Dr. Paul Farmer leaves a legacy of caring in HIV/AIDS treatment

By FYH News Team

Published on February 24, 2022

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Dr. Paul Farmer was chair of the Department of Global Health and Social Medicine at Harvard Medical School and co-founder of Partners in Health.

The public health world is mourning the death of a visionary and leader in global public health, a world-renowned anthropologist and medical doctor, Dr. Paul Farmer. The founder of Partners in Health was 62 when he died Monday in Butaro, Rwanda, at a teaching hospital he founded.

Farmer helped bring innovative ways to deliver cutting-edge health care to low-income settings in developing countries in the Global South. In addition to being a medical doctor, Farmer also had a Ph.D. in anthropology and wrote on issues of health, human rights and social inequality. In Haiti during the worst of the HIV epidemic of the 1980s and ’90s, Farmer delivered antiviral medicines door to door, in addition to treating patients in a teaching hospital he helped found, which was later called “Zanmi Lasante” (Partners in Health). At a time when many health practitioners thought that poor, rural communities would not be able to survive after being infected with the virus, Farmer won the respect of locals, from Rwanda to Haiti, by working with local civil society organizations, rather than international development agencies, on community healthcare models. He was certainly ahead of his time.

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I met one of Farmer’s colleagues in Haiti when I visited the country in August of 2009. Dr. Marie Marcelle Deschamps is a globally renowned physician and researcher on HIV/AIDS and other communicable diseases, and the deputy director of the Haitian Study Group on Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), working in Haiti. Farmer’s organization collaborated with GHESKIO on health programs in Haiti for decades and still does. I called Deschamps at her home in Port-au-Prince to talk about Farmer’s legacy and her memories of working with him.

Questions and answers have been edited for length, clarity and flow.

Q. Tell me about the first time you met Dr. Farmer.

A. I have been with GHESKIO since the beginning. I graduated (from medical school) in Haiti and then I went to the U.S. for a fellowship (at the National Institutes of Health), and then returned and co-founded GHESKIO with Dr. Paul. Our work is well known internationally and nationally.

I met Paul Farmer in the year 1984 or 1985. He was a young resident (physician), a young fellow. Me, I had been working since 1979/1980 in the fight against HIV. And I met with him on the airplane to Haiti after a meeting with the NIH (National Institutes of Health in the U.S. in Boston). He came up to me and said, “I know you, but we have not met, I am Paul Farmer and I am very interested in learning more of the work you are doing in Haiti on HIV/AIDS.”

I was really impressed by his approach. Then, maybe two weeks after I saw someone coming on the campus (of GHESKIO in Port-au-Prince) and it was Paul. He wanted to share with me the X-ray of one of the patients he was taking care of in Boucan-Carré. I had never heard of that place. It is a neighborhood in nearby Mirebalais where Zanmi Lasante is located.

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And he described his work with Fritz Lafontant, who was a Haitian priest working with the community and bringing social support and services in the region. He was Paul’s mentor. I was impressed that he came to the clinic at GHESKIO in Port-au-Prince just to make sure that he was not missing the diagnosis; he was a young clinician; he wanted to know more. Surprisingly, his patient’s X-ray was similar to that of a patient with tuberculosis. And at the time HIV/AIDS was already endemic in Haiti. I told him to put that patient on treatment, and that he may be infected with HIV.

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Then he invited me to his clinic at Boucan-Carré. He took me to the clinic on the side of the church and there were already people there waiting for him. He only had a few nurses. So many people were waiting for him and he was so humble. And also very intelligent and very educated.

When Paul believed in something he would go to the end to solve the issue.

Q. Tell me about Dr. Farmer’s role in HIV/AIDS care and the work you do at GHESKIO, in Haiti.

A. Paul impacted my life, my way of thinking. And I have to be sincere, Paul was a special physician. He was warm. He had, since the beginning, seen in the caring of patients as a global issue. For him, caring was not just prescribing. For him, care was approaching the patient in the whole context. And being in a poor country, particularly in an isolated place like Boucan-Carré, he was already learning Creole! This impressed me. He wanted to communicate with his patients, and he treated the poverty, not just the disease. That was unique.

Since then we have been working together on HIV/AIDS and cholera. He was a visionary and a leader as well.

Q. How are you feeling now that you learned of his passing?

A. I just cannot accept that Paul died. He was such a force; I am devastated. It was not expected. For me he was Haitian. Paul adopted Haiti like his home. He deserved the Nobel Prize.

We are very affected by the news. But we think that Paul would want us to continue the fight.

Dr. Marie Marcelle Deschamps is one of the world’s leading researchers on HIV/AIDS and the deputy director of GHESKIO. GHESKIO was founded in 1982 by a consortium of Haitian health professionals investigating a disease later identified as AIDS. Since its inception, GHESKIO has worked in close partnership with the Ministry of Health and Weill Cornell Medical School on treatment, care and research for patients living with infectious disease and now cardiovascular disease.

Carli Pierson is an attorney, former professor of human rights, writer and member of USA TODAY’s Editorial Board. You can follow her on Twitter: @CarliPiersonEsq

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