Day 709 Wednesday, February 23, 2022

“The idea that some lives matter less is the root of all that is wrong with the world.”

― Paul Farmer

A note from Pat O'Connor, Steve Lyman and Tom Bachelder about this Sunday's Emmaus Celebration:

Can you believe it? It seems that we just celebrated Christmas and here we are with Ash Wednesday staring us in the face. Our theme for the coming Sunday is “Cultivating Listening.”

The liturgy committee recently decided on Listening as our overall theme for the year and we hope we capture many aspects of listening in this liturgy. With the Lenten Season upon us we want to ask:

- What tugs at your heartstrings for spiritual attention?

- If you were to lay your ear upon the breast of Jesus just as St. John did at the Passover meal, would you hear the heartbeat of God,? what would be stirring in you?

- What is stirring in our Emmaus Community?

Our liturgy will provide a prolonged period of silence, a time for quieting the mind and contemplating what each of us needs. We want to welcome all to the table for this celebration. We hope to see you on Sunday 02/27/22. We join Zoom at 4:45 pm for conversation and fellowship and the liturgy begins at 5:00 pm. See you soon!

Grace Note:

Our dear sister Melva Freeman is back and better than ever. I got a call from Melva yesterday and she sounds wonderful. She thanks us all for our prayers and cards and good thoughts. We will see her on Sunday on ZOOM!

Daily Reflection on the life of Paul Farmer Pioneer of Global Health who died so young at the age of 62

“He has a very tender heart, seeing pain and suffering is very hard for him. It just hurt him. One thing I learned from Paul is about detachment. He wasn’t detached from anyone. That’s the beauty of him."

(Dr. Paul Farmer speaking with an H.I.V. patient, Altagrace Cenatus, at a Partners in Health hospital in Haiti in 2003. He worked to provide quality health care to some of the poorest people in the world.)

Paul Farmer, a physician, anthropologist and humanitarian who gained global acclaim for his work delivering high-quality health care to some of the world’s poorest people, died on Monday on the grounds of a hospital and university he had helped establish in Butaro, Rwanda. He was 62.

Dr. Farmer attracted public renown with “Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World,” a 2003 book by Tracy Kidder that described the extraordinary efforts he would make to care for patients, sometimes walking hours to their homes to ensure they were taking their medication.

He was a practitioner of “social medicine,” arguing there was no point in treating patients for diseases only to send them back into the desperate circumstances that contributed to them in the first place. Illness, he said, has social roots and must be addressed through social structures.

“If I am hungry, that is a material problem; if someone else is hungry, that is a spiritual problem.”

― Paul Farmer, In the Company of the Poor: Conversations with Dr. Paul Farmer and Fr. Gustavo Gutierrez

His work with Partners in Health significantly influenced public health strategies for responding to tuberculosis, H.I.V. and Ebola. During the AIDS crisis in Haiti, he went door to door to deliver antiviral medication, confounding many in the medical field who believed it would be impossible for poor rural people to survive the disease.

“Anywhere you have extreme poverty and no national health insurance, no promise of health care regardless of social standing, that's where you see the sharp limitations of market-based health care. ”

― Paul Farmer

Though he worked in the world of development, he often took a critical view of international aid, preferring to work with local providers and leaders. And he often lived among the people he was treating, moving his family to Rwanda and Haiti for extended periods.

“with rare exceptions, all of your most important achievements on this planet will come from working with others—or, in a word, partnership.”

― Paul Farmer, To Repair the World: Paul Farmer Speaks to the Next Generation

Dr. Farmer among patients in Haiti in 2003.

News of Dr. Farmer’s death rippled through the worlds of medicine and public health on Monday. “There are so many people that are alive because of that man,” Dr. Rochelle P. Walensky, director of the Centers for Disease Control and Prevention, said in a brief interview, adding that she wanted to compose herself before speaking further. Dr. Anthony S. Fauci, President Biden’s top medical adviser, broke down in tears during an interview, in which he said he and Dr. Farmer had been like “soul brothers.”

