Critical Discussion Questions

Want to keep the discussion going? Here are critical discussion questions and suggested campus activities that relate to Mountains Beyond Mountains. Post your responses here!

1. In 1804, Haiti became the first black republic in the world. Once regarded as the “Jewel of the Caribbean,” it is now the poorest and most densely populated country in the Western Hemisphere. What political and economic factors led to Haiti’s decline? http://www.travelinghaiti.com/index.asp

2. The first page of the first chapter contains violent images of Haitian life. How does this representation change over the course of the book?

3. In Chapter 4, Paul Farmer tells the author that he will be Kidder’s “Virgil” while in Haiti (p. 33) . [He is referring to Virgil’s role as a guide in the underworld in Dante’s epic poem The Inferno]. Is this an apt comparison? In what ways is Haiti an “underground”?

4. Read the Partners In Health vision statement. http://www.pih.org/who/vision.html

How does it compare to the mission of an HMO (e.g., Kaiser Permanente, Blue Cross/Blue Shield)?

5. A Haitian resident declares that Paul Farmer’s gift is healing (p. 27). What is your gift? Have you ever used that gift to assist others?

6. The folk healing practices of poor or non-Western peoples are often denigrated as superstition or sorcery (e.g., vodun, curanderismo). In what ways do these cultural practices address the absence of widespread health care in various communities? Have you, your family or anyone in your community engaged in folk healing practices?

7. One of Farmer’s aphorisms is “The physicians of the world are the natural attorneys of the poor, and the social problems should be solved by them” (p. 61). What do you think he means by this? Do you agree or disagree?

8. Kidder writes that “every war produced a public health disaster” (p. 119). Research a recent war or military invention, such as Iraq or Afghanistan, and investigate the public health outcomes.

9. Do some background reading on the current healthcare debate within the United States. How does “cost-effectiveness” come into play? What do you think Farmer’s position is? What is your position and why?

10. At various times, Farmer takes on the role of an ethnographer, public health advocate and physician. What is your understanding of anthropology, public health and medicine? What are their similarities? What are the key differences?

12. In Chapter 21, Farmer and Kidder have a tense discussion about how Cuba will be represented in the book. What were your impressions of Cuba prior to reading this book?

13. Paul Farmer declares that Americans are “lazy democrats” (p. 229). Do you agree with his sentiment?