Mountains Beyond Mountains: Part II

Evenings, after a long day working at the Winn-Dixie, she restocked the boat’s small refrigerator, fixed dinner, and washed dishes in the brackish water of the bayou.

Drinking water came from a convenience store miles away—without permission, the Warden or one of the children quickly shoved their plastic jugs under an outside spigot and hoped no one saw them.

In his last two years at Duke, for all his early infatuation with the social life and trappings of wealth, Farmer quit his fraternity and began concentrating on his studies. Focusing on science and pre-med courses, he earned mostly As.

Showing a natural resourcefulness, he had little money but got himself hired as an au pair, or domestic assistant, to a Franco-American family.

As he resumed his studies, Farmer discovered the work of a little-known German physician, biologist, philosopher, anthropologist, and politician—a polymath—named Rudolf Virchow.

Turning his back on the affluent trappings of Duke, Farmer began sensitizing himself to the centuries-old plight of the the poor.

Arrogant and humble at the same time, the radical, fearless nun and her fellow sisters were the most committed individuals Farmer had ever met. “They were just so much more militant, if that’s the word, than the WLs and the academics. They were standing up to the growers. They were the ones schlepping the workers to the clinics or court, translating for them, getting them groceries or driver’s licenses.”

In Sister Julianna’s company, on tours of North Carolina tobacco plantations, Farmer met a number of Haitians. They were living in such wretched conditions that he wrote an article about the deplorable situation.

After recently receiving a letter from her father, she was eager to talk to him about family matters. She quickly discovered that phone lines at the Teleco building weren’t functioning. Ophelia wasn’t surprised—the phones in Mirebalais worked half the time at best—but she still felt frustrated, and a little dejected.

Walking back to the Eye Care house, her gaze strayed to the building’s balcony. She was surprised to see a “pale and rangy fellow,” a blan like her, appearing totally at ease in a town where white people were not common.

Her mom had suffered a stroke, and after enduring a long convalescence, then had to confront a painful divorce from Ophelia’s father.

While he had not yet attended Harvard Medical School, it seemed to Ophelia that Farmer already seemed to know a lot about medicine and especially anthropology. He said he’d come to Haiti to do ethnography—a branch of anthropology that centered on learning about a culture from the people who had inherited and were making culture—and his special field was going to be medical ethnography.

She was more than smitten by Farmer. She wondered if she was falling in love. But she had to return to England, where she hoped to start her pre-med work. She had told Pel she wanted to become a doctor, too.

Like Farmer, the priest believed in liberation theology as a “powerful rebuke to the hiding of poverty,” and he worked diligently to bring public awareness to the plight of rural Haitians. He ran a rudimentary one-doctor health clinic in Mirebalais and, along with his wife, helped build schools and organize groups for adult literacy in several small towns, including Cange.

They didn’t want to wait until the afterlife for things to get better, as some missionaries were resigned to telling them. They wanted justice and equality now. The message suited Farmer temperamentally, because for all his scholarly understanding of developing nations’ problems, his strongest impulses were pragmatic.

Farmer began with a preliminary health census. He enlisted five Haitians who were his age—he required that each had at least one year of junior high school—to go from hut to hut in Cange and two neighboring villages. They recorded the number of families, recent births and deaths, and the apparent causes of morbidity (disease) and mortality.

One morning in Mirebalais, they both skipped church, electing instead to watch the heavy downpour from Père Lafontant’s empty rectory.

She spent that whole summer in Haiti with him. In the evenings, over coffee, she’d help him with his formal medical education, which he’d summarized on thousands of highly imaginative flash cards. One side of a card might read, “Show me, sir, the lesions of Horner’s syndrome & oculomotor nerve paralysis. And what the divvil’s an Argyll Robertson pupil?”

If someone was gravely ill with an infectious disease such as TB, malaria, or typhoid, the patient would be sent to the clinic, Bon Sauveur, that he and Père Lafontant were building in Cange.

He had been giving away money for years, to Catholic charities and needy friends, even before he had much of his own; now he found himself on boards of prestigious organizations and becoming friends with important politicians and dignitaries.

