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To Repair the World

To Repair the World: Paul Farmer Speaks to the Next Generation

Edited by Jonathan Weigel
With a foreword by Bill Clinton
Copyright Date: 2013
Edition: 1
Pages: 298
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  • Book Info
    To Repair the World
    Book Description:

    Here, for the first time, is a collection of short speeches by the charismatic doctor and social activist Paul Farmer. One of the most passionate and influential voices for global health equity and social justice, Farmer encourages young people to tackle the greatest challenges of our times. Engaging, often humorous, and always inspiring, these speeches bring to light the brilliance and force of Farmer's vision in a single, accessible volume. A must-read for graduates, students, and everyone seeking to help bend the arc of history toward justice,To Repair the World:• Challenges readers to counter failures of imagination that keep billions of people without access to health care, safe drinking water, decent schools, and other basic human rights; • Champions the power of partnership against global poverty, climate change, and other pressing problems today; • Overturns common assumptions about health disparities around the globe by considering the large-scale social forces that determine who gets sick and who has access to health care; • Discusses how hope, solidarity, faith, and hardbitten analysis have animated Farmer's service to the poor in Haiti, Peru, Rwanda, Russia, and elsewhere; • Leaves the reader with an uplifting vision: that with creativity, passion, teamwork, and determination, the next generations can make the world a safer and more humane place.

    eISBN: 978-0-520-95543-1
    Subjects: Anthropology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-x)
    (pp. xi-xvi)

    I’ve learned that in addressing any country’s—and the world’s—most pressing challenges, competition can almost always be fruitful. This shouldn’t be surprising; think of how often we hear calls for competitiveness in business, or how we value the achievements of a superior jazz musician or athlete. But while good policy will draw on this tension among competitors, to solve the great social problems before us, from climate change to pandemic disease, we know we need to turn from competition to cooperation and partnership. This is especially true when these problems afflict the poor and marginalized, as they disproportionally do....

    (pp. xvii-xxviii)

    Anyone who has heard Dr. Paul Farmer speak knows the pull of his stories, the speed of his wit, and the force of his vision. When he describes the work of Partners In Health (PIH) in Haiti or Rwanda or Russia, we can’t suppress the feeling that he’s figured out what it means to do the right thing, to make the world a better place. It’s inspiring. It’s also uncomfortable because that right thing rarely resembles what we do every day. He makes us face poverty and injustice, which most of the time we are content to ignore. He makes...


    • [PART I Introduction]
      (pp. 1-6)

      For most of us, the phrase “modern medicine” brings to mind the rapid development of health interventions since the mid-twentieth century and the sharp declines in mortality they have brought to many parts of the world. And it should. The progress of medicine and public health in the last sixty years has been nothing short of stunning. But such cheering often obscures the fact that so many simply don’t have access to health care, period. This was the take-home message, as my medical students say, of the first speech in this volume, “General Anesthesia for the (Young Doctor’s) Soul.”


    • General Anesthesia for the (Young Doctor’s) Soul? Brown Medical School, Commencement MAY 28, 2001
      (pp. 7-19)

      Last Monday, sitting in clinic in rural Haiti, I realized that I was sweating for two reasons. One, it was seasonably hot. We always sweat in clinic. Two, I was frightened about giving this address. The fear itself had two sources. One, it’s a great privilege to be here on this day, the day of your oath taking and transformation. Two, most graduation speeches are boring and forgettable. (Some are memorable largely because they are so boring.)

      This latter realization struck fear in my heart. I sat there, hearing the multitudes outside, and tried hard to think of a single...

    • Epiphany, Metanoia, Praxis: Turning Road Angst into Hope—and Action Boston College, Commencement MAY 23, 2005
      (pp. 20-30)

      Ladies, gentlemen, fathers, sisters, parents, families, graduates: surely you don’t blame me for being nervous. It’s been a while since I sat in that seat, and I don’t want you all to find this boring or irrelevant. A week ago, a friend emailed me an article from theBoston Globeabout how commencement speakers are chosen. It sent a chill right through me: “The graduates almost always prefer well-known figures, particularly from the entertainment world, in hopes of a speech that will provide a lighthearted finale to their college years, college administrators say.”11The article, which mentioned Boston College and...

