Thoughts from Paul Farmer, MD, PhD
I was lucky to get involved in public health in the 80’s. Thirty years ago when I was an undergraduate, I took a class in medical anthropology. I had no idea what medical anthropology was but it had “medical” in it. I was 20 years old and I thought, well, I want to be a physician, so I’ll take the class. I really got engaged in the classroom, and that one class led me to work in the emergency room at Duke as a volunteer. Later I worked with migrant farm workers where I met a lot of patients. By the time I was in college, I decided that I would like to go to Haiti, which I did after I graduated. I first went to Haiti the year between my undergraduate training and my starting medical school at Harvard.
My experience with the migrant farm workers engaged me intensely in public health work. At 21 years old, meeting people who have left their home country and who have ended up in very difficult circumstances in the United States as migrant farm workers, is very compelling. I think the term that we were using— pragmatic solidarity—is very similar to compassion. Compassion is something that I assume almost all of humans feel, but making that pragmatic is a different step all together.
Compassion means, literally, suffering with, but we want to have a substantial impact. “Suffering with” is really not very pragmatic unless it is linked to reducing suffering, and that’s where I think global health needs to go. It is not just about acknowledging the suffering of others. It is also about asking the question, “how much of this suffering is premature or even unnecessary and what might we do collectively to lessen it?” So compassion, suffering with, is for me not the way for global health to proceed unless it is linked to really pragmatic efforts. In my experience in Latin America and Africa and even in the United States and Siberia, I really almost never encountered someone who might say, “Look, I’m suffering, would you suffer with me?”
Dr. Farmer, a medical anthropologist and physician, has dedicated his life to treating some of the world’s poorest populations to raise the standard of health care in underdeveloped areas of the world. He is a founding director of Partners In Health (PIH), has worked in infectious-disease control in the Americas for nearly two decades and is a world-renowned authority on tuberculosis treatment and control.