Mountains Beyond Mountains: Part I

The soldiers’ job was to reinstate the country’s democratically elected government, in the process stripping power from the junta—a government composed of military leaders—whose corrupt and cruel reign had gone on for three years.

The captain was stationed with eight American soldiers in Haiti’s rural central plateau, charged with keeping the peace for 150,000 Haitians, mostly peasants, spread over a thousand square miles.

Farmer asked the captain if anyone in the compound needed medical attention. Carroll advised him that he had some sick prisoners the local hospital refused to treat, so he had ended up buying the medicine himself. Farmer flashed a smile. “You’ll spend less time in purgatory,” he replied.

I sensed that the doctor knew Haiti far better than the captain, and that he was trying to give him some important information. He suggested the murder suspect be arrested again, and this time held indefinitely.

I found the two men’s views ironic. The captain, who described himself as “a redneck,” was arguing for due process. Farmer, who championed human rights and clearly was on the side of the poor, was arguing against it.

I found the two men’s views ironic. The captain, who described himself as “a redneck,” was arguing for due process. Farmer, who championed human rights and clearly was on the side of the poor, was arguing against it.

Doktè Paul, as his Haitian friends called him, made it clear that he didn’t hold the captain or his men responsible for not being able to fix Haiti’s problems; he blamed United States foreign policy for being naive.

He insisted that imposing political order on Haiti, no matter how much financial aid was provided, wouldn’t improve the problems of poverty and disease.

Most Haitians, who trace their ancestry to West Africa, have been exploited for 250 years, no matter what government was in power.

Rather than stay safely away, Farmer bribed his way back in, to continue his work at the Mirebalais hospital. My curiosity was piqued by his unusual life, and once back in the States, we kept in touch via email.

I was aware from media coverage that in addition to his work in Haiti and seeing patients in Boston, Farmer had begun working internationally in the field of tuberculosis.

Perhaps my curiosity about Farmer had never gone away, and now I was more intrigued than ever.

Farmer’s whimsical tone didn’t mean that everything he said wasn’t completely serious. He wanted the doctor to begin treatment immediately, rather than subject the patient to further tests.

Joe was isolated in a special room with negative airflow, just in case he did have TB, which can spread in the air and is highly contagious. He lay on his bed dressed in blue jeans and a T-shirt, a small man with scarred and wiry arms and prominent collarbones.

It wasn’t that I thought Farmer was being vain; rather, I felt I was in the presence of a different person from the one I had been chatting with a moment ago, someone whose ambitions I hadn’t yet begun to fathom.

The original village was submerged when a government dam was built in 1956. The residents immediately became squatters, scrambling up the steep hillsides to remake their homes and farms on land they didn’t own.

Dressed in jeans and a T-shirt, strolling into the main courtyard, Farmer was inevitably greeted by a crowd beseeching him not just for medical help but personal favors, such as delivering a letter for them to the United States, or procuring a pair of reading glasses or nail clippers or a wristwatch or just food.

Dressed in jeans and a T-shirt, strolling into the main courtyard, Farmer was inevitably greeted by a crowd beseeching him not just for medical help but personal favors, such as delivering a letter for them to the United States, or procuring a pair of reading glasses or nail clippers or a wristwatch or just food.

Dressed in jeans and a T-shirt, strolling into the main courtyard, Farmer was inevitably greeted by a crowd beseeching him not just for medical help but personal favors, such as delivering a letter for them to the United States, or procuring a pair of reading glasses or nail clippers or a wristwatch or just food.

The policy at Zanmi Lasante was that everyone had to pay a modest services fee, the equivalent of eighty American cents per visit, because Farmer had been advised by local doctors that not to charge would encourage patients to take advantage of him.

By using seventy community health workers, Zanmi Lasante had vaccinated all the children in the area and greatly reduced local malnutrition and infant mortality.

Ulcers, glaucoma, gastritis, gangrene, cancer, broken limbs, malnutrition, and a host of infectious diseases—almost everything came through the doors of Zanmi Lasante.

Ulcers, glaucoma, gastritis, gangrene, cancer, broken limbs, malnutrition, and a host of infectious diseases—almost everything came through the doors of Zanmi Lasante.

Two young Haitian staff doctors hovered over her, not quite sure what to do. “Doctors, doctors, what’s going on with you?” Farmer asked plaintively, not angrily, as he examined the girl. He recognized the symptoms of some type of meningitis, an inflammation of the brain and spinal cord.

Farmer didn’t like the idea of “noncompliant” patients, those who did not follow his instructions. He wasn’t angry or even disappointed with them—he accepted that all humans had weaknesses—but he was insistent that everybody take their medicine, even if that meant someone from the clinic tracking them down.

We parked beside the rusted hulk of a small cement factory. A hundred yards away was a concrete buttress dam, which supplied hydroelectric power to Port-au-Prince.

Farmer frequently gave speeches, lots of them, and invariably he mentioned the dam we were now staring at. When he discussed the interconnectedness of the rich and poor parts of the world, the dam was his favorite metaphor.

I walked with Farmer across the top of the Péligre Dam with its rusted railings and flaking concrete. To our right the choppy waters of the Artibonite rushed away, and to our left were a few small vessels plying the placid blue waters.

On the other side of the dam, a path of loose dirt and stones veered almost straight up. Farmer began climbing and I followed. Eighteen years earlier, crossing a street in Cambridge, he had been hit by a car, and the surgically repaired leg canted out at a slight angle, making his gait a little awkward.

The houses we passed were more battered than many of those in Cange—dirt floors and roofs of banana fronds that leaked in the rainy season, turning floors to mud.

I was beginning to see the extent of his ambition. He didn’t just want to change Haiti at a grassroots level. He wanted to improve the lot of impoverished peoples across the world.

Farmer listened to their requests for an additional community health worker in their area, and I was sure he would find a way to oblige them.

On the last leg back to Cange, I straggled up out of another ravine and as usual found Farmer waiting for me.

Moving to the edge of a cliff, however, he stared somberly at the yellow mountains in front of us and the yellow mountains beyond those mountains and over Lac de Péligre. The view reminded me of the Haitian proverb “Beyond mountains there are mountains,” which meant that when you’d solved one problem, you couldn’t rest because you had to go on and solve the next.

Moving to the edge of a cliff, however, he stared somberly at the yellow mountains in front of us and the yellow mountains beyond those mountains and over Lac de Péligre. The view reminded me of the Haitian proverb “Beyond mountains there are mountains,” which meant that when you’d solved one problem, you couldn’t rest because you had to go on and solve the next.