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PARTNER TO THE POOR: A Paul Farmer Reader.

PARTNER TO THE POOR: A Paul Farmer Reader by Haun Saussy, ed. Berkeley, CA: University of California Press, 2010. 662 pages, index. Paperback; $27.50. ISBN: 9780520257139.

Paul Farmer is best known for his work as the founding director of Partners in Health. Through this organization, Farmer has demonstrated the need to provide medical care to the poorest and most vulnerable people on Earth, such as HIV-AIDS patients in Haiti and TB patients in Russian prisons. But even more, he has demonstrated the feasibility of providing care for these persons when one holds a clear ethic of justice and equity and a conviction that health care is a human right. This reader is an argument for these convictions.

Partner to the Poor is one in a series published by the California Series in Public Anthropology. The twenty-five readings included are previously published material, organized in a chronological manner, but also by theme. The three themes are Ethnography, History, and Political Economy; Anthropology amid Epidemics; and Structural Violence. The readings are not scientific publications, but read more like an expose of a besetting health-care injustice, followed by stories of his experiences in seeking to redress that issue, and then concluding with his straightforward recommendations for how the world and health-care organizations should change the way they function in response to this heightened awareness. For example, after exposing the problem of TB among Russian prisoners, he then goes on to argue that TB is as much punishment for these people as is their incarceration.

Farmer is eminently qualified to straddle the disparate worlds of power and wealth over against poverty and inequality. His professional life has been spent nearly equally between the developing world (Haiti, Peru, Rwanda, Russia, and inner city Boston), and the academic setting in which he works in Boston, at Harvard University and Brigham and Women's Hospital. For those who enjoyed the Farmer biography, Mountains beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World by Tracy Kidder, the present book would be a good next step toward fully appreciating the ideology that drives him.

Farmer shares economist Jeff Sachs' argument that developing countries need more aid money. Working in the field of global health myself, I am sympathetic to his argument, but the recent book Dead Aid,byAfrican Dambisa Moyo, shows that this point is arguable. ASA readers will also notice that Farmer's approach to ethics and justice is highly relativistic. For example, we are meant to sympathize with drug-addicted HIV-AIDS patients as victims of structural violence, in which the individual is absolved of personal responsibility for her or his condition.

The book is not one sustained argument; individual readings can be read alone. However, for readers new to Farmer, one or two essays alone are unlikely to draw one in to the ethos and perspective that is unique to Farmer. The section New Agenda for Health and Human Rights, beginning on page 457, is meant to guide our thinking on global health, but is equally needed in the USA as we continue our national debate on health-care reform. Sections of this book should be required reading in all schools of public health.

As a compilation, the book can be a bit repetitive. For example, the history of Haiti is introduced several times. Additionally, the focus on Haiti, which is a rather unique country, left me wondering at several points whether his conclusions can be applied to the majority of the countries in the world who do not share Haiti's convoluted and tragic history.

Farmer is as effective as a politician as he is as a scientist. Although he patches together evidence to buttress his arguments, most of his arguments are made through highly personal stories and anecdotes. I could not help but see the similarity he bears to missionaries who are likewise driven by a passion for their cause, and often too busy to do the critical evaluation necessary to validate their work, and so resort to moving stories. On the other hand, his mastery of the literature in politics, history, medicine, anthropology, and public health allows him to make solid arguments with persuasive, multidisciplinary defense. He has coined highly communicative phrases such as structural violence, stupid deaths, microbial El Nino, and socio-medicine. His writing is highly engaging and intellectually satisfying. His writing style is one which ASA authors might emulate in seeking to make our cause known in a more accessible way to a wider public.

Reviewed by Mark A. Strand, China Director, Shanxi Evergreen Service, Shanxi Province, China.
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Author:Strand, Mark A.
Publication:Perspectives on Science and Christian Faith
Date:Jun 1, 2011
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