In Mountains Beyond Mountains and Dr. Kim’s May 21, 2013 address to the World Bank Group, we are introduced to two of the world’s most preeminent world health justice advocates. While Dr. Farmer and Dr. Kim worked together in Haiti, Peru, and Cuba, as illustrated in Mountains Beyond Mountains, their respective careers took two different roads: Dr. Farmer became an anthropologist, and Dr. Kim went on to become the President of the World Bank Group. While both men seek to reduce global health inequities, they approach this monumental task in several different ways.
First, Dr. Farmer has a fairly simple goal of helping the poor to obtain health services, while Dr. Kim wishes to eradicate extreme poverty completely in one generation. Secondly, Dr. Farmer appears to believe that the best approach to helping the poor is through the establishment of local health clinics in impoverished areas. Dr. Kim, on the other hand, hopes to achieve universal health coverage for all global citizens. Finally, Dr. Farmer is motivated by a strong moral and religious sense, while Dr. Kim appears to be in pursuit of a political career. Both approaches are courageous stances toward the problem of global health inequity, but Dr. Farmer has a more realistic and attainable stance in regards to this goal.
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"Approaches to Global Health Care".
In Mountains Beyond Mountains, Dr. Farmer comes across throughout the narrative as a tireless “foot soldier,” working on behalf of the disadvantaged classes in Haiti, Peru, and Cuba. While Dr. Farmer had a highly prestigious medical and academic career in the United States, he nonetheless was willing to get his hands dirty in order to help his patients, even contracting Hepatitis A in the course of his work (Kidder 152). For Farmer, serving the poor in person is a vocational calling, and he seems to consider this to be a war that is best won fighting one battle at a time. Farmer also considers his work as a physician in these areas to have a social impact; as he mentions early on in the book, “the physicians are natural attorneys of the poor” (Kidder 61). Dr. Kim, on the other hand, believes that global health inequity is a problem that can be best solved through massive policy changes on the part of world leaders; for instance, Kim mentions in his speech that it is possible to “end extreme poverty in the world” (n/a) in one generation, through government-level interventions.
Dr. Kim’s ambitious goal of eradicating extreme poverty from the Earth in a single generation is targeted toward achieving good health for all global citizens. Dr. Kim believes that the achievement of economic growth throughout the world will be the key to eliminating poor health among members of the world’s poorer classes. For instance, Kim mentions in his speech that “economic growth coupled with specific health and education interventions have contributed to improving people’s lives” (n/a). In other words, Kim believes it is useless to provide health care to the poor if this is not coupled with real financial and social assistance.
Dr. Farmer, on the other hand, is much less of a political animal than is Dr. Kim, and he comes across as being solely interested in assisting the poor in developing nations with their immediate health concerns. Throughout Mountains Beyond Mountains, Dr. Farmer often comes across as a man who is not easily given to being overly idealistic or credulous. Kidder illustrates this personality trait of Dr. Farmer in his description of an interaction he had with Dr. Kim at a clinic in Haiti: “Farmer wasn’t enthusiastic, but once he gave in, he did everything he could to help” (130).
In addition to his reticence to give into overly idealistic “grand schemes,” Dr. Farmer comes across as a man who is motivated to help the poor through an internal sense of social justice, which is likely influenced by Christianity. For instance, Dr. Farmer quotes a Biblical passage when questioned about his motives for helping the poor (Kidder 185), and he seems to be more involved in the day-to-day technical details of helping those who are in need. To illustrate, when Dr. Farmer went to Peru to assist with an outbreak of tuberculosis in the rural areas of that nation, much of his time was spent determining which class of antibiotics would be most effective for the Peruvian population.
On the other hand, Dr. Kim appears to be more content to govern the social health justice movement from the sidelines, and proposes measures such as obtaining universal health coverage for all poor citizens in every nation (n/a), which is quite a tall order. As we in the United States have witnessed with the advent of “Obamacare,” many impoverished individuals who have insurance for the first time are unaware of how to use it, and do not understand the concepts of deductibles and “in-network providers.” Thus, Dr. Farmer appears to have a far more realistic approach to issues of health justice.
Reading both Mountains Beyond Mountains and Dr. Kim’s speech to the World Bank Group caused me to reflect on the difficulty of providing health care for the global poor. As health technology advances, and thus necessarily becomes more expensive, this will be an even greater challenge in the years to come. However, setting wild goals such as eliminating poverty in one generation or giving health insurance to every single citizen is a project that is unlikely to bear much fruit, or truly help anyone.
