“Dear Polo, we miss you,” wrote a Haitian health worker some twenty years ago, to the physician and medical anthropologist Paul Farmer. “We miss you as the cracked dry earth misses the rain.” At the time Farmer reportedly commented, “After thirty-six hours? Haitians, man. They’re totally over the top. My kind of people.”
When Paul Farmer passed away in February at the age of sixty-two, the deluge of tributes on social media and major news outlets reminded us that his kind of people could be found in every place he had gone—and in some places where he hadn’t. Young and old, rich and poor, atheist and Hindu and Catholic, people from many walks of life took inspiration from Farmer’s quest to cure the world. Our aim, as he once put it, “is nothing less than the refashioning of our world into one in which no one starves, drinks impure water, lives in fear of the powerful and violent, or dies ill and unattended.”
Like many of the other people Farmer mentored, I discovered his work by way of Tracy Kidder’s inspiring biography Mountains Beyond Mountains (2003). Hearing about the book as a college freshman, I put it on my birthday list and received it as a gift that May. I recall sitting down to read it one morning and finishing late in the evening of the same day. My eyes were aching, yet somehow I felt more energetic than I had in years. It was my first exposure to the idea that poor health is a kind of social injustice, and it gave me new eyes for the story of my brother, who was adopted from an orphanage in Guatemala City when he was four. Kidder’s book also offered an irresistible image of Farmer as a real, imperfect, modern, funny, endearingly human person, one who was pursuing what seemed to me a saintly life. The book was just a snapshot of that life, and no doubt it concealed as much as it revealed. But anyone who read it would want to know more, and by the end of that summer I was deep in the pages of Farmer’s own books.
I was not often taken to church as a child, and, perhaps for that reason, I was slow to appreciate the reverent, almost devotional quality of Farmer’s following. Obituaries described him as a “giant of public health,” the world’s “most extraordinary medical humanitarian.” Bill Clinton said he was “one of the most extraordinary people I have ever known.” John Dear, a Jesuit priest who knew Farmer for decades, has argued that the Church should recognize him as a saint. On Twitter, the indie rock band Arcade Fire wrote that “Paul Farmer changed our lives forever. He showed us how to work harder for others than for yourself. He was the punkest mother f***er WE ever met. Steal from the rich and give to the poor. Make yourself useful. WE will keep fighting for Haiti until the end of time.”
Many of the tributes published since Farmer’s death celebrate his bedside manner and his work as a builder of hospitals, health systems, universities, and the movement for health equity. How on earth did he do it all? With the help of many others, as he was always quick to recognize. But then why did so many people want to help him? How did he spark such an earnest moral reckoning among such a diverse and devoted following? I believe we can begin to answer this question by turning to his own writing.
Farmer’s scholarly writing spans several decades and a few different academic disciplines. Some of his books and articles are more approachable than others. Farmer’s writing is often personal, describing the world as he saw it and walking readers through his own surprises, setbacks, and delights. Years ago, as I began to make my way through his books and scholarly articles, I discovered that his writing is unambiguously Catholic. He was not just a good Catholic who also happened to be a very good doctor, nor was he simply motivated by his faith to produce compelling secular ideas for a secular milieu. In order to understand his books and grasp the full power of his moral vision, I discovered I would need to study not only ethnography, infectious-disease ecology, and systems design, but also the gospels. I would also need to understand the emergence of liberation theology as a countercultural movement within the wider tradition of Catholic social teaching. These sources seemed to be an indispensable context for Farmer’s writing, first because he referenced them frequently, but later because my increasing exposure to Catholic social thought allowed me to read between the lines of Farmer’s work and see a deeper meaning in his project. He used the resources of the Catholic tradition to understand human suffering, to rebuke the principalities and powers that maintain the sorrows of the poor, and to nurture the fierce hopefulness for which he was so well known.
“Bearing witness” is a term with deep religious roots that were lost on me when I first encountered it in Farmer’s 2003 book, Pathologies of Power: Health, Human Rights, and the New War on the Poor. The first part of this book bears witness to poverty and poor health in Guatemala, Mexico, Haiti, Cuba, and Russia. In one instance, Farmer and Ophelia Dahl, co-founders of the health-care charity Partners In Health, found themselves in northern Guatemala. A local indigenous organization had requested their assistance for a mental-health project. The aim was to locate and disinter people whom the Guatemalan army had buried in mass graves during the country’s thirty-six-year civil war. Why?
Because the victims had been “buried with their eyes wide open.” And neither they nor their kin would know peace until they were buried properly. “So that their eyes may close,” explained Miguel, who, along with Julia, spoke as their leader. My own eyes were stinging, but not from the smoke. Again, a silence fell over us, this time a silence of complicity and solidarity. Ophelia spoke first, saying that we who would never know their suffering would try to do our part, and also that we would bear witness in the hope that such crimes could not be committed so readily in the future.
This scene beautifully conveys Farmer’s humanizing vision of health equity. Here to “bear witness” is a pragmatic expression with broad appeal. Yet Farmer did not shy away from the term’s religious roots, though he addressed the issue ethnographically rather than philosophically, by reflecting on the faith of the people he encountered in his work. In the following paragraphs he describes looking up from this meeting to see a small portrait of the recently martyred Bishop Juan José Gerardi, who was bludgeoned to death in 1998 after releasing a report that indicted the Guatemalan army for deaths and disappearances during the conflict. Farmer quotes the bishop’s final speech before his death:
In our country, the truth has been twisted and silenced. God is inflexibly opposed to evil in any form. The root of the downfall and the misfortune of humanity comes from the deliberate opposition to truth, which is the fundamental reality of God and of human beings. This reality has been intentionally distorted in our country throughout thirty-six years of war against the people.