ACCOMPANIMENT
FROM COMMUNITY-BASED HEALING TO A MODEL FOR GOOD GOVERNANCE
Simply put, we define accompaniment as being there, together, for as long as it takes. We accompany first and foremost our patients, whom we often refer to as “our bosses.
CLICK TO ADVANCE
Because we realize any meaningful social progress is only born out of
true solidarity and partnership, accompaniment must be rooted in shared
experiences, pressing our shoulders together, breaking bread with one
another, and supporting whoever needs assistance, for as long as they need it.
Choosing not to assign a time limit to accompaniment is key. Only by keeping an open commitment to collaboration, we can aspire to solve problems that were caused by centuries of oppression and to find the hope needed to overcome seemingly insurmountable hurdles.
CLICK TO ADVANCE
Just as accompaniment cannot be limited by a timeframe, it cannot be
limited by a predetermined scope of work. In the 1980’s, in Haiti, the term
accompaniment was used to describe much of the work of community health workers, who accompanied neighbors with chronic disease and served as living links between villages, health centers, and hospitals.
CLICK TO ADVANCE
The power of this simple idea, a staple in liberation theology, came to me in contemplating patients facing both poverty and chronic disease. They missed appointments, didn’t fill prescriptions, didn’t ‘comply’ with our counsel. And this was true in every country in which I’ve worked. But when we began working with community-health workers to take care to patients, the outcomes we all sought were much more likely to happen. Instead of asking, ‘Why don’t patients comply with our treatments?,’ we began to ask, ‘How can we accompany our patients on the road to cure or wellness or a life with less suffering due to disease?’
CLICK TO ADVANCE
- Dr. Paul Farmer, Sacred Medicine
Today, the term may be used more broadly to describe what we seek to do in almost a dozen countries with ministries of health or with other public officials, donors, and partners. Certainly, there will be times when we invoke other paradigms, from directly observed therapy to technical assistance, to describe what we do. But the notion of accompaniment can inform these other paradigms and infuse them with a pragmatic solidarity that will be visible, whether we name it or not. A time-bound, scoped approach might treat the medical aspects of diseases, but if we fail to tend to the social root causes of suffering, we will never be able to treat the person. Likewise, technical expertise without compassion and solidarity will never be sufficient to fully heal the sickest communities.
CLICK TO ADVANCE
True accompaniment becomes then more than just a way to confront hard
challenges or to sustain high aspirations; it becomes a model that can be used to reshape governance of public resources and to ensure a more equitable redistribution of both opportunity and dignity. The open-source nature of PIH’s approach welcomes refinement, adaptation, and broad replication. This means that, ultimately, the goal of PIH is not necessarily to operate in every corner of this world, but rather to create a replicable approach to achieve global health equity. Of course, accompaniment cannot be a one-way street. We must seek accompaniment of those we serve and lean on their wisdom and experience so we can imagine together solutions to those complex problems that affect their daily life.
CLICK TO ADVANCE
True accompaniment does not privilege technical expertise above solidarity or compassion or a willingness to tackle what may seem to be insuperable challenges. It requires cooperation, openness, and teamwork…Much more can be accomplished looking forward with an open-source view of the world. Ideas for good governance, whether of organizations, or government bureaucracies, or corporations, are meant to be shared, and shared widely.
- Dr. Paul Farmer
ACCOMPANIMENT
Andrea Tibbetts
Created on November 12, 2025
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Transcript
ACCOMPANIMENT
FROM COMMUNITY-BASED HEALING TO A MODEL FOR GOOD GOVERNANCE
Simply put, we define accompaniment as being there, together, for as long as it takes. We accompany first and foremost our patients, whom we often refer to as “our bosses.
CLICK TO ADVANCE
Because we realize any meaningful social progress is only born out of true solidarity and partnership, accompaniment must be rooted in shared experiences, pressing our shoulders together, breaking bread with one another, and supporting whoever needs assistance, for as long as they need it. Choosing not to assign a time limit to accompaniment is key. Only by keeping an open commitment to collaboration, we can aspire to solve problems that were caused by centuries of oppression and to find the hope needed to overcome seemingly insurmountable hurdles.
CLICK TO ADVANCE
Just as accompaniment cannot be limited by a timeframe, it cannot be limited by a predetermined scope of work. In the 1980’s, in Haiti, the term accompaniment was used to describe much of the work of community health workers, who accompanied neighbors with chronic disease and served as living links between villages, health centers, and hospitals.
CLICK TO ADVANCE
The power of this simple idea, a staple in liberation theology, came to me in contemplating patients facing both poverty and chronic disease. They missed appointments, didn’t fill prescriptions, didn’t ‘comply’ with our counsel. And this was true in every country in which I’ve worked. But when we began working with community-health workers to take care to patients, the outcomes we all sought were much more likely to happen. Instead of asking, ‘Why don’t patients comply with our treatments?,’ we began to ask, ‘How can we accompany our patients on the road to cure or wellness or a life with less suffering due to disease?’
CLICK TO ADVANCE
- Dr. Paul Farmer, Sacred Medicine
Today, the term may be used more broadly to describe what we seek to do in almost a dozen countries with ministries of health or with other public officials, donors, and partners. Certainly, there will be times when we invoke other paradigms, from directly observed therapy to technical assistance, to describe what we do. But the notion of accompaniment can inform these other paradigms and infuse them with a pragmatic solidarity that will be visible, whether we name it or not. A time-bound, scoped approach might treat the medical aspects of diseases, but if we fail to tend to the social root causes of suffering, we will never be able to treat the person. Likewise, technical expertise without compassion and solidarity will never be sufficient to fully heal the sickest communities.
CLICK TO ADVANCE
True accompaniment becomes then more than just a way to confront hard challenges or to sustain high aspirations; it becomes a model that can be used to reshape governance of public resources and to ensure a more equitable redistribution of both opportunity and dignity. The open-source nature of PIH’s approach welcomes refinement, adaptation, and broad replication. This means that, ultimately, the goal of PIH is not necessarily to operate in every corner of this world, but rather to create a replicable approach to achieve global health equity. Of course, accompaniment cannot be a one-way street. We must seek accompaniment of those we serve and lean on their wisdom and experience so we can imagine together solutions to those complex problems that affect their daily life.
CLICK TO ADVANCE
True accompaniment does not privilege technical expertise above solidarity or compassion or a willingness to tackle what may seem to be insuperable challenges. It requires cooperation, openness, and teamwork…Much more can be accomplished looking forward with an open-source view of the world. Ideas for good governance, whether of organizations, or government bureaucracies, or corporations, are meant to be shared, and shared widely.
- Dr. Paul Farmer