On Tuesday, Feb. 19, Chief Strategist and Co-Founder of Partners in Health (PIH) Dr. Paul Farmer spoke at the first 2019 installment of the Guilford Bryan Series at the Greensboro Coliseum at 7:30 p.m.

PIH is an international nonprofit organization that has provided health care services since 1987, taking on research and advocacy projects that seek to improve health care for those who are sick and living in impoverished conditions.

Prior to the main event, a Q&A session with Guilford students, faculty and staff members was held in the East Gallery of Founders Hall from 4:00 p.m. to 4:45 p.m.

Terry Akin, chief executive officer of Cone Health and one of the sponsors of the Bryan Series event, opened the talk before Farmer took the stage.

“It’s hard for me to think of a more compelling, inspiring and impactful topic than Dr. Farmer’s work,” Akin said. “Tonight, you are going to hear from a man who, through his own organization and partnership with others, has made a profound difference. This work is life changing. It is world changing. It stands as an example to the rest of us. It really, truly does and these are the kinds of efforts that can have an impact globally, nationally, at the state level and right here in Greensboro.”

President Jane Fernandes delivered the opening remarks for the lecture and added to Akin’s comments on Farmers work, emphasizing the relevance of his work to the Guilford community.

“I have learned from talking to him and being in his presence while he was talking this afternoon that he is a physician and an anthropologist,” Fernandes said. “When he is treating patients with infectious diseases throughout the world, he is a physician, and he is an anthropologist when he takes the time to understand why they don’t have the treatment for a disease and how he can help to develop a treatment by understanding the plagues where the people live and their culture and their language and their beliefs.

“I saw that happen with the students at Guilford College, and that is precisely something that we teach the students at Guilford College to do. We teach them to know their discipline and to take the knowledge of their discipline into their community and with respect for the community and work for the politics of change. So, this was a perfect match for us.

Farmer is a Kolokotrones University Professor at Harvard University, and serves as the chair of the Department of Global Health and Social Medicine at Harvard Medical School. He is also serving as U.N. Special Adviser to the Secretary-General on Community-based Medicine and Lessons from Haiti.

Farmer opened his talk by describing an accident that prevented him from travelling to Haiti as a third-year medical student at Harvard University.

“I thought, if I had been a woman living in a rural property in Haiti and I had been hit by a car, maybe they would have told me to look both ways before crossing the street,” Farmer said. “And certainly, there wouldn’t have been an ambulance and there certainly wouldn’t have been dozens of hospitals to choose from. So that’s the first lesson I wanted to share.

“I swear that this is not supposed to be an anecdote about me, but rather about public health and global health equity. In public health, as it is sometimes practiced, it is all about prevention, but not about care, when in fact, those two must go together.”

A medical anthropologist and physician, Farmer is the recipient of the Margaret Mead Award from the American Anthropological Association, the Outstanding International Physician Award from the American Medical Association and the Hilton Humanitarian Prize, which he received with his PIH colleagues. He has written on various topics, ranging from health to human rights and the consequences of social inequality.

Farmer referenced a diagram of the Triangular Trade to illustrate the significance of looking beyond the medical knowledge that is often emphasized when approaching global health problems.

“History and political economy are always important when you wish to understand contemporary health problems,” Farmer said. “We don’t learn about them in medical school or nursing school. In fact, we don’t learn about them very much in any school.”

In discussion of the 2014 Ebola outbreak and spread, Farmer shed light on the division between public health and medicine that has taken place.

“Why those three countries?” Farmer said. “Which three? Sierra Leone, Liberia and New Guinea, and only those three really. (I felt that) we knew that Ebola was not going to spread … to the United States. We have local departments of public health, the Centers for Disease Control, the National Institutes of Health (and clinical facilities).

“(The divorce between medicine and public health) happened in a different way. It’s happened in a way where we are not saying, ‘Okay, don’t think about caring for the critically ill and injured. They’re the poor. They’re the natives.’”

Farmer distinguished and highlighted what he called, “six pitfalls in global public health: lessons from chronic infectious disease.” The pitfalls included the notion of prevention versus care, the absence of specialists, weak infrastructure, fixed costs and cost of inaction which includes social costs of orphaning, loss income and out-of-pocket health expenditures. Another highlighted how global public health is generally not sustainable, which Farmer suggests we should open discussion of rather than closing it.

Other major points of conversation included the topic of AIDS and suppressive therapy and how he chose to go into the study of infectious disease.

Farmer shifted the discussion to his experiences in Rwanda, showing attendees a graph of the country’s plummeting child mortality rate, and later talked about Ebola being a caregiver’s disease.

“Most pathogens that really cause serious disease among humans, they’re zoonoses, but that happens once and that’s called the spill-over event,” Farmer said. “And then all that spread is person-to-person transmission through care giving.

“It’s a disease caused by caring about your family and your neighbors. Period. And to ask people to stop eating bush meat would have no impact, and did have no impact, I believe, in this.”

The talk closed with a session where Farmer was able to answer questions posed by those in attendance at the main event. The session was facilitated by Associate Vice President Ty Buckner.

To close the 2018 to 2019 Bryan Series season, Diana Nyad will be speaking at the next Bryan Series event on Thursday, April 11 at the Coliseum.