With love and tears: My first and last memories of Dr. Paul Farmer
PHOTO: Dr. Paul Farmer (right) and Dr. Sriram Shamasunder on the Butaro hospital campus in Rwanda on Feb 17. Dr. Farmer died on Feb 21.
Dear HEAL Community: 

We lost a giant this week. So many of us, so many of our fellows, partner sites, and so much of the collective energy to build a movement for health equity, access, justice can be traced back to Paul Farmer.

His example set the bar impossibly high for what we expect in the under-resourced communities we all serve. To analyze, understand and struggle relentlessly against the barriers that prevent high-quality care everywhere. We have a long way to go. But we have each other, individually and collectively as HEAL and much broader health equity movement globally to hold us steady as we struggle. 

So grateful for each of you and our worldwide community that ripples out continuing the work of Paul’s life.

Sincerely,

Sri (on behalf of the HEAL team) 
By Dr. Sriram Shamasunder, UCSF HEAL Initiative Co-Founder
The last time I saw Paul Farmer was less than a week ago.

I had traveled to Rwanda to teach the inaugural medical school class at the University of Global Health Equity in Butaro, a rural village. It is a place Paul Farmer helped dream and blossom into reality, a gorgeous, pristine medical campus arising in a very rural area among the beautiful hills of Rwanda.

I did not expect to see Paul Farmer there. I had last seen him at his 60th birthday right before the pandemic. That was a star-studded affair in New Orleans. He seemed comfortable among the rich and famous.

But there he was in rural Rwanda, teaching, seeing patients and spending time with Rwandan colleagues. He seemed more at home. He knew each medical student and gleefully came to the daily morning report — the discussion of clinical cases — with a cup of tea and a bright grin. He said he delayed his travel to Sierra Leone, where his organization Partners in Health has worked for years, because of one patient.

The patient was a young man in his mid-30s, had AIDS, and an infection that arises from end-stage AIDS and a profoundly weakened immune system. The infection had ravaged his body and mind.

In a span of two weeks with treatments, the patient had gone from minimally responsive to opening his eyes and nodding. Paul had cancelled his travel plans to try to see this patient through. He believed the patient would get better and wanted to be around to see it.
By Dr. Bhibav Acharya, Co-founder at Possible Health, Nepal and Associate Professor and Fellowship Director for Global Mental Health at UCSF
When we were in 11th grade, my friends and I wanted to bring healthcare services to an impoverished village near Pokhara, my hometown.

The best solution we could imagine was what is colloquially called a ‘health camp’: show up in a village with a doctor and some medications, go through hundreds of patients in a few hours, and leave. 

We believed that since doctors and medications were expensive, and the poor could not pay, a health camp was the best we could do. In college, my anthropology professor introduced me to the work and writings of the physician and medical anthropologist Paul Farmer, who described relegating the poor to such meager services as, quite simply, a ‘failure of imagination’.

His influence transformed my thinking regarding the most vexing problems in global health: the poor are not to blame for their economic condition and its attendant health challenges. Rather, the blame falls on our collective lack of imagination, which is rooted in, to borrow another phrase from Paul, ‘the idea that some lives matter less’. And that is how Paul began to live in my mind, as he did for thousands of others interested in healthcare. 

Paul provided the requisite vocabulary to make sense of deep inequities, and he inspired with his actions. He and his team at the non-profit, Partners in Health, have brought life-saving healthcare services to indigent populations by supporting 230 healthcare facilities in 12 countries. 

His work inspired me to go to medical school and co-found the non-profit organization Possible with other like-minded medical students, all of us committed to expanding high quality healthcare in rural Nepal. 
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