Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Could Cure the World can bring about feelings of discomfort as the book often asks that the reader question their own role in health disparities. Farmer very importantly resists the Western tendency to categorize social ailments. Instead, he highlights the interconnectedness of of identities. As such, he does not suggest that health stands alone. Instead he argues that a “broken world” is what has caused the health crisis in Haiti. More often than not, health crises are left for governments or non-profits to tackle. He rigorously fights against charity complexes and uses the West’s genocide of Native Americans as an example. He traces how colonialism is the root of poor health conditions in many countries. He argues that not only were these crises avoidable they could also come to an end. However, Western countries have not cared enough...
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to question the role of capitalism and colonialism. This is the moment where Farmer draws the reader into the story. He, like so many of his contemporaries, make the claim that you live the way you do because someone else lives the way they do. With this in mind we are all directly responsible for the health crisis in Haiti. I wholeheartedly agree with Farmer and respect his courage to speak truth to power. We must all recognize the ways we are historically implicated in the conditions of others.
As noted in Mountains Beyond Mountains, there is significant global inequality in access to healthcare, and this is closely tied to the economic inequality that occurs globally. This unequal distribution of wealth and healthcare occurs because of our systems of trade and economics. Free trade and capitalism, the currently dominant global ideologies in these areas, are both primarily focused on increasing the efficiency of production through innovation. These ideologies do not try to ensure that everyone has equal access to the increases in efficiency. Thus, it has typically fallen on governments and nonprofits to ensure widespread access to these innovations. However, this access typically comes with higher taxation rates or requires significant charitable giving. In both of these cases, this money could alternatively be directed toward developing further innovations. This leads to a trade-off. With wider access, innovation can become slower, and vice versa.
The question for society then becomes, At what point is the loss of innovation worth the increase in access? In the case of healthcare or food production where human life is at stake, I would say that ensuring wider access is worthwhile. Therefore, I would personally tend to agree with Paul Farmer.
However, this is a simplified version of the moral dilemma associated with inequality. Additional complications come into play in the real world. For example, increased inequality has been associated with societal instability. In some cases, this has led to widespread protests, violence, or even revolution. On a personal level, this again leads me to support reducing income inequality.
The Gini coefficient is a measure of inequality. The World Bank page linked below shows it for different countries. A higher coefficient suggests increased inequality.
The resource from Columbia, also linked below, discusses inequality and the social costs associated with it.
References
Dr. Paul Farmer, physician and anthropologist, is the co-founder of Partners In Health, a non-profit organization that states that it has two major goals:
... to bring the benefits of modern medical science to those most in need of them and to serve as an antidote to despair ...
The essential argument of Farmer is that we have a moral obligation to alleviate suffering and thus that poverty should be no obstacle to medical care.
I agree that income inequality and the ensuing level of inequality in medical care are morally problematic. Adequate food, shelter, safety, and medical care seem to me fundamental human rights, especially in a world that has more than sufficient wealth to distribute these universally.
In the case of infectious diseases, given the level of global travel and migration, it also seems in the self-interest of wealthier countries to aid poorer ones, as diseases know no borders. It is only by global programs of vaccination and care that we can eradicate diseases rather than leaving reservoirs permitting the diseases to recur.
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