In February, the nation lost someone who may be the closest we’ve ever seen to a saint in medicine. Most physicians and anyone involved in global health is familiar with Dr. Paul Farmer’s selfless work.
After taking some time to reflect on Dr. Farmer’s life, I am even more amazed by his global impact. For those who don’t know him, Dr. Farmer was a physician and medical anthropologist based in Boston but traveled the world in promoting health.
After spending many years of his youth volunteering at hospitals in Haiti, a young Farmer attended Harvard Medical School. He planned to return to Haiti after graduation to open a medical clinic, which led to his co-founding of the Partners in Health clinic. That began as a modest single room facility and later grew into an international nonprofit system of 16 medical centers with over 7,000 employees.
Dr. Farmer’s reach spanned several countries and multiple continents. In addition to Haiti, Partners in Health clinics and health strategies were deployed all over the world, including in Rwanda, Uganda and Peru. Along with his expertise in health care infrastructure development, Dr. Farmer’s mastery of public health concepts saved countless lives.
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From his work on infant mortality, to HIV transmission, his efforts will be felt globally for decades.
Through Partners in Health, Dr. Farmer may have helped more people access health care than anyone in history. I believe it was his understanding of social determinants of health that really made his presence on Earth so impactful.
As a self-described practitioner of “social medicine,” he had a clear understanding of upstream contributors to poor health.
By looking at Dr. Farmer’s work abroad, we can learn a lot about health here in the states. Poverty, food insecurity and poor education may be more severe in developing countries, but the impact of those social determinants of health is not diminished here.
The delivery of health care has only a modest impact on health compared to social factors: While health care accounts for approximately 10% of an individual’s overall health, social determinants of health account for up to 70%.
Unfortunately, we often misunderstand health as a spectrum. Poor health starts well before someone becomes ill. This is why current and popular solutions to addressing health disparities are access, access, access.
But our overemphasis on health care access is nothing more than a bandage if we do not address the cause of the cut in the first place.
Dr. Farmer understood that without access to healthy foods, we cannot fend off chronic diseases. He knew that living in impoverished communities is a risk factor for poor health. He was well aware that communities with sub-par education are also communities with sub-par health.
I am also certain he would agree that the realities of living in poverty impact psychological, mental and physical health.
We do not have to go overseas to see these struggles. I see them affecting my patients in Tulsa every day. People in every city in our country face these issues.
All of us, whether in health care or not, should take a page out of Dr. Farmer’s book and work to address the issues of poverty, food insecurity and poor education plaguing our communities.
I truly believe that even if we do not set foot in another country, we can honor Dr. Farmer’s legacy by applying his practices stateside. There is plenty of need here at home.
Dr. Farmer died in his sleep from an acute cardiac event on Feb. 21 in Rwanda, where he was involved in medical education. He was 62.
I cannot think of a better way to honor his incredible life’s work than working to address the health inequities here in America. I sincerely hope that Dr. Farmer would have agreed. Bless his wonderful soul.