Ophelia travels to Cange in the early 1990s, at the time of Haiti’s military junta. She’s terrified of being arrested or killed for being associated with Paul, who supported Aristide. She’s even more disturbed after she learns that Farmer has accepted 10,000 dollars from Tom White—money which he plans to use to fund an underground pacifist resistance movement. Farmer becomes more reckless in his life. One day, soldiers stop him in his car and order him to say, “Long live the Haitian army.” Farmer refuses at first, but eventually gives in when the soldiers point their guns at his head.
This scene seems like another test of the rigidity of Farmer’s beliefs. Farmer is fearless and idealistic, but he’s also practical and willing to compromise. He gives into the Haitian soldier, not because he’s frightened, but because he knows he’s too valuable to others to allow himself to be shot—if he dies, hundreds or thousands of future patients may die as well. It’s strange to think about yourself in such distant terms, but we get the sense that Farmer is used to thinking exactly this way.
One day, a soldier comes to Farmer’s hospital, armed. Farmer rushes to the soldier and tells him to leave. The soldier points his gun at Farmer and asks him, “Who the fuck are you?” Farmer coolly replies, “I’m the person who’s going to take care of you when you get sick.” The soldier continues pointing his gun at Farmer for a few moments longer, than leaves the hospital. Kidder notes that Farmer was absolutely right: because of his superior medical knowledge, he was never hurt or attacked during the time of the junta—he was simply too valuable to Haiti.
Farmer knows when to compromise on his political stances, but he also knows when his value as a doctor gives him the freedom to be political. In simplest terms, Farmer is valuable to Haiti—both the poor and the rich. As a result, he has a special license to say what’s on his mind, since the Haitian government knows they’d be foolish to hurt him in any way.
In 1993, Farmer receives his MacArthur genius grant. At the awards ceremony in Chicago, Farmer notes ruefully that his own fortunes are improving as Haiti’s are declining. At least three of his close Haitian friends have been murdered. In the winter, he decides to travel to Quebec City, where he writes most of a book called The Uses of Haiti. In this book—which Kidder considers the best of his works—Farmer describes the history of American foreign policy in Haiti. He details America’s refusal to recognize Haiti as a democracy during the early 1800s, and its decision to fund the modern Haitian army, right up to the time of the junta. Farmer alleges that the U.S. government doesn’t oppose the junta in Haiti, but actually supports it economically by breaking its own trade embargo with Haiti. Farmer supports American military intervention in Haiti, because, he reasons, America already has intervened militarily in the country—the only difference is that now, America could use its military to support democracy instead of dictatorship.
Farmer accumulates a large number of awards and honors during his career as a doctor. But instead of resting on his laurels, as many other great doctors would do, he uses his increasing influence to throw himself into the task of eradicating poverty and disease in Haiti. Journalism is one of Farmer’s most important weapons for fighting injustice. By “getting the message out,” Farmer is convincing the people of the U.S. to join him in his quest. One could argue that this is the reason that Farmer agreed to let Tracy Kidder write a book about his career: Farmer wants to educate young, talented people in the U.S. (and around the world) about the importance of medicine and charity work in the Third World.
For much of 1994, Farmer lectures across America about the situation in Haiti. He isn’t particularly popular, since he’s regarded as a “left-wing” extremist. Some of his audiences ask him if he’s Haitian, as they can’t imagine any other reason he’d care so much about Haiti. Fed up with lecturing, Farmer returns to Haiti in October of 1994, the day that Aristide is reinstated as president.
Although Farmer is a charismatic writer and speaker, he finds lecture tours stifling at times—he’s so used to working one-on-one with his patients that lecture tours feel distant and ineffectual by comparison. It’s a mark of the public’s narrow-mindedness that Farmer’s audiences assume he must be Haitian: the idea of helping foreigners is so alien to them that they assume Farmer must have some selfish or nationalistic reason for his work in Haiti.
When Farmer returns to Haiti, he finds a country torn apart by the junta. Thousands have been killed for allegedly opposing the military, and public health has declined throughout the country. Père Lafontant has completed a new hospital, but most of Zanmi Lasante’s other health projects have been abandoned. Zanmi Lasante is one of the only places that shelters people who have been beaten or hurt for opposing the junta. Because of this “politicization” of the hospital, many hospital workers have resigned in fear.
Zanmi Lasante wasn’t designed to be a political institution at all: it’s only goal was to help those who needed help. But in a war-torn country headed by a corrupt dictatorship, apolitical institutions automatically become political. By taking care of opponents of the junta, Zanmi Lasante starts to look like an anti-government institution.
Farmer is now 35 years old. In the U.S. he’s a superstar in both medicine and anthropology, and one of the most highly regarded doctors in the country. Nevertheless, he regards PIH as his most important job. At the time, PIH has only a few dozen members, mostly in Boston. PIH runs AIDS-prevention programs for Haitian immigrants in the city, and supports a few health projects in other parts of North America (a public housing program in Mexico, for instance). Kidder notes that PIH is on the verge of changing altogether, and becoming an international player in the process.
As the second part of this book comes to an end, Farmer is at the height of his prestige: he has the MacArthur Grant, and he’s renowned in the medical and anthropological worlds. And yet Farmer is still unfulfilled, as he hasn’t accomplished his (admittedly impossible) goals of fighting poverty and disease in the Third World. Farmer is always striving to do more. As he’s already said, he’s not a saint, but he’s always trying to “work harder.”