Pessimism and Privilege

Pessimism and Privilege

Partners in Health was formed by Dr Paul Farmer and some peers including Roald Dahl’s daughter Ophelia, in the late 1980s after Farmer became determined to make a difference to the people he met in Haiti as a medical student.

The success of Partners in Health in places as far flung as Haiti, Russia and Rwanda, is proof that optimism combined with love, focus and action, makes incredible difference.

Global health statistics available through many organisations such as The Gates Foundation and UNICEF confirm that to be on the right side of history, you really need to take an optimistic and informed view of what is actually happening in this era of progress.

The same can be said for indigenous health here in Australia.  When a colleague said recently “what is the point of what we do because nothing is changing”, I was surprised and a little disturbed, as I pondered on the information available to us through many sources that in fact, as difficult as things continue to be, strides of improvement are well documented, well known and deserve to be celebrated.

If you’re privileged enough to express pessimism about the point of helping others, you’re privileged enough to access the plethora of information that justifies optimism.

This I Believe – Dr Paul Farmer:

I believe that health care is a human right.

I have worked as a doctor in many places and I have seen where to be poor means to be bereft of rights.

I saw early on, still just a medical student, the panicky dead-end faced by so many of the destitute sick.  A young woman dying in childbirth.  A child writhing in the spasms of a terrible disease for which a vaccine has existed for more than a century.  A friend whose guts were irreparably shredded by bacteria from impure water.  An 8 year old caught in crossfire.

“What a stupid death”, goes one Haitian response.

Fighting such stupid deaths is never the work of one, or even of a small group.  I’ve had the privilege of joining many others providing medical care to people who would otherwise not be able to get it.  The number of those eager to serve is impressive and so is the amount that can be accomplished.

I believe that stupid deaths can be averted.  We’ve done it again and again.  But this hard and painful work has never yet been an urgent, global priority.  The fight for health as a human right, a fight with real promise, has so far been plagued by failures.

Failure because we’re chronically short of resources.

Failure because we’re too often at the mercy of those with the power and money to decide the fates of hundreds of millions.

Failure because ill health, as we’ve learned again and again, is more often than not, a symptom of poverty and violence and inequality.  And we do little to fight those when we provide just vaccines, or only treatment for one disease or another.

Every premature death, and there are millions of these each year, should be considered a rebuke. 

I know it’s not enough to attend only to the immediate needs of the patient in front of me.  We must also call attention to the failures and inadequacy of our own best efforts.  The goal of preventing human suffering must be linked to the task of bringing others, many others, into a movement for basic rights.

The most vulnerable; those whose rights are trampled; those rarely invited to summarise their convictions for a radio audience, still believe in human rights, in spite of or perhaps because of, their own troubles.

Seeing this in Haiti and elsewhere has moved me deeply and taught me a great deal.  I move uneasily between the obligation to intervene and the troubling knowledge that much of the work we do, praised as humanitarian or charitable, does not always lead us closer to our goal.  That goal is nothing less than the refashioning of our world into one in which noone starves, drinks impure water, lives in fear of the powerful and violent, or dies ill and unattended.

Of course such a world is a utopia and most of us know that we live in a dystopia.  But all of us carry somewhere within us, the belief that moving away from dystopia moves us towards something better and more humane.

I still believe this.


6 thoughts on “Pessimism and Privilege

  1. On reading this, I decided to re-read Mountains Beyond Mountains. Can’t find it. Guess I have loaned it out. What an inspirational man Dr Paul Farmer is. Thanks for reminding me Helen.

    Liked by 1 person

  2. Thanks! I needed this today. So disillusioned by my work, the attitudes of my colleagues and my frustration at the lack of ‘best practice’ or even client centred care in an area that is comparatively well resourced.


  3. Thanks Helen
    I did a great MOOC based on the work of Paul Farmer and some of his colleagues and students, “Global Health Case Studies from a Biosocial Perspective”. I think it contributed to my decision to do a PhD – an approach to health and suffering that is casually overlooked in the usual health science perspectives in Australia.

    So I strongly recomend this on line course – no cost but huge benefit.

    Liked by 1 person

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