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6873: Paul Farmer in The Observer newspaper (fwd)
Keywords: health, Paul Farmer, Partners in Health, George Soros
A third of the world's population carries the TB bacterium. This year it will
kill another two million people - more than any other infectious disease. But
if anyone can save them it's Paul Farmer, a self-effacing doctor based in
rural Haiti (with a little help from George Soros)
by Tracy Kidder
The Observer (London)
Sunday January 28, 2001
(this is the first part of a long article - the whole thing can be viewed at:
- Charles Arthur for the Haiti Support Group)
On maps of Haiti, National Highway 3 looks like a major thoroughfare. And,
indeed, it is the gwo wout la, the biggest road across the Central Plateau, a
dirt track on which trucks of various sizes, overfilled with passengers, sway
in and out of giant potholes, raising clouds of dust, their engines whining
in low gear. A more numerous traffic plods along on donkeys and on foot,
including a procession of the sick. They are headed for the village of Cange
and the medical complex called Zanmi Lasante, Creole for Partners in Health.
In an all-but-treeless landscape, it stands out like a fortress on a
hillside, a large collection of concrete buildings half-covered by tropical
greenery. Now and then on the road, a bed moves slowly towards it, a bearer
at each corner, a patient on the mattress.
Zanmi Lasante is famous on the Central Plateau, in part for its medical
director, Dr Paul Farmer, known as Dokte Paul, or Polo, or, occasionally,
Blan Paul. The women in Zanmi Lasante's kitchen call him ti blan mwen - 'my
little white guy'. Peasant farmers like to remember how, during the violent
years of the coup that deposed President Aritide, the unarmed Dokte Paul
faced down a soldier who tried to enter the complex carrying a gun. One
peasant told me, 'God gives everyone a gift, and his gift is healing.' A
former patient once declared, 'I believe he is a god.' It was also said, in
whispers, 'He works with both hands' - that is, both with science and with
the magic necessary to remove ensorcellments, to many Haitians the deep cause
of illnesses. Most of the encomiums seem to embarrass and amuse Farmer. But
this last has a painful side. The Haitian belief in illness sent by sorcery
thrives on deprivation, on the long absence of effective medicine. Farmer has
dozens of voodoo priests among his patients.
On an evening last January, Farmer sat in his office at Zanmi Lasante,
dressed in his usual Haiti clothes - black pants and a T-shirt. He was
holding aloft a large white plastic bottle. It contained Indinavir, one of
the new protease inhibitors for treating Aids - the kind of magic he believes
in. A sad-faced young man sat in the chair beside him. Patients never sat on
the other side of his desk. He seemed bound to get as close to them as
Farmer is an inch or two over 6ft and thin, unusually long-legged and
long-armed, and he has an agile way of folding himself into a chair and
arranging himself around a patient he is examining that made me think of a
grasshopper. He is about 40. There is a vigorous quality about his thinness.
He has a narrow face and a delicate nose, which comes almost to a point. He
peered at his patient through the little round lenses of wire-rimmed glasses.
The young man had Aids. Farmer had been treating him with antibacterials, but
his condition had worsened. The young man said he was ashamed.
'Anybody can catch this. I told you that already,' Farmer said in Creole. He
shook the bottle and the pills inside rattled. He asked the young man if he'd
heard of this drug and the other new ones for Aids. The man hadn't. Well,
Farmer said, the drugs didn't cure Aids, but they would take away his
symptoms and, if he was lucky, let him live for many years as if he'd never
caught the virus. Farmer would begin treating him soon. He had only to
promise that he would never miss a dose. 'My situation is so bad,' the young
man said. 'I keep injuring my head, because I'm living in such a crowded
house. We have only one bed, and I let my children sleep on it, so I have to
sleep under the bed, and I forget, and I hit my head when I sit up.' He went
on, 'I don't forget what you did for me, Dokte Paul. When I was sick and no
one would touch me, you used to sit on my bed with your hand on my head. I
would like to give you a chicken or a pig.'
When Farmer is relaxed, his skin is pale, with a suggestion of freckles
underneath. Now it reddened instantly, from the base of his neck to his
forehead. 'You've already given me a lot. Stop it!'
The young man was smiling. 'I am going to sleep well tonight.'
'OK, neg pa [my man].'
Farmer put the bottle of pills back in his drawer. No one else is treating
impoverished Haitians with the new anti-retroviral drugs. Even some of his
allies in the Haitian medical establishment think he's crazy to try. The
drugs could cost as much as $18,000 a year per patient. But the fact that the
poor are dying of illnesses for which effective treatments exist is, like
many global facts of life, unacceptable to Farmer. Indeed, to him it is a
* * * * * * * * * * * * * * * * *
....this article continues (at some length) and can be found on
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