On January 12, 2010 an earthquake of magnitude 7.0 hit the Haitian capital of Port-au-Prince, leveling much of the city and killing hundreds of thousands of people. Among the damage were nearly all federal infrastructures, the nursing school and the General Hospital. In the days that followed, patients were treated in tent clinics with minimal resources. In the months that followed, progress seemed to be minimal despite billions of dollars promised by the international community. In October, a cholera epidemic claimed thousands of more lives.

Dr. Paul Farmer, co-founder of Partners in Health and UN Deputy Special Envoy to Haiti, has worked in Haiti for nearly thirty years. Although Partners in Health started in Cange, in the central plateau of Haiti, the earthquake brought many of the workers into Port-au-Prince to aid the injured. Farmer recounts the days, weeks and months following the earthquake: the challenges, the grief, but also the resilience of the Haitian people. Although he begins by describing the immediate damage of the earthquake and the devastation of the first few days, he then takes a step back. He asks the reader to view the earthquake and aftermath as not merely an isolated event, but as a result of hundreds of years of political and economic instability and therefore describes the earthquake as an “acute-on-chronic” event. From this viewpoint, the slow progress and particularly devastating effects can be understood as a result of decades of political instability, a poor economy due to a depletion of natural resources and deforestation, and a particular vulnerability due to the 2008 hurricane season which had recently devastated Haiti.

Farmer not only recounts the story of Haiti in the months following the earthquake, but also its tragic history from being the world’s leading exporter of coffee and sugar and the first nation in the Western hemisphere to end slavery, to being labeled “the poorest country in the Western hemisphere.” This is an engaging and educational book both for those knowledgeable of Farmer’s work as well as those who are looking for a first book on the topic. By carefully explaining the historical context of the earthquake, Farmer’s book is simultaneously insightful, thorough, and accessible to any reader. However, the book is not overwhelmed by history; his recollection of the ruin, chaos and death reveals his personal experiences in Haiti and vividly recreates those devastating days and weeks for the reader. Additionally, Farmer uses his experiences in Rwanda and Rwanda’s success story as a possible example for how Haiti can “build back better.” He ends the book describing Haiti as being at a crossroads: there is the potential for progress, but also potential for stagnation and a continuation of the instability that has plagued Haiti for decades. While much can be gained and learned from an initial read, there is much to learn from Farmer that multiple reads of this book would continue to be useful.