When Doctors and Nurses Become Activists
PIH leaders reflect on their global health careers, activism
Posted on Dec 16, 2021
Nothing more could be done.
It was an excuse that doctors and nurses with Partners In Health had heard all too often over the decades, from hospital rooms in the United States to hillside communities in Carabayllo, Peru.
Our doctors and nurses were called to advocacy because they cared for patients who were sick, suffering, and died due to unjust social conditions. Sometimes, these patients were treated unjustly because they were from a marginalized group; in other cases, medical care was provided in rundown facilities without enough staff, medications, or diagnostics. Our clinicians knew that providing compassionate, dignified, modern medical care as a basic right demanded a fight against injustice.
For more than 30 years, PIH doctors and nurses have taken their fight for health equity beyond the walls of the hospital and into the streets and the halls of power—demanding that health leaders listen to and care for those whose illnesses embody the oppression they face.
Below are the stories of four clinicians—among many—at PIH, who chose to speak up when others fell silent and inspired generations of future doctors and nurses to merge their passions for medicine and social justice.
Sheila Davis, Chief Executive Officer
In the early days of the HIV epidemic in the U.S., Sheila Davis became a nurse—and an activist. As she cared for patients dying of the disease, many of them gay men neglected by the U.S. health system, she remembers desperately advocating for her patients’ wishes: to have their partners by their side.
But in case after case, hospitals overruled the patients’ wishes and sided with the birth families instead, who often didn’t approve of the relationships and banned long-term partners from patients’ rooms. It was a time Davis remembers as difficult and infuriating, and it set in motion her passion for health equity.
In the years since, Davis has become a relentless advocate for gay marriage, LGBTQ+ rights, and health equity, pushing for policy change at the hospital, state, and national levels to make health care truly accessible for all—a passion that has since led her to PIH, where she is the first nurse to serve as chief executive officer.
“Nurses have a long history of social justice as a foundational piece of our profession. As my career has morphed from direct patient care at the bedside to my work at PIH, the integration of social justice and health equity has continued—and strengthened.” – Sheila Davis
Paul Farmer, Co-Founder and Chief Strategist
As Dr. Paul Farmer and PIH co-founders treated patients for various ailments in Carabayllo, Peru, one of their closest friends lay dying of multidrug-resistant tuberculosis. His death made one thing became clear: The next stage of the fight wouldn’t be in Lima. It would be in Geneva.
World leaders, including within the World Health Organization, had turned their backs on those sick with drug-resistant tuberculosis, with official policy dismissing the disease as too complicated and costly to fully address in settings such as Lima, a city where extreme wealth and poverty were juxtaposed.
But Farmer, PIH co-founders, and Peruvian leaders, including Dr. Jaime Bayona and others in Lima, refused to accept this status quo. While treating hundreds and eventually thousands of patients, they also took their fight to the halls of power, calling on the global health establishment to take action and eventually changing global health policy—a moment captured in the award-winning documentary Bending the Arc.
That, for Farmer, pointed to the power of bringing together the worlds of medicine and activism. It would be a lesson soon translated to the growing challenges of AIDS, cancer care, and a host of other global health issues.
“Learning this difficult stuff about health and well-being in the world, you’d think that going to medical school and doing a PhD in medical anthropology would prepare you for that. But it doesn’t. I think I’ve learned more about these matters from activists.” – Dr. Paul Farmer
Joia Mukherjee, Chief Medical Officer
Before she was a doctor, Joia Mukherjee was an activist—fighting alongside women who were victims of domestic violence and with people leading the fight for AIDS drugs. The first time she spoke publicly about global HIV inequality, during her senior lecture at the end of her infectious disease fellowship at Harvard in 1999, many in the audience had two words in response: “That’s unrealistic.”
“I got incensed,” Mukherjee recalls. “I remember having arguments and arguments and arguments with so many doctors, many of whom had never set foot on the African continent.”
Her senior talk, completed with PIH Co-founder Dr. Jim Kim as her faculty mentor, was informed by her work in Uganda, where she saw firsthand how social forces like poverty coerced young girls into exchanging sex for money. Poverty, not lack of knowledge or behavior, put them at risk for contracting HIV. Her conviction that something wasn’t right only became stronger after reading the PIH publication Women, Poverty, and AIDS by Paul Farmer, Margaret Connors, and Janie Simmons.
That set in motion a decades-long career in global health, where Mukherjee has intersected medicine and activism at every turn and spoken out on issues ranging from gender-based violence to mass incarceration in the U.S. to vaccine inequity amid COVID-19.
For Mukherjee, medicine and activism aren’t just complementary—they’re two sides of the same coin. Doctors, nurses, and others in health care must understand the causes of injustice as well as they understand genetics.
“If somebody’s in the hospital and you’re taking care of them and you send them back home and home is under a bridge—you’re doing harm,” she says.
“You can’t separate injustice from health outcomes. Anyone who says they don’t care about social justice is not actually a health provider; they’re not looking at the data. The disparity in life expectancy between Roxbury Crossing station and Back Bay station [in Boston]—a 6-minute T ride—is 30 years.” – Dr. Joia Mukherjee
Patrick Ulysse, Chief Operations Officer
As a young doctor in a rural clinic in Haiti, Dr. Patrick Ulysse saw patient after patient sick with HIV—but there were no antiretroviral drugs on pharmacy shelves. The only thing he could do was refer patients to clinics far away, where they were often denied care because they couldn’t afford the drugs.
Then, Ulysse heard about a clinic run by Zanmi Lasante, PIH’s sister organization in Haiti, where patients could get HIV drugs, as well as food and housing assistance—for free.
As Zanmi Lasante began supporting several of his patients, Ulysse saw the intersection of medicine and social justice first-hand—a vision that would ignite his passion for health care as a human right and inspire him to dedicate his career as a doctor to pushing for social change.
In recent months, that calling has led him to speak out against vaccine apartheid and urge world leaders and drug-makers to make COVID-19 vaccines free and accessible to all. “We are calling on pharmaceutical companies to share the vaccine technology and imploring the U.S. government to scale manufacturing capacity,” he says. “It is a moral imperative and public health emergency.”
“Truly caring for patients means building health systems that benefit not only the patient who has reached the doors of our clinic or the operating table, but also those who are too poor or too sick to arrive.” – Dr. Patrick Ulysse