Paul Farmer, the celebrated doctor of the poor in Haiti and West Africa, gave a somewhat rambling talk last night.
It was billed as challenging us “to consider how our moral, ethical, and spiritual traditions inspire us to create sustainable and effective change to health care for the most vulnerable communities, at home and abroad.”
One important thing stood out amidst the disjointed points he made: that development workers (including health professionals) need to practice and practice and practice … “cultural humility.”
He admitted that after 30 years of working in a rural Haitian community, and being fluent in the local patois, he still is not “inside” that culture. Connecting with people requires active listening, and one must assume that much is being left out or misunderstood.
He also recited a mantra of rules for success, including people, supplies, and systems. He noted that virtually all the contagious diseases of late (such as Ebola) were spread by well-meaning but poorly designed health care systems. One example was of a nun’s clinic in West Africa that because of shortages of supplies were re-using needles! Many health care givers died before those weak practices were discovered and remedied.
His last major point is that inequality of distribution of health care is, in his opinion, relatively easy to fix, compared to other major developmental issues. Indeed, health care indicators around the world are soaring, even as income level growth is slowing. Income growth and health improvement can be complements, or health improvement can be a component of faster income growth.