16903: (Hermantin) Maimi-Herald--Book Review- Mountain Beyond Mountains (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: leonie hermantin <lhermantin@hotmail.com>

Posted on Sun, Oct. 05, 2003

NONFICTION | MOUNTAINS BEYOND MOUNTAINS
HEALTHHERO
THE EXTRAORDINARY PAUL FARMER HAS A FAN IN THE AUTHOR AS HE WORKS MIRACLES
AND CLIMBS MOUNTAINS FOR HAITI'S POOR.

BY ANNE BARTLETT

abartlett@herald.com

No question about it: Dr. Paul Farmer is a hero. His Zanmi Lasante health
clinic in Haiti's central mountains has made a huge difference to the
region's quality of life. His work at Boston's Brigham and Women's Hospital
provides succor to the down-and-out in the midst of affluent indifference.
And his Partners in Health organization is spreading his approach to public
health in assorted hellholes around the globe.

But can Farmer's highly individualized efforts really change anything? Can
one man's heroism serve as a model that can be replicated? Bestselling
author Tracy Kidder is the Everyman who asks those questions as he follows
Farmer's intense, peripatetic life in Haiti, Peru, Russia and points in
between in Mountains Beyond Mountains.

Kidder notes that his previous books -- The Soul of a New Machine and
Hometown among them -- didn't require such a strong authorial presence,
because they were about ordinary people doing interesting things. Farmer,
internationally known for his pioneering work on drug resistant TB and other
public health crises, is an extraordinary man. So Kidder acts as the
reader's surrogate in this book, marveling and despairing at his subject's
outsized qualities.

Simply put, Farmer believes that medicine is the truest form of social
service. He thinks doctors shouldn't just treat a disease in isolation, but
instead treat the conditions that cause the disease. Their primary
responsibility is to the poor. And no excuses should be accepted. ''There's
a lot to be said for sacrifice, remorse, even pity,'' says Farmer. ``It's
what separates us from the roaches.''

Farmer lives that philosophy. No one works harder or cares more. As his
Partners in Health organization has expanded, he could easily have become a
full-time fund-raiser. He's a good diplomat and negotiator. But he still
routinely treks for hours through the Haitian mountains to make house calls
-- hut calls, really -- to find out whether some desperately ill patient is
still taking his medication.

Unsurprisingly, Farmer can be a difficult person to live with. His long-time
devoted girlfriend left him because his work would always come first. He's
now a married father, but spends minimal time with his family. He has been
known to lose his temper at his most loyal, hard-working partners when they
prove marginally less committed than he is. It goes with the territory.

Kidder is an admirer, and he has done Farmer and his PIH colleagues justice.
The book is filled with compelling journalism. Among the most memorable
tales are Farmer's rackety upbringing by his eccentric father in a
Brooksville, Fla. campgound; a tragicomic struggle to bring a dying child
from Zanmi Lasante to Boston, via unreliable Haitian ambulance; and a
drunken karaoke party in Tomsk, as Farmer's top lieutenant tries to convince
hard-eyed Russian generals to support a prison TB program.

Kidder's description of Farmer's visit to Cuba to attend an AIDS conference
will raise the blood pressure of many Cuban American exiles. Farmer is a fan
of the Castro regime's public health accomplishments. Says Farmer, ''If I
could turn Haiti into Cuba, I'd do it in a minute.'' Kidder reports his
semi-argument with his subject: ''I felt that Farmer was suspending his
usually sharp critical judgement,'' he writes.

Kidder is less perceptive in writing about Haitian politics. Farmer is a
long-time supporter of President Jean-Bertrand Aristide and was briefly
thrown out of the country when it was run by an anti-Aristide junta. But
Kidder doesn't report Farmer's attitude to Haiti's current crisis, except to
note that he is angry about the impact of the U.S. aid freeze. Kidder
glosses over the subject too superficially, seeming to exclusively blame
U.S. policy without addressing the Aristide government's faults. We never
learn what Farmer thinks of Aristide now.

But Farmer's mission isn't about politics, it's about providing health care
for the poor. Under his leadership, Partners in Health has convinced the
World Health Organization to support a new TB treatment program and gained
the financial support of the Gates Foundation in Peru and the Soros
foundation in Russia.

Why, then, is Farmer still walking the mountains? He could surely help more
people by refocusing his energies.

Maybe not, Kidder says. He believes Farmer's very ''craziness'' gives him
the moral authority to inspire. ''I once heard Farmer say that he hoped a
day would come when he could do a good job just by showing up,'' writes
Kidder. ``It seems to me that time has already arrived.''


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Anne Bartlett is The Herald's Miami-Dade politics and government editor.

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