In Mountains Beyond Mountains by Tracey Kidder, we learn about the life of doctor Paul Farmer and his pursuits to solve many of the world’s health problems. His approach is unconventional, but it works. It involves being there with the people he wants to help, getting his hands dirty, not just working in a lab. In his work, he emphasizes an important aspect of Catholic Social Teaching, the Preferential Option for the Poor, or as he calls it O for the P, and he describes it as “a special concern in distributive justice for poor and vulnerable persons.” Although his organization Partners in Health, or PIH, is a non-religious organization, he cites this concern for distributive justice as the moral guideline he follows in his work. PIH hospitals are in some of the most economically disadvantaged locations known for their poverty and health problems, but even with these circumstances the workers at these hospitals are trained to care for the patients with the utmost respect, even more than what might be found at some of the best hospitals in the United States. Another important aspect of how Farmer runs patient care at PIH hospitals is the aspect of care that goes beyond giving the patient medication and leaving them. He emphasizes that factors like the caloric intake of the patient, a big factor in a country like Haiti where malnutrition afflicts a large portion of the population, as well as the quality of water they drink which is also important to successful treatment for many diseases. These are examples of the kind of resources that Farmer provides to patients in addition to medicine and treatment. An important contributor to Farmer’s vision of O for the P on a global scale is Jim Kim, a friend of Farmers who also worked for PIH. Mr. Kim was responsible for the tasks involved with running the organization and spreading the message of PIH in the political field. Providing healthcare in foreign countries can require the approval or support of the government. In Mountains Beyond Mountains we learn about his desire to spread O for the P in this quote:
“As sometimes happened, Paul seemed to know what Jim was thinking. ‘What do you want to do now?’ he asked. There was warmth in the question, Jim felt, a real invitation for him to come clean. ‘Political work is interesting to me, and it has to be done,’ he said. ‘I prefer it to taking care of patients. It’s O for the P on an international scale.”
The name of the book has a meaningful story behind it. “Beyond mountains there are more mountains” is the translation of a Haitian proverb and where the name of the book comes from, but what does this proverb mean exactly? According to Tracey Kidder “Sometimes it’s used (by Haitians) to express the idea that opportunities are inexhaustible, and sometimes as a way of saying that when you surmount one great obstacle you merely gain a clear view of the next one. Of course, those two meanings aren’t inconsistent, and I meant to imply both in the title.” The title conveys the spirit, scale, and difficulty of Dr. Paul Farmer’s work. This proverb can also be used for many other circumstances such as at school. A student might finish a big assignment and has reached the top of the mountain and has an amazing feeling but then there is another mountain that will be next assignment. That is how I visualize this proverb.
There are two vital characters in this story and in the creation of Partners in Health, Ophelia Dahl and Tom White. These two individuals do great work and many acts of compassion. Tom White helped create PIH and donated a significant amount of money without choosing to be recognized. Ophelia Dahl went to Haiti to satisfy her father and worked for Eye Care Haiti and while there she met Farmer and they became involved in a relationship Both Dahl and White have done great work but their compassions drastically differs from Farmer’s, while Farmer has saved thousands of lives, both directly and indirectly. He treats the patients he works with as family, and shows them the care they deserve but most of the world won’t give them. Paul works unbelievably hard to save every person he can, and to change the world to save more people than he can alone. He has no time for himself, and is busy traveling around the world to different PIH location and conferences to spread his message. Paul Farmer’s work is his top priority. Dr. Farmer appeared to have difficulty seeing the problems as a whole. He dealt with patients one at a time and as best as he could. By contrast I think White and Dahl looked at the problems more through a wide lens and saw the bigger picture. They helped many people, but not making a difference in individuals the way that Farmer did.
Doctor Farmer also discovered something important about the treatment of the poor, which is that they need money for food and other necessities along with having a health worker check on them to make sure they are taking the necessary medication to ensure they are cured. They have not lost a single patient in Haiti with this system, and if the US had this system we could likely have much better outcomes with our healthcare system. We could probably save tens of thousands of lives in the U.S. by adopting this philosophy of holistic patient care, especially for people living in poverty.
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