The Inspiring tale of Paul Farmer’s Zanmi Lasante

I am using my participation in the PEdAL ED Transcontinental Race No 5 to raise funds to develop and equip Zanmi Lasante’s incredible new teaching hospital in Haiti.  This is a little about Paul Farmer and Zanmi Lasante.

Fi read a huge pile of books while researching for her novel The Other Side of the Mountain, set in Haiti. One of the stand outs was the Pulitzer Prize-winning book, Mountains Beyond Mountains (From Harvard to Haiti: the remarkable story of one man’s mission to cure the world) by Tracy Kidder. Haitian’s love their proverbs and Mountains Beyond Mountains is an abbreviation of Dye mon, gen mon  – beyond mountains there are more mountains. This can be interpreted in two ways: there are endless opportunities, or (this is Haiti remember) overcoming one obstacle gives you a clearer view of the next one.  Paul Farmer, the subject of Tracy Kidder’s book, is an American physician and anthropologist who overcame a great many obstacles to realise one of his dreams – a medical complex in Haiti that treats patients free of charge. The complex he set up at Cange whilst still a medical student in his early twenties provided one of the key settings for The Other Side of the Mountain. We visited Cange last year and were given a tour. We were incredibly moved and inspired by what we saw.

In the spring of 1983, when he was twenty-three, Farmer first went to Haiti, his trip funded by the money he’d won for an essay he’d written on Haitian artists, and headed to the Hôpital Albert Schweitzer in Deschappelles in the Artibonite Valley where he’d been promised a job. Instead of finding a hospital where Haitians treated Haitians, he found only white, expatriate doctors and no job. On his return to Port-au-Prince he came across the charity Eye Care Haiti in the town of Mirebalais, (the country home of Madam Max Adolphe, the head of the Tonton Macoutes and formerly the warden of the notorious prison, Fort Dimanche, where the Duvaliers tortured their enemies). Here he met Ophelia Dahl who, at the age of eighteen and in order to please her father, had travelled to Haiti to do ‘good works’.

When Ophelia returned home, and having travelled around Haiti experiencing the poverty at first hand, Farmer raised money for a blood bank for a hospital in Léogâne. When later he discovered that the poor could not afford to be treated there, he realised he had to build his own hospital. He returned to Mirebelais to work at a clinic run by Father Fritz Lafontant, a Haitian priest who, together with his wife, helped build schools, and organise women’s groups and adult literacy programmes in impoverished towns. In May 1983, Father Lafontant took Paul Farmer to Cange, a squatter settlement of tiny lean-tos with dirt floors and roofs made of banana thatch, patched with rags, where the priest was planning to build a clinic. Farmer began to envisage his dream. He, too, wanted to build a clinic, but he also wanted to build a hospital and a community health system, which he would provide to the destitute for free.  He enlisted five Haitians to visit the villages in the area. Their surveys revealed a high mortality rate, particularly amongst mothers, which consequently led to a string of family such as hunger, prostitution and further deaths.

Farmer entered Harvard Medical School in 1984 then returned to Cange, bouncing between the two for several years and earning himself the nickname of Paul Foreigner. While Father Lafontant began constructing a clinic in Cange, Farmer started planning for the creation of a health service. He preferred to refer to this service as a ‘first line of defences’ – people would be trained to administer medicines, give classes on health, treat minor illnesses and learn to recognise the symptoms of major ones, such as TB and AIDS.

In the summer of 1985 Ophelia returned to Haiti to help Farmer with his research. Later that year, Farmer began raising money – Tom White, the wealthy owner/philanthropist of J.F. White Contracting Co, was the first major donor – and in 1987 he hired a lawyer to draw up papers to create a public charity in Boston which he called Partners In Health, and a corresponding sister organisation in Haiti, called Zanmi Lasante.  He turned to his old classmate at Duke, Todd McCormack, who was working for his father Mark at IMG, who joined him and Tom White on the board of advisers, then added fellow Harvard anthropology and medical student Jim Yong Kim to the group, which also included Ophelia Dahl.

Haiti has turbulent and violent political history, not least in Zanmi Lasante’s early years, as the country moved on from the Duvalier era (Papa & Baby Doc). There were no less than 14 regimes in the 10 years after Baby Doc was removed from his position of “President for Life” in 1986. As an open and prominent supporter of Jean Bertrande Aristide, Farmer frequently found himself on the wrong side of the government of the day, particularly following the coups which removed President Aristide from office in 1991 and 2004. Perhaps because it was providing the only healthcare available to a large part of the country, including to the henchmen of whoever was in power, Zanmi Lasante was allowed to survive through this period.

By 2003 it was serving about one million impoverished Haitians, who travelled for miles to be treated; it was sending about 9000 children to school each year, employing nearly 3000 Haitians, feeding many thousands of people each day, had built hundreds of houses for the poorest patients, had cleaned up water supplies in dozens of areas, installed water filters in patients’ homes and had assisted various environmental and economic projects throughout Haiti, such as reforestation.

Right from the start, in order to create a sustainable local system, Zanmi Lasante employed and trained Haitians as far as possible, rather than flying in foreigners as do so many of the NGOs operating in Haiti.  In 2013, PIH opened University Hospital in Mirebalais, a 300-bed teaching hospital that offers a level of care never before available at a public facility in Haiti and provides high-quality education for the next generation of nurses, medical students and residents.

And that’s just in Haiti!! PIH has developed into a worldwide health organisation, with Farmer overseeing projects in Russia, Rwanda, Lesotho, Malawi and Peru.

As well as Tracy Kidder’s Mountains beyond Mountains, PIH is the subject of a recent award winning documentary “Bending the Arc”.

Please check out the website: http://www.pih.org/country/haiti. You will be blown away.

Please help me support this the incredible Mirebalais project by sponsoring my Transcontinental Race.

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