She’d talk P.J. into weekend trips to Port-au-Prince, ostensibly to buy medicine and equipment for the clinic.

Once Ophelia asked if they could stop to buy some Diet Coke on the way. He said, “We don’t have time. We can’t do it.” His words nettled her.

Their arguing reached such a pitch that he stopped the truck and ordered her out. She didn’t obey, feeling both offended and exultant, smiling inwardly, thinking, “Yes! I got to you. You have this human quality. You’re flawed.”

For many years to come, the smell of revolt, of roadblocks and massacres, would be an abiding odor in Haiti and in Ophelia’s life and Paul’s.

PIH believed in sending resources directly to Cange, down “the steep gradient of inequality.” Farmer called it a show of “pragmatic solidarity.” Helping the most desperate people first was how they would change the way the world perceived poverty.

PIH believed in sending resources directly to Cange, down “the steep gradient of inequality.” Farmer called it a show of “pragmatic solidarity.” Helping the most desperate people first was how they would change the way the world perceived poverty.

One evening, hurrying around before catching his flight to Haiti, Farmer stepped off a curb and was struck by a car. His knee was shattered. He languished for three weeks at Massachusetts General Hospital, then returned with a huge cast on his leg to the apartment he shared with Ophelia.

For a long time I thought I could live and work in Haiti, carving out a life with you, but now I understand that I can’t. And that’s simply not compatible with your life—the life you once told me you would like to lead even ten years ago...namely your unswerving commitment to the poor, your limitless schedule and your massive compassion for others....

Still, the life she and Paul had shared was not something she was willing to throw away. She intended to remain a part of PIH and of Paul’s life. Eventually, she would take over the management of PIH’s finances and start an endowment.

He seemed to feel that he could tell her anything, now that he had no formal obligations to her. Being his confidante, she felt essential to him, in some ways closer to him than ever. She’d say to herself sometimes, “Being his wife would have been no bargain. But to be his friend is simply wonderful.”

On January 26, Chouchou, a handsome man in his mid-twenties, was scarcely recognizable. His face, and especially his left temple, was misshapen, swollen, and lacerated; his...mouth was a coagulated pool of dark blood; he coughed up more than a liter of blood in his agonal moments.

On January 26, Chouchou, a handsome man in his mid-twenties, was scarcely recognizable. His face, and especially his left temple, was misshapen, swollen, and lacerated; his...mouth was a coagulated pool of dark blood; he coughed up more than a liter of blood in his agonal moments.

His chest and sides were badly bruised, and he had several fractured ribs....Chouchou’s back and thighs were striped with deep lash marks. His buttocks were hideously macerated, his skin flayed down to the exposed gluteal muscles.

Incensed by the brutality, he reported the atrocity to Amnesty International, an organization that documents cases of human rights abuse. He also wrote a piece called “A Death in Haiti,” which the Boston Globe published under someone else’s name. Chouchou’s grave offense had been to mutter a disparaging comment about the condition of Highway 3, overheard by a soldier not even in uniform.

Incensed by the brutality, he reported the atrocity to Amnesty International, an organization that documents cases of human rights abuse. He also wrote a piece called “A Death in Haiti,” which the Boston Globe published under someone else’s name. Chouchou’s grave offense had been to mutter a disparaging comment about the condition of Highway 3, overheard by a soldier not even in uniform.

Farmer remembered all of his patients—he kept track of their faces and quirks and the dates he had seen them, using mnemonic devices, just like his flash cards in medical school.

From that moment on, Farmer curtailed his travel within the country.

During the three-year reign of terror, Zanmi Lasante was the only place that dared to treat people who had been beaten or shot. Afraid of reprisals from the military if they did seek help, many Haitians stayed away unless their health problems became critical.

Another casualty of the brutal regime was the Zanmi Lasante staff. Not that they were hunted or killed, but many left the clinic from fear, and Farmer noted the “paralysis” and “lassitude” among those who stayed behind.

In his mind, discipline and focus were paramount; energy was not to be squandered. But, in fact, a big change in PIH was coming. They were about to become players in international health.