The biggest public health challenge is rebuilding health systems. In other words, if you look at cholera or maternal mortality or tuberculosis in Haiti, they're major problems in Haiti, but the biggest problem is rebuilding systems.

The poorest parts of the world are by and large the places in which one can best view the worst of medicine and not because doctors in these countries have different ideas about what constitutes modern medicine. It's the system and its limitations that are to blame.

In fact, it seems to me that making strategic alliances across national borders in order to treat HIV among the world's poor is one of the last great hopes of solidarity across a widening divide.

Some people talk about Haiti as being the graveyard of development projects.

I critique market-based medicine not because I haven't seen its heights but because I've seen its depths.

I think, sometimes, that I'm going nuts, and that perhaps there is something good about blocking clean water for those who have none, making sure that illiterate children remain so, and preventing the resuscitation of the public health sector in the country most in need of it. Lunacy is what it is.

That's when I feel most alive, when I'm helping people.