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Bostonians of the year

The healers: Paul Farmer, Ophelia Dahl, and Louise Ivers

Louise Ivers, Ophelia Dahl, and Paul Farmer
By Stephen Smith
January 2, 2011

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The mountain stood barren and forlorn when they first set eyes upon it, nearly three decades ago. Paul Farmer and Ophelia Dahl were barely across the threshold to adulthood when they arrived in an impoverished village called Cange, in the Central Plateau of Haiti. The people ranked among the poorest of the poor in the country. No electricity. No clean water. Shacks to live in. And far too many succumbed to “stupid deaths,” as Farmer calls them – from conditions routinely treated or rarely seen in the United States: tuberculosis, malaria, and small ailments that, for lack of antibiotics, raged into consuming infections.

So Farmer, a physician and infectious disease specialist, Dahl, and others founded Partners in Health, occupying a small office in Cambridge and building a health charity distinct from other aid agencies. They vowed that theirs would not be a here-today-gone-tomorrow interloper. In Haiti, too often the good intentions and financial muscle of foreigners proved no match for years of neglect and privation. But Partners in Health, now headquartered in Boston, stayed, relying on an almost entirely Haitian workforce and embracing an ethos that views health, nutrition, and education as inextricably bound. It regards itself as a full partner with the Haitian Ministry of Health.

Eight years ago, Partners in Health began reaching out from Cange, enlisting an army of community health workers to make sure patients across Haiti were taking their TB and AIDS pills.

Then, beginning in the hours after a powerful earthquake laid waste to Port-au-Prince, Partners in Health assumed an even more prominent role: trying to heal a health system that was already in critical condition before the January 12 calamity killed more than 200,000. Leaders at Partners knew that neither the Caribbean nation nor their agency would ever be the same, both transformed in a crucible of tragedy.

Farmer, 51, whose spirit is invoked with an almost religious fervor by Partners in Health workers, responded from his perch as United Nations deputy special envoy to Haiti. Working with physicians and the government’s health ministry, he set about helping to rebuild by championing, for example, the construction of a large teaching hospital north of the capitol. And, in the United States, he took to the bully pulpit, arguing before Congress that the path to recovery in Haiti must be charted by that nation’s government and not outside aid agencies.

As executive director, Dahl, 46, presided over the biggest expansion – in the shortest period of time – Partners in Health had ever undertaken.

Dr. Louise Ivers, who happened to be in Port-au-Prince for a meeting on the Tuesday afternoon when the quake struck, began treating the battered and bleeding. In the months since, the 37-year-old Ivers, Partners’ chief of mission for Haiti, has presided over the growth of rehabilitation and mental health services, fueled by an outpouring of donations in the weeks and months after the catastrophe.

The challenge was and remains immense. Quake survivors were left with injuries of the body – amputated arms and legs, burns, gouges – and the mind. Some had endured loss so complete that they teetered on the edge of sanity. Survivors were settled by the hundreds of thousands into huge, fetid tent encampments that became petri dishes for the diseases of poverty. The latest is cholera, which finds easy prey among the weak.

Partners in Health, which earned its reputation in rural care, must now treat thousands in congested city camps. Life in much of Haiti remains desperate, but there is hope. On that mountainside in Cange where Partners in Health began, the once barren landscape has yielded to lush trees.

Stephen Smith, a Globe reporter, spent six weeks in Haiti last year. E-mail him at stsmith@globe.com.

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