Summary
In 1983, with Ophelia out of Haiti, Farmer traveled from Mirebalais to Cange with Fritz Lafontant, a Haitian Anglican priest. Lafontant had set up a basic health clinic in Mirebalais and was trying to serve smaller communities like Cange through building it a chapel and school. Farmer did not stay in Cange, but traveled throughout Haiti. He lived with the peasants and he ate with them, resulting in a case of dysentery so intense that an American public health authority wanted to send him home. He recovered, and he studied all aspects of Haitian life at close range. He talked with the peasants about their lives and went to voodoo ceremonies. Through these direct experiences, Farmer grew clearer on what he wanted to do. He did not want to help for a little while, like the doctors who helped and then went back to America. He did not want to think of himself as American. Instead, Farmer's mission emerged through his encounters with the people and land of Haiti. He drew some inspiration from the liberation theology the Catholics helping these people practiced, but his real creed was articulated by a poor Haitian woman who had just watched her sister die because she did not have enough money for a blood transfusion: "We are all human beings."

Farmer worked for a time in the clinic Lafontant ran in Mirebalais, and he also began to do his own study of Haiti. He studied both the economic contexts of their illnesses and suffering and the conceptual studies. Though he was a doctor trained in Western medicine, Farmer was willing to use whatever belief was necessary to help these people. In the fall of 1984, Farmer entered Harvard Medical School.

Analysis
If Mountains Beyond Mountains were a work of fiction, this would be a bridge chapter taking Farmer from his first love affair to his entrance into medical school. It is largely exposition, and covers an entire intense year in less than ten pages. There is only an occasional snapshot of intense suffering to suggest the nature of Farmer's experience in Haiti: Paul Farmer running around trying to collect the few dollars needed for a truck rental and a blood transfusion to save a woman's life. However, it is in this chapter that Kidder sketches in the essence of Farmer's approach. He bumps up against Catholicism again and again (in his background, in those serving the workers in North Carolina, and again here). He shares the beliefs of liberation theology that it is crucial to serve the poor, but he lacks the faith and the acceptance of hierarchy that allows these good people to help them within an established structure (be that political, organizational, or conceptual). Instead, he must see things for himself, make his own conclusions, and, in chapters to come, create his own solutions. As he does so, Farmer insists on the reality of suffering as being too big to fit within any theory, and in any case, abstract knowledge now exists for him only to serve real suffering people.