Part III, Chapter 13 Summary and Analysis
Summary
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.
Analysis
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.)
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