Lessons from Mountains Beyond Mountains

I was first introduced to Paul Farmer and the book that Tracy Kidder wrote about him in the summer of 2007 when we chose Mountains Beyond Mountains for a community-wide one book program. I brought it to class the next fall. Ten years later, this book still has plenty to say.

This semester, I am reading this book with my Senior English class and I am stunned that a book published fourteen years ago can remain so relevant and powerful. Paul Farmer’s experiences and organization may have changed since then 2003, and certainly, there has been upheaval in Haiti, but the messages in this book are just as important as ever.

Medicine is more than drugs, doctors, and hospitals: One of the key ideas in the book is that we need to provide a “preferential option for the poor.” Borrowed from Catholic Liberation Theology, this central tenet of Farmer’s organization compels him to go to great lengths to serve his most impoverished patients. This may mean far more than administering medicine or healthcare. Farmer provides water, food, housing, jobs, and much more.

This idea that healthcare goes beyond the traditional doctor, medicine, hospital combination is also key. Healthcare, according to Farmer, is the total wellbeing of a person and community. It is the goal of social activist medicine. What good are the pills that will cure the disease if the patients’ living conditions are horrible?

We are all connected to each other: Farmer challenges our assumptions about wealth and money. Farmer questions why some are so wealthy and others so poor. Where did this come from? What are its effects? He argues that Haiti’s poverty has provided much wealth to America. He suggests that no individual or community’s success is independent and solitary. Instead, those who have more have an obligation to help those who are in need.

This brings up two critical concepts: duty to the poor and the interconnected nature of our world. Farmer is religious in his devotion to the poor. One of the myths that he explodes is that our choices affect only us; on an individual and collective level, there is human collateral damage paying for our affluence.

We are obligated to help those who are suffering: This creates a relationship of obligation. If my comfort has been created by someone else’s pain, I have an obligation to do something about this. Farmer takes this very seriously and his efforts border on the superhuman and selfless.

Help people help themselves: Farmer is not a “white savior.” His organization and philosophy are designed to create self-sustaining local programs. He doesn’t sweep in, wave a wand, and leave. Instead, he helps people help each other. He trains, creates systems, and makes certain that they fit within the culture and values of the community. His approach is very different from the typical international aid approach.

Assume the best: Farmer talks about a “hermeneutic of generosity.” It is an assumption of a positive motive. People aren’t poor because they are lazy, addicted, or scamming the system. Farmer makes a conscious choice to take the higher road and presume the better nature. It is supercharged optimism.

We must fight the “long defeat:” Farmer knows that the battle he is fighting, the battle he invited us to join, is one that is going to be a “long defeat.” Farmer tells the writer of the book, Tracy Kidder, “We’re used to being on a victory team, and actually what we’re really trying to do in PIH is to make common cause with the losers. Those are two very different things. We want to be on the winning team, but at the risk of turning our backs on the losers, no, it’s not worth it. So you fight the long defeat.”

There will always be mountains beyond the mountains we climb: There will always be more challenges. Whether we “win” or are defeated, the fight must go on and we must contribute.

In times of discord, disagreement, and division, Farmer’s voice is one we need to hear. More than ever, we need to remember these lessons from Mountains Beyond Mountains.