Sheila Davis: "The World is Better Because of You"
PIH CEO Dr. Sheila Davis delivered one of several eulogies for Dr. Paul Farmer, PIH's co-founder and chief strategist, who died in Rwanda on Monday, Feb. 21. The following is an edited version of that eulogy, which she delivered during a small ceremony in Miami, Fla., on Saturday, Feb. 26:
Today I am speaking on behalf of 19,000 current PIH employees and many more thousands of past PIHers spanning far beyond the current 11 countries where we work today. This expansive, global community was brought together by Paul. And that doesn’t even begin to include all of the people who have heard him speak or teach, read his books, shared a flight or sat at a table next to him – all of whom were inevitably touched by his contagious spirit and passion.
Paul taught us all so much – how to treat HIV, MDRTB, Ebola and so many other clinical maladies, how to practice pragmatic solidarity, and how to integrate dignity, beauty, and social support into care delivery. But, most importantly, he taught us – by modeling accompaniment – that our lives are in service to others.
Paul and I first crossed paths in the 1980s when I was a nursing student in Boston and for many years to follow within the HIV community, he as a doctor and me as a nurse. I, like many others who worked in global health, watched as Paul and PIH transformed HIV and MDRTB access to care and medications globally. I was at the International AIDS Conference in Barcelona in 2002 when Paul spoke on a panel in front of thousands and thousands of people and for the first time I saw the full extent of Paul’s ability to inspire. He not only spoke about the hard science of infectious disease as any good ID Doctor I’d ever met, but he also didn’t hesitate to relentlessly and powerfully call out the horrific injustices that were happening in regards to HIV treatment. He had a way of cutting through the noise of excuses and insane justification – for what Paul called stupid deaths – in a way that somehow compelled listeners to join him. That moment changed the HIV/AIDS epidemic, and millions upon millions of lives have been saved since, because of Paul.
I did not get to know Paul as a person and friend until I was asked to join PIH in 2010 to coordinate nursing efforts. Yet it wouldn’t take me long to learn that Paul’s three favorite places to be were with patients at the bedside, doing teaching rounds in the hospital with the trainees and clinical teams, and planting flowers and tress with the grounds teams.
The year I began working at PIH was the same year the University Hospital of Mirebalais was being built out of the figurative rubble of the devastating 2010 earthquake – an accomplishment that was possible thanks to the vision, dedication, and work of many of you here today. Now stands a 320 bed internally accredited and renowned teaching hospital that is training a new generation of Haitian clinicians in specialties like surgery, pediatrics and emergency medicine.
Paul helped design that amazing hospital with 6 operating rooms, a critical care unit, and advanced modern lab that cares for thousands of patients from throughout all of Haiti. In addition to those state of the art services, HUM is also surrounded by trees, plants and ponds – all planned and touched physically by Paul. Paul taught all of us that every person deserved a dignified beautiful space to receive health care – and he created just that. Every PIH supported hospital and clinic around the world has his commitment to beautiful healing spaces imprinted upon it. I distinctly remember my last visit to Sierra Leone, when Paul and I spent time together at the national psychiatric hospital. He was so excited to show me all work had been done since my last visit. Although he was happy for me to see the new working bathrooms, fully stocked medication room and new wards for patients to live in, he was most excited – as many of you would already guess – to show me everything he had so carefully planted himself side by side with the grounds team (who he adored and who adored him back).
From Rwanda over the past month, Paul talked with many of us via text and WhatsApp and was simply thrilled to be actively teaching and training medical students. He shared stories about how amazing the University of Global Health Equity in Rwanda students and about the commitment and integrity of the Butaro District hospital staff. He was in awe of their clinical brilliance paired with compassion and empathy—he was so proud. He told me and many others that these students in Rwanda, Haiti and around the world were our future and that they would do what we did and so much more. Paul knew, long before any of us, that just going and taking care of patients, although admirable and important, was never enough. That the only way to change the injustices in clinical deserts was to change the way doctors, nurses, researchers and operations and administrative students are educated. That academia and clinical care were intrinsically linked. And that you need the Staff, Stuff, Space, Systems and Social Supports – as he lovingly referred to as the five “S”s – to provide quality care. Paul knew our patients, regardless of geography deserve that, and this inspired him to dream big, always. The most recent of which is the University of Global Health Equity in his beloved Haiti.
Yet what inspired me most about Paul was his practice of accompaniment. He had a unique ability to meet people exactly where they were – no matter where that was – and sit beside them, with them, accompanying them. From community health workers, who are our true heroes and teachers as Paul would always say, to patients to colleagues – Paul would show up, listen, and make the person in front of him feel special. The last time we talked, Paul told me about a young man who had sadly passed away. He talked about the young man’s father and how strong the father was in his love and grief. And in that moment, I was blow away because, as always, Paul was fully present with that patient and his father, even while dealing with so much in the background. By extraordinary means, Paul was always able to extend the individual experience to inform why and how we needed to urgently mobilize to improve the care for the community, and even country and world as a whole.
We talked of loss, as we would often do. Working in HIV, we both lost thousands of patients and we would often talk about our belief, our faith, and what that meant to us. Paul supported me through the loss of my mother, sister and most recently my father in the first year of serving as CEO. And when I sent him a picture from the Miami airport just a few months ago of my son-in-law and my amazing granddaughter, Jennie, arriving for the first time from Haiti to join my daughter here in Miami, the first thing he said to me, was your dad would have loved her. It was in that moment, that I realized how much he accompanied me too.
As the tragic news rippled through our community, reaching the expansive corners of the world that Paul has touched, I was privileged to receive messages of love and support on behalf of the PIH family. Through these messages, I learned a Haitian Kreyol phrase “yon gwo mapou tonbe” – which translates roughly to “a big tree fell”. I couldn’t help but be reminded of the beautiful poem I read at my sister’s funeral: "When Great Trees Fall," by Maya Angelou. The poem reads, in part:
"When great trees fall,
rocks on distant hills shudder,
lions hunker down
in tall grasses,
and even elephants
lumber after safety.
When great trees fall
small things recoil into silence,
eroded beyond fear.
And when great souls die,
after a period peace blooms,
slowly and always
irregularly. Spaces fill
with a kind of
soothing electric vibration.
Our senses, restored, never
to be the same, whisper to us.
They existed. They existed.
We can be. Be and be better. For they existed"
Just like the Redwood trees growing on the UGHE campus (which resulted from tiny seedlings that he proudly carried from California to Rwanda in his suit pocket) Paul’s legacy will continue to reach towards the skies and spread their branches wide. Generations to come will bask in those amazing, strong, powerful and resilient trees, as will the seeds of Paul’s teaching. Health care as a human right, the moral imperative for the preferential option for the poor, and the concept of expert mercy has taken root in all of us.
Paul is the reason we are all here. He created the PIH community and a global health movement.
Dearest Paul, the world is better because of you. PIH will continue on the path you expertly laid out. We will be better, we will care for more people, we will continue to make possible what others deem impossible, and we will lead the movement toward global health equity . You gave us our assignments in your brilliant writings, speeches, and the wisdom you imparted on every single person you touched. You taught us by example by modeling expert mercy and your work fighting for the poor will continue. The world is a much better place because of you Paul and the movement will continue and grow, because you existed.