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living saint he had ever known. His professional life—indeed, even his personal life—reflected total commitment to what he called “a preferential option for the poor,” a belief that poor people had the same right to health as the rich and shouldn’t get second-class care.

Klinik Bon Saveur sat on a promontory overlooking Lac Péligre. Its architecture was half functioning hospital and half gothic monastery. “Leave it to Harvard to nail down the prime real estate,” I joked, to break the ice. Paul launched into an apology (in the philosophic sense) about the clinic and the people it served. The people in the village we saw as we drove up were all squatters. They had been flooded out of their ancestral homes when the Duvalier government built the dam that created Lac Péligre. Built with USAID dollars, the dam was intended to generate hydroelectric power for Port-au-Prince. Of course, that never happened: No one ever figured out how to keep the intake valves clear.

“So that’s progress in Haiti,” deadpanned Paul. “The power never worked and the people lost their land. There is a lot of poverty here in Haiti, but that’s the difference between decent poverty and indecent poverty. Land is the Haitian peasant’s birthright. For years, the United States was afraid Haiti would go communist, so the government poured millions into Haiti to prop up the Duvalier regime. In the process, thousands of Haitians were displaced from their land. No longer able to subsist and support their families, they slipped into the squatter state you saw as you approached.” I made a mental note not to joke with Paul ever again.

I asked Paul how we might work together. Paul is all about service and commitment to the poor. He wasn’t interested in volunteers who showed up occasionally with no thought about follow-up or continuity of care. He was intrigued, however, about a long-term partnership for Thomonde between Medishare and his charity, Zanmi Lasante. Thomonde was his biggest problem. Without access to health care, the people in Thomonde were close enough to Cange to come when desperately ill, but not close enough to come for routine care. Thomonde’s population dwarfed that of Cange. Paul’s sta-

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