Mountains Beyond Mountains

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Dr. Paul Farmer was instrumental in changing world views on how we treat the indigent. He understood that you couldn’t just treat the disease and the person got better. He learned that first you had to understand that the beliefs of the people you treat had a great influence on how they followed the advice of the doctor. Second if the person could not even afford to eat all the medicine in the world wouldn’t help if the patient was starving. Perhaps his greatest accomplishments were to serve on a committee that worked to get funding for MDR-TB treatment. Farmer understands that a patient’s religious beliefs strongly influenced their health. In rural areas many believed disease was a curse handed down by God. “Haitians believe in sorcery because their culture has evolved in the absence of effective medicine, so of course they believe in sorcery, in sickness that someone has sent to them.” Dr. Paul understood Haitian’s needed to be taught the science of how diseases were spread, but health workers shouldn’t mock their beliefs. He understood in order for people to recover, medicine alone couldn’t account for why some got better and others died. Dr. Paul is second realization was that you had to treat more than the current illness. “Giving people medicine for TB and not giving them food is like washing your hands and drying them in the dirt.” This Haitians saying caused him to do a study. He learned that just giving the medicine doesn’t work. Even though both groups were given free treatment only 48% of the group that just received a free doctor visit and medicine were cured. By contrast 100% of the group that received the medical treatment, cash stipend and follow up treatment were cured. The extra food, child care and transportation made the difference. Farmer work with world renowned doctors to get a grant to treat MDR-TB along with Jim Kim they explained that when only one drug company makes a medicine they price gouge. Farmer and Kim encouraged drug companies...
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