Take a photo of a barcode or cover
4.2 AVERAGE
4.2 AVERAGE
I really did enjoy this book. The sections related to international health policy and pharmaceuticals interesting. I gave it three stars, though, since I could put it down and be easily distracted by other books.
Powerful book. It certainly makes me question what I'm doing with my life. I'm not so zeroed in on a cause like Paul Farmer is, but I know my current vocation as a software engineer isn't my life's work. Cheers to those who are searching.
informative
inspiring
medium-paced
emotional
hopeful
informative
inspiring
medium-paced
Well written, engaging story of a larger than life model for many.
Mountains Beyond Mountains: The Quest of Dr. Paul Farmer A Man Who Would Cure The World, by Tracy Kidder, was the University of Washington’s first ‘common book’ in 2005. The whole city of Seattle was reading this book. I was working at Lifelong AIDS Alliance and had heard Paul Farmer speak through a work talk. Being an case manager and adherence counselor I didn’t read the book back then, it was too much; now years later finally I read this book that has been sitting on my shelf waiting, I am grateful for Farmer’s work that laid the foundation for the path I was on. Beyond mountains there are mountains is a Haitian proverb. Tracy Kidder walked miles and hours over those mountains with Farmer to see clients, he traveling with him to Lima, Peru; Cuba; Chiapas, Mexico; Guatemala; and Siberia, Russia; giving him a close look at Farmer’s life and work.
Paul Farmer died February 21, 2022 at age 62. Reading this book is a witness to the amazing work he did to make progress for multiple drug resistant (MDR) TB and AIDS in underserved countries, where massive death from disease is devastating. The work he accomplished globally by his organization Partners In Health (PIH) set up with the name Zanmi Lasante in the region of Cange, Haiti. He was dedicated in his work with anthropology, using ethnography, and medicine; he was committed to the people who needed care the most. He made inroads in Haiti where he was affectionately addressed as Doktè Paul, Peru, Siberia; he worked to treat people that others did not think were possible to save. Everything seemed against his view to treat people with MDR. “…Paul laid out a comprehensive theory of poverty, of a world designed by the elites of all nations to serve their own ends, the pieces of the design enshrined in ideologies, which erased the histories of how things came to be how they were.” For Haiti, that included its rule by France and the United States.
He had his own language; and spoke multiple languages: Creole, French, Spanish for starters, adding on others as he needed. He worked in each community bringing in locals to work with him and forming centers that functioned against odds.
He had a benefactor in Boston who was determined to die poor, his work was construction and he poured his money into the project when no one else was supporting it. It was a unique mixture of his dedicated personality that brought people in to work with him. And it was his work that began the change to use generic drugs that were affordable for these difficult illnesses. Farmer saw the problems with the World Health Organization’s (WHO) Directly Observed Therapy (DOTS) program, that didn’t address drug resistant TB. They were cycling through making the problem worse. “MDR is basically because of human errors. If you can’t treat it right, don’t do it.” said Arata Kochi who framed the term to DOTS-Plus at the Academy of Arts and Sciences in Boston, 1998.
At this time Farmer was going to Peru and they were talking about Russia. The idea was to drive down drug prices. “Doctors without Borders took on the job of finding generic manufacturers of second-line drugs….put up the cash to buy the first shipments.”
I knew this back when I too was working in the field, but reading the book now I realize how much I didn’t know. For example, I did not know that HIV-positive Haitian refugees were quarantined on the Guantanamo naval base from 1991 to 1993 when an American federal judge ruled it unconstitutional. Farmer said, “Quarantine has never been shown to be an effective measure in controlling sexually transmitted diseases.” “Both Guantanamo and Cuba’s AIDS sanatorium were quarantines. But it is a lie to say they weren’t different.” Cuba made testing for HIV mandatory and had very accurate rates; out of 11 million on the island only 2,669 tested positive as of 2000. They acted quickly to clean up the blood supply.
Quotes:
“You can’t sympathize with the staff too much or you risk not sympathizing with the patients.”
“Many aid experts from prosperous places gladly expressed hopelessness on the Haitians’ behalf, Farmer would say.”
“He had problems with groups that on the surface would have seemed like allies, that often were allies in act, with for example what he called WL’s”—white liberals, some of whose most influential spokespeople were black and prosperous. “I love WL’s, love ‘em to death. They’re on our side,” he had told me some days ago, defining the term. “But WL’s think all the world’s problems can be fixed without any cost to themselves. We don’t believe that. There’s a lot to be said for sacrifice, remorse, even pity. It’s what separates us from roaches.”
