Health advocate makes call to action
The iconic founder of the Partners in Health initiative yesterday exhorted public health authorities to embrace a more pragmatic approach to their global mission, recognizing "the right to sutures, the right to generators" as fundamental human rights.
Dr. Paul Farmer of Harvard University, whose quest to save the impoverished and ailing is chronicled in the best-selling book "Mountains Beyond Mountains ," acknowledged that his call to action "may not seem sexy."
"But we need to think about such prosaic issues as supply chains for sutures," Farmer said. "It is when people have the chance to eat and be well that they build democratic institutions."
Farmer's message received a rousing reception during the opening of the American Public Health Association's annual meeting, which is drawing 13,000 specialists to Boston this week. They were reminded by the city's current health commissioner, John Auerbach , that his predecessors in the job included Paul Revere , who led the nation's first public health department.
Farmer's work in the developing world began two decades ago when, as a medical student at Harvard, he ventured to Haiti and helped establish a community health project.
It was there, he said , that gender inequality and poverty ceased to be classroom abstractions and became a "grisly spectacle of young women dying because they were pregnant and poor."
Four years later, in 1987, he helped found Partners in Health, a campaign to address conditions such as tuberculosis , and AIDS.
Its model, which emphasizes hiring and training local residents to provide health services , has since been exported from Haiti to parts of Latin America, Russia, Africa -- and Boston, where Partners in Health has its headquarters.
In his speech yesterday, Farmer stressed the importance of paying those community health workers .
He said paying health workers in the developing world is emblematic of how social justice and public health must be interwoven. The pursuit of social justice, Farmer said , "once inspired" the practice of public health "but now seems to embarrass us."
Farmer had just returned from Malawi and to illustrate the divide in medical resources , he provided this example: A hospital in Malawi where 12,000 babies are born each year has two obstetricians and one operating room.
By contrast, Brigham and Women's Hospital , with about 8,500 deliveries annually, has 100 obstetricians and 40 operating rooms .
The developed world, Farmer said, should give back some of the resources taken away from developing worlds. And that, he said, means focusing less on conducting surveys and more on providing real resources. "Many of our patients are hungry," Farmer said, "and last time we checked, the treatment for hunger is food."
Stephen Smith can be reached at stsmith@globe.com. 
