If you look at people who seek a lot of care in American cities for multiple illnesses, it's usually people with a number of overwhelming illnesses and a lot of social problems, like housing instability, unemployment, lack of insurance, lack of housing, or just bad housing.
So I can't show you how, exactly, health care is a basic human right. But what I can argue is that no one should have to die of a disease that is treatable.
What the American public thinks is very important to the future of global health. Many people are moved by the idea that there is unnecessary suffering in the world, and we could do a lot to stop it. We have the technologies necessary to stop most of the suffering.
I mean we grew up in a TB bus and I became a TB doctor.
I don't know much about climate change. But I'm pretty sure we better figure out what to do to lessen its impact - at least its health impact - and that's not going to happen unless you have a lot of young talent interested in these topics.
I've been working in Haiti 28 years - I thought I'd sort of seen it... I've gone through a number of coups, the storms of 2008, I thought, you know, that I'd seen things as bad as they were going to get, and I was wrong.
One of the things we have to acknowledge is that if you look at Haiti, many billions of dollars have gone into development aid there that have not been effective.
I can't think of a better model for Haiti rebuilding than Rwanda.
There is nothing wrong with underlining personal agency, but there is something unfair about using personal responsibility as a basis for assigning blame while simultaneously denying those who are being blamed the opportunity to exert agency in their lives
...In a world riven by inequity, medicine could be viewed as social justice work.
The biggest public health challenge is rebuilding health systems. In other words, if you look at cholera or maternal mortality or tuberculosis in Haiti, they're major problems in Haiti, but the biggest problem is rebuilding systems.
We've taken on the major health problems of the poorest - tuberculosis, maternal mortality, AIDS, malaria - in four countries. We've scored some victories in the sense that we've cured or treated thousands and changed the discourse about what is possible.
People call me a saint and I think, I have to work harder. Because a saint would be a great thing to be.
I can't sleep. There's always somebody not getting treatment. I can't stand that.
That's when I feel most alive, when I'm helping people.
I recommend the same therapies for all humans with HIV. There is no reason to believe that physiologic responses to therapy will vary across lines of class, culture, race or nationality.
It is very expensive to give bad medical care to poor people in a rich country.
We want to be on the winning team, but at the risk of turning our backs on the losers, no, it is not worth it. So we fight the long defeat.
But if you're asking my opinion, I would argue that a social justice approach should be central to medicine and utilized to be central to public health. This could be very simple: the well should take care of the sick.
If I am hungry, that is a material problem; if someone else is hungry, that is a spiritual problem.
You can't have public health without a public health system. We just don't want to be part of a mindless competition for resources. We want to build back capacity in the system.
The idea that because you're born in Haiti you could die having a child. The idea that because you're born in you know Malawi your children may go to bed hungry. We want to take some of the chance out of that.
We have to design a health delivery system by actually talking to people and asking, 'What would make this service better for you?' As soon as you start asking, you get a flood of answers.
What I can argue is that no one should have to die of a disease that is treatable.
For me, an area of moral clarity is: you're in front of someone who's suffering and you have the tools at your disposal to alleviate that suffering or even eradicate it, and you act.
The only way to do the human rights thing is to do the right thing medically.
The poorest parts of the world are by and large the places in which one can best view the worst of medicine and not because doctors in these countries have different ideas about what constitutes modern medicine. It's the system and its limitations that are to blame.
God gives us humans everything we need to flourish, but he's not the one who's supposed to divvy up the loot. . . You want to see where Christ crucified abides today? Go to where the poor are suffering and fighting back, and that's where He is.
With rare exceptions, all of your most important achievements on this planet will come from working with others- or, in a word, partnership.
The essence of global health equity is the idea that something so precious as health might be viewed as a right.
If access to health care is considered a human right, who is considered human enough to have that right?
The idea that some lives matter less is the root of all that is wrong with the world.
I critique market-based medicine not because I haven't seen its heights but because I've seen its depths.
At the same time, it is obvious that clinicians in Haiti are faced with different, and, in fact, greater, challenges when attempting to treat complications of HIV disease.
I think, sometimes, that I'm going nuts, and that perhaps there is something good about blocking clean water for those who have none, making sure that illiterate children remain so, and preventing the resuscitation of the public health sector in the country most in need of it. Lunacy is what it is.
I've been asked a lot for my view on American health care. Well, 'it would be a good idea,' to quote Gandhi.
Since I do not believe that there should be different recommendations for people living in the Bronx and people living in Manhattan, I am uncomfortable making different recommendations for my patients in Boston and in Haiti.
The human rights community has focused very narrowly on political and civil rights for many decades, and with reason, but now we have to ask how can we broaden the view.
I've been impressed, over the last 15 years, with how often the somewhat conspiratorial comments of Haitian villagers have been proven to be correct when the historical record is probed carefully.
Some people talk about Haiti as being the graveyard of development projects.