There are major events shaking the world to its core, and we will continue to cover them here at Steady. But today we wanted to pause and remember someone who died this past week, and whose legacy of achievement, determination, and hope can inspire us even as we mourn what the world has lost with his passing.
Many of you may know of Paul Farmer and his incredible work as a visionary for public health. His sudden death from an “acute cardiac event” while in Rwanda sent shock waves across the world of global health and elicited a flood of remembrances and testimonials. Here was a person who had, from an early age, a drive and organizational principle to help others. He was able to do the unthinkable through a potent mixture of good judgement, wisdom, and, yes, courage.
We all may hope to find something deep within ourselves that calls us forward in our life’s journey. Dr. Farmer found his mission and I think reflecting on what that was and what he was able to accomplish can help all of us ask some of the fundamental questions of life: How do we hope to be remembered? What is our purpose? Why are we here? It has had me thinking a lot, dear readers, and I hope it encourages that reflection in you as well.
Dr. Farmer’s fame as a champion for action in the face of cynicism made him a revered leader, admired by his peers in science, as well as political leaders, and even celebrities who were drawn to his story.
Ultimately, it was the countless lives he saved and the hope he fostered in some of the most forgotten and forlorn corners of the globe that represents a more complete testimonial of the value of his work, and the hole he leaves behind. As the author, and friend of Dr. Farmer, John Green wrote in the Washington Post:
“Here is what I want you to know about Paul Farmer: He simply did not accept the idea that inequality of health-care access is natural or inevitable. Because of his belief, and because of the nonprofit health organization Partners in Health that he co-founded, millions of people in some of the poorest nations on Earth are alive today…
I don’t really believe in heroizing individuals, but Paul was, for me and for many, a hero. As a medical anthropologist and physician, he was deeply committed to the belief that all human lives had dignity and that every person deserves access to high-quality health care. He lived this belief for his entire career.”
Dr. Farmer understood that health is ultimately a metric measured one life at a time. He believed that to isolate one factor of disease without addressing root causes was to put a bandaid on symptoms rather than treat the complete person.
He had little patience for those who preached from positions of privilege about the limits of what was possible. To get down into the world as it is, to listen to need and react, building bonds between the healers and the sick, was the work he knew would provide the most help. The New York Times, in its obituary, outlined how innovative Dr. Farmer was:
“He was a practitioner of “social medicine,” arguing there was no point in treating patients for diseases only to send them back into the desperate circumstances that contributed to them in the first place. Illness, he said, has social roots and must be addressed through social structures.
His work with Partners in Health significantly influenced public health strategies for responding to tuberculosis, H.I.V. and Ebola. During the AIDS crisis in Haiti, he went door to door to deliver antiviral medication, confounding many in the medical field who believed it would be impossible for poor rural people to survive the disease.
Though he worked in the world of development, he often took a critical view of international aid, preferring to work with local providers and leaders. And he often lived among the people he was treating, moving his family to Rwanda and Haiti for extended periods.”
Dr. Ashish K. Jha, the Dean of the Brown University School of Public Health who has become a fixture on television calmly leading us through the COVID pandemic, remembered his friend and colleague in The Atlantic. Born in India, Dr. Jha was particularly attuned to the fraught historical inequities that have long plagued the global fight for public health (including with the COVID response), and how Dr. Farmer pushed against them.
“Throughout his life, [Dr. Farmer] fought against a counterproductive mindset that has haunted efforts of global health. The field that started as “tropical health” had been deeply rooted in the colonial context of caring for the subjects of Western rule. As European powers left their colonies in the global South, the nomenclature of the field changed to “international health,” but the field kept that deeply colonial framework—we the anointed global North providing charity for the uncivilized global South. Even now, the field often views its work from a perspective of constraint. With the limited resources we have, what is the most good we can do?
Paul hated that question. He preferred to flip it on its head: Given all the good we can do for our fellow humans, what are the resources we need to make it happen? He was unconstrained by small thinking. He rejected the artificial limitations we put on caring for the world’s poor—limits we would never put on ourselves or our families. He refused to accept the soft bigotry of low expectations.
We will not attempt to further summarize Dr. Farmer’s life story, his co-founding of Partners In Health, and all his cascading accomplishments. There are many in-depth and compelling obituaries and outpourings of personal remembrances, including the ones we have shared here. We encourage you to read them.
What we wanted to accomplish was first and foremost to honor this man and his work. We also wanted to highlight the perspective we can gain more broadly from his example. For if anyone embodied the spirit of “Steady” it was Dr. Farmer.
We are living in a time when the challenges can seem insurmountable, when we are in danger of succumbing to despair. Dr. Farmer’s work should remind us that, as trite as it may sound, the impossible can be possible. What is often required is challenging the naysayers and cynics, and upending conventional wisdoms. “Cynicism is a dead end,” Dr. Farmer once said. Broad change at a societal level can happen, but it often is driven by the bottom up rather than the top down.
Few of us have the intellect, training, or energy to do what Dr. Farmer did. But we can all follow his example in ways that can make real differences. While it is important that we vote and organize in the political sphere, it is also important that we find ways to address the wants of the most needy in our communities.
Over the course of my reporting career, I have seen this occur in ways too numerous to count. Most people are, by nature, helpers. In times of crisis, there is a natural instinct to assist, even at personal sacrifice. We can see that happening right now in the brave defense of Ukraine. There will always be those who seek to diminish this instinct by dividing us into different camps, us and them. We must fight against that. One of the greatest tragedies about the pandemic is that in a moment when we should all have rallied to the necessities of public health, craven political actors have sought to maximize their power by trafficking in lies that continues to cause deaths to rise to unimaginable numbers.
Dr. Farmer shows us a different way. It is not one of pollyannaish prognostications. It is one where hope is earned through the work of showing up where others have not. It is the work of seeing the world as it is, and then finding the mechanisms for change. It is not accomplished with buzzwords or sweeping declarations; it is earned by understanding, with empathy, our common humanity. Dr. Farmer had the educational and intellectual tools to do anything he wanted; he chose the poorest countries and the bleakest conditions to deploy those tools, and in so doing redefined the horizons of health.
The fact that so many were inspired by Paul Farmer, that his work continues with the countless people he mentored, is a reason to have optimism about our global community now and into the future.
Change can come. Hope is possible. Steady.
Paul Farmer was one of the people who inspired my daughter to become a doctor. She now works in a “safety net” hospital, treating those the horrid American health system leaves behind, and teaches med students and residents in her field. I am thankful for his vision and commitment.
I feel woefully uninformed to have never known of this remarkable man and I thank you, Steady, for making me think and learn and grow in positive ways.