Case HistoryWorking abroad
Paul Farmer: building hospitals as a way of practising
He went to Haiti as a volunteer before medical school, and kept two careers running for life: frontline care in Cange and a Harvard professorship.
By The Editors
Independent
From the public record. Written from the published sources listed at the end. RICH DOCTOR has not interviewed Dr Paul Farmer; every quotation comes from a cited source.
Their path
- 1959
- Born in North Adams, Massachusetts
- 1983
- Begins volunteering in Haiti's Central Plateau
- 1987
- Co-founds Partners In Health
- 1990
- MD and PhD in medical anthropology, Harvard
- 1993
- MacArthur Fellowship
- 2015
- University of Global Health Equity begins in Rwanda
- 2022
- Dies in Butaro, Rwanda, aged 62
Paul Farmer went to Haiti before he trained as a doctor. In 1983, as a college volunteer, he began working in Haiti’s Central Plateau, in the village of Cange.1 He would return there for the rest of his life.
Two careers at once
Born in 1959 in North Adams, Massachusetts, he studied medical anthropology at Duke, graduating in 1982.41 In 1987, while still a student, he co-founded Partners In Health, which began in Cange.12 In 1990 he completed both an MD and a PhD in medical anthropology at Harvard.4
What followed was unusual: not a choice between frontline work and academic medicine, but both, for decades. He trained in internal medicine and infectious diseases at Brigham and Women’s Hospital, and rose to become a University Professor at Harvard and chair of its Department of Global Health and Social Medicine.43 All the while he kept treating patients in Haiti and, later, Rwanda.
His anthropology was not a side interest. It gave him the argument at the centre of his work: that poverty and inequality are causes of disease and should be treated as clinical problems. His books, including AIDS and Accusation (1992) and Pathologies of Power (2003), made that case.4
Building as practice
He described himself without false modesty. “There is nothing I like more than building a hospital,” he once told an interviewer, “that’s what I call a good pastime.”1
Partners In Health built hospitals in Haiti, including one after the 2010 earthquake.1 In Rwanda, the University of Global Health Equity began in 2015, with Farmer as its chancellor.14 He received a MacArthur Fellowship in 1993 and the Conrad N. Hilton Humanitarian Prize, shared with Partners In Health, in 2005.43
He died in his sleep in Butaro, Rwanda, in February 2022, aged 62, while teaching there.12 He was married to the Haitian medical anthropologist Didi Bertrand, and they had three children.1
What the path shows
Doctors who want to work in low-resource settings are often told to choose: a career at home, or a life abroad. Farmer refused the choice, and showed that each could strengthen the other. The professorship gave his work in Haiti and Rwanda reach and resources; the clinics kept his scholarship honest.
His other lesson is about scale. He did not stop at treating patients. He built the institutions that would keep treating them after he had gone.
Written by
The Editors
RICH DOCTOR editorial team
Pieces bylined to The Editors are written and edited by the RICH DOCTOR editorial team and represent the publication's own view. Every claim is sourced, and corrections are made openly.