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As one of six kids who spent part of his boyhood without running water in a converted passenger bus in a Florida trailer park, Paul Farmer has come a lot further than his untraditional beginnings might have predicted.
Farmer may have been born with a plastic spoon in his mouth. But his hardscrabble childhood forged a quicksilver intellect and unstoppable drive. Exposed to the miseries of the world's poor, he turned his formidable focus, coupled with a genius for innovation, to solving their health problems.
"What set him apart as a young man was his ability to envision things that no one else could. A lot of young people go to places like Haiti and see the desperate conditions, but they feel stymied when it comes to doing something. Paul saw an opportunity, drew up a plan, and saw it through," says Ophelia Dahl, who went to Haiti with Farmer in 1983 and is now president and executive director of Partners in Health.
Son of a rootless, restless father who bounced from salesman to fruit picker to would-be commercial fisherman, Farmer is a physician and medical anthropologist with a MacArthur "genius" grant on his resume and two Harvard doctorates simultaneously earned. The seeds for his lifework, however, were planted when he was an undergraduate at Duke University, volunteering at Duke's hospital and in local migrant labor camps where Haitians worked the tobacco and vegetable fields. After graduation, he enrolled in Harvard Medical School and headed to central Haiti, volunteering to work in Cange on the central plateau, a collection of tin-roofed hovels in the poorest region of the poorest country in the West.
Global model. In Cange, he studied medicine at Harvard long distance, applying what he was learning to his Haitian patients. To support his work, he founded a small, Boston-based charity called Partners in Health in 1987 with fellow Harvard medical student Jim Yong Kim. PIH set up a clinic called Zanmi Lasante, Creole for "partners in health," which became the settlement's first community-based healthcare delivery system.
Today, the well-equipped facility, with its operating rooms, blood bank, satellite communications, laptops, and other components of modern medicine, is a global model for delivering public-health services. PIH fights tuberculosis, AIDS, malaria, and other infectious diseases afflicting millions of the poor in Haiti, Peru, Russia, Mexico, Guatemala, Rwanda, and Boston's inner city. And its approach is unique. Patients receive not only lifesaving medicines and surgical care but also food, clean water, housing, education, and other social services, all delivered by locals trained in nursing skills and paid as community health workers.
This holistic approach by PIH, coupled with revolutionary drug protocols Farmer and Kim developed, proved that patients with drug-resistant tuberculosis could be cured rather than die by the hundreds of thousands each year. PIH's success in this and in treating AIDS patients has been so impressive that the World Health Organization has reversed long-held policies and now uses PIH treatment models in more than 30 countries.
To the self-deprecating, 46-year-old Farmer, it's only a modest start. "A small group of British abolitionists in the [19th] century began a movement that said, 'Slavery is wrong, and we're going to change it.' And they did," he says. "I believe we can convince people that it's wrong for the destitute sick of the world to die unattended. We can change that, too."
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