Year: 2024
Type: article
Abstract: Paul Edward Farmer died on February 21, 2022, in Butaro, Rwanda (Figure 1).From a childhood living with his family of eight in a converted school bus, he became a prominent public anthropologist, global health physician, and leading medical humanitarian and health justice advocate.Farmer helped build hospitals, medical schools, and community care networks for the poor in numerous countries.He cofounded the organization Partners In Health (PIH) which modeled new approaches in global health policy and healthcare, cultivating partnerships between wealthy and poor institutions and demonstrating that diseases like TB, HIV, and Ebola can and must be treated among all people, including the poor.He advanced understandings of structural violence, illuminating the mechanisms through which social forces like poverty and racism cause harm, and he joined others to demand meaningful change from those in power.Farmer was born October 26, 1959, in North Adams, Massachusetts, the second of six children.His father, "Paul Senior," was a "free spirit" who rejected class hierarchies and taught his children to stand up for the underdog.Paul Sr. worked as a high school math teacher, coach, salesman, and traveling film projectionist.Paul's mother, Ginny, raised the children before completing her degree at Smith College and becoming a librarian.Their father gave his children drive, discipline, and principled defiance of authority; their mother gave them compassion, kindness, and warmth.When Paul Jr. (his siblings called him "PJ") was young, the family moved to Birmingham, Alabama, then to Brooksville, Florida, where they lived in campgrounds in repurposed buses and later in a houseboat anchored in Jenkins Creek.The family bathed in the creek and brought drinking water from town.One summer when it was especially difficult for the family to make ends meet, Paul and his siblings worked several days harvesting oranges in the orchards nearby, later remembering how difficult the work was (Farmer, 2009).His siblings remember PJ as especially academically inclined.He was the founding President of the Herpetology Club in junior high and at age 11 used a pointer and his own drawings to teach his family about reptiles.Farmer attended Duke University on a full scholarship, majoring in biochemistry until his third year when he was "hooked" by a medical anthropology course (Farmer, 1985) and changed to anthropology.In the class, he read Shirley Lindenbaum's (1979) analysis of the frightening infectious disease kuru (the first recorded prion disease among humans) through the lenses of history, colonialism, and sorcery as well as biomedicine.He read Arthur Kleinman's (1981) Patients and Healers in the Context of Culture and began a multiyear correspondence with Kleinman about his growing interests in psychological and medical anthropology.One of Farmer's mentors at Duke, Atwood Gaines, hired Farmer onto an ethnographic project in Alsace, France, where he went door-to-door asking ordinary people about the meaning of injustice and suffering (see Gaines & Farmer, 1986).Also at Duke, Farmer volunteered with the United Farm Workers in migrant labor camps on tobacco plantations near campus, working with a Belgian nun to interview Haitian migrant workers (Rylko-Bauer, 2016).Here, he saw principles of liberation theology put into practice and began to read Latin American liberation theologians, encountering the movement for a "preferential option for the poor" and "accompaniment" (see below).Farmer received his BA in anthropology in 1982 and moved to Haiti the next year.Two centuries earlier, Haitian people had driven out their French enslavers, after which imperialist powers including the United States crippled the young nation with debt, leading to generations of impoverishment, neocolonial exploitation, and political dictatorship (Crawford-Roberts, 2013;Farmer, 1994;Porter et al., 2022).By the 1980s, Haiti, once the most profitable French colony, was the most impoverished country in the Western Hemisphere; many Haitians suffered severe malnutrition, and only the richest had access to biomedical care.Farmer volunteered in a clinic in rural Mirebalais on Haiti's Central Plateau.There he met the Haitian Anglican priest Father Fritz Lafontant, who with his wife Yolande and other local community leaders had established a clinic, school, and women's group in the squatter settlement of Cange (Figure 2).In Cange, Farmer was inspired by the villagers' endurance and pride but angered by their unnecessarily dire conditions, the village having recently been displaced by a dam.Political and economic injustice, he saw, propagated and proliferated sickness.Later he would explain that Haiti was "the best teacher I've ever had" (Farmer & Narang, 2007).While in Haiti, Farmer was accepted to Harvard Medical School, where he joined one of the first cohorts of MD/PhD students in anthropology.Medical anthropology was then a rapidly growing subfield, engrossed in debates between "clinical" and "critical" approaches (should medical anthropologists ally with health professionals to improve clinical outcomes, or should they criticize the health establishment's role in perpetuating the economic and racial injustices that produce sickness?)and between competing visions of the discipline's identity as primarily scholarly and focused on research, or as applied and oriented to practice.Farmer had little patience for these debates, finding them "hard to take too seriously" (Mas, 2022).Medical anthropology, he was sure, could do all of this.His mentor Arthur Kleinman was advancing forms of "clinical anthropology,"
Source: American Anthropologist
DOI: 10.1111/aman.28019
Authors: Seth M. Holmes, Angela C. Jenks
Language: English
Subfield: History
Field: Arts and Humanities
Domain: Social Sciences
SDG: No poverty
Open Access status: hybrid
Estimated APC paid: $3,240
OpenAlex ID: W4403259931