Global Health

Countering Failures of Imagination

This is a post I wrote with Michelle Truong for the GlobeMed at UT website. You can check out the original post here.

In several events at the University of Texas at Austin last week, Dr. Paul Farmer spoke about health and human rights, building integrated health systems, and working in solidarity with those in the poorest communities in the world.

If you don’t know of Dr. Farmer or Partners in Health, grab a copy of Tracy Kidder’s Mountains Beyond Mountains. Kidder presents a biographical account of Dr. Farmer’s work in some of the poorest areas of the world and of the founding of Partners in Health, an organization that brings healthcare to the world’s poorest communities.

Paul Farmer and Partners in Health have dramatically impacted both of our lives. Brian read Mountains Beyond Mountains on a 2010 trip to Nicaragua and recommended it to Michelle, who read it right before leaving for GlobeMed at UT’s first GROW trip to El Salvador. Perhaps the words rang especially true in Central America, but his story showed us the impact one person can have on the world through his devotion to serving the poor, to working towards a more equitable global health. Like the many others introduced to Dr. Farmer in Mountains Beyond Mountains, we were deeply inspired to learn more as we delved further into the field of global health.

“Equity is the only acceptable goal.” – Paul Farmer

We were all familiar with his work, so the short introduction quickly turned into a question and answer session that was only cut off by the next item on his itinerary. Together we joined FACE AIDS, public health students, and others passionate about global health in a discussion with Dr. Farmer on the problems and solutions in delivering equitable healthcare to all. Especially notable were Farmer’s comments on the involvement of youth in the global health equity movement. He reminded us of the importance of “echoing the important equity questions from here” and “finding a part of the movement important to you.” Other questions led to discussions on providing a preferential option for the poor, the success of the Rwandan healthcare system, and the power of community health workers.

The content of the discussions was inspiring and reaffirmed our persuasions on global health, but what struck us most was Dr. Farmer himself. Far from guarded, he came across as a professor holding office hours with his favorite students. He remembered the name of each person who found a microphone. He would refer back to Matt’s question. To the specific comment that the architecture graduate student said, remembering details about her that made it seem like they were already good friends. Kidder describes in his book how Farmer was remembered by college friends as not being able to cross campus without asking someone about her grandmother’s health. Clearly this recollection had not been exaggerated. Never before have we met someone as truly friendly and interested in others as Dr. Farmer. His investment during that hour is a true testament to his belief in the potential of students in the future of global health. Having someone with the experience and expertise such as Paul Farmer engage in frank and genuine dialogue with students is deeply encouraging to those of us striving to follow on a similar path.

“The engine for this type of work is to just keep trying.” – Paul Farmer

A lecture that evening provided a forum for 800 members of the public to learn from Farmer about health, human rights, and Haiti after the earthquake. Using this natural disaster as a case study, Farmer gave structure to the nebulous idea of “countering the failures of imagination.”

His work through Partners in Health is a shining example of this. A world of critics has stood by in their assertion that delivering world-class healthcare to the poorest classes in the world is simply unsustainable and not cost-effective. Farmer and Partners in Health essentially ignore them and go on to demonstrate some of the highest treatment and cure rates in the world for diseases like tuberculosis, HIV, and cholera.

“Limit the amount of time you’re arguing about it and increase the amount of time you’re actually working on it.” – Paul Farmer

In so doing, Farmer illustrated the possibilities of re-imagining what we think as limitations. Continually questioning and believing that the conventional “impossible” is actually possible engenders the type of innovation needed to address global issues.

“It’s a lot scarier to not try.” – Paul Farmer

Undergraduate students still in the process of learning and obtaining a degree are often seen as less than primed to enact substantial positive change in the world. But Farmer’s encouragement of student activists such as GlobeMed and FACE AIDS is a stepping-stone in re-imagining the limitations of millennials.

“I’ve got some major props for GlobeMed here tonight.” – Paul Farmer

Farmer’s dedication to speaking with students, staying until nearly 2am to meet, greet and sign books, is not only his way of investing in his “retirement plan” but indicative of the need for universities to be breeding grounds of collaboration to further the pipeline of future change-makers.

“I think that student activists are my retirement plan. Student activism is a special brand of activism. You guys keep doing what you’re doing.” – Paul Farmer

Paul Farmer’s visit helped us as students see our role in the future of global health. He helped reaffirm the passion that fuels our work in GlobeMed, a labor of love that takes place between classes, before and after exams, and late into the night powered by caffeine. Being students swamped with school, it is easy to fall into complacency and frustration, but the momentum will be propelled forward if we continue to counter the failures of imagination.


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