EDITORS’ NOTE: Last month, Paul Farmer, M.D., an anthropologist and co-founder of the nonprofit health organization Partners in Health (PIH), died while in Rwanda. Among the Harvard professor’s many achievements was the creation of hospitals in Haiti and Rwanda. He visited Albert Einstein College of Medicine in 2009 and was the keynote speaker at our Global Health Center’s inaugural Global Health Symposium. His work and writings helped inspire Einstein students and Montefiore physicians interested in following his global-health path. In this post, Einstein’s Gloria Fung Chaw, M.D., who is the associate director of the Global Health and Clinical Skills Fellowship program, and Montefiore residency program graduate Jean Claude Uwamungu, M.D., who is an assistant professor at Louisiana State University at Shreveport, reflect on Dr. Farmer and how he influenced and shaped their careers.
Gloria Fung Chaw, M.D.
On February 21, the world lost Dr. Paul Farmer, one of the giants in global health. When I heard the news from my close friends at Partners in Health, I went from disbelief to being deeply saddened…who was going to fill this enormous vacuum?
Paul’s death sparked a reconnection with close and distant friends I met in Rwanda while working with PIH. Around the world, hundreds of tributes poured in, as millions have been touched by his work, his vision, his brilliance, his love, and his relentless advocacy for social justice and equity. Despite the incredible loss we all felt, we reflected on the impact his life had on all of us and felt some comfort knowing that the community he created, and brought together from so many corners around the world, will continue the mission he started decades ago.
As a medical student at Einstein (class of 2008), I was fortunate to meet the late Dr. Albert Kuperman, associate dean for educational affairs, whose vision and humanism set the stage for Einstein to be among the first medical schools to offer global-health experiences to their students. I benefited from Dr. Kuperman’s leadership, the Uganda elective he fervently supported, my incredibly committed global-health mentors, and the Social Medicine course I took as a second-year student. My career path in global health started to take form.
After residency, I joined PIH in Rwanda as a district clinical advisor. Our role was to accompany the Rwandan clinical team, providing care at one of the district hospitals and supporting health programs sponsored by PIH. Truthfully, I never had much interaction with Paul in person. However, his very high standards for patient care, program performance, innovation, and quality were ever present; although we couldn’t always attain them, they were the benchmark we were aiming for. In line with PIH’s mission, we were expected to push the envelope and provide a level of care not usually available in rural Africa at a government facility, including cancer care, cardiac care, and longitudinal management of chronic diseases. Many organizations and individuals would’ve found the challenges insurmountable—and they often were. But that was not the culture at PIH; “Whatever it takes” is what we strove for. Idealism trumped cynicism. It was refreshing.
During my time in Rwanda, I met Dr. Jean Claude Uwamungu. We worked together in the medical wards in Kirehe hospital, and thereafter he became the director of medical education and training for PIH in Rwanda. Fast-forward to 10 years later: Claude has now completed internal medicine and cardiology training at Einstein/Montefiore. He was one of the first people I spoke with after hearing of Paul’s passing.
Claude and I reflected on the impact Paul and PIH have had on us. Despite the incredible loss we feel, we are so grateful for the community he created, consisting of thousands of people around the world and dozens of lifelong friends and mentors we found through them. Global health has become mainstream, and social justice and equity are now everyday parlance in medical schools and healthcare institutions. However, there are few in the world who walked the walk when it comes to a true commitment to health as a human right. In a time when doctors are becoming weary of corporate medicine, and cynical about proclamations of justice and equity without real action, I am comforted that I can always find inspiration and hope in the community that Paul left behind for all of us, and that his legacy will continue for decades to come.
Jean Claude Uwamungu, M.D.
I learned about PIH in 2009 when I was in medical school. After graduation, I worked as a generalist physician in a district hospital built in partnership between PIH and the government of Rwanda. I quickly learned that PIH was focused on helping the government improve healthcare services by providing additional resources. The organization empowered the local people to find their own solutions, with emphasis on community-based healthcare programs. I was very fortunate to work alongside an organization and people committed to social justice early in my career.
My personal interaction with Paul started in 2013 after I joined PIH to work in medical education. He loved teaching and always made an effort to meet medical students and doctors at the district hospitals during his site visits, frequently reminding all of us about our responsibility to society. He had knowledge about almost everything in medicine and always shared his wisdom with those around him. He didn’t shy away from making jokes, something he did with humility and a genuine smile. Some of his best gifts to us were copies of his books—always signed with words of kindness and affection. Most of us who worked with him have copies of these lasting memories of Paul’s generosity.
During my journey to residency, Paul was always available for guidance and support despite his busy work in West Africa during the Ebola outbreak there. During my clinical training at Einstein/Montefiore, I had an opportunity to work with colleagues and mentors inspired by Paul’s work and who are advocates of social justice and health equity. Paul had a great impact on my career in medicine and my becoming a better person. It is a privilege to be one of his students and part of the global community he created.
Paul spent his career living in communities of people who needed him most. He worked in solidarity with people in resource-limited settings to build health systems while showing the world that it is possible to reduce health inequities. His impact on medicine, public health, and medical education is immeasurable. Paul’s untimely passing leaves us with the task of continuing the work he started and carrying his vision forward.