Dr. Paul Farmer compared Haiti in the aftermath of the Jan. 12 earthquake to a chronically ill patient who suffers an acute, life-threatening event.

“We are in unchartered territory,” Farmer said Thursday at Harvard Medical School. “A certain humility about diagnosis, prescription and prognosis is surely to be warranted.”

Haiti presents a history of the worst health status in the western hemisphere and a long history of chronic problems: crushing poverty, insufficient water and food, poor sanitation, corrupt politicians, etc. “To be credible, any analysis must be historically deep and geographically broad,” Farmer said.

The earthquake killed hundreds of thousands and leveled nearly all government buildings, the national hospital, schools and scores of homes. This devastating disaster was an “acute on chronic affliction evident at last to the world,” Farmer said.

“What then is the diagnosis?” he asked. “My Haitian colleagues insist recovery is possible. Haiti’s is not a terminal illness.”

The founder of Partners in Health, who has worked in Haiti for more than two decades and whose wife is Hatian, described harrowing stories of destruction, heartbreak, as well as uplifting stories individual heroism and giving. The question he probed Thursday regarded the role of universities and institutions, such as Harvard, in the response and recovery efforts (click here to view a video of this conference).

“The biggest problem in Haiti is that health services are not being delivered,” said the co-founder of the GHD Project. One role a research university and medical school could play in the reconstruction is to study and improve the delivery of health services with the understanding that “global health” is not a discipline but rather a collection of complex problems, he said. “To study these problems astutely and ethically, we have to study health status as health care services are or aren’t being delivered.”

The problem is not new, but now it is under the international spotlight. Questions as to why Haiti lags so far behind its neighbors and efforts to improve their lot are not new either. Thousands of NGOs work in Haiti. In the recovery stage, this could be a blessing or a curse.

Cooperative teams and systems to deliver services effectively are needed to build Haiti back better and stronger, Farmer said, adding that those decisions and plans must be made in consultation and solidarity with the Hatians.