Fourteen years ago in Rwanda, Dr. Paul Farmer had many reasons to relish his success, though that wasn’t his style.
By then Partners in Health, the nonprofit he co-founded in Boston two decades earlier, had expanded from a single clinic in Haiti to treating the poorest people in nine nations with an annual budget that had grown to $50 million. For Dr. Farmer, it would never be enough — there would always be still more destitute patients to serve.
“I go to bed worrying about all the promises we’ve made,” he told the Globe in April 2008, “and I get up each morning thinking we haven’t made enough promises.”
A physician, anthropologist, and humanitarian regarded by many as a saint, Dr. Farmer died in Rwanda Monday. Dr. Sheila Davis, chief executive of Partners in Health, said he apparently suffered a sudden cardiac event while sleeping.
Dr. Farmer was 62 and over the past 35 years had become perhaps the world’s most visible and passionate advocate for delivering quality health care to those with the greatest needs and the least money.
“Medicine should be viewed as social justice work in a world that is so sick and so riven by inequities,” Dr. Farmer told the Globe.
Demonstrating by example, he lived simply and donated to Partners in Health hundreds of thousands of dollars he was awarded through a string of honors for his work.
Along with his cofounders, he also helped raise millions to create health care facilities and programs that have now branched out to 11 nations, including Haiti, Peru, and Rwanda.
“He was our north star — for millions of people, really — and one of the key people pushing for global health equity,” Davis said.
“I think he was so able in such a succinct, passionate, and visionary way to say what is true and what is obvious,” she said. “It’s obvious that there’s a moral imperative to care for people all over the world, but he was the first one to say it plainly.”
Tracy Kidder, the Pulitzer Prize-winning author whose 2003 book “Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World” introduced Dr. Farmer to a world audience, said Monday that “he did an awful lot more than anyone could possibly have predicted that one person could pull off.”
“When I first met Paul, he had this vision of trying to start a movement to bring an end to health care inequities in the world,” Kidder said. “I thought he’d done quite a lot already when I met him. Looking back, he’d only started.”
Among Dr. Farmer’s many honors were a MacArthur fellowship in 1993, when his work was focused mainly in Haiti, and the 2020 Berggruen Prize that carried a $1 million award, which he received during the coronavirus pandemic.
Dr. Farmer has shown that “health care disparities worsen the pandemic, and he calls for the social as well as medical support needed by all communities ravaged by coronavirus,” Dr. Amy Gutmann, a juror for the Berggruen Prize and president of the University of Pennsylvania, said when the award was announced in December 2020.
Scores of tributes came in from around the world Monday including one from Governor Charlie Baker, who called Dr. Farmer “a living legend — a man who made a life out of helping people in many countries address some of the world’s most difficult and dangerous public health issues.”
“Paul Farmer changed the way health care is delivered in the most impoverished places on Earth,” former president Bill Clinton wrote on Twitter. “He saw every day as a new opportunity to teach, learn, give, and serve — and it was impossible to spend any time with him and not feel the same.”
Along with being co-founder and chief strategist of Partners In Health, Dr. Farmer was the Kolokotrones university professor and chair of the global health and social medicine department at Harvard Medical School. He also was chief of the Division of Global Health Equity at Brigham and Women’s Hospital.
Rochelle Walensky, a former Harvard colleague who is now director of the Centers for Disease Control, said in a tweet that Dr. Farmer was an “unparalleled visionary for global public health.”
Born in North Adams in 1959, Paul Edward Farmer Jr. was one of six children. His father, Paul Sr., was a teacher, and his mother, Ginny Rice Farmer, worked at grocery store checkouts.
During Dr. Farmer’s childhood, the family lived for a time in a converted school bus in Alabama and later on a boat anchored along Florida’s Gulf Coast.
In a New Yorker magazine profile, Kidder wrote that Dr. Farmer’s father “died suddenly, at the age of 49, in apparent good health, while playing basketball.”
