There is so much we take for granted about health care here in Boston, the Medical Mecca. It never occurs to us that we won’t get the health care we need—because here we can and do. If we ever think about children in places like Rwanda, it’s the way we thought of “the starving children in Africa” our parents reminded us of when we didn’t want to eat our dinners: too far away to be real, and people we can’t help.
But they are very real, and we can help. That’s the message I took away yesterday as I listened to Dr. Paul Farmer give the annual Blackfan Lecture at Boston Children’s Hospital yesterday. And it’s the message that Boston Children’s has heard and understands; Boston Children’s knows that really caring for children means caring for children everywhere.
Farmer is chair of the Department of Global Health and Social Medicine at Harvard Medical School and a founding director of Partners in Health, an international nonprofit organization devoted to direct care, research, and advocacy for people who are sick and living in poverty. Since before medical school, he has been working passionately and diligently to bring health equity to the world. He has not only brought attention to the inequities, but has literally rolled up his sleeves and worked to find feasible, collaborative, community-based approaches to end those inequities.
And Boston Children’s is helping him.
There are many challenges when it comes to bringing good health care to the poor, especially in places like Haiti or Rwanda that have been ravaged by natural disasters and war. But there is much about doing it that is very simple: sometimes all it takes is peanut butter to cure a starving child, sometimes all it takes is getting medications to a rural area to treat tuberculosis, sometimes lives are saved by teaching how to warm a newborn baby or give CPR.
There are three things we need to do, Farmer said in his lecture, when we go to places like Rwanda and Haiti and Tanzania, places where there is little or no health care for the poor:
First—start taking care of people right away. The day you show up. That’s what Farmer, and many doctors from Boston Children’s, have been doing for years. They don’t wait for a fancy clinic to be built; they get right to work, taking care of the sick and injured, anyone that comes to them.
Second, rebuild and build. Create places where care can be given and taught. Boston Children’s has been part of building a hospital in Rwanda that will do just that—it will not only bring medical care to countless children, but will help train the next generation of Rwandan doctors. Which leads to…
Third, build the team that can carry on the work when you leave. There is so much to do in so many places—and, more importantly, there are so many people who can do the work if you teach them and empower them and help them find the materials they need.
The real caregivers, Farmer said, don’t work in hospitals. They are the people of the community who bring medicines to and care for the sick, who feed the starving children, who tend to the wounded and teach people how to live in ways that can keep them healthy. It’s this vast army of community health workers that give “medical home” a whole new, deeper meaning—by training and arming them, we make a difference that reaches further and longer than we can ever reach ourselves.
Because, ultimately, health care is not just about teamwork—but about reaching out a hand and saying, I’m here with you. I will take care of you.
That’s what Farmer has spent his life doing. And it’s what Boston Children’s has been doing since the first children entered its doors. Working together, we can make a difference for children everywhere.
To learn more, visit the website of the Global Pediatrics Program at Boston Children’s Hospital. You can also watch a video about the hospital built in Rwanda by Partners in Health, featuring Boston Children’s residency graduate Alexandra Vinograd.