As a 22-year old, I distinctly recall rumbling along Route Nationale #3, Haiti’s unpaved and unattended central vein, toward the town of Cange. While crawling up a dusty incline past the dam that spawned Lac Peligre on my right, a nervous anticipation set in.
Those nerves were not of the sort one might attribute to popularized descriptions of Haiti. Instead, they originated from the knowledge that just ahead rested what had been described to me in Port-au-Prince as “Dr. Paul Farmer’s castle.”
What was it about that hailed castle that created such nervous anticipation?
Like thousands of young students across the world, I had found a special resonance in the story of Dr. Farmer, told by Pulitzer-Prize winning author Tracy Kidder in Mountains Beyond Mountains. Never before had a narrative so powerfully captured the essence of a growing movement of young global health advocates unwilling to let the poor around the world die unnoticed of preventable disease, or what Haitians appropriately term “stupid deaths.”
So it was much to my delight that our tire was popped rather serendipitously outside Cange, leading me into the home of
Partners in Health (PIH) in central Haiti for a brief tour. Though I wasn’t a patient, the facilities at Cange still acted exactly as intended—as an antidote to despair (to steal a beautiful phrase from PIH); there was a quality about the place that seemed attainable for the communities I had come to know in rural Nepal.
That attainability haunted me as I left Haiti for Nepal. I knew of the staggering need for strong rural health systems here, especially in the battered and neglected Far-Western region, yet I wasn’t sure how to replicate what I had seen in Cange. I didn’t know how, that is, until I met Dr. Farmer’s former students who were rebuilding the health system in partnership with the government and community in Achham District through Nyaya Health. I suppose no one should have been surprised that students of Dr. Farmer had rooted themselves in a community that lacked a single doctor for over 250,000 people as recently as 2006. Nyaya Health’s presence in Far-Western Nepal, a forgotten fold of the earth nearly 9,000 miles from Haiti, is a testament to just how far PIH’s moral reverberations truly extend.
This week, Dr. Farmer himself will visit Nepal and Achham for the first time, 29 years after his work in Cange began. He comes with nearly all the accolades one could imagine, including a MacArthur “genius award”, a Harvard University professorship, and a post as Deputy UN Special Envoy for Haiti under President Clinton.
But, most importantly, Dr. Farmer will undoubtedly come with his characteristic commitment and pragmatism to understand and serve the poor, which is why all of us involved in developing rural health care systems can welcome his arrival as a bright contrast to the tragic ties of disease and privation which have bound Haiti and Nepal together in recent times.
When Dr. Farmer soon rumbles around a turn on Madhya Pahaadi Rajmaarga and arrives at Bayalpata Hospital in Achham District, his visit will accompany an opportunity to do as he recently advised graduates of Northwestern University to do: counter failures of imagination and harness the power of partnerships to improve the health of the poor.
That is a prescription desperately needed in Nepal, where the mountains are as mighty as any.
Mark Arnoldy is the Executive Director of Nyaya Health.