    • Three Stories, Three Paradigms, and a Critique of Social Entrepreneurship Skoll World Forum, Oxford University MARCH 28, 2008
      (pp. 31-45)

      A new year, early in the third millennium, dawns. New plagues—AIDS, drug-resistant tuberculosis, and hospital-acquired “superbugs” of all sorts—sweep rapidly across vast swaths of land, blurring national boundaries; old maladies that should’ve been history, such as smallpox, remain rooted in longstanding and increasingly unjust social and economic structures. Malaria, hookworm, and other parasites claim lives or simply drain energy from hundreds of millions; it’s hard to work when you’re tired and anemic or pregnant a dozen times before the age of 30. There are still rich people and poor people, but most economists agree that social inequalities, both...

    • The Story of the Inhaler College of the Holy Cross, Commencement MAY 25, 2012
      (pp. 46-56)

      Thank you for inviting me back to Holy Cross. I was last here as a guest of Father McFarland’s in 2005, and it’s an honor to share this podium with him and to be with you and your families today.27A lot has changed for many of us: we’ve been through everything from retirements to commencements, from earthquakes to reconstruction. But Holy Cross looks much as it did eight years ago. And as you, Class of 2012, head out into the world beyond, you’ll find comfort in the constancy of Holy Cross and in its capacity to adjust to change,...

    • Countering Failures of Imagination Northwestern University, Commencement JUNE 21, 2012
      (pp. 57-66)

      I’m so grateful to share this stage with Martha Minow and the other honorees whose talents collectively lead us from evil, keep airplanes in the sky, and teach us exactly how one thing is not like another.32They are reason enough to be glad to be in this stadium. But then there’s you: the new doctors, lawyers, engineers, teachers, journalists, and, last but not least, college graduates. It’s a glorious day to be here with you.

      Now, enough of this fluff. It seems unfair to me that I have to make an impression on you on this of all days....


    • [PART II Introduction]
      (pp. 67-71)

      The speeches in Part II explore the same equity challenges as the last section but are directed to members of the medical community, and especially to newly minted physicians. This is a group of people about to spend almost all of their waking hours caring for patients, usually in teaching hospitals and affiliated clinics. I would make the same remarks to any providers of clinical care—including nurses, psychologists, social workers, and community health workers.

      These comments convey three main messages.

      First, physicians have a hard time seeing thebig picture,the large-scale social forces that so often determine who...

    • If You Take the Red Pill: Reflections on the Future of Medicine Harvard Medical School, Class Day JUNE 5, 2003
      (pp. 72-86)

      Giving graduation speeches, I’ve discovered, is in ways akin to what we all went through second year, when we first really listened to case presentations: there are ground rules for what is said and what is not, but one isn’t sure exactly what they are. And just when you’ve mastered the sort of presentation appropriate to one medical specialty, you end up on a surgery team wondering, why all those withering glances during rounds when one begins, innocently enough, with “Mrs. Jones is a left-handed 57-year-old with seasonal allergies and a remote history of eczema, who now presents with hypotension...

    • Medicine as a Vocation University of Miami Miller School of Medicine, Commencement MAY 15, 2004
      (pp. 87-98)

      What better way to start and end a speech like this than to belt out a hearty congratulations? I’m here to serve up that bizarre admixture of cheerleading and avuncular advice that is the commencement speech. I feel lucky to be here because Miami has always loomed large in my life. I grew up in Hernando County, near Weeki Wachee, spring of live mermaids. Back then, Miami loomed large as the wild and crazy metropolis far to the south, the place we all wanted to visit—and would have except our parents even back then thought of St. Pete as...

    • Haiti After the Earthquake Harvard Medical School, Talks@Twelve Speaker Series FEBRUARY 11, 2010
      (pp. 99-110)

      As I left Boston to join my family in Haiti for the holidays, it did not occur to me that I would not be back here until today. I would like to express my gratitude, our gratitude, for the outpouring of support that has followed the earthquake that occurred one month ago tomorrow. That now seems like years ago, not days, but regardless, it is time to take stock of what happened and what is likely to happen in the coming months and years.

