man a pair of glasses, simply because the man had wished for glasses. Farmer says,
“You must never let your patients know you have problems too, or that you’re in a hurry,” even
if this means he is working late every day. In both settings, he advocates for his patients to the
best of his ability and takes the time to get to know them.
The difference for Farmer in his work between Boston and Haiti are the resources. An
example of this is when the author highlights the differences in costs spent at the different
hospitals Farmer worked in. In Brigham, a patient with tuberculosis would cost somewhere
between $15,000 and $20,000 to treat. In Zanmi Lasante, patients with tuberculosis were treated
and cured for less than $200, for an uncomplicated case. Availability of resources plays a big
role in treatment in Haiti. Farmer has the knowledge on how to cure most of the patients he sees,
but often times does not have access to the drugs necessary to complete treatment. In his book
Infections and Inequalities, Farmer expresses his frustration with the maldistribution of medical
technologies throughout the world. He writes about how he cured a patient with tuberculosis
simply by giving her medicine, highlighting the fact that these people are suffering from diseases
that we already have cures for. While Farmer is treating patients in Boston with the latest
technology and access to everything he needs, his patients in Haiti are crowded into dirty
courtyards by the hundreds, awaiting treatment for preventable diseases. Farmer treated a woman
with gangrene, who lost her hand simply because of a small injury that went untreated for too
long. Farmer has to fight to raise money and resources to treat AIDS in Haiti, because his
medical colleagues and experts in international health don’t support treating impoverished
Haitians with new antiretroviral drugs. There are vast disparities in hospitals and resources
between developed and under-developed countries.
 Another difference is the culture. While in America, Farmer can joke around with his
staff and speak freely, but he has to be more conscious in Haiti. With a per capita income of less
than an American dollar a day, the people of Haiti have lived in a country absent of medicine. As
a result, the people believe in sorcery, which is their way of explaining suffering. Often times to
treat a patient or talk to family members, Farmer has to navigate the belief system of the
community. He is not in a position to denounce their beliefs of sorcery and instead has to
convince patients that sorcery may not have been involved in this illness. In everything Farmer
does, whether it’s treating patients in Boston or Haiti, or talking with people such as the soldiers
in the government or the staff at his hospitals, he does it with kindness. Even when expressing
his frustration with the government and the restrictions certain legislation places on him, Farmer
is polite and well-educated. While his life is split among extremes, he maintains his values
wherever he happens to be treating patients.