THE BLOG

The Good Doctor Prescribes Health Care for the World's Poor

05/25/2011 12:45 pm ET

We met Paul Farmer sitting on the steps of the Sheldonian Theatre in Oxford.

He is a very busy man. But today, he spent the afternoon talking with us.

There we sat. Farmer, amused by our excitement. Us, a little in awe of the tall, thin man in the wire-rimmed glasses.

After all, this is the man who upon entering Rwanda in 2005, the minister in charge of HIV/AIDS said, "Just put them in the worst, most rotten part of Rwanda, and they'll flourish."

How could we not be in awe?

Farmer's story begins with his father. Paul Sr. had some unconventional ideas about raising kids. He loaded his six children into a bus in a Florida trailer park. They traveled around, had no running water and learned about life in America.

As a teen, he encouraged Farmer to take on odd jobs. One was a sharecropper.

Back then, you didn't see a young, white teenager working in the fields among the Haitian workers. Some looked down on the work but Farmer thrived. He learned some Haitian Kreyol and listened to stories about the poverty on the island nation.

Farmer went on to study anthropology at Duke University and received his MD and PhD from Harvard. Between these prestigious degrees, he traveled to the home of his migrant worker friends.

It was 1983 and Haiti was the destination for American tourists. Farmer wasn't there for the beaches. Instead, he traveled to through the Central Plateau region to the town of Cange.

Cange is a settlement made up mainly of squatters and crudely constructed shacks. There were no doctors to treat a broken leg let alone the diseases the plagued the population.

So, Farmer went to work setting up a clinic.

The idea was simple. People were sick. Farmer could treat them. So, he did - just as he would a patient in Boston.

When you think about it, the notion that everyone should be treated equal seems pretty basic. But, the reality is that medical care is not evenly distributed around the world. For Farmer, this was unacceptable.

The doctor established Partners in Health and went to work building a health care model that would work in developing nations - places where others said treatment would never work.

Farmer's model has two components. First, everyone must have access to medical care. Second, not everyone who provides it needs to be a doctor.

Farmer trained community members in basic medicine. It was mainly preventative measures like hand-washing, family planning and condom use. The goal was to stop illness in its tracks through education. The community health workers were paid for their services and would go about teaching, referring and delivering medicine.

The results proved disbelievers in the medical community wrong. People with HIV were enrolled in antiretroviral programs with results similar to those in the United States. Patients received treatment for malaria and typhoid. Farmer even developed protocols for treating multi-drug-resistant tuberculosis which were adopted around the world.

More than 20 years later, Farmer has opened clinics in Peru, Russia Lesotho and Malawi. They even flourish in Rwanda just as the minister predicted. Within eight months, 30,000 people were tested for HIV and 700 enrolled in an ARV program in the town of Rwinkwavu.

Like we said, how could we not be in awe?

Farmer isn't some sort of far-out idealist touting universal health care for all. Instead, he proved that not only is adequate care possible in impoverished communities, denying that treatment is unjustifiable.

We seek out the best medical care for our loved ones when they get sick. Farmer showed that's true for everyone.

Not to provide it is simply wrong.

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