      On the afternoon of January 12, one of our colleagues, a Harvard infectious disease specialist originally...

    • The Tetanus Speech University of Miami Miller School of Medicine, Commencement MAY 15,2010
      (pp. 111-120)

      Congratulations, fellow doctors! It’s an honor to be back among you and a pleasure. Let me start by thanking not only your teachers and the Miller School’s leaders, but also by doing the Miami thing and thanking your families for their sacrifices and support. It’s close enough to Mother’s Day that we should offer a round of applause for all the mothers here today.

      But this speech is not for faculty or families. I’d like to send you on your way with counsel that might prove useful over the next few years. Most of you will spend those years in...


    • [PART III Introduction]
      (pp. 121-127)

      One common thread in this section, and in the book as a whole, is an argument against the notion that disparities of risk and outcome are random. Such disparities are no more random than are differing impacts of storms that have buffeted Haiti more than its neighbors Cuba and the Dominican Republic and Jamaica—or that of Hurricane Katrina on inhabitants of New Orleans, stratified by income and place of residence. They are, rather, reflections of broader social forces and social structures in which we all participate, whether we are aware of it or not.

      Unnatural disasters, including those just...

    • Global Health Equity and the Missing Weapons of Mass Salvation Harvard School of Public Health, Commencement JUNE 10, 2004
      (pp. 128-142)

      It’s a great honor to address you today. I was in Haiti in April when it was announced that I’d be speaking today, and I received an email from one of my HSPH students. He wrote, “I heard you’re the commencement speaker this year . . . you beat out Bono!” He’s here today—the student, not the singer—and I plan to ask him what he meant. I admire Bono a great deal—he’s a fine singer, fills stadiums—and decided to take it as a compliment. It reminded me that Bono once opened a Harvard commencement address by...

    • Making Public Health Matter Bloomberg School of Public Health (Johns Hopkins University), Commencement MAY 24, 2006
      (pp. 143-155)

      The first thing I’d like to say is hello, public health warriors, and congratulations!

      I take graduation speeches seriously and try to do research about my host institution. I like speaking at public health commencements in part because there’s no school song and no lacrosse team. But it’s still difficult to give a cheerful yet serious speech of great relevance at such a diverse gathering. Your families are here. Your friends. Teachers of biostats as well as policy wonks. People from red states and blue; Muslims, Christians, Jews. Cost-effectiveness gurus and human rights–types. Left brain, right brain. Scorpios and...

    • Unnatural Disasters and the Right to Health Care Tulane School of Medicine, Commencement MAY 17, 2008
      (pp. 156-162)

      What a pleasure to be back in this great city. I’m especially grateful that a former teacher of mine is now your dean, since it means all I have to do to have two nice meals in the French Quarter is to deliver your send-off message.18

      Congratulations, Class of 2008, and welcome to the remarkable, promising, exciting world of medicine. You’re adding MD to your names at a wonderful, challenging time. Since you’re members of Tulane med school’s Class of 2008, you’re also veterans of another experience. You were just starting your second year of medical school when Katrina struck....

    • Exploring the Adjacent Possible Georgetown University, Commencement MAY 21, 2011
      (pp. 163-174)

      Hello, Hoyas! I’m not sure what a Hoya is, but looking out over the crowd I know that I am contemplating a bumper crop of something good.19Your kind-looking faces reassure me: as much as I love Georgetown, I accepted this speaking gig only because it was to occur on May 21, 2011. And that meant I wouldn’t have to actually give the talk, since they told me that the Rapture was to have occurred today. Seriously, it’s my great privilege to join you not at the End of Days, but rather on your last day as college students, to...


    • [PART IV Introduction]
      (pp. 175-181)

      This last section of this book includes addresses that were difficult to write and to deliver. They touch on subjects not often discussed in medicine and public health, though they must be confronted every day in clinical practice: loss and grief, making meaning of suffering and death, consolation and solidarity. Where injury occurs often and death prematurely, these topics cannot be avoided.