“When you talk about iconic giants in the field of public health, he stands pretty much among a very, very short list of people,” said Dr. Fauci, who first met Dr. Farmer decades ago, when Dr. Farmer was a medical student. He added, “He called me his mentor, but in reality he was more of a mentor to me.” Remembering Paul Farmer (1959-2022) “It’s not just about health security, in the senses of defending yourself,” he said. “It’s not just about charity, although that’s not so bad. It’s also about pragmatic solidarity with those in need of assistance.”

When Paul was around 12, his father bought an old bus and fitted it with bunks, converting it into a mobile home. Paul, his parents and his five siblings spent the next few years traveling, mostly in Florida, living for a time on a boat moored on a bayou. He credited this period with giving him “a very compliant GI system,” a knack for sleeping anywhere and an inability to be shy or embarrassed.

One summer, he and his family worked alongside Haitian migrant workers picking oranges, listening curiously as they chatted to one another in Creole from atop ladders. That was Paul’s first encounter with Haiti, the country that would captivate him in his 20s and then propel him toward a career in public health.

After graduating from Duke University, he moved to Haiti, volunteering in Cange, a settlement in the central Artibonite plateau of the country. He arrived toward the end of the dictatorship of Jean-Claude Duvalier, when Haiti’s hospital system was so threadbare that patients had to pay for basic supplies, like medical gloves or a blood transfusion, if they wanted treatment.

In a letter to a friend, he wrote that his stint at the hospital wasn’t turning out as he had expected. “It’s not that I’m unhappy working here,” said the letter, excerpted in Mr. Kidder’s book. “The biggest problem is that the hospital is not for the poor. I’m taken aback. I really am. Everything has to be paid for in advance.”

Dr. Farmer decided to open a different kind of clinic. He returned to the United States to attend Harvard Medical School and earn a degree in anthropology, but he continued to spend much of his time in Cange, returning to Harvard for exams and laboratory work.

The clinic in Haiti, at first a single room, grew over the years to a network of 16 medical centers in the country, with a local staff of almost 7,000.

Among them was a teaching hospital in Mirebalais, about 40 miles north of Port-au-Prince, that opened in 2013 and offered chemotherapy drugs, a gleaming new $700,000 CT scanner and three operating rooms with full-time trauma surgeons. There, poor patients with difficult diseases paid a basic fee of around $1.50 a day for treatment, including medication. Partners in Health also expanded into Rwanda, where Dr. Farmer helped the government restructure the country’s health system, improving health outcomes in areas like infant mortality and the H.I.V. infection rate.

“In this increasingly interconnected world, we must understand that what happens to poor people is never divorced from the actions of the powerful. Certainly, people who define themselves as poor may control their own destinies to some extent. But control of lives is related to control of land, systems of production, and the formal political and legal structures in which lives are enmeshed. With time, both wealth and control have become increasingly concentrated in the hands of a few. The opposite trend is desired by those working for social justice.”

― Paul Farmer, Pathologies of Power: Health, Human Rights and the New War on the Poor

He was particularly proud of the fact that the clinics he helped build were staffed by local doctors and nurses whom he had trained.

“He had a very tender heart,” she said. “Seeing pain and suffering was very hard for him. It just hurt him. I’m a social worker by training. One thing I learned is about detachment. He wasn’t detached from anyone. That’s the beauty of it.”

By Ellen Barry and Alex Traub

• Obituary: Dr. Farmer, a physician and anthropologist, sought to bring high-quality health care to some of the world’s poorest people.

• ‘Mountains Beyond Mountains’: The 2003 book by Tracy Kidder told Dr. Farmer’s life story. Read the first chapter here.

• His Writing: In “Fevers, Feuds and Diamonds,” Dr. Farmer examined the inequalities that worsened Ebola’s spread in West Africa in 2014.