" (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...

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)

The third major reason for going global was more political and yet ethical in nature. By doing something in a wealthier nation, Farmer and his colleagues could effectively influence healthcare efforts around the world especially healthcare policies in poor countries. "Russia might represent the kind of opportunity Paul and Jim had hoped for….a chance to alter health policy toward the poor on a global scale." (p. 221)

If I had been in his place, I would have done the same thing because Farmer's reasons are very logical and also take into account the bigger picture. His reasons for expanding his work to wealthier nations could effectively influence health policy around the world including Haiti and such global approach was indeed what these crusaders needed.

Reference

Tracy Kidder. Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World. Random House Trade Paperbacks (2009)