      My teachers and colleagues in anthropology, the discipline that has informed much of my research and writing, are the experts, if anyone is, on the ways human beings make sense of loss. But the speeches collected in Part...

    • Who Stands Fast? Union Theological Seminary, Union Medal Acceptance Speech DECEMBER 6, 2006
      (pp. 182-190)

      Two Tuesdays ago, three Haitian coworkers, an American volunteer, and an unlucky soul looking for a ride were kidnapped at gunpoint between Port-au-Prince and Cange, the village where Ophelia and I have been working for almost 25 years. Two days later, upon payment of a ransom, they were freed.

      On April 9, 1945, as Allied forces claimed victory in Germany, Dietrich Bonhoeffer was hanged in the Flossenberg concentration camp.

      Although there is all the difference in the world between kidnapping and execution, between social disintegration and war, between surviving and dying, I’d like to contemplate some of Bonhoeffer’s last words...

    • Courage and Compassion in the Time of Guantánamo Emory University, Commencement MAY 14, 2007
      (pp. 191-202)

      Forgive me, dear graduates and families and friends, if I’m a bit intimidated about being your commencement speaker. I consider it a great honor, of course, but you’ll have to admit there’s been a fair amount of flak about this part of the festivities. I’m accustomed to being second choice and don’t mind losing out to major contributors to higher education, such as Will Ferrell or the Rock.

      In any case, friends here have sent me copies of the editorials and letters in your campus newspaper, theWheel. So I know that Emory is at least polite about such matters...

    • Spirituality and Justice All Saints Parish (Brookline, MA), Spirituality and Justice Award Acceptance Speech APRIL 27, 2008
      (pp. 203-212)

      I am very grateful for this award and for the chance to speak to you. It’s somewhat conventional to open remarks, whenever awards are concerned, with disclaimers. Here is mine: I’m pretty sure I don’t deserve an award for spirituality and justice. As one person in a huge team seeking to promote basic rights for those living in poverty, I shouldn’t be singled out in such a manner. No one can promote justice on his own. The Partners In Health team, thousands strong, promotes justice by making pragmatic interventions designed to bring health care, education, and clean water to the...

    • Making Hope and History Rhyme Princeton University, Commencement JUNE 1, 2008
      (pp. 213-222)

      It’s an unconventional opening gambit, outside of a courtroom, to ask for your sympathy. But, really: was it absolutely necessary to have me compete with Steven Colbert? Please don’t tell me that all the students wanted Colbert and that I’ve been imposed on you by the faculty and administration. Last year, Seamus Heaney had to follow Bill Clinton, but Heaney is a Nobel Prize–winning poet, and both have the gift of gab. Since this is Princeton, and not the small community-based college where I teach, I’m not surprised that an academic rather than an entertainer was chosen as commencement...

    • The Drum Major Instinct Boston University, Martin Luther King Jr. Day Celebration JANUARY 19, 2009
      (pp. 223-232)

      Everybody knows Dr. Martin Luther King’s four most famous words. They were spoken during his 1963 speech on the Mall in Washington. It’s an event that is on a lot of people’s minds these days because of another event that is shortly to take place in Washington and that might be taken to confirm the ability of majority Americans, after decades of being pushed, educated, and transformed, to judge each other “not . . . by the color of their skin but by the content of their character.”

      Today I’ve been invited to reflect on another of Dr. King’s sermons,...

    • Accompaniment as Policy Harvard Kennedy School of Government, Commencement MAY 25, 2011
      (pp. 233-248)

      Rudolf Virchow, one of the heroes of public health, contended that “medicine is a social science, and politics is nothing other than medicine writ large.”32That was in 1848, and it would please me greatly to think that Virchow’s point has been taken. In any case, I’m grateful for the invitation to deliver a commencement address at the Kennedy School, where governance and policy are the focus of your studies.

      Although I’m a physician, these past two years have been an object lesson about the difficulties of scaling up—of moving from caring for individual patients to building health systems...

  9. NOTES
    (pp. 249-264)
    (pp. 265-266)