Miami Herald - Sunday, October 05, 2003
Carl Hiaasen

The group is protesting the murder of its leader, Amiot M tayer, and calling for the resignation of President Jean-Bertrand Aristide.

Gang members who once supported the embattled Aristide now claim that he had a hand in M tayer's killing.

It's another confusing, murky drama in a country that remains hostage to chaos and violence. Every time I see such disturbing headlines, I think of Dr. Paul Farmer, a Harvard physician and anthropologist who practices medicine deep in the Haitian countryside, near the town of Cange.

Farmer is ferociously obsessed with the idea that decent healthcare should be available to the world's poorest and neediest people, and for two decades he has focused on the poorest and neediest place in the Western Hemisphere.

And he's done some astounding things. His public clinic, Zanmi Lasante, treats hundreds of thousands of peasants who might otherwise never encounter a doctor; curing tuberculosis, managing HIV, vaccinating against smallpox, polio and other diseases that were long ago eliminated from our fortunate lives.

The breadth of Farmer's heroics, and those of his co-workers, is detailed in a moving new book, Mountains Beyond Mountains, by Pulitzer Prize-winning author Tracy Kidder.

I mention Farmer because the good work he's trying to do has been directly, and sometimes tragically, impacted by the hard-line U.S. policy toward Haiti.

It's not exaggerating to say that untold numbers of innocent Haitians, including many children, have suffered and died because of severe cuts in international aid orchestrated by the Bush administration. The stated purpose of blocking those funds was to pressure Aristide into initiating electoral reforms. Hawks in Congress and the White House have never trusted the Haitian president, who was democratically elected in 1991, overthrown by a military junta, then reinstalled after the Clinton administration sent troops in 1994.

That Haiti is not yet a model of modern democracy is no surprise to anyone familiar with its bloody political history, or the choke-hold of indescribable poverty that grips most of its more than eight million people.

Aristide surely is no saint, but U.S.-led efforts to chasten him have -- just like the Cuban embargo -- punished those who least deserve it.

The cuts in grants and aid to Haiti caused some rural medical facilities to cut back services or to close, resulting in huge numbers of sick and elderly patients going untreated and, in many cases, dying. Farmer's clinic in Cange was virtually stampeded by those desperate to save their children and loved ones.

Last year he sent me an e-mail describing the situation and in July testified with remarkable restraint before a U.S. Senate committee.

"Blocking development and humanitarian assistance is a terrible tactic and moral error," Farmer said. "It is also a medical and epidemiological error."

A short time later, the United States restored a relative trickle of funds to Haiti, but not before dunning its paltry national treasury for past debts.

Partners in Health

In recent years, Farmer's Boston-based charity, Partners in Health (to which he donated his MacArthur "genius" grant, as well as his Harvard paychecks) has expanded its disease-eradication campaign to the slums of Peru and the prisons of Russia.

Haiti, though, remains first in Farmer's heart. Having first visited as a med student in the early 1980s, he has spent far more time there than anyone now making policy decisions in Washington, D.C.

The doctor holds strong opinions about America's role in Haiti's plight, and in its future. If we can spend $1 billion a week rebuilding Iraq, he asks, can't we spend a fraction as much to rebuild a starving neighbor and ally?

His e-mails are occasionally tinged with frustration and anger, but I'd probably react the same way after watching a baby die for lack of clean drinking water or a simple antibiotic. But, far from being depressed by the seemingly endless misery that he sees, Farmer is energized with the hope and determination that comes from saving lives, which he does every day.

They help everybody

So far, the medical complex in Cange has been relatively unbothered by the civil unrest afflicting some of Haiti's cities. It helps that Farmer and his staff are known to offer medical help to anyone who needs it, from the Cannibal Army to the Haitian Army.

Reading Kidder's book, it's easy to feel guilty for doing so little while "Dokt Paul" is doing so much. "I'm not a candidate for canonization," he protested in an e-mail last week.

He has no interest in fame, except to the extent that it brings attention to the execrable conditions in Haiti.

He would cringe if he knew that he has figured so prominently in this column, but it seemed the best way to tell the story.

Farmer is the most reliable witness I know to the human damage inflicted by dogmatic politicians -- and to the incredible achievements that are possible when common sense and compassion prevail.

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