At Global Public Health Conference, Farmer Calls for Equal Care for the Vulnerable

Professor Paul Farmer delivered the keynote speech Monday evening, rounding out the one-day “Ethical Challenges in Global Public Health” conference. Scholars from the fields of law, ethics, public policy, and medicine convened to discuss ethical questions raised by pollution and climate change. 

The conference also served as an opportunity to celebrate BC’s new global public health and the common good minor.

Farmer is the Kolokotrones University Professor of Global Health and Social Medicine at Harvard Medical School’s Blavatnik Institute and the founder of several hospitals and medical schools.

Farmer called on Catholic social teaching as the guiding principle of his speech, emphasizing that the public health community must keep the powerless and disadvantaged in mind to prevent discrepancies in care—a form of Catholicism’s preferential option for the poor.

He invoked historical examples of the “preferential option for the rich and white” to display the origins of unequal medical access and showcase this occurrence today. His first example was Ronald Ross, who won the Nobel Prize in Medicine for his research on the life cycle of malaria in mosquitoes. He traveled to one of the most malaria-ridden outposts of Britain: Freetown, Sierra Leone.

Ross suggested segregating the city, despite the fact that mosquitoes can fly. Farmer used his example to demonstrate the misuse of public health studies as a method to quarantine and marginalize those afflicted with disease.

The second example—the 1918 Influenza outbreak—fell under the category of the “preferential option for the empire,” according to Farmer. A British ship traveling to Sierra Leone Port carried influenza to West Africa. The viral infection spread rapidly through railway lines. Within a month, 4 percent of the Freetown citizens had died. Again, the solution to this problem was strict quarantine. 

Farmer pointed to an Oct. 2, 1918 report in The Lagos Standard that described sick people shuttled into a building, only to sit in anticipation of certain death. He noted that although such a situation is recognized as horrific today, a similar case arose during the 2014 Ebola crisis. He dubbed this recurring pattern the “preferential option for the artists formerly known as the empire.”

In 2014, 70 percent of people in West Africa who got sick with Ebola died, Farmer said, while no white American treated in U.S. hospitals died. Farmer cast this disparity as an issue of access to medical care. His problem with the situation was the same as 1918: Vulnerable groups were quarantined rather than treated.

When there is not a doctor, nurse, or other healthcare professional, the family becomes the caregiver—which ultimately places the entire family in harm’s way, Farmer said. Now, Ebola and other diseases are often spread through caregivers, and after the British left in 1962, they left behind no medical or nursing schools to train people professionally, according to Farmer.

Farmer said that public health crises often pit the health of the privileged against the health of the afflicted. He called on universities to shift their attention to reparative work in the post-colonial world with a focus on equity, lest public health repeat the same mistakes of its past. 

“And you can see why this idea of preferential option for the poor is so important in building a proper global health ethic,” Farmer said. “And I can tell you, having been to schools of public health all over this country—and in other countries as well—that this is not the language that we hear. This has to be the foundation of our ethics of global health.”

Featured Image by Jonathon Ye / Heights Editor