2009-Paul-Farmer.Pdf
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Inspired by Paul Farmer’s relentless determination to deliver healthcare to the poorest among the poor, The Echo Foundation devotes this year’s study to the power of personal commitment. “One by One by One…..” honors the transcendent worth of each living soul. Like a breath of hope, Farmer’s work sweeps across continents, one person at a time. Joined by Dr. Michael Rich, Partners In Health, and countless others, Farmer has created an elegant and effective model for the delivery of healthcare worldwide. Developed by Echo student interns, this curriculum guide offers educators and students alike a user-friendly tool with which to access the world of global healthcare. The special chapter by Echo Footsteps Ambassadors to Rwanda provides a window into the experience of twelve Charlotte students who studied the PIH model, Rwandan history and the reconciliation, and then traveled to that extraordinary country to learn first-hand. Through Echo's unique collaboration with Partners In Health, and Nkondo Primary School in Rwinkwavu, we observed the challenges to equity in healthcare as we experienced the beauty and blessing of bonds that bind us to all people. With wishes for an inspired and rewarding year, Stephanie G. Ansaldo, President The Echo Foundation “One by One by One ........” Paul Farmer & Partners In Health “This is the duty of our generation as we enter the twenty-first century—solidarity with the weak, the persecuted, the lonely, the sick, and those in despair. It is expressed by the desire to give a noble and humanizing meaning to a community in which all members will define themselves not by their own identity but by that of others.” —Elie Wiesel, Nobel Laureate for Peace This curriculum guide is generously underwritten with a grant by The Everett Foundation THE ECHO FOUNDATION 1125 E. Morehead St., Suite 106 Charlotte, NC 28204 Foreword This summer, charged with creating Echo’s 2008-2009 curriculum guide, we observed global human suffering of the severest nature from perspectives of media on six continents. In pictures, we saw tuberculosis patients reduced to diaphanous skin and brittle bones. In words, we heard the despair of women who were infected with HIV/AIDS after being raped by men as familiar as philandering husbands or as distant as enemy soldiers. We challenge you to take a step back and to view the world through the eyes of the impoverished and diseased. We hope that our curriculum convinces you of the urgency and of our collective responsibility to uplift the millions of people who suffer in our world. Our four core chapters (Ch. I-IV) introduce the subject of global health. The first of these chapters is devoted to Dr. Paul Farmer (Student Dialogue speaker), Dr. Michael Rich (Humanity’s Day speaker), and Partners In Health (PIH)—an organization, co-founded by Dr. Paul Farmer, that ameliorates health conditions in underprivileged regions of the world by holistically addressing the needs of a society. The second core chapter expands on the environment in which PIH works, elucidating the variety of challenges people in the Third World face in attaining health. The third core chapter highlights the initiatives of nations, communities, and organizations that have alleviated health disparities. Our fourth and final core chapter aims to help you better relate to the healthcare crisis abroad by exploring the difficulties in healthcare provision right here at home. We have included a page of discussion questions at the end of each core chapter to reinforce the themes covered throughout the chapters. The page of discussion questions for both chapters four and five can be found at the end of our fifth chapter “Election 2008,” as the themes for both chapters come together. Our sixth chapter, “Footsteps in Rwanda,” is a collection of essays and photographs by 2008 Echo Footsteps Ambassadors. They share what they saw first-hand in Rwanda and the impact of the trip on their own perspectives. We also include classroom activities to facilitate the introduction of global health issues, and we encourage you to explore our resource page in the appendix. The latter links to websites and literature that expand on our curriculum guide. When you are convinced of the necessity for change, explore the “Activism” and “Election 2008” chapters and use the Internet to find opportunities to act. Have a wonderful year filled with new discoveries and new opportunities. With hope, Caitlin Mullins Xiaoyang Zhuang Student Intern Student Intern The Echo Foundation 4 “One by One by One……..” Table of Contents I. Dr. Paul Farmer, Dr. Michael Rich, and the Work of Partners In Health A) Dr. Paul Farmer and Partners In Health [PIH] 1. “Dr. Farmer’s Remedy for World Health: Partners In Health on 60 Minutes” …. 