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Dr. Paul Farmer, a Man Who Bent the Arc

Paul Farmer smiling.

“The idea that some lives matter less is the root of all that is wrong with the world.”

― Paul Farmer

Dr. Paul Farmer, co-founder of the nonprofit health organization Partners in Health, global health leader, author, anthropologist, and humanitarian, died Monday at age 62 while in Rwanda where he’d been teaching at University of Global Health Equity, a university he co-founded. He is survived by his wife Didi Bertrand Farmer, a medical anthropologist and community health specialist, and his three children.

Paul was a friend. He was someone I met 20 years ago at the beginning of my career in human rights.  Completely unassuming, down to earth and affable, you would almost forget “Polo” — what many folks in Haiti affectionately called him — was, in fact, one of the most famous doctors in the world. His humility and authentic care of people matched his consistent and significant impact on public health and human rights. The news of his unexpected death is devastating to those who worked alongside him and learned from his leadership.

Paul Farmer and the visionaries of Partners in Health (PIH) changed the way non-profits were accountable to the people they claimed to serve. 

Paul led PIH at a pivotal time in the global AIDS pandemic. While the George W. Bush administration touted their commitment to eradicating HIV/AIDS and other diseases, their officials were cynical about treatment compliance particularly from patients in Africa and Haiti. Partners in Health worked with local communities, first in Haiti and then around the world to disprove racist theories and uplift local/indigeonous solutions.   

Paul always uplifted community and team approaches. He believed in intersectional approaches, not just intersections of identity but also systems — medicine, law, political science, engineering, and infrastructure — as all being essential to bettering peoples’ lives. 

In a 2020 NPR interview, Paul put words to this systemic and intersectional approach: 

I’ve learned that social disparities like racism get into the body. How does something outside of us get into us? If you look at apartheid in South Africa, you see that people get sick with tuberculosis, malaria and other diseases because of poor work conditions, lack of jobs, shantytowns. You have to look at what’s happening to the patient in front of you and think about ways to address social disparities. If there’s food insecurity, then you provide food when you provide care. Or if patients drop out of treatment, you provide transportation to the clinic, or you send community health workers to the patient.”

He learned by listening to and trusting the experience of those he was serving.

When encountering resistance from the WHO about giving HIV medication to Haitians surviving in resource poor settings, one colleague recalled that Paul created a medication chart that relied on the sun’s position. Paul worked with Loune Viaud to provide funds and structure for Haitian “accompaniers” who worked within their local communities and across the countryside to ensure patients had enough food, water, housing, and other basic necessities to support patients in staying the course with their medications. Paul himself would often be the accompanier, walking for hours to check on his patients. 

He worked with local leaders to open a teaching hospital in Mirebalais, Haiti in 2013 after co-founding the Institute for Justice and Democracy in Haiti. When asked in an interview about his vision for this hospital while in mid-construction, he responded: “We want to be able to say, just once, that the quality of care we’re giving to people living in abject poverty is as good as if they were born in some ritzy part of Manhattan, say. That vision of equity and justice and decency is what we’d like to give birth to.” His vision “reshaped our understanding” of “what it means to treat health as a human right and the ethical and political obligations that follow,” according to the committee chairman of the Berggruen Prize, which Paul was awarded in 2020.

Dr. Paul Farmer dedicated his life to providing excellent care in partnership with people in impoverished places around the globe. Joia Mukherjee, Chief Medical Officer at PIH wrote, “He also gave us a hell of a road map. His prolific and incisive writing, remarkable speeches, amazing teaching and constant, compassionate clinical work will remain my North Star.  His accompaniment of patients, staff at all levels, his friends, our families was a constant reflection of the better world he strove to create.” 

There was simply no one like Paul.

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