"This is Not a Hobby: Taking Global Poverty Seriously " - Speech by Dr. Paul Farmer

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From: K M Ives <[e-mail]>

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HAITI LIBERTE
"Justice. Verite. Independance."

* THIS WEEK IN HAITI *

April 23 - 29, 2008
Vol. 1, No. 40


TAKING GLOBAL POVERTY SERIOUSLY
by Paul Farmer

The following are excerpts from a speech delivered by Dr. Paul Farmer of the
Harvard Medical School to the Inaugural Millennium Campus Conference of the
Global Poverty Initiative at Massachusetts Institute of Technology (MIT) in
Boston on Apr. 19. Farmer is the founder of Partners in Health, a world-wide
healthcare network which began with a clinic in Cange on Haiti's Central
Plateau. The wide-ranging speech, delivered to an audience of 800, was
entitled This Is Not a Hobby: Taking Global Poverty Seriously.

Here we are again at MIT, talking about-among other things-how we can bring
technology to bear on the persistent problem of global poverty.... We need
solutions and a plan to implement them in precisely those parts of the world
that have never benefitted from the remarkable innovations in technology
that have made life better for so many of us. Why have these innovations
never reached the bottom billion? There are many reasons, and they are
complex, but one of the reasons is that too little attention has been paid
to the hard work of actually bringing these advances into the villages and
slums in which the poor live. To be frank, too many people have treated such
efforts as a sort of hobby - a solar panel here, an ingeniously designed
water pump there, an alchemical miracle that turns turnips into fuel over
there.

Those gathered here today know that these scatter-shot efforts, no matter
how innovative, will not suffice to reverse the awful trends now evident
around the world. New plagues - AIDS, drug-resistant tuberculosis and
hospital-acquired "superbugs" of all sorts - sweep rapidly across vast
swathes of land, blurring national boundaries. Old maladies that should've
been history, like smallpox, remain rooted in long-standing and increasingly
unjust social and economic structures. Malaria, hookworm, and other
parasites claim lives or simply drain energy from hundreds of millions; it's
hard to work when you're tired and anemic or pregnant a dozen times before
the age of 30. There are still rich people and poor people, but most
economists agree that social inequalities, both global and local, have grown
rapidly over the past three decades. The earth itself is tired and
malnourished. Man-made environmental crises dry up lakes, wash topsoil into
the seas and smother reefs, and-from what we can tell-spark huge storms. A
billion people do not have safe drinking water. A war built on lies will
cost, one Nobel laureate economist tells us, three trillion dollars. (...)

This conference draws together health, education, technology, economics, and
public policy - and all are necessary components of this global fight for
food. If you've been reading the paper recently you will have seen news of
the food riots happening in Haiti. This is not just a problem of rampant
malnutrition - though that is of course a huge problem where we work in the
Central Plateau and most of the country. It is, rather, a problem of global
collusion, unfair trade agreements, and crazy agricultural subsides. I was
in Haiti during the years the country was pushed, by countries with their
own ridiculously high ag supports for rice and others cereals, to drop
import tariffs on rice and sugar. Within less than two years, it became
impossible for local farmers to compete with what the Haitians called "Miami
rice." The whole market in Haiti fell apart as cheap, US-subsidized rice --
some of it in the form of "food aid" -- flooded the market. There was
violence -- "rice wars" -- and lives were lost. Within that time, Haiti,
once the world's largest exporter of sugar and other tropical produce to
Europe, began importing even sugar-- from US-controlled sugar production in
the Dominican Republic and Florida. It was terrible to see Haitian farmers
put out of work and all this sped up the downward spiral that led to this
month's food riots. Within a decade of all of these pressures to "open up
Haitian markets," Haiti was still under intense pressure from the so-called
international community to privatize. In the mid-90s, when U.S. support for
President Aristide's return was linked to continued privatization and
removal of any trade protections that might have helped the farmers, most of
them working small plots of land, become competitive, Oxfam declared Haiti's
economy one of the most "open" in the world. This at a time when US
agribusiness continued to enjoy ludicrous levels of subvention.

This is an awful story that is hidden away from all the headlines of rioting
Haitians and it reminds us that no one group of innovators, not even
agricultural whizzes who can come up with drought-resistant,
super-high-yield, supersize-me maize or wheat, will be enough to solve the
global problem of food insecurity. It will require technical innovation and
a movement for social justice. That's what we need to build here, and what
the generation now in college here needs to take on. (...)

Medicine and public health will not solve the world's problems, but can
offer part of the solution to some of them. What's been shocking to me over
the past 25 years is the lightning speed at which many policymakers...
decide that a complex intervention is "too difficult" or "not cost-effective
in Haiti or Africa," or "not sustainable." In microfinance parlance, many of
my patients are "poor credit risks," but aren't they the very people we
claim to serve in the first place? And this is why I chose to make a
loyalist's critique of our movement to end global poverty: we need to be
aware that each of the terms and concepts and tools we've developed can be
used to deny the destitute access to goods and services that should be
rights, not commodities. They're not full participants in the magic market,
after all. How many times have you heard that people will value something
more if they pay for it? And yet how many times have you seen data showing
this is so regarding vaccines, bednets, or external fixators after picking
up a landmine? Does anyone really believe that a mother loves her newborn
more if she's had to pay some sort of users' fee to access prenatal and
obstetric care? (...)

Look around this room and you will see a conspicuous absence of poor people.
You'll see people of every hue and background, but not the poor. And my
comment is not really a critique: what matters is less that we invite them
to MIT and more that we fight for their right to survive and to become
themselves social entrepreneurs. Without them, the movements we seek to
build, and the innovations we seek to share, will not succeed. If a movement
can have two Achilles heels-and I know I've mangled the metaphor-this is the
second one. We cannot build an environmental movement or a movement for
sustainable development that does not have the social and economic rights of
the poor at the center of the movement. And they are decidedly not there
yet, for the environmental movement has for too long been a movement of the
privileged. (...)

Berthold Brecht, who is almost always right, has argued that "the compassion
of the oppressed for the oppressed is indispensable. It is the world's one
hope." I fear that, at this late date, an additional kind of solidarity is
necessary. A social-justice movement that links the rich world and the poor,
MIT to the villages in Haiti and Rwanda to which I return again soon , the
movement that links concern for the earth with respectful solidarity towards
its poorest inhabitants, is our last great hope for a world marked by less
suffering and violence and premature death. It's our last great hope for the
generations to come, and for our own children, privileged though they may
be.