Paul Farmer recognizes early on that treating diseases without addressing the living conditions that patients live in is impractical. He admires Rudolf Virchow not only for his scientific accomplishments, but also for connecting health with social conditions. In his early trips, he sees how the creation of a clean water source reduces health problems in Haiti’s central valley, and the inclusion of a monthly stipend with treatments ensures proper completion of regimens. Likewise, his first-hand encounters with Haiti’s military governments show how political instability disrupts medical treatment, causing as many deaths in wartime as the actual combat.

While Tracy Kidder doesn’t use the term, much of Farmer’s philosophy falls under the concept of intersectionality: the idea that solutions to social problems cannot target just a single issue. Haiti’s medical crisis is connected to its crippling poverty, which ties in with its history of slavery and oppression. Zanmi Lasante’s services go beyond medicine to include food kitchens, education, women’s services, and housing upgrades. The result is that Cange, the poorest part of Haiti, now has better control of tuberculosis and AIDS than some American cities.

Neither Kidder nor Farmer ignore the role of race in Haiti’s problems.