While renowned anthropologist and physician Paul Farmer, MD, PhD, attended a public health class on community diagnosis at Harvard University in the 1980s, he learned about the basic health care package known as “GOBI”-- growth monitoring, oral rehydration, breast feeding, and immunization--often cited as the most effective way to save lives of children in the developing world.
His first thought was that this is indeed a very minimum package, and wondered “what if you get hit by a car”?
Not long after, rushing across campus, Farmer walked in front of a car and experienced firsthand some of the glaring differences between health care in the United States and that which can be experienced in parts of Haiti, Rwanda, and other places in which he has served as one of the world’s most successful leaders in promoting global health equity.
At Harvard, ambulances picked him up promptly and took him to the hospital, whereas in many other locations around the world he would not have been so fortunate.
“If I had been a poor person, lying in a road, that wouldn’t have been paved, there would not have been an ambulance…people would lean over me and say ‘you should’ve looked both ways before crossing the street,” Farmer said.
This mindset that victims simply should have been more careful evidences partly why Farmer’s efforts have been so crucial. Farmer co-founded the international medical relief organization
Partners In Health in 1987 to respond to the health needs of Haiti’s Central Plateau region. The organization has since expanded to answer the call in Siberia, Rwanda, Lesotho, and other places in need across the globe.
Farmer chronicled some of his well-respected career in public health in a recent lecture at Penn called "Global Health versus Global Health Equity: Health, Social Justice, and the Research University."
A packed Irvine auditorium – ranging from medical students interested in global health, to Farmer’s peers when he began his career and other health leaders – was treated to stories from Farmer’s service as UN Special Adviser to the Secretary-General on Community Based Medicine and Lessons from Haiti, and other global health endeavors to address significant needs worldwide.
Lawrence Shulman, MD, deputy director for clinical services at the Abramson Cancer Center and director of Penn’s Center for Global Cancer Medicine, met Farmer when he was an intern at Brigham and Women’s Hospital, and Shulman was the attending in oncology.
“Paul is one of the few people I know who can work in the trenches on the ground in some of the poorest places in the world like Haiti and Rwanda, but learn how to build in those settings very effective, high-quality care delivery systems, and at the same time go to a third level, which is international policy” Shulman said. “And he’s had a tremendous effect on policy and how we look at global health.”
Farmer’s visit was sponsored by Penn's Perelman School of Medicine and Center for Global Health (CGH). Directed by Glen Gaulton, PhD, the Center launched in 2015 to improve worldwide health equity through awareness and access to care, discovery, research, and education. The Center for Global Health at Penn Medicine thus mirrors many of Farmer’s aspirations.
“We live on a single planet, we’re a single people, we may be separated by oceans and boundaries, but we’re all part of the same human family,” Shulman said. “We all deserve to help each other.”
Receiving countless awards for decades of service to global health, Farmer’s contributions to the field include numerous books and publications revealing insights into novel, community-based methods to administer high-quality medical care in areas lacking sufficient health resources.
As the Kolokotrones University Professor and Chair of the Department of Global Health and Social Medicine at Harvard Medical School, and chief of the division of Global Health Equity at Brigham and Women’s Hospital in Boston, Farmer reaffirmed that American academic medical centers must play a critical role in world health equity. This role can include the resources already existing in those institutions, such as providing analysis of worldwide health epidemics, providing training for health providers, and support for opening new health clinics.
A focus solely on research and not care delivery can exacerbate world health epidemics, like the recent Ebola outbreak, Farmer added, arguing that well-resourced research universities should allocate the staff, space, and systems to address emergencies as they occur globally.
While reminding the audience that battles against Ebola are not fully over, Farmer cites public health efforts in Rwanda as evidence that long-term success can be achieved in places where nearly all hope had once been lost.
Twenty one years ago, Rwanda was among the poorest places on Earth, and had the highest infant mortality, Farmer noted. Ravaged by epidemics like malaria and typhoid, the country has been transformed as the first country on the continent to achieve all the health-related millennium development goals.
In between grave concern about poverty, health disparities, outbreaks and other challenges, Farmer’s stories of hope inspired the next generation of global health leaders to build on successes and answer the call from all parts of the globe in need.