Farmer studied Rudolf Virchow who said, “If disease is an expression of individual life under unfavorable conditions, then epidemics must be indicative of mass disturbances of mass life.” And, “My politics were those of prophylaxis, my opponents preferred those of palliation.” And, “Medicine is a social science, and politics is nothing but medicine on a large scale.” “It is the curse of humanity that it learns to tolerate even the most horrible situation by habituation.” “Medical education does not exist to provide students with a way of making a living, but to ensure the health of the community.” “The physicians are the natural attorneys of the poor, and the social problems should be largely solved by them.”
On political correctness Jim Kim (Korean doctor who worked with Farmer) defined: “It’s a very well-crafted tool to distract us. A very self-centered activity. He was able to get grant from the Gates Foundation to improve global health. “Paul and Jim mobilized the world to accept drug-resistant TB as a soluble problem,” Howard Hiatt told me one day in 2000, in his office in Brigham.” He went on to say, “At least two million people a year die of TB. And those people who doe include large numbers of people with drugs-resistant strains….” It was a growing problem, like AIDS and malaria.
Jim Kim, in Russia sang karaoke for the Russian generals, “I’m a terrible singer, but in my culture, Korean culture, if you respect someone and you have a deep affection and admiration for the people you’re with, you should embarrass yourself by singing for them. So I will sing for you.”
“In fact, large foundations tended to finance narrowly focused campaigns against well-publicized diseases. None was likely to be interested in simply paying the bills, year after year, for a comprehensive health care system like Zanmi Lasante.”
“Erasing history, he liked to say, always served the interests of power.” Farmer
“Americans are lazy democrats, and it is my belief, as someone who shares the same nationality as Ludmilla, I think that the rich can always call themselves democratic, but the sick people are not among the rich.” “Look I’m proud to be an American. I have many opportunities because I’m American. I can travel freely throughout the world, I can start projects, but that’s called privilege, not democracy.”
“To Farmer, the distinction between prevention and treatment was artificial, created, he felt as an excuse for inaction.”
“But I have to limit the amount of time I put into explaining all that or it just sucks your soul dry.” Farmer
“Are you incapable of complexity?” That was an epiphany for me. Are you going to punish people for thinking TB comes from sorcery?”
“Long ago in North Carolina, Farmer watched the nuns doing menial chores on behalf of migrant laborers, and in the years since he’s come to think that a willingness to do what he calls “unglamorous scut work” is the secret to successful projects in places like Cange and Carabayllo. “And,” he says, “Another secret: a reluctance to do scut work is why a lot of my peers don’t stick with this kind of work.” In public health projects in difficult locales, theory often outruns practice. Individual patients get forgotten, and what seems like a small problem gets ignored, until it grows large, like MDR. “If you focus on individual patients, “Jim Kim says, “you can’t get sloppy.”
“He’s still going to make these hikes, he’d insist, because if you’re saying that their lives matter less than some others’, and the idea that seven hours is too long to walk for two famlies of patients, you’re saying that their lives matter less than some others’, and the idea that some lives matter less is the root of all that’s wrong with the world.”
“If you do the right thing well, you avoid futility.”
An important book.
Paul Farmer died February 21, 2022 at age 62. Reading this book is a witness to the amazing work he did to make progress for multiple drug resistant (MDR) TB and AIDS in underserved countries, where massive death from disease is devastating. The work he accomplished globally by his organization Partners In Health (PIH) set up with the name Zanmi Lasante in the region of Cange, Haiti. He was dedicated in his work with anthropology, using ethnography, and medicine; he was committed to the people who needed care the most. He made inroads in Haiti where he was affectionately addressed as Doktè Paul, Peru, Siberia; he worked to treat people that others did not think were possible to save. Everything seemed against his view to treat people with MDR. “…Paul laid out a comprehensive theory of poverty, of a world designed by the elites of all nations to serve their own ends, the pieces of the design enshrined in ideologies, which erased the histories of how things came to be how they were.” For Haiti, that included its rule by France and the United States.
He had his own language; and spoke multiple languages: Creole, French, Spanish for starters, adding on others as he needed. He worked in each community bringing in locals to work with him and forming centers that functioned against odds.
He had a benefactor in Boston who was determined to die poor, his work was construction and he poured his money into the project when no one else was supporting it. It was a unique mixture of his dedicated personality that brought people in to work with him. And it was his work that began the change to use generic drugs that were affordable for these difficult illnesses. Farmer saw the problems with the World Health Organization’s (WHO) Directly Observed Therapy (DOTS) program, that didn’t address drug resistant TB. They were cycling through making the problem worse. “MDR is basically because of human errors. If you can’t treat it right, don’t do it.” said Arata Kochi who framed the term to DOTS-Plus at the Academy of Arts and Sciences in Boston, 1998.
