Monday, February 19, 2007

My Heart Still Beats for Haiti – A Review of “Mountains Beyond Mountains” by Tracy Kidder: The Quest of Dr. Paul Farmer

I must warn you that this Blog posting will be more than the usual review of a book. Pulitzer Prize winner, Tracy Kidder, has done a remarkable job of writing a book, Mountains Beyond Mountains,” that tells the compelling story of Dr. Paul Farmer, a Boston-based physician whose real home is Haiti - and other places in the world where infectious diseases still await eradication.

Reading Mountains Beyond Mountains brought back to me the sights, sounds, smells and symphony of problems that is the Republic of Haiti. Haiti was my home for 11 months in 1974-75. I served during that period of time as the administrator of a tiny village hospital in Fermathe, an hour’s drive into the mountains above Port au Prince. I left Haiti to return to the U.S. and graduate school, but Haiti has never left me. I still speak the language, Kreol, and whenever possible, I look for opportunities to taste the scrumptious Haitian dishes I grew to love - like Cabrit Kreol (roast goat meat), rice and red beans and pumpkin soup! Kidder’s book resonated with me so strongly that it reignited my desire to get back to Haiti as soon as possible, and find ways to join in the fight that Dr. Farmer and Partners in Health continues to wage against staggering odds.

I do not yet know Paul Farmer personally, but for years I have been hearing about his pioneering work in the village of Cange in the parched Cul de Sac, a sun-baked section in the interior of Haiti accessible only across a lunar landscape masquerading as a road, the infamous Highway 3. In that forsaken and impoverished (even by Haiti’s egregious standards of poverty!) area, Dr. Farmer and his colleagues have managed to construct a modern hospital and create an innovative approach to public health that has dramatically improved the chances for survival of those afflicted with TB, AIDS and other infectious diseases that are rampant in this Caribbean nation.

Kidder is a participant observer in this saga of one man refusing to accept the status quo in Haiti – and eventually in other neglected places, like the prisons of Russia. Kidder traveled with Dr. Farmer to Haiti, Cuba, Russia and countless other spots around the globe. The picture that he paints of Paul Farmer is a complex one of a man who is both larger than life and also very human in his idiosyncrasies and refusal to play by the accepted rules of medicine and public health. While revolutionizing the delivery of medical care to one of Haiti’s most deprived areas, Dr. Farmer has managed to rattle a few cages and ruffle a few feathers. How could it be otherwise?

I cannot begin to claim objectivity in responding to Mountains Beyond Mountains.” There probably are not many other readers of this book whose life experiences so closely parallel those of Dr. Farmer in so many dimensions: we both live in Boston, speak Kreol, have run a hospital in rural Haiti and have worked in Russian prisons! Needless to say, I can’t wait to meet Paul Farmer face-to-face and share war stories.

As I read through this stunning book, I found myself smiling knowingly about the way that things work – or don’t work – in Haiti. Tires blown out by the sharp rocks in the road, roads impassable after a rain shower, catching a ride into the capital city shoehorned into a tap-tap full of peasants bringing baskets of chickens to market. I found myself weeping when I read of a young patient died of cancer despite the extraordinary length that Dr. Farmer’s team went to try to save his life. It reminded me of many I had known in Haiti who dies young - cut down needlessly by diseases the rest of the world had long ago forgotten about. I found myself getting angry all over again at the results of decades of economic mismanagement, political corruption and ill-conceived development projects that have kept Haiti mired in its perennial role as the Western Hemisphere’s poorest nation.

Given my knowledge of the extraordinary challenges that face anyone who desires to accomplish anything in Haiti – fighting bureaucracy, despair, disease, poverty, climate, corruption and a total absence of infrastructure – I am in awe of what Dr. Farmer and his team has been able to accomplish in Haiti. His superhuman commitment to do whatever it takes to bring modern medicine to the people of Haiti is both inspiring and intimidating. How can one man manage to do so much? Yet, the truth is that despite this one man’s Herculean individual efforts, he has also managed to raise up and inspire a growing team of men and women who join with him and Partners in Health to expand the work in Haiti and in other parts of the world where an enlightened approach to public healthy is sorely needed.

Kidder’s balanced presentation of Dr. Farmer and his work has inspired me to learn more about the needs that Partners in Health is trying to meet. Given my personal knowledge of Haiti’s overwhelming needs and problems, I am committed to exploring with Dr. Farmer and his team ways that I may be able to leverage my network on behalf of the work of Partners in Health. As that process of exploration moves forward, I will keep readers of the White Rhino Report informed.

This book is a “must read.” One need not have an interest in Haiti to find value in this book. Even if reading the book does not inspire you to do something to help Haiti or Partners in Health, I guarantee that it will make you question whether you are doing enough to make a difference in contributing to the causes that you do care about.

On several occasions in the book, Tracy Kidder describes accompanying Dr. Farmer as he made the long trek up one mountain and down the next valley – up and down all day long – to reach the hut of a patient in need of care. It was a grueling hike that was both exhausting and inspiring for Kidder to see Dr. Farmer’s dedication and the response of his isolated patients. Those treks through Haiti’s “mountains beyond mountains” serve as a fitting metaphor for the journey that many readers will have in walking through the pages of this book. There will be many highs and lows along the way, and it will be a journey that will test your limits. But the end result is well worth the effort.

For more information about the work of Partners in Health, I urge you to visit their Website:


No comments: