Mountains Beyond Mountains by Tracy Kidder tells the story of Dr. Paul Farmer, who through his brilliant, compassionate work in Haiti and other places stricken by poverty has changed the way much of the global health community works with impoverished nations. He co-founded Partners in Health while still a med student.
Farmer grew up in a trailer park or living on a fishing boat with his big family. He was always smart in school and marched to his own beat. He got a full scholarship to Duke University where he studied Anthropology. He wanted to focus on Medical Anthropology so he applied to Harvard and Case Western, the only schools that had such program. He got into Harvard. He visited Haiti to get a feel for the kind of career he was dreaming of and wound up pretty much living there and starting a clinic in one of the poorest areas of a very poor country. He actually spent most of his time in Haiti during medical school, studying in between serving patients and only showing up for exams. He graduated near the top of his class. He now teaches at Harvard as well as speaks around the world on global health issues. And he still serves patients one on one.
The author, Kidder, follows Farmer around, walking 7 hours to visit two patients for instance, or flying with him to Boston, Peru, Cuba and Russia to help establish clinics there (or in the case of Cuba to note how well they have controlled TB/AIDS and seek expert help from them). Farmer wrestles with all kinds of issues; how to work with the poor, how to fund raise to make his dream happen, how to deal with the World Health Organization and politics, how to cope with death, the needless death and misery of the poor, and the complexity of living in both the 1st and 3rd world and trying to make moral decisions constantly. Kidder obviously deeply admires Farmer, who is a lovable genius who can't quite buy into the cost-benefit analysis approach to healthcare - every patient in front of him deserves the best care he can give him or her. He loves being a doctor and well, doctoring.
This book was hard to put down. Kidder is an excellent writer (see my review of Strength in What Remains) and Farmer is such an interesting and admirable man. I don't know much about the issues covered in this book, but I should! I want to read books by Farmer, especially the one entitled Haiti after the Earthquake. The whole time I was reading about Farmer I kept thinking that he has got to be one of the 36 righteous men who save the world. Dr. Farmer and his lifework are both complex and compelling. Kidder does a good job of portraying that complexity. Farmer is constantly torn, between serving the poor of the world and seeing his wife and child, berating his co-worker for wanting to sightsee in Russia while working there, but having his (Farmer's) own pretty fishpond in clinical compound in Haiti, trying to decide if it is right to spend $28,000 to save one dying boy in Haiti or should that money be better spent getting medicine to a lot of people? Kidder himself gets pulled into this guilt-ridden tension, sheepishly worrying about his own health in the midst of witnessing the horrific misery of the poorest of the poor. And the book introduces the reader to many of the people who helped Farmer, Ophelia Dahl (daughter of Roald Dahl) and Jim Kim - cofounders of Partner's in Health and others who have devoted their lives to serving the poor.
All this made me reflect on my own attitude toward the poor. At one point in the book when Farmer is yet again begging for desperately needed money, he says something like: if only I had all the money Americans spend grooming their dogs! It made me think of that gospel story of Rich Lazarus and Poor Lazarus, poor Lazarus not even getting the scraps fed to the dogs. Farmer is definitely influenced by the gospel and the often Catholic impulse to serve the poor. He takes it very seriously even though he has problems with aspects of Catholicism. Partners in Health takes the Catholic concept, made famous in Liberation Theology, of the preferential option for the poor as their moral imperative. I feel Kidder is mostly objective in his telling of Farmer's story, and I trust most of his narrative, but I did get a bit of anti-Catholic feeling from him at times (and also in the previous book). For instance, Kidder tells of Mother Teresa's visit to Haiti. Farmer got hot under the collar about the sister visiting Mrs. Baby Doc Duvalier and complimenting her on her work with the poor. I can see why Farmer would find that unjust. I am sure Mother Teresa blundered at times and had different strategies to awaken a sense of duty and compassion to the poor, some more effective than others. But the whole incident felt very taken out of context. When I got to the end the book, the only bibliographical resource cited for Mother Teresa was Christopher Hutchin's awful and terribly biased book on her. Huh? Kidder does often note that many nuns and priests help Farmer and that many of those who are involved in his projects are religious but he never elucidates on that. But it really is a huge and complex story with many characters so I am not really too disturbed by this. I just noted it as I read this eye-opening book.
This book made me feel ashamed of my own luxurious, self-centered lifestyle. I am now compelled to ask myself, where is my preferential option for the poor? What have I done for the least of my brethren? How have I loved my neighbor as myself? Farmer is really Christ-like in his whole life-long embrace of the poor. And I haven't even gone into the bulk of the second half of the book which tells how Farmer saved the world from drug-resistant tuberculous, which began to be rampant in poor areas of the world due to the WHO's incomplete understanding of how best to administer medicine to those living in abject poverty.
I highly, highly recommend this book to anyone in the first world who needs to be jolted out of their complacency. And who doesn't? Go to Read 52 Books in 52 Weeks for more book reviews.
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