IT ISN’T OFTEN that you wake up to news that shatters your core. This happened to me last week when I learned of Dr. Paul Farmer’s death. I was washing the dishes in the kitchen when my phone dinged. It was a message from a friend with an emoji of a tear rolling down the face. My heart sank. "Is it my mother?” fearing my worst fears. Reluctant, I opened the message to a twitter link. In a momentary relief, but then, my heart sank. I was thunderstruck: Paul Farmer. "How, why? Why him, God” Why him?
The last time I was leveled by someone’s death, was when I heard of Anthony Bourdain death by suicide. He was a manly man I revered. Sinful, ungodly, living life his way without a tinge of regret. He questioned God’s righteousness and believed in the power of shared human experience. These bonds of endearment and a common craze for food, were his religion. For years, I followed his work on the screens, books and through meandering imaginations. His death was sudden, a friend whom I had never met was gone.
Granted, these were two very different men, but they both impacted my life. Both were passionate about what they did and both had empathy toward others. And both were outspoken, direct, and marched "to their own drum.”
But Paul Farmer was my friend. Everyone who met him felt that way. He listened. He asked questions. And he never forgot your story. I first met Paul in 2012 in Boston, Massachusetts. I was working on a feature film "Open Heart” by Kief Davidson, about Paul’s work. Fresh out of college, I could not contextualize what a giant he was in the field of public health. I’ll admit prior to meeting Dr. Farmer, I had no knowledge of healthcare delivery, the political intricacies and its social implications.
I learned Paul Farmer co-founded Partners in Health with Ophelia Dahl, a health care advocate, and Dr. Jim Kim (former president of the World Bank) Their revolutionary work on behalf of global healthcare was born out friendship and love. His beliefs were disruptive, a necessary recipe for success. For starters, the organization was formed to bridge the global inequities that prohibited access to healthcare. He wanted to see a just world in which a cancer patient in rural Rwanda or Haiti "would” have the same access to medication a patient in America would have. If this was not daring enough, while his colleagues in Cambridge, Massachusetts were studying how to reduce unnecessary surgeries, Dr. Farmer would be studying why people in rural poor countries don’t have access to surgery when or if they should need it.
This is what made Dr. Farmer an enigmatic physician. He was fearless and called the medical and pharmaceutical industry to account. At Harvard, I attended a class lecture where he spoke about healthcare delivery. First, he believed if a patient was not responding well to treatment, "you should blame the physician and not the patient.” He lost me here for a moment while trying to process this statement. For him treating a disease was not the ultimate goal but rather a deep-diving into the root causes. "That’s where you start” he said with an impenetrable conviction.
The success of the organization required thinking outside the box. He did not subscribe to the idea that physicians should sit waiting for patients at the clinic. "When a patient does not have food, shelter or means of transportation—” before he could finish the sentence, I connected the dots. I pulled my lips inward "why hadn’t I thought of this before?” I have lived half my life in rural Rwanda. I know from which he speaks. For Paul, poverty and diseases are two equals. This is why he was a prominent advocate for food support for his patients. He formed an alliance with industry leaders like The Bill & Melinda Foundation and former president Bill Clinton Foundation in the supply of food and access to medication.
One of his many disruptive moves was the creation of "accompanists” community members who would be trained to administer drugs intake. An army of women who would visit patients in their homes, ensure they are eating enough, drinking plenty and taking the right medication at the right time. This task force would then collect necessary data on the patients which in turn informed the clinics how the patients were responding to treatment. By involving the community in the provision of healthcare, he not only served individuals, he strengthened the community fabric and created a stay against isolation.
All his life, Paul fought battles for the poor, the marginalized, and the sick with triumphant results— in Haiti and Rwanda to name but a few. He took on tuberculosis and AIDS when most doctors looked away. He dared to challenge and change deep-held beliefs that diseases were caused by angry ancestors or punishment from vengeful gods. I imagined the struggles he faced explaining to someone that, prayers and biblical passages alone cannot heal diseases or debunking the belief that tuberculosis is not an ancestral manifestation that can be healed with offerings. This is a fight most doctors would not undertake. This reckoning with traditional beliefs was a herculean effort of the mind and an unimaginable extortion of will. His life’s mission was a daily series of relentless and compassionate acts of bravery.
I shadowed Paul in the back-country of Rwanda— places with no running water, no electricity, without internet access or hot shower. I failed to understand why a privileged American chose us -- a people with no means and did so without expecting anything in return. At Harvard, Paul was a celebrity, a global icon any country, any organization would be honored to have onboard. Instead, his heart led him to Rwanda, allowing him to hear the far-cries unheard by many. As we traveled through rural communities, I was tormented by the level of poverty we encountered in the villages, yet people seemed happy and satisfied with very little.
His devotion to the poor left me in total confusion. He created an ecosystem that hired healed patients to become gardeners at the clinic, guards, cleaners because he knew the power of human dignity. In a little over a year working with Paul on the film, I had never seen him angry. What frustrated Dr. Farmer, as was the case a few days before his death, was losing a patient. He earned a new name in Rwanda Muganga mwiza (good healer) because he earnestly cared for the poor.
In 2008, before I had ever heard of Paul Farmer, my friend Ishmael and I attended a private dinner at James Wolfensohn's (former president of the World Bank) home in Jackson Hole, Wyoming. It was there , the host predicted that the 21st century will come to be known as the African Century.” I had no idea what he meant then. As Africans, we are not only seeing ourselves in a new light of opportunity, we are working to end structural inequalities. There is no end to our potential.
But the road ahead is not without its pain. My time watching Paul work in Rwinkwavu and Butaro was not easy… defeated and uncertain, I walked away and returned to Washington, DC. Looking back, a decade later, what disturbed me then is what drives me now to walk the path Paul Farmer cleared for us.
The passing of Paul Farmer probes deep questions within me: "What can I do to make a difference in the world with the gifts that are mine? What am I passionate about? What am I willing to give my life to in order to help others? One of the last conversations I had with Paul was in Butaro he said to me, "Your generation will do more good if you stay focused.” His words ring truer today with a greater urgency.
I want to focus my energy on what will have the greatest impact for the greatest good. I want to supply clean water to millions of Africans. I grew up in Gisenyi and witnessed women like my mother and grandmother walking to collect water and then, the weight of carrying water home, day after day. I want to make water accessible to everyone like Dr. Farmer did with medicines. I know this is an ambitious goal that requires a sober assessment of the truth of what it will require of me and the team I hope to create on the ground. Already, I am looking with an endless churning of questions, alongside a trove of information adorned with a wall of worries. But this is my dream and I worked with a man who turned dreams into a movement. I saw what it takes. It takes all of us working toward something larger than ourselves.
As we hold our collective memory in honor of Dr. Farmer, with tears welling in our eyes, grieving with a heavy heart— may we celebrate his life. His cup was full. His head was in the right place and his bosom throbbed where God intended it to be. Rest in peace Paul— the world will always remember that you have lived.
The views expressed in this article are of the author.