Mountains beyond Mountains

Just when you think you’re beginning to understand Paul Farmer, he’ll say something that throws you off balance. In Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World (Random House, 2003), author Tracy Kidder paints a finely-drawn portrait of a renowned medical doctor and anthropologist. Farmer is a complex hero, battling against forces of the status quo in the complex arena of tuberculosis and HIV/Aids.

Like Paul Farmer himself, the book is always on the move. From Lima, Peru to Moscow, Russia and many places in-between, by the end of the book, the reader feels entitled to some of Farmer’s frequent flyer miles. But if the journey is wide-ranging, the narrative always returns home to Haiti, the dusty village of Cange on the central plateau. It was there in the late ’80s that Farmer – not yet out of medical school – began Zanmi Lasante, a clinic that would grow into a full-fledged hospital, focusing on the treatment and cure of tuberculosis. An astounding 25% of Haitians die before the age of forty. As a Roman Catholic who espouses liberation theology, Farmer sees in Matthew 25 (Parable of the Sheep and Goats) a rousing call to prefer the poor as a way to bring greater health care equality between countries.

As a both an M.D. and Ph.D. in medical anthropology, Paul Farmer has a keen eye for the relationship between world view and health. Haiti is famous for its voodoo. The old proverb claims:  “Haiti is 90% Roman Catholic, and 100% voodoo.” With the growth of evangelicalism in Haiti, the percentages would no longer be valid, but the insight should not be lost. Whatever one’s faith, the draw to old belief systems is strong. What Farmer does is nuance the popular perception of voodoo as primarily hate motivated. In a conversation with his assistant, Ti Jean, the doctor asks whether half of voodoo ceremonies are attempts to drive away illness. Ti Jean puts the figure at three-quarters (p. 298).

This has profound significance for Christian missionaries working among the poor, whether in Haiti, Africa, or other impoverished areas. If we view the Gospel only as a mandate to send people confidently into eternity – to invite them to join “Club heaven,” as a friend of mine called it – then we are missing the holistic nature of the Kingdom that our Lord preached. What does the message of holiness of heart and life have to say to physical suffering, to Haitians dying before they reach the age of forty? For Paul Farmer, the answer is simple: “I was sick and in prison, and you visited me.” Healing can be direct (miraculous) or indirect (through time-proven natural remedies, or trained medical professionals). If we expect new Christians to forsake old world views like voodoo because of their connection with the occult, then we must bring-to-bear the full resources of our faith, God’s desire for the well-being of both spirit and body.

Mountains beyond Mountains portrays a hero for our time, but hardly a perfect man. On Tracy Kidder’s reading, Dr. Farmer has struggled to maintain a positive home life, as his wife and daughter live in France and he rarely sees them. For those who need a rated G book, Mountains hardly qualifies, since it sprinkles the “F” word liberally. At other times, Farmer takes a dubious Robinhood approach, stealing drugs and medical supplies from Western hospitals to use them in poorer countries. While one can hardly condone any of these failings, the overall message of an “O for the P” – a preferential option for the poor -is never lost. Jim Kim, one of Farmer’s colleagues, paraphrases anthropologist Margaret Mead (p. 164) : “Never underestimate the ability of a small group of committed individuals to change the world.”  To that, we can all say “amen.”

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Gregory Crofford, Ph.D., is a missionary with the Church of the Nazarene, and Director of the Institut Théologique Nazaréen. He is author of Streams of Mercy: Prevenient Grace in the Theology of John and Charles Wesley (Emeth Press, 2010), available by clicking here. Crofford lives in Nairobi, Kenya.

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