Poor patients needed more than medicine to recover, so Partners in Health also provided them with food. They offered school fees for the children. They installed systems to purify the water that caused so many illnesses. And they always trained and hired local staff, who would follow up with patients to identify and help remove barriers to their treatment.
Farmer, a Harvard-trained physician, also trained as a medical anthropologist. Kidder wrote that Farmer learned from local staff that more than three-quarters of voodoo ceremonies were attempts to drive away disease. He saw little reason to argue with people about creeds and faith; instead, he has always focused on delivering high quality health care. The voodoo priests he treated ended up serving as conveyor belts for the clinic, bringing their own sick parishioners to seek treatment. Farmer approached people with humility and respect, which they reciprocated.
Farmer’s own stale Catholicism has been rejuvenated by his encounters with liberation theology, with its acerbic critique of inequality and injustice. He did not see theology as an obstacle to his mission. He said he had “faith” but also added: “I also have faith in penicillin, rifampicin, isoniazid and the good absorption of fluoroquinolones, in laboratory science, clinical trials, scientific progress, that HIV is the cause of all AIDS cases, that the rich oppress the poor, that wealth flows in the wrong direction, that it will cause more epidemics and kill millions of people.
Farmer was just 62 when he died while training staff at a Rwandan hospital he helped establish. He had lived nonstop, treating patients from all over the world, fundraising, cajoling, begging and teaching.
Sociologists recognize a form of power called “charismatic authority” – Max Weber called it “the authority of the extraordinary and personal gift of grace”. Farmer certainly represented that. He inspired a generation of doctors, nurses, public health workers, activists and ordinary people. He has used the respect and awe he has garnered to pressure world leaders and to help lead the charge to change the way public health works.
But what happens to a movement when its charismatic leader dies? In this case, the best option is what sociologists call “charisma routinization” – things continue to work because they become entrenched and institutionalized, not just because an extraordinary person wields enormous personal influence. .
Since the early days, PIH had already grown larger and more institutionalized, attracting millions in donations from individuals as well as foundations. They spread from Haiti and Peru to places like Rwanda, Sierra Leone, Lesotho and the Navajo Nation. But they are still weak compared to the needs. And their type of work is even more crucial now, since the pandemic has not only caused suffering from Covid-19 – many basic health care services have been interrupted around the world. As always, the poorest, globally, will suffer the most from these disruptions, which will require considerable effort to improve.