I became really quite actively involved with them in the middle of the 90s when they, after they had discovered an epidemic of multidrug-resistant tuberculosis [MDR-TB] in Peru in a barrio in Lima where they had been delivering medical care. That problem of MDR-TB was one that was, of course, lethal and they began treating patients with second-line drugs, as many as four or five or six a day. Now, their approach as anthropologists in the communities in which they worked then and where they've worked since, has been first to get to know the community, to train community health workers as medical assistants, and thus, when a patient is found to have MDR-TB and let's... is put on, let's say, five drugs a day, that patient isn't given the prescription or even the drugs, rather the individual, the neighbor in the next barrio who's been trained as a community health worker comes to see the patient three times a day, delivers the medication, watches the patient take the medication and reports any side effects to a nurse or to a doctor.

Resistance is great problem with respect to all micro-organisms, and one of the principle causes of resistance, of course, is when an individual takes a drug, but not long enough to wipe out the infection, thus the bug in question, the microbe in question, has had a chance to condition itself to the antibiotic and thus to... to be able to live with it. Resistance is a not a phenomenon that is seen in the places where Paul and Jim work. They showed me their results in... in Peru and they reached 100 patients and it was clear that 85 had been cured. They asked my help in approaching the World Health Organization that had really decreed that it wasn't cost-effective to treat people with MDR-TB. Paul and Jim are able to do cost-effectiveness analysis, but they don't... they feel it doesn't apply when a human life is concerned, and particularly the life of an impoverished person, so they persisted.