Remembering Paul Farmer

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“Haiti is a place for big questions,” an intelligent American woman said to me nearly three decades ago, in Haiti. Paul Farmer, who died unexpectedly on Monday at age 62 in Rwanda, found his calling in Haiti. People talk a lot about how skilled a physician and public health innovator Farmer was. But his real importance lies in the fact that no one ever asked the big questions more incisively or stubbornly. What makes him an awkward hero for the rest of us is that he asked a lot from human beings, beginning with himself. As Tracy Kidder put it in his bestselling book about Farmer, Mountains Beyond Mountains, Farmer redefined the phrase “doing one’s best.” (Kidder published a reminiscence of Farmer in Tuesday’s New York Times.)

Kidder did a valuable service to the world by making Farmer famous with his book, and from colleagues of Farmer’s I know that Kidder gave quite a bit of his money earned from it over the years to Partners in Health, the organization that Farmer co-founded. Another way to learn about Farmer and PiH is the 2017 documentary Bending the Arc. Farmer’s own writings that I admire include his 2003 commencement address at Harvard Medical School, in which – before the metaphor got hijacked by the paranoid right – he urged young soon-to-be elite doctors to “take the red pill,” i.e. don’t settle for the status quo or for a life of comfortable affluence, but rather go out into the world as it really is and make yourselves useful. (The address is reprinted in the collection To Repair the World: Paul Farmer Speaks to the Next Generation, edited by Jonathan Weigel.)

Another of his essential writings is the thorough essay “Who Removed Aristide?” published in the 15 April 2004 issue of the London Review of Books, in the early wake of the undeniably U.S.-sponsored second coup of February 29, 2004 against Jean-Bertrand Aristide (“We’re glad to see him go” – Dick Cheney), the former priest who had first been elected president in 1990 as an eloquent – and provocative – champion of Haiti’s poor. Like other great figures, Farmer risks becoming sanitized into a cheap feel-good avatar that leaves the rest of us off the hook, but he should be accurately remembered as having been very political. And, with all due respect to his excellent book The Uses of Haiti, his LRB essay might be his most important political writing. It’s worth quoting at length from his response to me when I asked him about it, shortly after its publication, at his small house on the rural Central Plateau. “I thought, ‘Poor Haiti, man,’ he told me.

I was watching the spectacle of the dailies every day, with growing anxiety I might add, because it was a very dangerous time, and seeing so much inaccuracy in the reporting. And then, of course, the architects of this plan to unseat the elected government of Haiti knew that shutting off all aid to Haiti, in a country this poor, would probably do the trick with a little push from arming the former military. They didn’t arm themselves; they’re not weapons manufacturers. Somebody had to be paying for it; they had no money.

And to watch this all sort of in slow motion, from rural Haiti – because it was in the Central Plateau where all of this was based. And, you know, having gone through harassment of our staff, and losing patients who were murdered by these people, I figured okay, now they’ve had their way, they overthrew the elected government. Poor Haiti. No English-speaking, English-writing person is going to write about the connivance of the great powers in doing what they’ve done so many times in Haiti, which is assisting in the trampling of the will of the majority. And the majority of course here, that’s the poor majority. …

I was trying to get something out there quickly in English. I knew it wouldn’t end up in an American publication. Brian” – Brian Concannon, an American lawyer close to Haitian grassroots movements – “was the one who did all the fact-checking. I took out anything that I couldn’t buttress with seventy pages of footnotes.

At the urging of my friend Kathy Sheetz, I had ridden up the mountain to Cange, the site of the celebrated Zanmi Lasante (Partners in Health) clinic, and had the good fortune to spend four days there in Farmer’s company. Kidder’s book was still in hardcover, and Farmer’s fame was still just gathering steam. Kathy gave me her copy, but I declined to read it until after I had met the man and formed my own impressions.

It helped that my introduction to Farmer was from Mme. Yolande Lafontant, known as Mamito, the wife of Father Fritz Lafontant, the charismatic Episcopal priest who was Farmer’s Haitian mentor and who had also worked with my father. Too much Farmerology neglects sufficiently to appreciate the role played in all that he accomplished by Père Lafontant, who died of Covid-19 last year at age 96. In 2010 after the earthquake, I asked Père Noé Bernier, a younger priest in the city of Cap Haïtien, “So Paul Farmer couldn’t have done all the things he’s done without Père Lafontant?”

