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Harvard infectious disease expert Paul Farmer: An anthropological approach to medical advancement in the third world

The other day, we met up with the Education for Good team at Dream Impact, a co-working space in Cheung Sha Wan. We brought to the table CUHK’s newly established social innovation platform SoCUBE, as well as the content plan for Cubic Zine (what you’re reading!). Ever full of ideas, Education for Good’s Executive Director and Innovation Consultant Freddy Law chimed in, “You’ve got to cover the Harvard professor Paul Farmer then!” Well then, let us dive into the story of this American medical anthropologist, who spent most of his life travelling between Haiti and Harvard, spurring medical development with benevolence in less developed countries.

Having taken home countless awards, the now 60-year-old is, beyond doubt, Harvard’s pride and joy. Paul earned his MD and PhD in Anthropology from the famed institution. The specialist in infectious disease then practised in a hospital while doing research at Harvard; he became the chair of Department of Global Health and Social Medicine till this date, and was awarded the esteemed University Professor in 2010.

Each time visiting a PIH base, Paul Farmer always volunteers his consultation services. His first visit to Haiti in 1983 shocked him not in terms of culture, language or geography, but the extreme poverty. (Photo: Partners In Health)

Restoring the third-world medical system

His qualifications and academic accomplishments made an impression for sure; what made his name known was his 30 years of humanitarian work. With a few friends (including the later World Bank President Jim Yong Kim) Paul set up an NGO Partners In Health (PIH) in 1987, pioneering a community-based strategy to healthcare in the impoverished regions – setting up clinics and schools, training locals for medical outreach etc.

The 80s was when the majority of professionals thought infectious diseases (e.g. AIDS, tuberculosis) were incurable in the third world; PIH was the one and only calling this conventional belief into question. They trained locals to deliver medicine to their ill neighbours, successfully treating at least 15,000 AIDS patients.

To date, PIH has nurtured 5,300 doctors, nurses and community health workers, benefiting up to 4.5 million people. It has branched out to more than 10 African and American countries. Paul remains PIH’s brain; the Chief Strategist continues shaking up traditions while visiting their service countries each year.

Perhaps, all thanks to his training in anthropology, Paul is genuinely empathetic. In an interview with Harvard Gazette in 2018, he pleaded to policymakers to bear in mind that even the poorest patient or injured are humans, not “abstractions” or “numbers”. He saw this as the way to designing humanistic policies. Health has a lot to do with social justice, “The idea that some lives matter less is the root of all that’s wrong with the world.”

PIH’s medical services largely employ local workers, who visit patients at their homes for health assessments and referrals. This pic shows the personnel from Lesotho, Africa. PIH has made 800 thousand house calls just in 2018. (Photo: Partners In Health)

Childhood aboard a school bus

Haiti has long been stricken with extreme poverty and political turmoil; the US President Donald Trump, not filtering his words as usual, once called this Caribbean country a “shithole”. So why has Paul – a white American – almost made Haiti his second home country? He even speaks fluent Creole, the local language!

Turns out, as far back as his uni days, Paul has already caught attention of the plight the Haitian immigrants were suffering from in the US. This humanistic sense likely stemmed from his extraordinary childhood, when he spent his days on a school bus revamped into living quarters. His father, the free-spirited mastermind behind the project, took his family cross-country – it’s little wonder that Paul became versed in social injustice.

For nearly half of his PhD studies in Harvard, Paul stayed in Haiti, building from a community-based health care project, to a large hospital serving over 150 thousand patients. As Haiti’s dictator fled to France in 1986, AIDS infection rates in urban slums escalated, prompting Paul to found PIH in Boston the year after. His innovative approach to infectious disease control in Haiti (including raising the female literacy rate) has been adopted by the World Health Organisation in as many as 30 countries.

By Kary Wong@ORKTS
English Translation by Cathy Wong@ORKTS