Sunday, May 2, 2010

Mountains Beyond Mountains by Tracy Kidder

This is an insightful book about an extraordinary human being, Dr. Paul Farmer, who founded Partners in Health (Zanme Lasante) in 1987 with Ophelia Dahl, Dr. Jim Yong Kim (now President of Dartmouth College) and others, first based out of Cange, Haiti. He graduated near the top of his class at Harvard Medical School, despite barely attending classes as he spent most of his time in Haiti. Farmer is now on the faculty at Harvard Medical School and is an attending physician at Brigham and Women's Hospital in Boston. PIH provides services free of charge to patients living in poverty.
Tracy Kidder, tells the story with a deft hand, often asking tough questions of the protagonist - happily, Kidder is a far better writer than Farmer. On the surface this appears to be a simple book, but stepping back from it raises some very fundamental and controversial conundrums. It is hard to read a book about Haiti without coming across the phrase Deye mon gen mon, which is Creole for "beyond mountains there are mountains," a literal view of Haiti's topography as well as a profound commentary on what it takes to move the poverty stricken country forward.
Religious faith was disdained at Harvard, yet so important to the poor, Farmer came to believe that faith must be something good. Farmer is a believer in liberation theology, a branch of Catholicism, to provide a preferential option for the poor (an "O for the P", p. 174). He has devoted his life to provide medicine in the places that need it the most. Some readers contest his take on liberation theology as shallow and misguided.
Towards the end of the book, Kidder wonders if anyone could reproduce Farmer's work in Haiti or elsewhere. Farmer and Kim do things that no one else can do, Zanme Lasante can't survive Farmer. PIH relies too much on a genius. Farmer chooses to doctor in obscurity, so that he knows he doctors first of all because he believes it's the right thing to do. In the end, are the means justified ? Farmer's extraordinary accomplishments have not gone without severely compromising his own personal life.

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