a book review by Jane Casewit

March 12, 2010

It is a timely honor to present Tracy Kidder’s remarkable book, Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World, to Creative colleagues and others who work to alleviate some of the burdens of those less fortunate than ourselves. The book’s title is a Haitian proverb: Deye mon gen mon or “Beyond mountains there are mountains.” A simple but fitting image for the challenges Haiti presently faces.

The January 12th earthquake with a magnitude of 7.0 devastated hundreds of thousands already living on the fringes of what is humanly bearable. Tracy Kidder adeptly describes Paul Farmer’s early years and brilliant academic and professional career at Harvard Medical School. This rich description leads the reader to realize that Farmer’s destiny lay in making an indelible difference in the health of thousands of people. We read that Farmer was one of six children born into a modest family with a strict father and a devoted mother. During his childhood in Alabama, he first encountered Haitian migrant workers and spent several summers helping them pick fruit. Before long, Farmer’s father moved the entire family to Florida where they lived in a small mobile home and then on a small house boat without running water. In spite of the family’s cramped quarters and simple lifestyle, the young Famer excelled academically. This period of his life prepared him for later challenges, such as enduring the wretched conditions of the dusty settlements in Cange, located on Haiti’s middle plateau.

It was in Cange, we read, that Farmer sorted out his life goals and philosophy. Kidder chronicles how Farmer sought to understand the beliefs of Haiti’s Vodun faith and employ these lessons in curing hundreds of people with malaria. Inspired by Catholic Liberation Theology, Farmer sheds light on his beliefs: “The fact that any sort of religious faith was so disdained at Harvard and so important to the poor—not just in Haiti but elsewhere, too—made me even more convinced that faith must be something good.” It was also in Cange in the 1980s that Farmer met his companion for many of his decisive years in Haiti, Ophelia Dahl, the daughter of the famed children’s author Roald Dahl. Ophelia Dahl’s support and help is interwoven throughout Kidder’s account of Farmer’s life and work in Haiti and his time at Harvard. Though they never married, Dahl is presently in Haiti coordinating the relief efforts of “Partners in Health,” the organization she helped Farmer found.

Defying enormous odds, Farmer, Dahl and their Haitian and American collaborators raised the money to set up a health clinic for desperately poor people in Cange. In the process of curing thousands of cases of malaria and tuberculosis (TB), they discovered why many TB patients in developing countries are unable to be cured of TB even when treated with the most modern medications. Farmer proved that the poor in Haiti and elsewhere were victims of “multidrug resistant TB,” a disease that, as Farmer notes, “makes its own preferential option for the poor.”

Farmer discovered the underlying causes of this complex dilemma and was able to halt the spread of TB in Peru, Cuba, Siberia, Africa, and the suburbs of Boston, but he always returned to Haiti. By 1995, Farmer’s founding organization, “Partners in Health” was building hospitals and health centers all over the country and sending out mobile clinics to treat every variety of human illness, without charge. “Partners” also distributes food to the hungry, delivers babies and conducts family planning visits. Over 120 countries have now adopted Farmer’s prescriptions for treating the drug-resistant forms of tuberculosis and his models for public health for the poor.

This biography of Paul Farmer pokes at the unacknowledged uneasiness that many feel about our own place in the world. Kidder’s account of how Paul Farmer vanquished this “ambivalence” is exemplary.

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