10 2. “The PIH Model of Care” 3. “Partners In Health’s Projects” 4. “Wiping Out TB [Tuberculosis] and AIDS” 5. “Croc Attack: Trendy Footwear Fights Sand Fleas in Haiti” B) Dr. Michael Rich 1. “Breaking Down Barriers”……………………………………………………..… 24 2. “Rwanda Scales Up PIH Model as National Rural Health System” C) Discussion Questions………………………………………………………………………. 29 II. Pathology in the Third World A) Introduction 1. “What is the Third World?”……………………………………………………… 33 2. “AIDS in the World, 2007” 3. “Tuberculosis and MDR-TB [Multi-Drug Resistant Tuberculosis]” 4. “Nets Boost Africa’s Malaria Fight” 5. “Malnutrition Getting Worse in India” B) Social Facets 1. “A Dose of Reality: Women’s Rights in the Fight Against HIV/AIDS”………... 42 2. “HIV/AIDS Delivers Heavy Blow to Third World Education” 3. “Why Girls in Liberia Need to Stay at School” 4. “HIV/AIDS Reduces Children’s Education Chances” 5. “AIDS in Africa: A Quest of Trust” 6. “Refugees Denied Access to Health Care” C) Economic Facets 1. “Brain Drain Hits Poor Countries Hard”………………………………………… 63 2. “Millennium Development Goals (MDGs) Are “Just Words” If Financing Is Not Made Available” 3. “Why Aid Does Work” 4. “Why Aid Doesn’t Work” (Table of Contents continued) The Echo Foundation 5 “One by One by One……..” D) Political Facets 1. “Inside Zimbabwe’s Healthcare Crisis”………………………………………….. 73 2. “Nigeria Puts Polio Eradication at Risk” 3. “UK [United Kingdom] Alleges Misuse of Aid Given for Polio Vaccine” 4. “U.N. [United Nations] Confronts Another Sex Scandal” 5. “Report Indicts U.S. Government and Inter-American Development Bank for Violations of the Rights to Clean Water and Health in Haiti” 6. “War Fever: Malaria in Conflict” 7. “Burma Junta Forces Health Workers Underground; Volunteers Risk Their Lives to Dispense Aid” 8. “Congo Ceasefire Brings Little Relief for Women” E) Discussion Questions………………………………………………………………………. 94 III. Healthcare Initiatives in the Third World A) Community Involvement 1. “Community Health Workers”…………………………………………………... 96 2. “Siberian Jail is Champion in TB [Tuberculosis] Fight” 3. “Why Madagascar’s HIV Rates Are Low” 4. “Combating HIV/AIDS, Malaria and Other Diseases Through ‘Edutainment’ in Rwanda” B) Access to Treatment 1. “Drug Patent Rules Must Allow Exceptions for Public Health”………………… 107 2. “WHO [World Health Organization] Promotes New Strategies to Combat Threats to Global Public Health” 3. “User Fees: A Necessary Evil?” 4. “BURUNDI: Side Effects of Free Maternal, Child Healthcare” C) Global Action 1. “WHO [World Health Organization]: New Quick TB [Tuberculosis] Test Rolled Out in Africa”…………………………………………………………….. 117 2. “The $10 Solution” 3. “A Life Saver Called ‘Plumpynut’” 4. “PEPFAR [President’s Emergency Plan for AIDS Relief] Reauthorization Bill Introduced as a Bold Plan to Fight AIDS; Women, Disproportionately Affected by AIDS, Stand to Benefit” 5. “Debt Swap Initiative Kicks Off in Indonesia” D) Discussion Questions………………………………………………………………………. 130 (Table of Contents continued) The Echo Foundation 6 “One by One by One……..” IV. Delivering Healthcare in the West A) Introduction 1. “The Health Care Crisis”…………….…………………………………….…...... 132 2. “Health Care Crisis: Number of US Uninsured Soars, Along With Big Pharma Profits” B) Healthcare Observed 1. “Free Clinic Helps People Who Need It Most”………………………………….. 138 2. “When Your Local Pharmacist Is In Mexico” 3. “France’s Model Health Care for New Mothers” V. Election 2008 A) How Does Your Candidate Measure Up in Healthcare Provision? ……………....……….. 146 B) Discussion Questions………………………………………………………………………. 157 VI. Footsteps in Rwanda A) Welcome Letter from Cate Auerbach, Footsteps in Rwanda, Student Intern…………….... 160 B) Footsteps Student Ambassador Pages……………………………………………………… 161 C) Reflections…………………………………………………………………………………. 173 D) WE NEED YOU!: Echo and Nkondo School……………………………………………… 175 VII. In the Classroom A) Debate……………………………………………………………………………………… 178 B) Socratic Seminar…………………………………………………………………………… 179 C) Draw to Promote Awareness………………………………………………………………. 179 D) Analyze a Political Cartoon………………………………………………………………... 180 E) Political Cartoon Sketch…………………………………………………………………… 183 F) Creative Writing…………………………………………………………………………… 184 G) Understanding the Vote Through Rapid Fire Debate (Election 2008)…………………..… 185 H) The Economics of Starting an NGO [Nongovernmental Organization]..…………………. 186 I) Maslow’s Hierarchy of Needs……………………………………………………………... 187 J) Musical and Artistic “Relativism”…………………………………………………….…... 189 K) Refugee Health…………...………………………………………………………………… 190 VIII. Activism A) Fundraising Ideas…………………………………………………………………………... 196 B) Activism Resource Page…………………………………………………………………… 197 C) Help Fight Childhood Malnutrition……………...………………………………………… 198 D) Write to Your Politicians…………………………………………………………………..