How Paul Farmer Changed Medicine

Paul Farmer was a doctor, medical anthropologist and mentor who died Monday, in Butaro (Rwanda). Partners in Health (the organization that he co-founded) confirmed his death in a tweetOn Monday. He was now 62. Didi Bertrand Farmer was his widow. He is also survived by three children and thousands of students and patients, such as myself. Even though messages from politicians and stars pour in, it’s his coworkers and students who collectively grieve the loss. Paul Farmer was a leader and an inspiration for many who worked to improve the health of people around the world.
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Farmer graduated from Duke University in 1982 and went on to Harvard University where he earned an MD as well as a PhD. These formative years saw him travel to Haiti many times, including volunteering in a Cange hospital. In this role, he introduced a new concept to healthcare, medicine. It has since become an exclusive privilege for those who have money and access. All people deserve the same high quality of care. He believed, “The idea that some lives matter less is the root of all that is wrong with the world.” This led him to co-found Partners in Health in 1987 as a young medical student at Harvard Medical School, alongside Ophelia Dahl, Thomas J. White and Jim Yong Kim. It was able to provide high-quality healthcare in places with limited resources such as Lesotho, Rwanda and Haiti.

Dr. Farmer didn’t just believe in the idea of health as a human right, he lived and taught those values. He remained a doctor throughout his professional career, which is a rare but important feat. While to those outside of medicine, this may not resonate as significant, to those of us within that circle it is an extraordinary move – moving mountains at the systemic level by leading an organization or making change in international health policy requires so much time and energy that typically physicians temporarily or indefinitely pause their clinical practice. Dr. Farmer believed that it was about improving the individual’s lives. Tracy Kidder (author of Mountains Beyond Mountains, a book about Farmer, wrote, “he was a doctor first of all.” Dr. Farmer was always known for personally going on rounds in the hospital wards, letting the lived experience of patients guide him and others.

We were fortunate to have been his students. Dr. Farmer wanted to guide us on his journey to improve the health of everyone. His passion for teaching made clear that our lives depended upon the care that we gave. And it didn’t stop at noting a patient’s medication or writing down a diagnosis in a chart. It was about listening to their stories. In the Harvard University masters in medical anthropology program, Dr. Farmer was my student. He taught alongside greats such as Arthur Kleinman. I learnt from him about how the environment and biopsychosocial factors can lead to ill-health. Only recently, these concepts have been accepted into the medical school curriculum. In a world where medicine was primarily about biology, anatomy and physiology at the time, he explained how poverty in Haiti could increase HIV/AIDS’s timeliness or how a lack access to roads may prevent someone from receiving necessary treatment. In addition to knowing what HIV/AIDS does to a person’s immune system or what antibacterial medications to give for tuberculosis, it was about understanding the real, full life story of a patient to understand their illness.

“If you look at apartheid in South Africa, you see that people get sick with tuberculosis, malaria and other diseases because of poor work conditions, lack of jobs, shantytowns. You have to look at what’s happening to the patient in front of you, and think about ways to address social disparities. If there’s food insecurity, then you provide food when you provide care. Or if patients drop out of treatment, you provide transportation to the clinic, or you send community health workers to the patient,” he told NPR in a 2020 interview. These factors were a crucial part of health and disease, and he trained the next generation of healthcare professionals to make these connections.

He was a pioneer in the movement for social justice and global health through his revolutionary approach. His own efforts and those of his students helped improve the well-being of many people around the globe. He was loved by everyone, patients, trainees, and colleagues. Dr. Farmer was also the godfather of more than 100 children (mostly Haitian).

This is significant because Dr. Farmer was able to bring the social justice movement and care of the most vulnerable peoples around the world into the hands and minds of large audiences, helping to restore global health to the U.S. He shared his vision of more equitable healthcare with the public through 12 books and articles.

In 2015, he founded the University of Global Health Equity (in Butaro in Rwanda) by bringing together government officials and health professionals. He was kind, gracious, and humble as he accompanied each of us on this adventure. When, from Rwanda, I’d asked him for help in setting up our early partnership with the University of Global Health Equity, after resolving the situation, he replied with gratitude for our work, as though it wasn’t all there because of his vision and efforts.

Rarely does a person meet a doctor so deeply rooted in compassion, caring and service that they can make a difference in the lives of others. We will miss a great man, but the global field of health will continue to be shaped by the thousands of students and many others who were inspired by his vision for equitable healthcare.


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