The Great Epidemiological Divide

The “Great Epi Divide” is a term coined by doctor Paul Farmer (who is the subject of the book Mountains Beyond Mountains) to describe two groups of people in the world based on what makes them sick and what kills them. The first group are the people that tend to die in their seventies from illnesses that are loosely-speaking “inevitable accompaniments to the aging of bodies”. The second group of people dies 10 to 40 years earlier than that from violence, hunger, infectious diseases that medical science knows how to prevent and to treat (if not cure).

The second group is defined by absolute poverty, lacking nearly every necessity: clean water, shoes, medicine, food.

What Mountains Beyond Mountains reveals (as many other sources do) that the people in the first group have very little real awareness of the conditions of life in the second group. More importantly, we can’t handle thinking of them as fellow human beings. The problem is overwhelming. Early on in the book, Farmer describes other doctors working in Haiti that couldn’t wait to get back to America. They thought of themselves as “American first”, and human second, longing for the comfort of their life in the States over the brutal reality of their moral calling in Haiti.

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