Excelling at academics, Dr. Farmer attended Duke University on a scholarship, graduating summa cum laude in 1982 with a bachelor’s degree in anthropology — he was a trustee emeritus at Duke when he died.
Afterward, he traveled to Haiti to spend a year working in public health clinics. While there, he began mastering the Creole language and was inspired to pursue what would eventually become Partners in Health while working in the village of Cange, according to a biography on the Academy of Achievement website.
He was in Haiti when he learned that Harvard Medical School had accepted him, and he moved to Cambridge to study for a joint medical degree and doctorate in anthropology, which he received in 1990.
While still a medical student, he began working with others to found health projects in Haiti, and his efforts caught the attention of Tom White, a philanthropist who had made his fortune turning J.F. White Contracting into one of Boston’s biggest construction companies.
In 1987, Dr. Farmer founded Partners in Health with Ophelia Dahl, Dr. Jim Yong Kim, Todd McCormack, and White, who contributed $1 million to help launch the organization.
“He was among the most special people on earth. He was tremendously warm, always interested and deeply empathic. Brilliant and worldly,” said Gary Gottlieb, who retired in 2019 as chief executive of Partners in Health, of Dr. Farmer. “He saw each person as extraordinary, important, and significant.”
In a 2003 Globe interview, Dr. Farmer discussed the enormity of the organization’s undertaking.
“The problems we work on — the ‘we’ being Partners in Health — are really rebukes, not to me or to them or to you, but to all of us,” he said. “Can you look at a problem like AIDS and say, ‘We’ve all done our best; there’s no blame to be assessed, no judgment to be made.’ Of course not. We’re total failures, all of us, in the equity department.”
Even though his prowess as a public speaker left him much in demand — “he was on zoom 15 hours a day for the past two years, talking with people around the world,” Davis said — Dr. Farmer was always most comfortable treating patients, including many who never met a doctor before.
“To see him with patients was to really understand that he was a doctor first of all. He just loved his patients. He was the doctor we all wanted to have,” Kidder said. “I think that was the fuel for everything.”
Dr. Farmer was featured in the 2017 documentary, “Bending the Arc,” and wrote, co-wrote, or co-edited about a dozen books, including 2020′s “Fevers, Feuds, and Diamonds: Ebola and the Ravages of History.”
In Sierra Leone several years ago as an Ebola outbreak was waning, Dr. Farmer would make physical contact with patients “when people were phobic of contact,” Gottlieb recalled.
“People in the street, hotel, staying in rural areas, would come to try to connect with him,” Gottlieb said. “He would sit and listen to their stories and try to understand how to improve their lives and health care while dealing with the tragedy of enormous loss. He didn’t believe there was anything that couldn’t be corrected. He was devastated by the poison of poverty.”
Dr. Farmer was seemingly unafraid of any danger, as was evident from the opening of Kidder’s first chapter in “Mountains Beyond Mountains”:
“Six years after the fact, Dr. Paul Edward Farmer reminded me, ‘We met because of a beheading, of all things.’ ” Their first encounter was in 1994, after the assistant mayor in one Haitian community had been brutally killed.
Kidder wrote in the New Yorker profile that while in Haiti, Dr. Farmer met and married Didi Bertrand, “the most beautiful woman from Cange.” She also has worked for Partners in Health.
In addition to his wife, Dr. Farmer leaves their three children, Catherine, Elizabeth, and Sebastian. A complete list of survivors and plans for a memorial service were not immediately available.
Though some called Dr. Farmer a saint when he was alive and in tributes Monday, he had shrugged off such praise.
“It was never about him to him,” Davis said. “He had such a star quality, but he would laugh when people said that to him because it was always about the work.”
For Dr. Farmer, who often existed on far less downtime than anyone around him, there was always more to be done.
“I can’t sleep,” he told Kidder years ago. “There’s always somebody not getting treatment. I can’t stand that.”
Jessica Bartlett of the Globe staff contributed to this report.
Bryan Marquard can be reached at firstname.lastname@example.org.