For nearly 30 years, physician and medical anthropologist Paul Farmer has been proving that quality health care can be delivered successfully to millions of the world’s poor. It began, in 1983, with a visit to Haiti. Today, Partners In Health (PIH), still most famous for its ongoing work in Haiti, has a presence in 12 countries around the world. Their work has three goals: to care for patients, to alleviate the root causes of disease in their communities, and to share lessons learned around the world. PIH is based in Boston and also serves a group of marginalized, chronically ill patients there, as part of its domestic effort. Founder Dr. Paul Farmer is a recipient of the Elfenworks Foundation In Harmony with Hope award. Contact: www.pih.org ~ 888 Commonwealth Avenue, 3rd Floor / Boston, MA 02215 ~ (617) 998-8922
Dr. Paul Farmer, recipient of a 2007 In Harmony with Hope award: “Since I do not believe that there should be different recommendations for people living in the Bronx and people living in Manhattan, I am uncomfortable making different recommendations for my patients in Boston and in Haiti.”
Partners In Health operates projects in the Caribbean, Central and South America, Central Asia, Africa, and – closer to home – in Boston’s inner city. In addition to fighting diseases such as tuberculosis, AIDS, and malaria, the organization also works to address the poverty that so often causes poor health by providing access to clean water, food shelter education, and economic opportunities. Using accompagnateurs, or community health workers who have been trained and employed to provide medical and psychosocial support for their neighbors, PIH discovered that building a bridge between health clinics and the community delivers results around the world. This model’s success stems from training members of the community to deliver medicine, find sick patients and bring them to the clinics, and ensure that the patients have the support they need to get well.
The growth of Partners In Health coincides, in part, with the growth of the AIDS epidemic. Farmer and his crew discovered cost-effective, efficient ways to deliver care and support to those AIDS patients. PIH also turned its attention to tuberculosis (particularly the drug-resistant variety), which has been ravaging the world’s poor communities. The innovative drug protocols Farmer and his partners have developed have been so successful that the World Health Organization is now using PIH treatment models around the world.
The fact that PIH has programs in the United States speaks volumes of our own health-care delivery model. Farmer’s own childhood–much of it spent living in a bus, tent or houseboat–awakened in him an understanding of the plight of the poor and the disenfranchised. And, unlike others who are overwhelmed into inactivity by the need, Farmer resolved to do something about it at a young age.
PIH serves the sickest HIV-positive and other chronically ill patients in the Boston area through its Prevention and Access to Care and Treatment (PACT) project. Adapting the accompagnateur model, PACT employs community health workers to monitor a group of very ill and marginalized patients and ensure that their medical and social needs are being met. The program works: immune system strength increased for HIV-positive patients who’d been enrolled in the program for 12 months; and hospitalizations of AIDS patients in the program decreased by 17%, while the costs of inpatient stays that did occur dropped by 37%. PIH is supporting efforts to replicate the PACT model at hospitals in New York City, Miami and the Navajo Nation.
Farmer’s worldwide efforts have garnered him significant praise and attention, including a MacArthur “genius” grant and considerable funding from numerous foundations. But it is largely for his work with marginalized inner city patients living in Boston that we salute him. Despite his tremendous achievement, Farmer believes he can do more. He has said, “If I were truly influential, everyone in the world would have the right to health care, food, clean water, other basics. That’s the goal.” To find out more about how to support Partners In Health, visit their website at pih.org.
