Optional Epidemic

December 9, 2014
Paul Farmer
Harvard professor Paul Farmer / Photo: Jon Chase, Harvard staff photographer

The large number of deaths from the Ebola virus is due to the lack of sufficient medical care, said Harvard professor and physician Paul Farmer at a public forum on December 8.

Farmer, who has devoted his life to bringing health care to the poorest regions of Haiti, Africa, and other parts of the world, drew attention to the inaccurate perceptions around the spread of the epidemic, which has killed over 6,000 people in 2014, mostly in Liberia and Sierra Leone.

Joining Farmer on the panel were Harvard professors Evelynn Hammonds, Ahmed Ragab, who is also the director of the Science, Religion, and Culture Program (SRC) at Harvard Divinity School (HDS), and Harvard Medical School's David Jones.

The forum became a place of serious reflection about structural inequalities and how perceptions get shaped, which often leads to how resources are directed.

"The cost of believing that something is so lethal and fatal is significant," Farmer explained.

Hammonds drew attention to how perceptions about the transmission of Ebola had been shaped mostly through the media, while noting how epidemics "pull the covers off" how the poor, vulnerable, and sick are perceived.

Farmer, who is the co-founder of Partners in Health, declared his commitment to rebuilding health systems as his "biggest major commitment" in the last decade.

"We don't make pledges lightly. This is a significant endeavor," he stated. "We are looking for support."

In answering questions about Harvard's support, Farmer and Hammonds praised the University’s continued engagement. The forum was organized by the SRC Program at HDS and the Ackerman Program on Medicine and Culture at Harvard Medical School.

"Harvard is the biggest troop contributor," said Farmer.

Ragab added that Harvard should be engaging more with the wider community, which was the reason the forum was held off campus at First Parish in Cambridge.

In a discussion that went on for over 90 minutes, Farmer explained that nobody should be dying of Ebola. Those who have died, he said, died because of a lack of medical care and prompt infusion of fluids and electrolytes.

"If we had the staff, stuff, space, and systems, we could get people earlier into a place where they could get supportive care," said Farmer, who pointed out that the reason not a single American had died of Ebola is because they had been "scooped out" of miserable conditions.

"I wouldn't want to get care there. If I were to get Ebola, I would want to be airlifted back here ASAP. Or maybe to Europe," he said.

What heightened the spread of the disease, according to Farmer, was the lack of a health care system that could provide adequate care. About 90 to 95 percent of Liberia does not have electricity, and there is a "tremendous amount of work" to be done to get the systems even to a level of mediocrity.

Still, Farmer quoted his colleague Dr. Larry Brilliant in observing that "outbreaks are inevitable, epidemics are optional."

—by Kalpana Jain