If we fail to act
by Paul Farmer, M.D.
As a physician who has battled infectious diseases in Haiti, Rwanda and elsewhere, I know we are in the midst of a staggering wave of killing, one that brings to question all notions of moral values. The numbers alone are telling. Even if we consider only the big three infectious killers — AIDS, tuberculosis and malaria — we are faced with tens of millions of preventable deaths slated to occur during our lifetimes. A recent document from the United Nations suggests, for example, that more than 80 million Africans might die from AIDS alone by 2025. A similar toll will be taken, on that continent, by tuberculosis and malaria. Adding other infectious killers to the list, the butcher’s bill totals hundreds of millions of deaths over the next few decades.
Have these numbers lost their ability to shock or even move us? What are the human values in question when we hear, and fail to react to, the news that each day thousands die of these maladies unattended? Where, amid all these numbers, is the human face of suffering? What values might guide our response to such suffering?
These are rhetorical questions, but not ones without answers. Much can be done to avert these deaths. Allow me to offer the example of Joseph, a patient of mine. On the afternoon of March 17, 2003, four men appeared at the public clinic in Lascahobas, a town in central Haiti, bearing a makeshift stretcher. On the stretcher lay a young man, eyes closed and seemingly unaware of the five-mile journey he had just taken. After the four-hour trip, the men placed their neighbor on an examination table. The physician tried to interview him, but Joseph was stuporous, so his brother recounted the dying man’s story.
