As Farmer obtains tenure at Harvard and splits his attention across different projects, Hiatt laments that the doctor should focus on global-scale projects. Ophelia feels that he has both “towering self-confidence” and “hunger for affirmation” (189).

Kidder accompanies Farmer on a globetrotting trip. They drive from Zanmi Lasante to the airport, with Farmer stopping to arrange a prisoner’s release, comparing the occasion to Matthew 25. He dresses up on flights to please his Haitian supporters and reserves most of his luggage space for gifts, but he is frustrated with how easily he can leave the crowded island, where few even know what an escalator is. Farmer uses a layover at the Miami airport to clean up, and he walks off a toe injury he suffered overnight.

The two fly to Cuba, where Farmer notes the healthier ecosystem in comparison to its Caribbean neighbor. While Farmer sees flaws in every ideology, he appreciates the communist nation’s excellent medical system and framework for “managing poverty.” They attend an AIDS conference with the goal of obtaining AIDS antiretroviral drugs, permission to send two Cange residents to a Cuban medical school, and an aid commitment from a French ambassador. Farmer gives two talks on AIDS-TB coinfections and the source of AIDS in Haiti.