Summary
Chapter 21 describes Farmer's trip to Cuba (and Kidder's trip with him). Farmer admires Cuba's public health system, and Kidder indicates that Cuba does a better job of tracking illnesses such as AIDS than most countries. However, despite Farmer's admiration for Cuban practice and equality, and his support of Marxist theories of social and economic analysis, Farmer distrusts the more theoretical and ideological elements of Marxism.

Farmer went to Cuba to attend a conference, and while in Cuba, he visited his friend Dr. Jorge Perez and with Dr. José Miyar Barruecos, a representative of Cuba's Council of State. Luc Montagnier, who discovered the HIV virus, was there, as was the French ambassador to Cuba. Farmer tried to get both Barruecos and the ambassador to help Haiti. Farmer's conference presentation explained that in Haiti, HIV infection is rooted in the country's extreme poverty, especially for women. Kidder accompanies Farmer to an AIDS quarantined treatment facility. While describing their travels, and Farmer's visits with patients, Kidder recounts Cuba's success against HIV. When they discuss Cuba, Farmer insists that Kidder tell things his own way, fearing that his admiration for Cuba will make him seem less credible. This leads to a squabble between the two men, which is resolved after Kidder gets sick with diarrhea and Farmer treats him.

Analysis
As part of a narrative, this chapter is odd and crowded. On one hand, it is quite straightforward: it describes Farmer in another context, where he continually, even tirelessly, works for the health of the poor. Paul Farmer remains who he is, no matter what context. In that it further demonstrates Farmer's consistency. On the other hand, Kidder foregrounds his own role in the narrative more explicitly than in any other. He quotes entire stretches of dialogue, touches on his own feelings, and even discusses the state of his bowels. This seems a direct response to Farmer's request that Kidder tell his own side of the story about Cuba. In doing so this way, Kidder is careful not to embrace Farmer's enthusiasm for Cuba too fervently. He also includes his own speculations about Cuba's loss of political freedoms as the cost for its superior public health. The result is a portrait of Cuba that is beautiful but relatively stiff and distant when compared to the descriptions of Haiti. Haiti, and Haitians, are portrayed as innocent by comparison. This is definitely due to Cuba's position as a Marxist country and the American mistrust of all ideological forms of collectivism.