“Oh, definitely,” he replied. “If you have the idea, the vision, you need somebody to help you with the vision, and sit down and put things together. He was there, looking for funds in the U.S. and everywhere, and Père Lafontant was the guy in Haiti, that could really implement the idea that he had.”

I have in my possession a Bible in French inscribed to me by Père Lafontant in the town of Mirebalais on March 19, 1982. I was sixteen at the time, and it was my first time in Haiti, indeed my first-ever trip outside the United States. “Dieu a un plan pour chaque homme en particulier,” he wrote. “La lecture quotidienne de ce livre te permettra de découvrir le plan de Dieu pour l’humanité.” Heavy stuff. Over the almost exactly forty years since then, I’m afraid I have not read the Bible daily, or really much at all for that matter, in either French or English. But I have learned a great deal from the world I find myself in, and for me it all began right there in Mirebalais with Père Lafontant, as it also did for Paul Farmer.

During those four days together in Cange in 2004, Farmer and I discovered some shared literary interests. Riding shotgun as he drove a pickup truck back down the mountain to catch a flight to Miami, I mentioned V.S. Naipaul, a talented and sensitive writer who had been an early role model of mine because he put a premium on experience and observation, but who had eventually succumbed to the blandishments of his many toadies. “You just can’t be that way if you’re living in a place like this,” said Farmer.

Because every day you wake up, you go to the clinic, you do your work, and you see evidence of your failure. Last night at about eleven o’clock a woman and her thirteen-year-old daughter showed up at our house, just saying, ‘I’m hungry. I haven’t eaten in two days.’ If you’ve been working on poverty and hunger issues for twenty-something years, and you’re not making progress on some fronts, I think it does keep you humble. Knowing that the world is so dented and damaged must be humiliating, if not humbling – one or the other. If you cocoon yourself away from the misery, then you can be delusional about how great and praiseworthy you are.

I told him that Graham Greene was one of my greatest literary heroes. “He’s my favorite writer,” Farmer enthused.

I suspect it takes a lot of discernment and humility, even if you’re proud of your writing like I think he was, looking for simplicity and straightforward prose, but at the same time you have to go out. If you look at his early stuff, though, like Journey without Maps with his cousin in Africa, it’s really kinda bwana-ish. And then the later stuff – people think he got more political, and they’re more dismissive of him. I just think he got more informed. Liberation theology figures in several of his later books, and I think he really retained that humility. Also, his characters are really people who are not sure if they’re ever going to get it right. They’re not confident of their analyses of the world.

“Look at Fowler in The Quiet American,” I pointed out.

“Yeah, yeah.”

“What do you think of The Comedians?” I asked – Greene’s 1966 novel set in Haiti during the Duvalier dictatorship.

“Well, The Comedians is maybe his first political book. And The Quiet American came before it, so that’s saying something, right? The Comedians is where the ‘locals’ – Africans, Vietnamese, whatever, in this case Haitians – start to come out. And there’s a very full-bodied character in there, Dr. Magiot, who is a physician and a Marxist. I think he compares favorably to previous characters who are African or Asian, because they’re sort of cardboard cutouts.”

As we came down onto the plain and neared the airport, we talked about how jarring it was for him to make the journey between Cange and Harvard every month, as he was doing in those days. “I’m not an economist,” he averred. “Nor do I play one on TV.”

But if you look at the experts, they say that starting in 1980 the indices of economic disparity between rich countries and poor countries have grown very dramatically. This is true within countries, and it’s true between countries. But I can’t imagine a single more startling leap than from rural Haiti to American affluence. That’s got to be sort of the number one, one-stop-shopping trip, right? From Cange to Miami, where I’m going right now. So if the economists are correct, and I’m sure they are, that the gap between the rich and poor is growing, then obviously the gap between my one-day travel between rural destitution and urban affluence in the United States is growing too. And I’m not recounting it that way because it has anything to do with me, or because my own experience of it is significant. I’m just saying, you know, as this continues, this process of widening gaps between rich and poor – it’s violent.

This piece is partially adapted from my book Bearing the Bruise: A Life Graced by Haiti, published in 2012 by Blue Ear Books.

This Substack newsletter from Blue Ear Books features occasional articles from authors of the books we publish. This newsletter is free, but consider supporting our work with a modest paid subscription.