Partners in Health

Paul Farmer, MD is a very influential man who has spent most of his life at the intersection of medicine, social justice, anthropology, and politics. The majority of his work has been in Haiti though certainly not limited to there. A recipient of his medical degree (M.D.) as well as a Ph.D. in Anthropology from Harvard, he started an organization called Partners in Health whose purpose is to provide a preferential health care for the poorest of the poor. PIH is now an international organization with active health care outposts in multiple continents. If you are interested the website is www.pih.org .

The model PIH uses when entering a country is based on these principles taken directly from their website.

1. Access to primary health care
A strong foundation of primary care is critical to successfully treating specific diseases, such as AIDS. People seek care because they feel sick, not because they have a particular disease. When quality primary health care is accessible, the community develops new faith in the health system, which results in increased use of general medical services as well as services for more complex diseases. Therefore, PIH integrates infectious disease interventions within a wide range of basic health and social services.

2. Free health care and education for the poor
The imposition of user fees has resulted in empty clinics and schools, especially in settings where the burden of poverty and disease are greatest. Because both health and education are fundamental routes to development, it is counterproductive (not to mention immoral) to charge user fees for health care and education to those who need these services most and can afford them least. PIH works to ensure that cost does not prevent access to primary health care and education for the poor.

3. Community partnerships
Health programs should involve community members at all levels of assessment, design, implementation, and evaluation. Community health workers may be family members, friends, or even patients who provide health education, refer people who are ill to a clinic, or deliver medicines and social support to patients in their homes. Community health workers do not supplant the work of doctors or nurses; rather, they are a vital interface between the clinic and the community. In recognition of the critical role they play, they should be compensated for their work. PIH doesn’t tell the communities we serve what they need—they tell us.

4. Addressing basic social and economic needs
Fighting disease in impoverished settings also means fighting the poverty at the root of poor health. Achieving good health outcomes requires attending to peoples’ social and economic needs. Through community partners, PIH works to improve access to food, shelter, clean water, sanitation, education, and economic opportunities.

5. Serving the poor through the public sector
A vital public sector is the best way to bring health care to the poor. While nongovernmental organizations have a valuable role to play in developing new approaches to treating disease, successful models must be implemented and expanded through the public sector to assure universal and sustained access. Rather than establish parallel systems, PIH works to strengthen and complement existing public health infrastructure.

The work of PIH has three goals: to care for our patients, to alleviate the root causes of disease in their communities, and to share lessons learned around the world.

As the debate continues, here is a voice on behalf of the poor for the sake of the poor that is not just rhetoric but passionate action.

Blessings...