A Tribute to Paul Farmer who died February 21, 2022
Doctor Paul Edward Farmer was born in 1959. He was the second of six children; he grew up in the mill town of North Adams, Massachusetts. In 1966, the family moved to Alabama and later relocated to Florida in 1971. They were so poor that they lived in a bus that his father had purchased in auction. There, as a young boy, he picked fruit with Haitian migrant workers and was probably influenced by that experience. The extent of the economic deprivation that he felt growing up helped him understand what it means to be without, and may have inspired him to devote his life’s energy to those in need.
Farmer is widely known for his remarkable and unrelenting service to the people of Haiti, driven by his desire to provide good quality health care and assistance to the impoverished people of that country. In addition, he has been a strong advocate for Haiti in the international arena and has been particularly critical of what he sees as America’s plan for fixing the nation’s enfeebled economy.
In order to have a clearer understanding of the economic and political forces that have come to shape present-day Haiti, it is important to have an historic perspective of this beleaguered country. Hispaniola was colonized by Christopher Columbus’ brother, Bartolomeo, for Spain in 1496. He established the capital at Santo Domingo (Dominican Republic) on the eastern side of the island. In 1697, the Treaty of Ryswick ceded France dominion over the western half of the island – present day Haiti. During the eighteenth century, Haiti operated as a slave colony and a leading port of call for slave ships. By the latter part of that century, nearly one out of every three slaves, who arrived in Haiti, died within a few years of reaching the colony.
In 1791, a revolt began against French domination. This revolt was led by François-Dominique Toussaint L'Ouverture (May 20, 1743 – April 7, 1803). Toussaint led enslaved blacks in a long struggle for independence over the French colonizers; ultimately, his movement abolished slavery, and secured "native" control over the Haitian colony. In 1797, following his victory, L’Ouverture expelled the French commissioner Léger-Félicité Sonthonax, as well as the British army; freed the slaves in neighboring Santo Domingo, and wrote a Constitution naming himself governor-for-life.
Between the years 1800 and 1802, Toussaint L'Ouverture - translated from the French, his name literally means “all saints” or “all souls opening” - tried to rebuild the collapsed economy of Haiti and reestablish commercial contacts with the United States and Britain. His rule permitted the colony a taste of freedom which, after his death in exile, was gradually undermined during the successive reigns of a series of despots. His last words were to his son in France, "My boy, you will one day go back to St. Domingo; forget that France murdered your father."
In 1804, the independent state of Haiti was formed and it was declared as a safe haven for runaway slaves. It is important to note here that the United States government refused to recognize Haiti’s independence. Sadly, the native population of Haiti is no longer extant; they were eliminated as a result of the Spanish domination that preceded the arrival of the French.
In 1825, King Charles X of France recognized the independence of the country only on condition that an indemnity of 150 million Francs - approximately one-half million dollars - be paid and that an agreement be reached regarding a reduction of import and export taxes placed on French goods; this arrangement was tantamount to extortion. These repayments continued until after World War II. The effect of this agreement was devastating to the Haitian economy in that it represented a mass transfer of wealth from the poor indigenous people of Haiti to wealthy foreigners.
From 1915 through 1934, Haiti was occupied by the U.S. military. The United States occupation of Haiti began on July 28, 1915, when 330 US Marines landed at Port-au-Prince as directed by President Woodrow Wilson. They were dispatched to the island with the express purpose of protecting U.S. corporate interests. It ended on August 1, 1934, during the presidency of Franklin Roosevelt.
Farmer first traveled to Haiti in 1983 while it was under the harsh dictatorship of the Duvalier family. At that time, it was considered to be the poorest country in the western world. Baby Doc Duvalier who was “President for Life” fled the country in 1986. The first attempt at democratic elections was undertaken the following year; the fragile nature of this movement towards democracy was made apparent by the fact that a massacre took place at one of the polling stations.
In 1990, Father Jean-Bertrand Aristide ran for President and on Dec 16, 1990 he won sixty-seven percent of the popular vote. He was a catholic priest who was an avid proponent of liberation theology and believed strongly in the, “preferential option for the poor,” reminiscent of the work and mission of Father Romero of El Salvador. He voiced opposition to the policies of Pope John Paul II and Ronald Reagan, President of the United States. As a consequence, President Bush, who succeeded Reagan, funded Aristide’s opposition and cut off aid. The paramilitary group Front for the Advancement and Progress of Haiti (FRAPH) rose to prominence and staged a coup on September, 1991 that left one thousand dead. Aristide ultimately returned to power in 1994.
Before the devastating effect of the recent earthquake, the Haitian economy was already in terrible shape. By the year 2000, the entire budget for Haiti, with a population of eight million people, was less than the budget of Cambridge, Massachusetts, a city of 100,000 individuals.
Farmer graduated from Harvard Medical School with an ancillary PhD degree in anthropology. He worked in Haiti for eight months out of every year without pay, serving peasants who had lost their land as a result of the construction of a hydroelectric dam. For the remaining four months of each year, he worked in Boston living in a church sanctuary. He was briefly expelled from Haiti during the reign of the military junta, but managed to sneak back into the country by bribing government officials. In 1994, Jimmy Carter was dispatched by President Bill Clinton to try to persuade the junta to abdicate their pernicious rule of the country.
The tireless energy of Farmer on behalf of the people of Haiti has earned him the affectionate title of the, “poor people’s doctor.” In 1999, he also worked at the Brigham and Women’s hospital in Boston and was the Professor of Medicine and Medical Anthropology at Harvard Medical School.
Farmer’s primary concern and professional interest lies in the realm of the relationship between economic inequality and infectious disease. In his mind, many of the premature deaths that occur throughout the world from uncontrolled infectious diseases are a direct result of the mal-distribution of medical technologies. He is never reluctant to fault the rich countries for their failure to address this issue on a global scale, especially his home country, the United States.
On account of his strong commitment to the service of those in need and his passion to do whatever he can to counter the dire effects of poverty, he has created a remarkable community referred to as Partners in Health (PIH) in Zammi Lasante. This complex includes a woman’s clinic, a general hospital, an Anglican Church, a kitchen that prepares meals for 2,000 people daily and a treatment center for Tuberculosis (TB). This medical center possesses two laboratories and an ambulatory clinic that serves hundreds of people. One million peasant farmers - in a country of eight million -depend upon this facility. The per capita income of the average Haitian is about one dollar per day. Twenty-five percent of Haitians die before the age of 40. Farmer is so committed to the health and well-being of the people of Haiti that no one is turned away. In addition, PIH helps build schools, water systems and manages a vaccination program with the goals of vaccinating all children, reducing malnutrition and decreasing infant mortality.
In 1993, Farmer was awarded a MacArthur Genius Grant of $220,000 for his efforts. He donated the entire sum to PIH. The following is an excerpt of his acceptance speech on receiving this grant: “The individuals who are living in dire poverty throughout the world may well exceed one billion in number. The suffering, starvation and premature death that is a consequence of this poverty is unconscionable in a world where the wealthiest nations enjoy an abundance and have ready access to a multiplicity of resources that are denied to so many of their fellow humans. In many regards, the scale of this suffering is due to a lack of access to an adequate food supply, appropriate medical technology, education and basic information.”
Dr. Paul Farmer had dedicated his life to demonstrate that these horrific conditions can be effectively ameliorated, if not entirely eliminated, by making available to everyone what is currently available only to some
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