The Courage to Change a Broken World

1001 Books To Read Before Your Kindle Battery Dies, Part 115
Tracy Kidder, Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World

Paul Farmer, Harvard-trained MD, had Haitian friends in his youth, so traveling to Haiti seemed the natural choice. When he arrived, he discovered a kind and magnitude of poverty that he couldn’t believe still existed within the United States’ sphere of influence. Moved by the plight of the suffering, he made Haiti his life’s work, teaching and treating patients part of the year at Harvard, so he could dedicate most of the year to Haiti.

Journalist Tracy Kidder discovered Farmer’s medical mission while reporting on the American invasion of Haiti in 1994, an invasion undertaken for supposedly benevolent purposes, to restore Haiti’s elected government. Kidder encountered Farmer because Farmer didn’t hesitate to name the discrepancies between the American mission, and what Americans actually did. Farmer’s confrontational style forced American diplomats to examine their choices. It also forced Kidder to question his own motivations as a journalist.

The Paul Farmer whom Kidder describes grew up relatively poor and rootless in the American Southeast. Trailer park denizens were “his people.” But he was also a hard worker, a speedy student, and an amiable, gregarious personality. He made friends and connections with an ease that might make others jealous. He maintained friendships with wealthy patrons and university peers, but also learned to speak Haitian Kreyol fluently, and won trust among the country’s chronically exploited peasantry.

This isn’t so much a biography, as a Boswell-like immersion in the subject’s life. Kidder follows Farmer to his free clinic in Haiti’s Central Plateau, among the poorest places in the Western Hemisphere. Farmer and Kidder walk along unpaved switchback roads through steep valleys, delivering medications to agrarian peasants who consider Farmer a literal wizard. Despite being younger than Farmer, Kidder often struggles to maintain Farmer’s breakneck pace and athleticism.

Although Haiti was the Western Hemisphere’s second nation to overthrow European colonialism, it never achieved the prosperity or stability of its older cousin, the United States. American slaveholders couldn’t abide a nearby neighbor populated by rebellious slaves, and never recognized Haiti until after its Civil War. Throughout the Twentieth Century, Haiti served as the proxy battlefield between America and France for hegemony over the nominally democratic world, a battle that propped up anti-democratic strongmen like the Duvaliers.

Dr. Paul Farmer

Farmer, moved by the peasants’ plight and the social mores of his Roman Catholic upbringing, saw bringing medicine to Haiti as his personal mission. But by “personal,” he didn’t mean “individual.” Kidder herein profiles several prominent allies, including Ophelia Dahl (daughter of Roald) and Jim Kim who participated in his mission. Farmer’s organization, Partners in Health, managed to parley several bouts of good luck into a longstanding project. These elements included wealthy benefactors, and Farmer’s own medical celebrity.

Two widespread diseases in Haiti, which dominated Farmer’s early career, were drug-resistant tuberculosis and AIDS. Though neither disease originated in Haiti, mean-spirited Northern PR spun those diseases together with Haitian identity in the world’s imagination. This meant that Partners in Health, backed with a comfortable but not large endowment, became a global leader in TB and AIDS treatment. Farmer’s mission suddenly went from regional and personal, to global. Farmer got dragged along with it.

Kidder was present to watch much of this sudden growth. He set out to write about Farmer’s work in Haiti, but during the writing, he accompanies Farmer on trips to Peru, France, Russia, and elsewhere. Kidder chronicles Farmer’s transition from a simple Haitian country doctor—something Kidder quotes Farmer saying he only wanted to be—to a transnational medical diplomat, visiting medical conferences in Europe and North America, and treating TB patients in Latin American slums and Russian prisons.

Throughout, Farmer is driven by his personal Christianity. Though Farmer eschews doctrine, and shows impatience with formal theology, he heeds the Gospel’s message of feeding and comforting “the least of these.” Kidder repeatedly Farmer citing a “preferential option for the poor,” a term from Liberation theologian Gustavo Guitierrez. Among Farmer’s allies is a former Salesian priest, Jean-Bertrand Aristide. Farmer embodies the self-effacing service described in the Gospels, and too often ignored by many First-World Christians.

This book shipped in 2004, as Farmer’s celebrity reached new heights, and describes a man with benevolent goals still before him. Three years later, Farmer died unexpectedly, on an outreach visit to Rwanda, his desire to retire to his inland clinic unfulfilled. This biography testifies to the good which First-World citizens can achieve, if we channel our privilege toward those in need. When we use our advantages to serve others, the world changes around us.