Mountains Beyond Mountains: Farmer\'s Dilemma

MOUNTAINS BEYOND MOUNTAINS: FARMER'S DILEMMA

Tracy Kidder's "Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World" is a true story of one man's crusade against infectious diseases in some of the poorest nations in the world- most prominently Haiti. The story revolves around many philosophical, ethical and political issues concerning healthcare to highlight the inequalities and disparities in healthcare access and distribution of wealth around the world. Dr. Farmer goes into the depth of some of the very modern but highly puzzling political issues such as role of the U.S. In Haiti and inadequate healthcare situation that U.S. has not been able to improve. Farmer notices that despite their best intentions, the peacekeeping forces of the U.S. In Haiti have not been able to bring about any real change in the social condition of people in Haiti. The soldiers have failed to go to the depth of cultural beliefs and traditions that heavily affect Haitians and their thoughts on healthcare. He understands the cynicism of soldiers as he believes that "had done their best" and felt that they "would not cry over things beyond their control" in Haiti (p. 8).

Farmer's work in Haiti focused on more than simply offering medical cures. He tried to get to the very roots of people's beliefs and noticed that Voodoo played a major role in their belief system and accounted for many healthcare issues. People did not always believe that they were sick. They would attribute it to Voodoo and hence Farmer had to get more involved in their belief system to offer them better treatments for infectious diseases like tuberculosis. "In one of his books, Farmer had written that there was a distinction, in the Haitian countryside, between belief in sorcery and the theories and practices called voodoo but virtually everyone including Catholics and Protestants and Voodooists, believed in the reality of maji, of sorcery. From many people around Cange, magic spells sent by enemies were the deep cause of many illnesses. And many people around Cange believed that Farmer like all good Voodoo priests, knew how to contend with maji" (p. 28) Thus sorcery was deeply embedded in the psyche of Haitian people and Farmer was clever enough to learn various beliefs in order to contend them successfully and offer better healthcare options to these poor and uneducated people.

Farmer would work with both science and magic to understand people better and to actually cure them. He was compassionate enough to realize that there was a much deeper political reason why poor people in some of the most downtrodden places still believed in the power of sorcery. The politics dictated their lives because in the absence of modern education and modern medical practices, they had come to rely on the old practice of magic which still held meaning for them. He explains: "Haitians believe in sorcery because their culture has evolved in the absence of effective medicine. So of course they believe in sorcery, in sicknesses that someone has sent to them. Why else would someone fall into coma? And when someone is very sick and people are used to seeing them die with the same symptoms and you give them meds and they rapidly recover, people think and then they start talking." (p. 28)

Once Farmer got involved with Haitian culture, he also found himself entangled in many dilemmas both ethical and political. The first one came in the form of science and magic. Is it ethical to learn sorcery and allow people to think that you are using magic to cure them when you obviously believe in the power of medical science far more than magic? Farmer offered an explanation of why he got involved with sorcery. He realized that without understanding the belief system that controlled the health of Haitian people, it would be impossible to offer them alternatives. Farmer's explanation was simple: "A doctor who knew nothing about local beliefs might end up at war with Voodoo priests, but a doctor anthropologist who understood those beliefs could find ways to make Voodoo houngans his allies." (p. 83)

This was an important step taken by Farmer to bring new ideas to Haiti. He knew that people wouldn't accept new treatments or alternative ones if they didn't trust the person offering them. In order to win their trust, he had to learn more about their cultures and beliefs and he did. This helped him in his cause and in his fight against infectious diseases in Haiti.

The other dilemma came in the form of working locally vs. working globally. When presented with an opportunity to work with some of the more advanced countries of the world such as Russia, Farmer was torn between choosing a poor country that needed him and the world at large that could use his ideas and help. "Russia would mean even more days and weeks away from Haiti, a place much more afflicted by TB and every other disease." (p. 221)

Farmer did not at first know what to do. Should he become a global anthropologist and doctor who was a true crusader or should he limit his energies to Haiti and other poor countries of the region. Farmer finally realized that money coming in from his efforts in other countries could help in his Haitian endeavors. "PIH could legitimately use some of Soro's money to pay salaries." (p. 221). Money was not the only reason for Farmer to go global; there were other more humanitarian reasons as well. He found that, "Russia's epidemic was ravaging its prisons, and prisoners were part of PIH's special constituency." (p. 221)