I join so many in the world in grieving the loss of Dr. Paul Farmer, a remarkable and tireless champion of equitable access for health care for all people, including people in the developing world. During all of the years I served in health care in East Africa — in Kenya and South Sudan — I heard so many stories about Paul Farmer and read many books and articles about him. He helped feed my thirst for a companion in the struggle for justice and equal access to quality health care for all. Paul was a genius at finding ways to give this care to those in countries and areas that had few resources to draw upon to provide that care.
In 2000, I began working as a physician assistant at the Kitale AIDS Program in Western Kenya during the peak of the HIV/AIDS epidemic in Africa. By then Paul Farmer was already an internationally known champion and “expert improviser” in health care. He was already immersed in the AIDS crisis in Haiti, one of the first areas to experience the devastation of this disease — before it became widespread in Africa. He was also tackling multi-drug resistant tuberculosis in Peru and Russia, among his many other projects.
Then, in 2004, antiretroviral medications, which had already become standard treatment in the developed world, became available to resource-poor developing world countries. Our small rural clinic was now offered the chance to order these medications.
But many advised against this, including some I knew personally. People said, “These medications have to be taken regularly, at the same time every day. Your people don’t even have watches. How will they be able to do this? People on these medications have to be monitored carefully with expensive lab tests, which you don’t have. If people start them and then can’t do it, you will be responsible for helping to create resistance to these drugs.” Their “reasons why not” just went on and on.
But I was plagued by the question “How could I not get these medicines and deny my patients the only hope they would have?” And yet, the naysayers were many.
I sought out returned lay missioner Susan Weissert, who at the time was on the Maryknoll AIDS Task Force, working to coordinate Maryknollers who were working with this huge health challenge all over the world. I asked her advice.
She said, “Why don’t you write and ask Paul Farmer?”
“Oh sure,” I said, a bit sarcastically. “I probably won’t even reach him, let alone get a response. He is involved all over the world.”
Susan had met him at an international AIDS conference and said, “You never know. It can’t hurt to try. And I wouldn’t be surprised if you do hear from him.” Then she gave me his email address.
So I wrote to Paul Farmer, not even knowing what part of the world he was in on that particular day.
Within 20 minutes he responded to my email with great encouragement! He told me that it could all be done very simply, with just a few small things: a thermometer, a scale, a finger prick hemoglobin blood test, and mentioned a few things to watch out for. He gave me a simple plan for a clinic such as ours. And he encouraged me to not give up!
We followed his advice and used his plan, and for the next several years we ran a very successful HIV/AIDS clinic. We were seeing hundreds of people who, as one of my medical friends put it, had “one foot in the grave” return to healthy, productive lives.
Most of our 90 children who were HIV-positive gained weight and recovered their energy so rapidly that we were astounded and overjoyed to see them resume a much more normal childhood.
Our clinic continued for several years until a larger non-profit organization came into the area and opened a more updated, well-equipped facility for HIV/AIDS care and we were no longer needed.
Now, upon hearing the news of Paul Farmer’s death, how I wish I had written to him several years later and told him what he had done for us — for one small rural clinic in Kenya — and how many healthy and happy people are living there today thanks to his simple email to me.
For all that Dr. Paul Farmer has been for us and countless others around the world: Deo Gratias. May he Rest in Peace.