At this time Farmer was going to Peru and they were talking about Russia. The idea was to drive down drug prices. “Doctors without Borders took on the job of finding generic manufacturers of second-line drugs….put up the cash to buy the first shipments.”
I knew this back when I too was working in the field, but reading the book now I realize how much I didn’t know. For example, I did not know that HIV-positive Haitian refugees were quarantined on the Guantanamo naval base from 1991 to 1993 when an American federal judge ruled it unconstitutional. Farmer said, “Quarantine has never been shown to be an effective measure in controlling sexually transmitted diseases.” “Both Guantanamo and Cuba’s AIDS sanatorium were quarantines. But it is a lie to say they weren’t different.” Cuba made testing for HIV mandatory and had very accurate rates; out of 11 million on the island only 2,669 tested positive as of 2000. They acted quickly to clean up the blood supply.
Quotes:
“You can’t sympathize with the staff too much or you risk not sympathizing with the patients.”
“Many aid experts from prosperous places gladly expressed hopelessness on the Haitians’ behalf, Farmer would say.”
“He had problems with groups that on the surface would have seemed like allies, that often were allies in act, with for example what he called WL’s”—white liberals, some of whose most influential spokespeople were black and prosperous. “I love WL’s, love ‘em to death. They’re on our side,” he had told me some days ago, defining the term. “But WL’s think all the world’s problems can be fixed without any cost to themselves. We don’t believe that. There’s a lot to be said for sacrifice, remorse, even pity. It’s what separates us from roaches.”
Farmer studied Rudolf Virchow who said, “If disease is an expression of individual life under unfavorable conditions, then epidemics must be indicative of mass disturbances of mass life.” And, “My politics were those of prophylaxis, my opponents preferred those of palliation.” And, “Medicine is a social science, and politics is nothing but medicine on a large scale.” “It is the curse of humanity that it learns to tolerate even the most horrible situation by habituation.” “Medical education does not exist to provide students with a way of making a living, but to ensure the health of the community.” “The physicians are the natural attorneys of the poor, and the social problems should be largely solved by them.”
On political correctness Jim Kim (Korean doctor who worked with Farmer) defined: “It’s a very well-crafted tool to distract us. A very self-centered activity. He was able to get grant from the Gates Foundation to improve global health. “Paul and Jim mobilized the world to accept drug-resistant TB as a soluble problem,” Howard Hiatt told me one day in 2000, in his office in Brigham.” He went on to say, “At least two million people a year die of TB. And those people who doe include large numbers of people with drugs-resistant strains….” It was a growing problem, like AIDS and malaria.
Jim Kim, in Russia sang karaoke for the Russian generals, “I’m a terrible singer, but in my culture, Korean culture, if you respect someone and you have a deep affection and admiration for the people you’re with, you should embarrass yourself by singing for them. So I will sing for you.”
“In fact, large foundations tended to finance narrowly focused campaigns against well-publicized diseases. None was likely to be interested in simply paying the bills, year after year, for a comprehensive health care system like Zanmi Lasante.”
“Erasing history, he liked to say, always served the interests of power.” Farmer
“Americans are lazy democrats, and it is my belief, as someone who shares the same nationality as Ludmilla, I think that the rich can always call themselves democratic, but the sick people are not among the rich.” “Look I’m proud to be an American. I have many opportunities because I’m American. I can travel freely throughout the world, I can start projects, but that’s called privilege, not democracy.”
“To Farmer, the distinction between prevention and treatment was artificial, created, he felt as an excuse for inaction.”
“But I have to limit the amount of time I put into explaining all that or it just sucks your soul dry.” Farmer
“Are you incapable of complexity?” That was an epiphany for me. Are you going to punish people for thinking TB comes from sorcery?”
“Long ago in North Carolina, Farmer watched the nuns doing menial chores on behalf of migrant laborers, and in the years since he’s come to think that a willingness to do what he calls “unglamorous scut work” is the secret to successful projects in places like Cange and Carabayllo. “And,” he says, “Another secret: a reluctance to do scut work is why a lot of my peers don’t stick with this kind of work.” In public health projects in difficult locales, theory often outruns practice. Individual patients get forgotten, and what seems like a small problem gets ignored, until it grows large, like MDR. “If you focus on individual patients, “Jim Kim says, “you can’t get sloppy.”
“He’s still going to make these hikes, he’d insist, because if you’re saying that their lives matter less than some others’, and the idea that seven hours is too long to walk for two famlies of patients, you’re saying that their lives matter less than some others’, and the idea that some lives matter less is the root of all that’s wrong with the world.”
“If you do the right thing well, you avoid futility.”
An important book.
adventurous
informative
inspiring
medium-paced