Physician's medical roots: liberation theology

When the noted physician and social activist Dr. Paul Farmer speaks on college campuses, as he frequently does, he packs the lecture halls. “Young students today are altruistic and engaged,” he told NCR.

Farmer has been “engaged” himself for some years. He co-founded Partners In Health (PIH), a nonprofit medical group, in 1987, providing medical assistance in Haiti. The organization is now partnering with local medical teams in more than a dozen countries, among the poorest on the planet.

In 1993, Farmer was awarded a MacArthur Foundation “genius grant.” He quickly used the money to establish the Institute for Health and Social Justice, PIH's research and advocacy arm.

The 55-year-old Farmer, a degreed physician and anthropologist, is today the Kolokotrones University Professor at Harvard University. In May 2009 he was named chairman of Harvard Medical School's Department of Global Health and Social Medicine.

He spoke with students at Catholic Theological Union in Chicago earlier this year. Not mincing words, he tells impressionable students that the idea that some lives matter less than others is the root of all that's wrong with the world.

That evening in Chicago, in a packed banquet hall, CTU recognized Farmer’s work, awarding him its “Blessed are the Peacemakers” award. The honor is given to someone who exemplifies CTU values of peace, justice and reconciliation.

Farmer is quick to say he traces his social justice awakening to the months he spent in Haiti in the 1980s following graduation from college.

He shares the story of growing up in small-town Florida where, he says, he sat through many boring sermons and where going to church was something he did “to fulfill obligations to parents and grandparents.” Not exactly an inspiring Catholic faith launching, he acknowledges. By the time he was in high school, he says, he and his siblings saw little reason to continue going to Mass. He found no meaningful connection between life and his religion.

That world of lethargic Catholicism was about to change in Farmer’s life. The first serious inklings occurred while he was an undergraduate student at Duke University Durham, North Carolina. That’s when he began, he says, to hear about the wars the United States was fighting in Central America — and the news that Salvadoran soldiers had massacred an entire village with bullets made in Lake City, Missouri. Suddenly, those wars did not seem so distant.

Recalls Farmer: “That’s when I learned about the resistance to tyranny and violence offered by many members of the church, and thought: same church, same world. Not two or three worlds, but one.”

One important moment in his radicalization, looking back, he says, was in March 1980 when he heard about the assassination of San Salvador Archbishop Óscar Romero, gunned down in the middle of Mass.

Upon graduation Farmer wanted to travel to West Africa. “I have no idea why I wanted to go to West Africa. I applied for a Fulbright. Never got an interview. Haiti was Plan B.” Off he went.

Among the advice he now offers young students: “Be patient. Things don’t always work out the way you think they will.”

Farmer spent a greater part of a year in Haiti; it was an eye-opener. “If conflicts in distant countries were what it had taken to revive my interest in Catholic social teaching, proximity to suffering and poverty taught me even more about what these lessons might mean.”

An ancient proverb asserts, “When the pupil is ready, the master appears.” And, so it was with Farmer in Haiti, he says.

It was in Haiti the young Farmer came across the writings of liberation theologian, Fr. Gustavo Gutiérrez and his seminal work, The Theology of Liberation. The story of how Farmer found Gutiérrez and his continued influence on Farmer’s life is captured in the book, In the Company of the Poor: Conversations with Dr. Paul Farmer and Fr. Gustavo Gutiérrez, published by Orbis books in 2013. The book is a collaboration of essays and conversations between Farmer and Gutierréz, which, in part, explores the connection between global poverty and chronic disease.

Liberation theology further opened Farmer’s mind, giving him an analytical framework to better understand the human suffering and disease he was encountering in Haiti.

The core of Gutiérrez’s moral teaching, the basis of his theology, has been the idea of a preferential option for the poor. It’s the notion that to understand the poor and live the Gospels one needs accompany the poor, seeing the world through their eyes, learning from them. Only then, can meaningful programs emerge. The establishment of social justice in this framework first requires analysis into the causes of injustice.

These ideas so stuck Farmer, so moved him, formed him, that when he co-founded Partners in Health a few years later the first sentence in his new organization’s mission statement was borrowed directly from Gutiérrez’ writing: “Our mission is to provide a preferential option for the poor in health care.”

The mission statement goes on to explain: “By establishing long-term relationships with sister organizations based in settings of poverty, Partners In Health strives to achieve two overarching goals: to bring the benefits of modern medical science to those most in need of them and to serve as an antidote to despair.”

Farmer says he could have chosen from several models in assessing international health care and delivery systems. The first two, the “charity” model and the “development” model, though useful, he says, he found wanting when it comes to rigorous examination. The third model, the one he has found most fitting — and best able to provide lasting medical care — is the “social justice” model.

“People who work for social justice tend to see the world as deeply flawed. They see the conditions of the poor not only as unacceptable, but also as the result of structural violence that is human-made,” he once wrote in America magazine.

“Making an option for the poor inevitably implies working for social justice, working with poor people as they struggle to change their situations. In fact, in a world riven by inequity, medicine could be viewed as social justice work, and most of what we do could be seen in this light.”

Farmer says the social justice model requires broad analysis, “a recognition that humanity is increasingly interconnected in the ever-advancing technology-driven world.” These interconnections, he thinks, allow fewer and fewer excuses for neglecting the plight of the poor and needy. Indeed, Farmer has made the case through decades of talk and work that much must be done. What’s lacking is will and commitment. It takes more than delivering medicine, he says; it takes moving powerful self-entrenched interests indifferent and even hostile to the suffering of many, “interests that control people’s lives by controlling land, systems of production and political and legal structures.”

He encourages young students whenever he can — whether they are entering the field of medicine or not — to work for social change. He tries to ignite their passions, sometimes telling them they will find inspiration in unlikely sources. He never expected, he says, that his inspiration would have come from a Peruvian priest, the father of liberation theology.

Citing the work of Gutiérrez, Farmer told a group of Notre Dame students, as recorded in In the Company of the Poor, that Gutiérrez helped him understand how poverty is “both a scandal and the chief issue for theological reflection.

“I think inequality and poverty are the chief human rights questions of our times,” he said. “Medicine has many powerful tools, but we’re not going to be able to use them justly without a plan to attack poverty — we need more ways of making a preferential option for the poor in health care to be better doctors.”

In the Company of the Poor is, in effect, a social and theological meditation on the condition on suffering by two friends who share a passion for justice and well-being. Farmer is author and co-author of nearly one dozen books, each with a distinctly moral bent. In the Company of the Poor highlights his distinctly Catholic moral take, founded in church social teaching and in liberation theology, beginning with, of course, the writings of the priest who came to be a good friend, Gustavo Gutiérrez.

[Tom Fox is NCR Publisher, is on Twitter @ NCRTomFox and can be reached by email at tfox@ncronline.org.]