Farmer Challenges Duke Community to Consider Health as a Human Right

Alumnus discusses work in Page Auditorium talk

By Marsha Green

Tuesday, April 22, 2008

Durham, NC -- Health care and human rights activist Dr. Paul Farmer believes that it is not leaders that change the world, but people.

“The technocrats and their plans are important, but [these movements] won’t succeed without the citizenry behind them … to fight for the rights of everyone,” Farmer said Monday to a full house at Page Auditorium.

Farmer is a Duke alumnus and the founder of Partners in Health, a non-profit organization that works to reduce health disparities in nine resource-poor countries. He was at Duke to give the inaugural Global Health Lecture, co-sponsored by the Duke School of Nursing’s Office of Global and Community Health Initiatives and the Duke Global Health Institute.

Drawing on recent experiences in Haiti and Rwanda, Farmer said health care is a human right that the larger community should be involved in providing.

“When we talk about global health, we're talking about equity,” he said. “We’re talking about access. We're talking about fairness and justice. We're talking about the notion that there should be certain rights-the right to clean water, the right to education, the right to health care.”

He said Partners in Health focuses on strengthening the public health systems in countries such as Haiti and Rwanda rather than trying to work around them. “In Haiti, we used grant money provided for the treatment of HIV/AIDS to rebuild the public health system,” Farmer said. “We do this for two reasons: you have to work with the public health system if you want to scale up. And if you care about the right to health, you have to find a way to revive the conversation about public rights.”

Involving Community Workers

Farmer also said societies need to find ways to include more community members in the work. “There aren’t enough doctors and nurses to provide all the healthcare needed today,” he said. “Are we going to pretend we can train enough doctors and nurses, or are we going to be innovative?”

In resource-poor countries, Partners in Health makes extensive use of community health workers (CHW) who can provide much of the support and care needed by patients afflicted with HIV/AIDS and associated illnesses. "If we don’t support the community health workers, we cannot provide the kind of care needed,” he said

Alyssa Sankin, a senior who upon entering Duke four years ago read about Farmer through the required freshman reading of Mountains Beyond Mountains, said she was pleased to hear him emphasize the importance of restructuring health care delivery.

“I remember reading Mountains Beyond Mountains and thinking ‘I would love to do something akin to Paul Farmer’s work, but I don’t want to be a doctor, so it is out of the range of possibilities,’” she said. “Two years later, when I was interning with the Tuberculosis Coordinator for the Millennium Villages Project, I re-read the book and realized I had infiltrated the field of global health and it had miraculously become very much in the range of possibilities.”

Sankin will graduate this May with a Global Health Certificate and has already landed a job at an international non-government organization that focuses specifically on global health.

Habits of Engagement

During his visit to Duke, Farmer also visited with student groups involved in global health. He met with nursing students, students involved in WISER, and medical residents who will be the first to begin Duke’s new global health residency. During his evening talk, he applauded the many efforts being made in global health at Duke since he was last on campus in 2006 to help launch the global health initiative, but he ended with a broader challenge to students:

“What can you do right now? Develop habits of engagement. I won’t say get involved in what I do. Just get involved in something to make the planet a better place.”