Book ReviewMountains Beyond Mountains: Healing the World: The Quest of Dr. Paul Farmer
Book ReviewBy Tracy Kidder (Random House, 2003)
Reviewed by Nancy Casey
from the November 2003 Newsletter
When you fly into Port au Prince, Haiti, the plane banks over the bay and you see a landscape that looks like the Snake River canyon near Wawawai in August: steep brown hillsides. The major difference is that the barren slopes of Haiti are dotted with houses. When physician/anthropologist Paul Farmer made that flight with writer Tracy Kidder, Farmer turned to Kidder and said, “It bothers me to look at it. It can’t support eight million people, and there they are. There they are, kidnapped from West Africa.”
I know that feeling. Everywhere you go in Haiti, you catch yourself marveling, not only that people live here, but that they can. It’s hard to look at it from a plane, and it’s hard to look at it on the ground. Harder still, is to figure out how to respond.
What’s amazing about Paul Farmer is that he has spent his adult life looking squarely at poverty, disease, bureaucracy, and injustice and consistently, unflinchingly responding. His responses have included walking miles over mountain paths to check on patients, “borrowing” drugs from a wealthy, prestigious US hospital with no TB patients to treat, or confronting high-level WHO officials with a paraphrase of their policies for treating TB and HIV patients in the third world: “Let ‘em die.”
Tracy Kidder followed Farmer around for months while researching this book, learning about the amazing scope of Farmer’s work: a clinic, schools, and housing programs in Haiti’s Central Plateau near the Dominican border that blossomed into TB eradication programs in Peru and the prisons of Russia and became a model for determined public health activists world-wide. But Kidder was equally curious about what makes Farmer tick. Getting inside of Farmer’s mind was one of the most fascinating parts of the book for me. He examines public policies and popular myths about global poverty with ruthless logic. He says what he thinks—and he thinks hard. His conclusions would seem far more outrageous if he wasn’t living them.
I gave this book to a friend to read, and she started it reluctantly. Just another one of those do-gooder tales designed to make me feel guilty, she supposed. When she finished, she admitted that she read it in a day and a half—couldn’t put it down. A page-turner about squalor and disease? Well, yes. And it’s funny, too.
Read this book. It’s a detective story about TB. It’s a tale of committed friends sitting up all night and making up their own hilarious language to describe a world that can spawn such injustice. It’s a beautiful glimpse of so many of the things that I love about living and working in Haiti. You’ll find yourself thinking through your own ideas about what’s fair and “right” in the world. You’ll laugh. And, well, you might cry, too.
When I got to page 188, the passage about how hard it is to look at Haiti from the air, I turned the book over, put my head on the table, and sobbed. Then I picked it up and started reading again. You can only cry over this stuff so much. Then you do something. And the interesting thing about “doing something” in the third world is that it’s not long before something hilarious and absurd happens. You cry. You laugh. You keep going. That’s what Paul Farmer does.
Nancy Casey has just finished a slow trip across the US, showing her slides of Haiti to every audience she could capture. As you read this, she just might be flying over the bay of Port au Prince on her way to the island of Lagonav where she works with the villagers on gardening projects. Once she arrives there, she’ll start building cisterns and take up her long-neglected correspondence with Moscow friends. You can learn more about her life in Haiti.
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