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A book that made a difference: Matt Kaiser

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Matt Kaiser (2006 graduate from Inman, Kan., with a B.A. in music)

A year or two ago, Dwight Krehbiel recommended a book to the Pre-Med Club for summer reading. It was called Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World. I thought to myself: “What a cliché, cheesy-sounding title for a book full of bleeding-heart stories about some guy saving people’s lives.” I was right, but this book was different.

It is the biography of Paul Farmer, an anthropologist, professor and physician. Author Tracy Kidder traces Farmer’s life from his eclectic childhood being raised on a boat to his trips back and forth between medical school in Boston and his clinic in Haiti. While in Haiti, Farmer founded a clinic that was the only health care provider for hundreds of thousands of peasant farmers in Haiti’s Central Plateau. During his work in Haiti, Farmer pioneered a community-based treatment method for patients with tuberculosis that has had better clinical outcomes than those in U.S. inner cities. Through conducting his own studies to find what was most effective, Farmer devised method of treatment and made sure each of his individual patients received not only their medicine but also a cash stipend to help with extra food, child care costs and transportation to the clinic. It was clinic policy that if someone didn’t show up for their regimen, someone from the clinic staff was to go out and find them, even if it took a five-hour hike by Farmer himself.

Farmer was doing all of this expensive and time-intensive care for individual patients in Haiti at a time in the 1990s when the World Health Organization’s official policy on treatment of TB included statements like “Multi-Drug Resistant TB (MDR) is too expensive to treat in poor countries; it detracts attention and resources from treating drug-susceptible disease.” Farmer’s colleagues and experts in TB had deemed the disease to expensive to treat in poor countries. They ridiculed him for being a mere clinician too interested in individual patients to see the big picture. Farmer rejected this idea completely, arguing that care for the individual in the community in terms not only of medicine, but also food, water and personal contact, was the solution to TB—not in the impersonal top-down policies of organizations that hope the disease will die along with the poor people who suffer from the worst form of it

Farmer saw the problem of disease and poverty caused by what he called the “misdistribution of medical technology.” The drugs and money to fight TB could be found in the United States, but not in places like Haiti. Faced with this problem, he did not just talk about how unjust life is. He didn’t just shrug and say, “This is the way the world is today” as poor folks with TB died. Farmer went into action on all levels to bring about change. He expanded his TB work to Peru and prisons in Russia, conducted studies to prove that his method of treating the individual was effective, lobbied health organizations to change their policies and got drug companies to lower the cost of TB medicine.

Through his efforts, the WHO adopted as standard policy Farmer’s recommendations for dealing with MDR. The price of TB medicine fell—drugs to treat a serious case cost $1,500 instead of $15,000. Farmer continued to be successful in treating his patients in Haiti, Russia and Peru.

This book told the story of a man who in the face of an insurmountable problem of treating a disease in poor areas did not just shrug and say, “That’s too bad—we should do something,” but acted in very concrete ways on behalf of individual people to bring about sweeping changes on a global scale. It was a lesson to my cynical side, the complacent part in all of us that says things never change. No, here was concrete proof of a single man rallying a small group of colleagues to change the lives of thousands of people. Here was idealism standing up to cynical reality and succeeding.

Reading this book played a part in helping me to identify a passion, a problem in life that motivated me, an issue that I had strong enough feelings about to want to get out of bed in the morning. Reading about the plight of the people Farmer was working with and the hassles they encountered caused by governments and organizations made me frustrated to no end. Farmer’s actions on behalf of the poor people everyone else had forgotten made me want to stand up and cheer. The stories of the Haitian peasants Farmer helped made me want scream: “What can I do to help?”

This next fall, I’ll be working at a clinic for uninsured folks in Colorado. The book with the cheesy title Mountains beyond Mountains is one of the many factors that helped me identify that that is the kind of work I want to do.

Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World, by Tracy Kidder (Random House: 2003)

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