Summary
Chapter 11 begins with Farmer's return to Haiti in a wheelchair (due to his broken leg) in December of 1988. He finds Haiti politically agitated. The peasants protest and try to oust any remnants of the former Duvalier power structure; the military government who took over after Duvalier and rule with U.S. aid and support strike back even more violently. The result is considerable social upheaval, and a society where patients might be killed in their hospital beds and voters at the polls. The small Catholic churches of the Haitian countryside are the seedbeds of political resistance. In 1986, Farmer was excited to hear one of these priests, Jean-Bertrand Aristide, articulate the political theology he had been looking for. They became friends, though obligations on both sides kept the men from spending much time together. In 1990, by the people's request, Aristide ran for president and was elected with 67 percent of the vote. This promised a great deal of change for Haiti, but most immediately, it led to even more violence in response.

Some of this spilled over onto Farmer, and Farmer's own work also led him into political involvement. Farmer completed his studies, earning an MD and a PhD in 1990. He won a prize with his anthropology thesis, which was titled "AIDS and Accusation." Studying the spread of the AIDS epidemic led him to commenting on American policies and attitudes toward AIDS, which included grouping Haitians as a risk group for the disease. Farmer's thesis analyzed the effects of AIDS on Cange and led him to realize once again how much medical suffering was tied to economics: he could prevent and/or cure more diseases if he had the means. When at the clinic in Cange, Farmer got threatening phone calls, and the clinic's phone was bugged. In September 1991, when Farmer tried to return to Haiti from the United States, he found his flight canceled. When he did make it back to Haiti, he treated a man who had been beaten by the authorities, but he had been so savaged that Farmer could not save him. He did, however, report the case to Amnesty International and wrote a piece on the incident for the Boston Globe.

Analysis
As a narrative, Chapter 11 is a bit crowded; so much is going on that it is almost hard to keep track of what is happening. Difficult though this is for the reader, this is a useful reflection of the tumult of Haiti—and Farmer's life. This brief chapter presents the formal conclusion of Farmer's studies, but it also shows his ongoing development from concerned individual to political player. These two are intertwined, and reflect a fundamental change in Farmer, one he did not necessarily welcome. When he had heard that Aristide might run for president, Farmer opposed the idea, essentially treating politics as an obstacle. It certainly was an obstacle for Farmer at certain points: barring him from the patients he cared about, contributing to disease, threatening his life, and so on. However, given the scope of his desires for public health reform, it was inevitable that Farmer end up involved in politics. (This can be seen in Chapter 12, when Farmer is forced to shift tactics and approach politics directly.) What is also striking is that it would be easy for anyone to say that he or she could not do what Farmer is doing: most people are overwhelmed by the idea of medical school or graduate school or helping the needy, and Paul Farmer tackled all three. However, Farmer's experience in Haiti gave him more medical training that his peers received, and his involvement there gave him more field experience than many anthropologists receive. In the end, it is as if Farmer's very existence challenged both the political and educational structures he was dealing with.