Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World

by Tracy Kidder
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In Tracy Kidder's Mountains Beyond Mountains, describe why Paul Farmer is dissatisfied with the current distribution of money and medicine in the world. 

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Farmer is dissatisfied with the distribution of wealth and medicine in the world because he believes that if wealth and medicine were equally distributed, there would not be a global health crisis. Farmer began his career in philanthropy and hands-on service in Haiti. He founded the nonprofit Partners in Health...

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Farmer is dissatisfied with the distribution of wealth and medicine in the world because he believes that if wealth and medicine were equally distributed, there would not be a global health crisis. Farmer began his career in philanthropy and hands-on service in Haiti. He founded the nonprofit Partners in Health and through this nonprofit opened a medical clinic in Haiti called Zanmi Lasante. Through his experience working in Haiti, Farmer developed a unique understanding of wealth and well-being. He argues that many of the health disparities in the world are preventable and that poverty is a major cause of the global health crisis.

For example, Farmer believes that the United States and other world powers have played a direct role in causing poverty in Haiti. He believes that the United States has inadvertently, and at times purposely, supported dictators in the country. He sees the political world as being directly related to the health and well-being of everyday citizens. As such, he argues that the United States is one of many causes of the health disparities seen in Haiti.

Another example is Farmer's brief work in Lima, Peru, in the 1990s. During this time, he had to lobby with pharmaceutical conglomerates to address the tuberculosis outbreak in the country. Farmer attributed the outbreak to inaccessible treatment. It was at this juncture in his career that Farmer theorized that the fact that a health crisis exists is evidence that society values some lives more than others. In this particular example, Farmer theorizes that pharmaceutical companies value themselves over the lives of Peruvians. Farmer is quoted as saying,

The idea that some lives matter less is the root of all that is wrong with the world.

Farmer takes an unusual and unpopular approach to medicine. While most American models follow the most cost-effective route, Farmer believes that when it comes to saving lives, any cost is worth it. Under this logic, all lives are equally valuable. Farmer lives up to his word by walking extreme distances to visit families and provide care. He does not believe that location or income should be prohibitive to medical care.

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One problem Farmer faced again and again in his work at the head of Partners in Health was the availability of funding for projects such as the health care center he was trying to build at Zanmi Lasante in Haiti.  As Kidder observes, ". . .large foundations tended to finance narrowly focused compaigns against well-publicized diseased.  None was likely to be interested in simply paying the bills, year after year. . . ."  Many, maybe most, potential donors were there to provide a one time gift, or, such as in the case of the Gates Foundation, a grant to be distributed for a finite amount of time, perhaps a few years.  What Farmer sought to do in Haiti was first, apply the "bandaid" by treating as many people as he could of whatever ailed them at the time, usually tuberculosis, sometimes AIDS, and then address the poor living conditions that created the root of the problem by providing cleaner homes and flooring, for example, decreasing or ending the conditions that made families vulnerable to diseases like TB, as well as providing sound preventive healthcare--through the center at Zanmi Lasante, for example.  His holistic approach, while sound, was (is) expensive, and unsuited to the traditional philanthropic approach where a onetime grant, fund or donation is the rule rather than the exception. 

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