World-renown global health advocate, Dr. Paul Farmer, died in his sleep in Rwanda, leading to an outpouring of both sadness and praise from many health and public health practitioners in the United States and around the world. At the time of his sudden death, Farmer was working in the central African nation at the medical school he co-founded with the Rwanda’s former minister of health, Dr. Agnes Binagwaho.
Farmer, a medical doctor and anthropologist with advanced degrees from Harvard, co-founded of the Boston-based Partners in Health (PIH). The group confirmed his death on Twitter today, Feb. 21, 2022. ABC News reported PIH had confirmed Farmer died from an acute cardiac event that happened during his sleep.
Despite his prestigious graduate pedigree and also having attended Duke University as an undergraduate, he eschewed the path of traditional power and influence that his elite training afforded him. He had his eyes set on the world, where many lacked access to basic health care. According to Duke University, Farmer sought to “strengthen public health systems in order to provide quality health care in some of the world’s most vulnerable communities.” By the time of his untimely death, he had established a wide following after having spent decades of his life working on addressing global health inequities, in Haiti, Africa, Eastern Europe, and Latin America.
It is fair to say Farmer influenced nearly a generation of health and public health practitioners in the United States who have an interest in global health and health inequities. Those singing his praises today range from policy hawks like Samantha Power, to Hollywood celebrities, to former President Bill Clinton, as well as scores of public-health minded doctors who shared comments on Twitter, expressing sadness at the news of Farmer’s passing.
Farmer left a mark with his peers and colleagues globally who shared his passion to fix the same root issues driving and underlying global health inequities. The day after Farmer’s death is filled with diversity of persons who work in those fields sharing personal comments explaining why Farmer mattered in this collective effort. One former colleague, Dr. Sriram Shamasunder, met Farmer as a university student and was inspired to join in the work Farmer was doing. “He conveyed with his words, the irresistibility of social medicine, where health workers aim to address the root causes of disease in its social and economic context,” wrote Shamasunder in an essay published by National Public Radio just after Farmer’s demise. “This work is where necessity, urgency, and joy become bound together.”
Nearly every graduate student I met at the University of Washington School of Public Health (UW SPH) when I got my degree there (2010-‘12, as an older student) shared tales describing that their interest in working in international health was influenced by Farmer’s thinking and writing. He also visited my alma matter to speak about his work. That praise felt very close to hagiography, which can also hide any famous person’s flaws and blind spots. Those who know better of making saints from mere mortals can easily describe this type of myth-making as “white saviorism.” That is real too, regardless of Farmer’s accomplishments.
Tracy Kidder’s famous book about him, Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World, is the one book that came up in many conversations among UW SPH grad students. Here are some works by Farmer that provide some insights to his influential thinking, which are not uniquely his and also are shared by many doing similar work. I have not read it, but clearly the book has what can best be called a “dedicated following.” One cannot deny that Farmer was tireless in communicating the change he worked on, in the mud and in the field.
A good profile of him can be found in a New Yorker piece from 2000 that is circulating among those in global health who are lamenting this loss. The myth-making portrait by Kidder in her book about Farmer is based on a Haitian proverb: the Haitian proverb “Beyond mountains there are mountains”—as you solve one problem, another problem presents itself, and you go on and try to solve that too. That is a good metaphor to living life, ready to engage and never losing your purpose why you do what you do.