The Washington PostDemocracy Dies in Darkness

Paul Farmer, a giant of public health, dies at 62

Paul Farmer visits facilities supported by his global health organization, Partners in Health, in Kono, Sierra Leone. (John Ra/Partners In Health)

Paul Farmer, a physician who devoted his professional life to improving health care in the most destitute corners of the world, a campaign that brought him international renown and was credited with improving if not saving millions of lives, died Feb. 21 in Butaro, Rwanda. He was 62.

His death was announced by Partners in Health, the global health organization that he co-founded in 1987, which said that the cause was “an acute cardiac event while he was sleeping.”

Sometimes described as a modern-day Albert Schweitzer, Dr. Farmer was a doctor, a humanitarian and, by all accounts, an almost otherworldly force whose aspirations for global public health seemed unattainable until he showed they were within reach. He was the subject of a widely read 2003 book by Tracy Kidder, “Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World.

Dr. Farmer first traveled to Haiti, one of the poorest nations in the world, as a volunteer in the early 1980s, just as he embarked on his studies at Harvard Medical School. He went on to found a network of 15 clinics and hospitals that now serve more than 1.3 million people in the most remote reaches of the country, according to Partners in Health. Dr. Farmer was personally engaged in that medical care, at times trekking many miles to make a single house call.

His work in Haiti expanded into the global mission of Partners in Health, which today works in a dozen locations across Africa, Central Asia, Latin America and the United States, where the group has assisted in recent years with the response to the coronavirus pandemic.

“He really stands out as one of the most influential global health figures of our time, and I don’t think that’s a hyperbole,” Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and the chief medical adviser to President Biden, said in an interview.

“He sacrificed personal comfort to go into the trenches with the people he cared for,” Fauci continued, describing Dr. Farmer as a “once-in-a-lifetime person.”

“He loved the people he took care of,” Fauci said, “and they loved him back.”

At the core of Dr. Farmer’s work was the conviction that the accident of one’s birth, whether in a poor country or a wealthy one, should not determine access to quality medical care. He brooked few objections from politicians or more pessimistic public health experts about the practicality of attempting to deliver full-scale medical services in places such as Haiti.

“We can spend $68,000 per [tuberculosis] patient in New York City,” he told Kidder, “but if you start giving watches or radios to patients here, suddenly the international health community jumps on you for creating nonsustainable projects.”

In projects from Russia to Liberia to Mexico and Peru, Dr. Farmer partnered with local governments and communities to improve maternal and child health and to combat diseases including AIDS, Ebola, multidrug-resistant tuberculosis and Zika.

In seemingly constant motion between his international clinics and the United States, where he was a professor at Harvard Medical School, Dr. Farmer was said to have filled his suitcases and briefcases with medicines and hauled them back to places where they were needed.

He inspired the admiration of philanthropists, who helped him continue his work on an ever grander scale, as well as the adoration of patients, who he said gave his work its meaning. Public health, as he envisioned it, was about not only the welfare of an entire community but also the well-being of every person within it.

“You can’t allow yourself to be overwhelmed for long because that’s going to leave you ineffective,” he told the New York Times in 2005.

During his first trip to Haiti, he recalled, he encountered a 7-year-old girl who was sick with malaria. She had a fever of 105 degrees and was “shaking like a leaf,” Dr. Farmer said. The only physician in the area did not make house calls.

“What can we do?” he recalled asking a Haitian colleague.

“About the little girl or the problem of malaria?” the man responded.

“Both,” Dr. Farmer replied.

“That moment stays with me,” he told the Times. “Even in situations that seem overwhelming, you try to focus on the individual patient. At the same time, you develop strategies to change the larger picture. You get others involved, go to people with power and try to get their help. One mustn’t assume that people with great power won’t help.”

Paul Edward Farmer Jr. was born in North Adams, Mass., on Oct. 26, 1959, one of six children. His mother was a grocery store cashier. His father, whom Dr. Farmer described as “not a very orthodox guy,” was a schoolteacher.

At one point during Dr. Farmer’s upbringing, his father moved the family into a retrofitted bus that had once been a tuberculosis mobile clinic. The family lived in the makeshift mobile home for five years, according to the book “Paul Farmer: Servant to the Poor” (2018) by Jennie Weiss Block. They later lived on a boat moored in a bayou on the Gulf Coast of Florida.

“When we were growing up in the campground, we were all sort of embarrassed by it, but I think all of us now feel grateful to my parents for having liberated us from middle-class expectations,” Dr. Farmer told the Times in 2003. “This makes my biography sound a little too neat. I mean, we grew up in a TB bus and I became a TB doctor. We worked picking citrus for about a nanosecond before my father admitted we could never make enough for us to live on, and years later I worked with Haitian migrant farmworkers. But it can be too neat and still true, right?”

Dr. Farmer enrolled at Duke University, where he received a bachelor’s degree in medical anthropology in 1982 before undertaking the volunteer mission that would in many ways set the course of the rest of his life. During his graduate studies, he traveled back and forth between Haiti and Harvard, where he received a medical degree and a PhD in anthropology, both in 1990.

Dr. Farmer began his work in the Haitian village of Cange, where he met his future wife, Didi Bertrand, the daughter of a local schoolmaster. Besides his wife, survivors include three children, Catherine Farmer, Elizabeth Farmer and Sebastian Farmer; his mother; Ginny Farmer; two brothers; and three sisters.

In addition to his post at Harvard Medical School, where he was chair of the department of global health and social medicine, Dr. Farmer was chief of the division of global health equity at Brigham and Women’s Hospital in Boston. He was the recipient of a 1993 MacArthur Foundation award, often called a “genius grant,” and, in 2020, the $1 million Berggruen Prize for Philosophy and Culture.

His books included “Infections and Inequalities: The Modern Plagues” (1999), ″Pathologies of Power: Health, Human Rights, and the New War on the Poor” (2003) and most recently, “Fevers, Feuds, and Diamonds: Ebola and the Ravages of History” (2020).

Among his admirers, Dr. Farmer was at times described as a secular saint — a label that he resisted.

“I don’t care how often people say, ‘You’re a saint,' ” he told Kidder. “It’s not that I mind it. It’s that it’s inaccurate.”

But, he added, “People call me a saint and I think, I have to work harder. Because a saint would be a great thing to be.”

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