--- title: 10 Questions for Paul Farmer | TIME description: Dr. Paul Farmer talks about saving lives in Haiti, Rwanda's thriving health care system and how to improve humanitarian aid canonical: https://time.com/video/a0apb6gK/ og:title: 10 Questions for Paul Farmer og:description: Dr. Paul Farmer talks about saving lives in Haiti, Rwanda's thriving health care system and how to improve humanitarian aid og:url: https://time.com/video/a0apb6gK/ og:image: https://cdn.jwplayer.com/v2/media/a0apb6gK/poster.jpg?width=720 og:type: video.other twitter:card: summary_large_image twitter:title: 10 Questions for Paul Farmer twitter:description: Dr. Paul Farmer talks about saving lives in Haiti, Rwanda's thriving health care system and how to improve humanitarian aid twitter:image: https://cdn.jwplayer.com/v2/media/a0apb6gK/poster.jpg?width=720 --- # 10 Questions for Paul Farmer > Sponsored content. Supplied in partnership with TIME. 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They are at time.com/newsletters and are separate from a paid subscription. ## Video: 10 Questions for Paul Farmer [Watch (HLS stream): 10 Questions for Paul Farmer](https://cdn.jwplayer.com/manifests/a0apb6gK.m3u8) (3:58)  _Published 2013-05-02. Dr. Paul Farmer talks about saving lives in Haiti, Rwanda's thriving health care system and how to improve humanitarian aid_ --- Jul 27, 2023 3:33 PM UTC --- ## More From This Series [All Videos](https://time.com/video/) [Meet Team USA: Declan Farmer and Josh Pauls](/video/XZn3fz4P/) ### Meet Team USA: Declan Farmer and Josh Pauls [The Ghosts of the 1994 Genocide in Rwanda's Churches](/video/B9BBJqnq/) ### The Ghosts of the 1994 Genocide in Rwanda's Churches [Hospital Shows Rwanda's Health Care Successes](/video/EME7U0Lh/) ### Hospital Shows Rwanda's Health Care Successes --- ## Transcript Hi, I'm Belinda Luscombe from Time. Paul Farmer is a physician who has tried, and actually kind of succeeded in bringing gold standard healthcare to the poorest people in the poorest nations. He has a new book, To Repair the World, and I'm delighted to say that he is here with us at Time today. Doctor Farmer, welcome. Thank you very much. You say the biggest failure that we have in providing healthcare to the people who are very poor, is a failure of the imagination. It must be a failure of the imagination because a lot of the technologies that you need or the human resources that you need to do a good job for, in settings of poverty, we have them elsewhere. You know, the idea that you could send a rover to Mars but not, you know, build a healthcare system for, that protects poor people is is just not possible that we couldn't do that. You write in the book about accompaniment rather than aid. Can you explain what that means? Well, you know, accompaniment is what a physician ought to be doing, or nurse. That is, you don't say to a patient hey here's the beginning of your illness and here's the end of it. You really say okay I'm gonna be your doctor for a long time. It seems to me, looking at aid, that it would be a better model then some of the other ones that have preceded it. So, you think this idea of accompaniment, you are a champion of, of great healthcare for the poorest. And the problem a lot of people have with that is that is really expensive and really difficult to provide such healthcare. Great health care may be less expensive than a radically administerd or tardedly administered health care at least I think it is. I've been lucky enough to work in places where there is you know enoumos constraint on. Health care expenditures, rural Haiti, rural Rwanda, and seeing you can build systems that can provide compassionate prevention and care for the whole population with a focus on serving the poorest. Probably for relatively limited amounts of money. So there's a story you tell in the book about happening upon a man who was about to die from an asthma attack. And it just so happens that the only piece of medical equipment you have on you at the time was an inhaler because you yourself are an asthmatic. And you managed to get enough of this inhaler Substance into the man that he could recover. I mean, what, what do you take away from that story? I had been there in his village in Haiti for another reason. For a community meeting and I didn't have a stethoscope and I didn't have my bag. His wife said please doctor, please. And so I went, and, if you're having an asthma attack and you can get. His medication was just Albuterol. It feels, it looks like a miracle but it's not a miracle. Then the next day he came to see me in the clinic. And brought me a you know, rooster and he prays on me and everybody in the village did. And you kind of like that, when you're a doctor. Right, who doesn't want a rooster? And who doesn't want a rooster, I was thinking more of the praise. But then to say you know, the best thing we can do, of course, is build systems that protect people from that kind of risk. So it sounds to me that it exhilarates you more to actually change public policy, to get prevention in place, rather than the hands- on healing of one guy. Yeah. In the last ten years life expectancy has almost doubled in Rwanda. Child mortality has plummeted. Death during childbirth, and deaths from patients who already have Aids, or tuberculosis has dropped precipitously. Now, is that because someone like me, went and delivered care? To an individual patient, or is it because people thought about the systems of healthcare delivery and how to bring them up to scale for all Rwandans? And it's really the latter. Dr. Farmer, thank you so much. 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