This chapter examines Farmer's and Kidder's trip to Moscow. This is Farmer's fifth trip trying to obtain a loan from the World Bank for the Russian TB program. On the airplane, he explains the history of the mission. Two years before, Howard Hiatt had sent him to George Soros' foundation to search for new money for Peru. This foundation declined to become involved, but described to him the similar work they were doing in Russia. The letter they sent explains the details of the $13 million Soros had committed to it. They had insisted on a DOTS only program with hospice care for those who didn't respond to it. Then, the collapse of the Soviet Union had been an ideal situation for the increase of TB and rising crime had led to over-crowded prisons where the TB flourished. Farmer told Soros his program was doomed to fail. Soros then yelled at Alex Goldfarb over the phone and asked Farmer for his help. At first, Farmer didn't want to give up his time in Haiti, but because prisoners were special constituents of PIH, he decided to get involved, especially because it was a way to show the consequences of neglecting health everywhere.
So Farmer went on a tour of the Siberian prisons with Goldfarb and realized, just as he had believed, that prisoners contract TB at higher rates than civilians, and in Russian prisons, it was 40 to 50 per times higher. It had become the leading cause of death there. What's worse, many of the TB patients left prison before they were cured and took it back to the civilian population. The situation was dire and the Russian response puny. It was worse than anything he had seen in Peru or Haiti. Unfortunately, when he and Goldfarb held a press conference to announce their findings, it was the same day that the Special Prosecutor released his report on the Monica Lewinsky scandal, so few reporters showed up. As a result, Farmer and Goldfarb flew to New York to speak with Soros. Farmer told the man that it........
The fight in Russia
is one which takes Farmer away from the places he really wants to be, but one
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