Study Guide


by Tracy Kidder



Zanmi Lasante
Zanmi Lasante is the medical center Dr. Paul Farmer founded in Haiti. On the way to Zanmi Lasante are mountains and villages comprised of wooden huts. Beggars can be seen everywhere. Farmer describes arriving at Zanmi Lasante as a “fortress on its mountainside, a large complex of concrete buildings, half covered with tropical greenery.” Hundreds of people crowd around the outside of the buildings everyday seeking medical treatment. Dr. Farmer begins the day by circulating through the crowd looking for the worst cases. At the end of the day, when Tracy Kidder and Dr. Farmer are walking back to Dr. Farmer's small house, a girl with meningitis is transported on a donkey ambulance and Dr. Farmer does a spinal tap.

A special young boy comes to Zanmi Lasante Childen's Pavillion with lumps on his neck. He is the kind of child that uplifts all of those around him, especially Dr. Farmer. His parents had the same disease, symptoms of scrofula. They are asked to go to Cange to be tested. Dr. Farmer, instead, goes to their home with Ti Jean and Tracy Kidder which is the whole way to Casse, requiring a very long hike by foot. On the way, Dr. Farmer makes a house call at an elderly couple's hut with dirt floors. The man has had a stroke and the woman is sick too. He treats them then resumes the hike to Casse. After several hours of hiking they arrive at Casse where several children and four adults run out of a tiny hut to greet the well-known doctor. This is a typical day for the doctor when living in Haiti and treating patients at Zanmi Lasante. Dr. Farmer loves going to help these patients in their huts. Kidder explains that these visits to the Haitian people's homes kept Dr. Farmer inspired to fight on their behalf.

One special case is a man by the name of John who comes to Zanmi Lasante with his mother, not knowing what he has. His white blood cell count is very high, higher than is usually found in tuberculous. His neck is swollen. Dr. Farmer goes to great lengths to get him to the U.S. be treated. They travel rough roads in an old ambulance that breaks down, and finally resort to using an emergency medivac flight to the States. Dr. Farmer rushes him to many hospitals in Boston who will not accept him. Finally,  Massachusetts General Hospital admits John who is diagnosed with nasopharyngeal carcinoma, a rare form of cancer. Eventually he dies because he is already “wasted,” a term that Dr. Farmer despises because it means that the cancer invaded his vertebra. Usually doctors do not go to such extreme lengths to save a patient who is so far gone. Dr. Farmer hates prioritizing patients; he has to decide who lives and who dies, because of the scarce medical resources in Haiti. Dr. Farmer is angry about the treatment situation because in a real triage situation everyone gets treated; it is just that the worst cases are treated first.

Among the poorest people, such as those in Haiti and Peru, many people are not treated at all because they are not among the few chosen to be given medicine. This is what Dr. Farmer fought to eradicate, the unfair medical practices available to poor people worldwide.

Brigham and Women's Hospital
At Bringham Hospital, Dr. Paul Farmer is a specialist in Infectious Disease. He is also associated with the HIV Central. Dr. Farmer has access to all the medical facilities and medicines that a patient needs in Boston. Compared to Haiti, Boston seems like paradise. Patients actually improve because there are adequate...

(The entire section is 1451 words.)