This article is an excerpt from the Shortform book guide to "Mountains Beyond Mountains" by Tracy Kidder. Shortform has the world's best summaries and analyses of books you should be reading.
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What is Zanmi Lasante? Why is Paul Farmer’s hospital in Haiti so important and inspiring?
Zanmi Lasante was founded by American physician Paul Farmer in Haiti. Its founding was underpinned by Paul Farmer’s grand vision: to treat everyone, regardless of their ability to pay.
Read the inspiring story of Paul Farmer’s Zanmi Lasante.
Paul Farmer in Haiti
In Mountains Beyond Mountains, Tracy Kidder tells the true story of Paul Farmer, a doctor and anthropologist who has devoted his life to providing health care to the poor in Haiti and around the world.
During his years at medical school, Paul Farmer visited a town in Haiti’s central plateau called Cange and was shocked at how miserable the local people had seemed. There were no medical services provided in the area and many people were obviously dealing with pressing physical ailments.
Farmer decided to set up a hospital in the region to serve local people’s need for affordable medical care. He named the hospital ‘Zanmi Lasante’, which means ‘Partners in Health’ in Creole.
Although there were other hospitals and clinics in Cange, many required patients to pay more than they could afford for treatment, including for the medical equipment used to treat them, like gloves. Furthermore, many clinics lacked basic sanitation.
In contrast, Zanmi Lasante hospital provided treatment to nearly everyone, regardless of their ability to pay. And although the staff at Zanmi Lasante sometimes made mistakes or botched lab testing, they were able to offer more affordable services.
In Haiti, Paul Farmer also envisioned a multi-level health system for Cange and the villages surrounding it:
- Preventative services: clean drinking water, sanitation, vaccines, and women’s health services
- A network of locals who could teach people about health practices and identify illnesses, particularly severe ones like tuberculosis.
For any ailments not addressed at these levels, people could seek treatment at Zanmi Lasante.
Funding for Zanmi Lasante Hospital
Farmer funded the hospital through a nonprofit organization by the same name: Partners in Health. He earned money from his job at the hospital in Boston—$125,000 per year—as well as from giving lectures and writing books. Whatever money he didn’t need to pay his bills went into funding Partners in Health.
The foundation got most of its funding from grants, including a $220,000 MacArthur Genius Grant, and one generous donor from the Boston area.
In 1999, Zanmi Lasante spent $1.5 million on treating patients, on-site and in their homes. In contrast, the author’s local hospital in the US treated roughly the same number of patients, but had an annual budget of $60 million and only treated patients on-site, not in their homes.
Daily Routine at Zanmi Lasante
Each day, Farmer spent the first hour of his time at Zanmi Lasante simply crossing the courtyard in front of the hospital complex. Hundreds of people gathered each morning seeking treatment, and Farmer took time to interact with anyone that approached him as he crossed. In addition to asking for treatment, people asked Farmer for favors like giving them money or sending a letter to the US on their behalf.
While Farmer crossed, he worked to spot patients that needed immediate medical attention, like a woman with gangrene in her hand. After reaching the building, he’d spend time answering emails in his office, then he’d see patients.
Patients came in with a variety of ailments, from a woman suffering from drug-resistant tuberculosis who needed pain medication, to a man who needed nutritional supplements to fight hunger.
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Here's what you'll find in our full Mountains Beyond Mountains summary:
- How Dr. Paul Farmer came to operate a hospital in Haiti
- What the connection is between sorcery and tuberculosis
- How Dr. Farmer's organization is a model for treating patients in poor countries