Fevers, Feuds, and Diamonds

Paul Farmer is probably the second most famous public health doctor in the world after Anthony Fauci. With degrees in both medicine and anthropology, he has both taught at Harvard and worked in underserved communities in Haiti and, as is the case in this book, west Africa during the 2014-2015 ebola epidemic.

Although he finished Fevers, Feuds, and Diamonds before the COVID-19 pandemic hit, he was able to squeeze some parallels between the two outbreaks into the final version of the book before it was published this fall. It is a long and depressing book, so let me simply note its main conclusions:

  • Neither pandemic was a historical accident that suddenly appeared out of the blue. The Ebola outbreak, in particular, was at least an indirect byproduct on centuries of imperialism which left west Africa ill-prepared to deal with this outbreak or any other public health crisis.
  • Public health systems always face choices. In this case, both the African governments and the global health community chose to give preventing further spread of the virus a higher priority than patient care.
  • We in the Global North enjoy and rarely think about the privileges we have as a result of our health care systems which, despite their many imperfections, mean that we suffer from these pandemics far less than people in the rest of the world.
  • In today’s globalizing and increasingly interdependent world, it has become harder and harder to isolate an outbreak in a single part of the world as we did six years ago. We were lucky then, but we were not so lucky this year.

This is an amazing book that you will have a hard time putting done. Until you get too depressed to continue, that is.