Part III, Chapter 13 Summary and Analysis
Chapter 13 opens by describing an "epidemiological map" in two colors: one for groups who die of old age, and the other who die from other causes, such as accidents, starvation, and illness. The two colors (populations) would be found on maps of every part of the world. While there is often a racial association for the groups, with people of color dying of illness more often, that is not universal. The only universally shared characteristic is poverty. Paul Farmer and his colleagues experienced this vividly when trying to treat diseases such as AIDS and tuberculosis (TB). TB has been largely eradicated from richer countries, but kills two million people a year in poorer countries. Moreover, TB is cured through administering drugs over a number of months, and the poor often find their treatments disrupted through circumstances. The result was that new strains of TB known as MDR (for "multidrug-resistant" TB) were bred through partial treatments. These resistant strains often spread through the poor populations, killing people who could have been saved. Farmer found himself trying to treat MDR in Haiti: he often failed while the military junta was in charge, but saved most of his patients after that time.
Chapter 13 begins a new section of Mountains Beyond Mountains and marks a new period in Farmer's life when he became move involved with public health concerns on a global scale. The image of the epidemiological map symbolizes this larger concern. It also serves as a useful symbol of Farmer's medical mission and of Kidder's approach to it. Farmer is trying to solve issues that cross national boundaries, matters that make common divisions like nationality, religion, or ethnicity irrelevant...and Kidder is willing to accept that approach as valid. (He does not apply any further political analysis on his own, to see, for example, if the rich/poor division holds, or if specific political systems do better or worse jobs of keeping their citizens healthy.)