Paul Farmer, appearing with a panel of colleagues to address the crisis in Haiti, said there have been too many prescriptions for Haiti and too little done to strengthen the Haitian people themselves. Long-term relief must be carried out collaboratively. Photo by Justin Ide/Harvard University.
When the earthquake struck Haiti on Jan. 12, doctor Louise Ivers narrowly escaped a building as it crumbled around her. The HMS assistant professor of medicine at Brigham and Women’s Hospital was in Port-au-Prince discussing, ironically, disaster preparedness. Within days, she was attending to acute injuries in the local hospital. She took extreme measures when needed, such as providing urgent, life-saving surgery to a man outside the protection of an operating room and without the support of anesthetics.
Stories such as this illustrate the “living links between Harvard and Haiti,” said Paul Farmer, cofounder of Partners In Health, in a noontime address to the Harvard medical community on Feb. 11. The talk, titled “Harvard and Haiti: A Collaborative Response to the January 12 Earthquake” included many similar stories demonstrating the responsiveness of the Harvard community, the fortitude of the Haitian people and the power of partnership.
But the talk also focused on potential.
“What is the role of the American research university in addressing the great social problems of our time?” asked Farmer, the Maude and Lillian Presley professor of global health and social medicine and chair of that department at HMS. “How do we solve the problems of poverty, privation, inequity and disasters both natural and unnatural?”
The answer, according to Farmer and a cadre of panelists, is to act. “To do Global Health, we have to do global health,” said Farmer. That is, the only way to get at the root of global healthcare problems is to examine them in the process of delivering healthcare around the world.
Farmer described his approach to action in medical terms. To make a diagnosis, he said, “You have to do the physical exam yourself.” Having spent the past 25 years providing and examining healthcare in Haiti, Farmer characterized the current condition as “an acute injury on top of a chronic condition”—a natural disaster imposed on years of impoverishment.
In terms of prescriptions, Farmer also took a page from the clinician’s textbook: “Plans for patients, if they are to succeed, must be plans made with the patient.” In the past, he said, there have been too many prescriptions for Haiti, and too little has been done to strengthen the hands of the Haitian people.
Haiti has long suffered chronic conditions. Now, with every single government building reduced to rubble, with its only public teaching hospital in ruins, with 225,000 homes destroyed and millions of people in need of food and clean water, action is imperative. Yet these actions must be in harmony and cooperation with the Haitian people.
To help, “a university like ours can offer its own brand of pragmatic solidarity and set the highest standards for research, teaching and service,” Farmer concluded.
More than 500 people attended the talk and panel discussion, including President Drew Faust and Dean Jeffrey Flier, who both gave introductory remarks. Steven Hyman, Harvard provost, and Julio Frenk, dean of HSPH, also were present. Panelists included the executive director of Partners In Health, Ophelia Dahl, and HMS instructors in medicine David Walton, Claire Pierre, and Koji Nakashima. Walton and Nakashima are Partners In Health physicians. The event was part of the Talks @ 12 series, periodic lunchtime presentations to the Harvard medical community, featuring faculty and special guests.
