In December 1988, Farmer returned to Cange in a wheelchair, and while his leg mended, he launched his study to improve TB treatment in the central plateau. Meanwhile, big events were happening in the country. Several un-elected governments attempted to take power, but invariably the country was under the control of the military. As a result, a great popular movement seemed to be gaining momentum. The peasants and the people in the slums had embraced what they called dechoukaj, which meant the uprooting of every visible symbol of the Duvalier family and the tontons macoutes. There was violence on all sides, but the Haitian military was particularly brutal. Catholic churches became the center of the popular revolt, and the most important priest among them was Jean-Bertrand Aristide.
Farmer decided to go to mass at St. Jean Bosco, the church where Aristide presided, to hear the priest speak. The crowd was rapt at his words when he applied the poverty and suffering of the Gospel to what they were suffering in their dear Haiti. Farmer remembered thinking that he had been looking all over for the progressive liberation theology church, and now he had finally found it. He joined the crowd moving forward to meet the priest, and after that, the two became friends. They didn't see much of each other in 1988, because of their commitments and because Aristide was busy surviving a series of assassination attempts, including the fire-bombing of his church arranged by the mayor of Port-au-Prince.
Farmer was working on his Ph.D. thesis in anthropology which he entitled AIDS and Accusation. AIDS had arrived in Haiti in 1985, and he would catalogue what he called the geography of blame. Haiti had been assigned the role of scapegoat in the eyes of American health officials. They insisted that the virus had originated in Africa, come to Haiti, and then to the United States. Farmer had marshaled a host of epidemiological data which proved that the virus had come to Haiti from the US, most assuredly through American, Canadian, and Haitian-American sex tourists who could buy assignations for a pittance in the slums called Carrefour. The accusations that Haiti had visited AIDS on America had done incalculable harm to the fragile economy of the country and to the poor Haitians themselves. The thesis he wrote was to be an interpretative anthropology of affliction, combining evidence from ethnography, history, epidemiology, and economics. He would use Cange as his example, renaming it Do Kay to protect it. Standing up above the town, he was reminded of all the failures and deaths he had experienced there, but he could also see the successes: communal water fountains, communal latrines, the public health project, the greenhouse, the artisans' workshops, and the Clinique Bon Sauveur. It had grown from 107 families to 178 households, and now nearly all the roofs were made up tin. It was no longer a miserable encampment of refugees , but just a typical extremely poor Haitian village.
Farmer received his Ph.D and his M. D. simultaneously in the spring of 1990. His thesis won a prize and was accepted for publication. He had been protected by numerous physicians at the medical school in his unorthodox attendance habits, and they hadn't hurt his educational standing. What's more, his experiences in Haiti as a virtual doctor made his acceptance by Brigham and Women's Hospital into their residency program less than surprising. He and Jim Kim both received a split clinical residency to spend half their time in Haiti and half in the United States.
By 1990, it seemed possible that Haiti would have a real national election. It wouldn't happen without a fight. Because the military had the country tightly controlled. Farmer himself was threatened by unknown voices over the phone. When there was an audible clicking sound with each call, he climbed the roof and discovered a crude bugging device and happily kicked it to pieces. He hadn't played a visible role in the politics of Haiti so he could only assume he was being targeted because he had been seen with Aristide. Once, Aristide had shown up at Zanmi Lasante with a truckload of flour for his orphanage. His truck wouldn't start, so they had loaded the flour into one of the clinic trucks which then broke down in a large puddle in the road. With the thought of the horror of the roads in Haiti on his mind, he said to Aristide, In the newspapers, it says you're going to be a candidate for president. I guess they don't know you very well, because you would never run for president. Aristide was noncommittal, but a week later, he declared his candidacy. It angered Paul at first, but then he realized that Aristide was the man the people wanted and he thought, Perhaps this is a singular chance to change Haiti.
Soon Farmer was ardently rooting for Aristide. On Election Day, many foreign observers oversaw the counting of the ballots, and Aristide won 67 percent of the vote, while 12 other candidates took 33 percent. Now, as Aristide said in one of his speeches in a revision of an old Haitian proverb, The rocks in the water are going to find out how the rocks in the sun feel. To Farmer, it wasn't Aristide who was the real victor, but instead the people of Haiti who had braved massacre and death to vote and reclaim their country. He had never felt so moved.
In the summer of 1991, Farmer returned to Brigham full of hope for his adopted country. Rumors of coups abounded, but there were no longer military checkpoints on the roads and a revitalized Haitian Ministry of Health had begun collaborating with Zanmi Lasante on AIDS-prevention work in the central plateau. Also, the money was now available to build a real hospital in Cange.
On September 29, 1991, Farmer got Jim Kim to cover for him and decided to take a short trip back to Haiti for a meeting about the new hospital. A Haitian refugee in America drove the cab that took him to the airport and told him there was trouble again down there. Farmer refused to believe it, but when he arrived at Miami, the sign above the check-in desk for Port-au-Prince said cancelled. He stayed in Miami to see if flights resumed and watched CNN stupefied to see that the Haitian army had deposed Aristide. Even when the flights resumed, he couldn't return, because the junta had placed his name on a persona non grata list. Finally, Father Lafontant bribed a Haitian army colonel to expunge his name from the list, and Farmer got a flight out. He made it through immigration without incident and drove to Cange through two military checkpoints.
Two days later, he was called away by a woman who said the local authorities had beaten her husband and he was dying. Farmer had seen a lot in Haiti, but this case impacted him more deeply than anything he had ever seen there. The man, whom Farmer called Chouchou Louis to protect his family, had made a disparaging remark about the road of the country. Unbeknownst to him, inside the truck he was riding was a soldier dressed in plain clothes. At the next checkpoint, he was taken inside an official building and beaten severely. They let him go, but his name was added to their blacklist. Eventually, he came out of hiding and sneaked back home. He was met by a local section chief and an attachÃ©. They beat him again and what was left of him absolutely appalled Farmer. Paul recorded all his wounds and eventually wrote a report called A Death in Haiti for Amnesty International. After the man died, Farmer took a different way back to the clinic out of fear for his own life. Later, Paul told some of his students that he took pains not to remember Chouchou even though he described his death several times in print. He told Tracy Kidder that to him, He died in the dirt.
This chapter is bittersweet, because it expresses the hope Farmer has that change will finally come to Haiti through the efforts of Jean-Bertrand Aristide. For awhile, Haiti is changed and the Health Ministry takes steps to help the poor, but the dream is crushed when the military deposes the man and the violence begins again. In this sense, Chouchou Louis is a metaphor for Haiti. In a moment of freedom, he speaks disparagingly about his country and is then beaten to death. In the same way, Haiti rises up to grab freedom momentarily and then is beaten back into submission.