In December 1988, after recovering from his broken leg, Farmer returns to Cange, Haiti. Haiti is in shambles at the time—the departure of Baby Doc has made the country weak and violent. Around this time, Farmer becomes closer with a priest named Jean-Bertrand Aristide, whom he’s known since 1986. Aristide exemplifies liberation theology, and his sermons are about fighting poverty in Haiti. At this time, Farmer is working on his Ph.D. thesis in anthropology, writing about AIDS in Haiti. In the thesis, Farmer argues that AIDS panic is weakening Haiti, since Haitians are considered an "AIDS group,” a label that’s more a product of racism than good science.
It’s remarkable to see how easily Farmer moves back and forth between academia and hands-on work in Haiti. He seems to see no real distinction between his anthropology research and his medical practice in Haiti. This is what makes Farmer such a good doctor: he’s willing to put in the hours with his patients, but he also backs up his work with a great deal of academic research that keeps him thinking in “big picture” terms.
In 1990, Farmer receives his Ph.D. and his M.D., and wins prizes for his AIDS thesis. He’s now 31 years old, and has been practicing serious medicine for 6 years. He’s accepted into the Brigham Hospital—one of the most prestigious in the world. Farmer and Kim, who’s also accepted to Brigham, make an arrangement that enables them to divide their time evenly between Cange and Boston.
It’s a testament to the good organization of the Brigham Hospital that Farmer is allowed to travel back and forth between the U.S. and Haiti for years. It’s also a testament to Farmer’s skill: Brigham would rather have him for half the time than not have him at all.
In 1990, it’s rumored that there will be elections in Haiti. To his great surprise, Farmer finds that he’s become a political target, and he receives threatening phone calls from the Haitian military. Although Farmer isn’t an overtly political figure (as far as the Haitians are concerned), he’s a popular figure, and is known to support Aristide in the upcoming elections.
It’s darkly ironic that Farmer becomes a political target because he supports the right of Haitians to elect their own leaders. Farmer wants the best for the people of Haiti: he wants them to live in a country with a stable government and a safe society. Sadly, the junta punishes him for supporting these causes.
In the summer of 1991, Farmer goes to work at Brigham, and uses the time to raise extra money for his clinic in Cange. The fundraising is a great success, and it appears that there will be a hospital in Cange after all.
Farmer is talented at working around problems, and even though he can’t work in Haiti, he finds other things to do with his time. In the world of medicine and global philanthropy, there’s always other work to be done.
On September 29, 1991, Farmer travels back to Haiti to consult about the hospital construction plans. When he arrives, he’s surprised to find that Aristide has been elected, and then immediately deposed by the military. As a result, Farmer has been declared unwelcome—he’s told that he’s unable to enter Haiti. Farmer flies back to Boston, where he spends the next few months, until Père Lafontant bribes the military to take Farmer’s name off the no-fly list.
Farmer and his friends aren’t above breaking the rules in Haiti. Morally speaking, Lafontant’s bribe is roughly equivalent to Farmer’s decision to smuggle beer into a homeless shelter: it’s technically against the rules, but it’s also done with the goal of helping others.
On his next trip to Haiti, Farmer is pleased to find that he can enter the country without a problem. He resumes his medical practice, helping a young man (Kidder names him Chouchou Louis to hide his identity) who’s been savagely beaten by the army. Chouchou is beaten for criticizing the state of the roads in Haiti—a statement the army interprets as an attack on their leadership. Farmer is unable to save Chouchou’s life. Afterwards, he is careful not to draw attention to himself. By treating a victim of the military government, he’s making himself a political target. Back in Boston, he adds Chouchou’s name to Amnesty International’s list of Haitian victims, and writes a piece on the man’s death in The Boston Globe.
Farmer faces an increasingly difficult task. Although his goals for Haiti are, on a fundamental level, political (he’s trying to improve Haitian society as a whole, not just the lives of individual Haitian patients), he must hide his political affiliations in order to retain his freedom and safety and thus continue to save lives. Nevertheless, Farmer continues his ambitious project for Haiti during this period by exploring other avenues for effecting change. Here, for example, he uses his talent for writing and journalism to spread the word about the injustices in the country.