And for Tracy Kidder, a Pulitzer Prize winner and author of Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, the Man Who Would Cure the World, researching the book was also a life changing event.
Kidder spoke to nearly 800 people as part of the inauguration celebration of Thomas L. Hellie as the 19th president of Linfield College. His book was selected as the common reading for incoming students and for MacReads, the community book club. "Mountains Beyond Mountains" is the story of Farmer, a doctor who has had a major influence upon contemporary global health intervention efforts. It follows his work to establish clinics and hospitals under desperate conditions in far-flung areas of the world, his compassion for and empowerment of the poor, his inner circle of believers, and his success in helping stem the international tide of new HIV and TB infections.
Kidder directed his comments to the students in the audience, encouraging them to consider what they can do for the poor or the marginalized in the world.
"For most of you, the question of what you are going to do with your lives is still unanswered," he said. "I think it's fair to say that is there is no skill that you acquire that can't be used to help the poor. The real message from this book is the example that has been set one small group of people can, in fact, improve the world. If one of your goals is to try to find a way to improve the world, then I don't think you have to worry about improving yourself."
You don't have to make the same kinds of sacrifices as Farmer to make a difference, Kidder added.
"Farmer's basic message is a plea that we pay attention to the world as it really is," he said. "Don't join with America's collective amnesia for the suffering that surrounds us. Don't forget about the forgotten people in this world."
Kidder met Farmer while in Haiti doing an article on the U.S. military. Although he wrote about Farmer's work setting up a clinic and public health program in one of the poorest parts of Haiti, it was several years before he decided to write a book. Farmer reluctantly agreed to cooperate.
"I think I knew the moment I met him that if I started following this guy around he was going to disturb my peace of mind," Kidder said. "He showed me more despair than I've ever seen before, yet it was the most exhilarating experience of my life. These problems are intractable and yet here was someone actually doing something, something effective and smart and ultimately really kind."
Farmer founded Partners in Health in 1987, two years before he set up his first clinic in Haiti. It was the first of many successful projects designed to address the health care needs of the residents in the poorest area of that country. Since its founding, PIH has expanded its operations to eight other sites in Haiti and five additional countries and has launched a number of other initiatives.
The original clinic Farmer founded has grown into a full-fledged public health and medical system that sends 5,000 kids to school each year, feeds thousands of people and has built hundreds of houses in dozens of locations. All of the care is free and all but a handful of the staff are Haitians. In 2005, the clinic performed about 2.5 million medical interactions and received about a million visits from patients.
"That's medical care on the basis of a major Boston teaching hospital where the budget runs about a billion and a half a year," Kidder said. "In Haiti, PIH spent only about $11 million dollars to do all its work."
Before meeting Farmer, Kidder said he skipped over articles about AIDs in Africa, thinking it was too big, too expensive and too complicated.
"But they have proven it's not," he said. "They have proven in Haiti that the entire range of disease can be treated successfully and economically in about as difficult a setting as you can possibly imagine. Now they are out to do much the same thing in Africa. At the invitation of the Rwandan government, PIH is beginning to work in the poorest province in Rwanda."
Kidder noted that there have been many articles about the failure of international health in countries and there will probably be more.
"It would be too easy to conclude that this kind of work is impossible," he said. "One of the principal values of this organization is that they proved that you can do this work and you can do it right. They combine idealism, competency and even brilliance that is extraordinary."