Paul Farmer examining a young Haitian boy in Cange, Haiti (Courtesy of Partners in Health)
In 1983 Ophelia Dahl, the 18-year-old daughter of Academy Award-winning actress Patricia Neal and noted children's author Roald Dahl (who wrote Charlie and the Chocolate Factory and the screenplay for the film adaptation "Willy Wonka and the Chocolate Factory") met Paul Farmer, 23, a student about to begin medical school. They were both volunteers in Haiti, working among the poor. They returned to states, she to Wellesley College and he to Harvard Medical School. There, Paul met Jim Yong Kim, and along with Ophelia, they would talk about the connections they observed and believed between moral responsibility, social justice, human development and peace in poor countries.
Paul was so committed to medical work in Haiti that he would fly to the shared-island country every Thursday and return for classes on Sunday night. He also "borrowed" medical supplies from various hospitals to take with him on his medical mission trips.
By 1987, the three young people realized that a clinic was needed. Encouraged by a local priest, Fr. Fritz Lafontant, they chose the village of Cange to be the center of their mission. Then they needed money. They met investor Thomas White and his wife, who wanted to give away their money during their lifetime, and with help from fellow student Todd McCormack, now working in media, they began Partners in Health. Its mission? "To provide a preferential option for the poor in health care."
"Bending the Arc" tells the story of this improbable organization and its remarkable work to bring health care to the people in developing countries.
Treating tuberculosis was the first challenge the new organization faced in Haiti. To make sure patients took the medications, Partners in Health developed a community-based model that trained local people to visit patients in their home six days a week to accompany them, to comfort them, and make sure they took their medications and had adequate nourishment.
The results were phenomenal.
Jim Yong Kim, Ophelia Dahl and Paul Farmer (Janet Kinnane, Courtesy of Partners in Health)
When Paul was in medical school he lived in the rectory of St. Mary of the Angels in Roxbury, Massachusetts, at the invitation of Fr. Jack Roussin. When Roussin went to Peru as a missionary, he soon invited Partners in Health to come there and spread their work beyond Haiti. There, Paul and Jim, now doctors, discovered "multi-drug resistant TB" or MDR-TB among some people. The government refused to acknowledge that MDR-TB even existed, because if they did it would jeopardize the aid they were receiving from organizations such as the World Bank. These organizations, and the medical professionals who advised them, believed that poor people should not be treated because they could not follow protocol.
When an official's daughter became sick with MDR-TB, however, Partners in Health treated her, and she was cured. Now, Partners in Health could embark on a community-based health plan to treat what could be classified as an outbreak that could easily spread.
Again, the results were amazing. Jim discovered that the expensive drugs needed were not patented and could be produced at a minimal cost. Yet, when Partners in Health published their results and presented them at professional gatherings, they were met with incredulity and obstacles such as lack of infrastructure and unsustainability. Partners in Health has proven this lack of infrastructure untrue: 98% of their 17,000 workers in community-based health today are local people.
Paul Farmer examining a patient in Cange, Haiti (Robert Billheimer, Courtesy of Worldwide Documentaries)
The film, which held me captive from the get-go, opens with the 1978 gathering of the World Health Organization at Alma-Ata, USSR, where the signatories declared that physical and mental health is a fundamental human right. But a global financial crisis soon followed. The World Bank and World Monetary Fund made loans to developing countries to pay back loans and demanded that these countries cut back on their health and education programs to do so. The film does not hesitate to state that the first world prospers on the backs of the poor.
As for the involvement of the World Bank in global health today, you have to see the film for the surprise and intensely moving development that has occurred in its governance.
After Peru, Partners in Health went to Africa and discovered that cervical cancer was the No. 1 killer of women. Partners in Health began an inoculation program against human papillomavirus or HPV, and Africa's greatest medical scourge, HIV. Next, Partners in Health was invited to Rwanda where, after the genocide in 1994, the country's health system was destroyed.
The country's dynamic former minister of health, Dr. Agnes Binagwaho, plays a major role in the film, as she demonstrates in her handling of the Ebola crisis in 2013-2016 that just because Africans may be poor they "are not stupid." Partners in Health is working with Rwanda to create a universal sustainable health care system.
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The title "Bending the Arc" comes from the abolitionist Theodore Parker (often attributed to Martin Luther King Jr.): "I do not pretend to understand the moral universe. The arc is a long one. … And from what I see I am sure it bends towards justice."
Anyone who cares about the good of people will watch this and probably experience a range of emotions, including a few tears. The filmmakers hope that by shining a light on the work of Partners in Health, it will educate and inspire people to action in the work of public health, justice and economics. Universal health care is possible. The unspoken words are that it can happen in the United States, too, if there is the will to do so.
Sr. Rose Pacatte with actress Marcia Gay Harden, Oct. 14 at a screening of "Bending the Arc" in Santa Monica, California (Dennis Brue)
The message that health care is a human right, not a commodity, humbly and mightily reverberates throughout.
At a recent screening, "Bending the Arc" filmmakers Kief Davidson and Pedro Kos were present and spoke about how long it took to make the film (they started in 2009) and how much Dr. Paul Farmer did not want to be singled out as the "great white hope" of developing countries. He had to be convinced to be part of the film. Academy Award-winning actress Marcia Gay Harden was also on the panel for the Q&A after "as a follower" of the film and the work of Partners in Health.
The convergence of health care, lay action, even the priestly vocation, with willing collaborators and incredible generosity of life and spirit, make "Bending the Arc" an outstanding documentary. Kudos to actors Ben Affleck and Matt Damon who were executive producers on the project. Ophelia Dahl, Todd McCormack, Fr. Fritz and Drs. Paul Farmer, Jim Yong Kim, Agnes Binagwaho and Joia Mukherjee all contribute to telling this story of making what is possible a reality.
[Sr. Rose Pacatte, a member of the Daughters of St. Paul, is the director of the Pauline Center for Media Studies in Los Angeles.]
