Strength in What Remains

Strength in What Remains Plot Summary

Introduction

In the summer of 1994, a young medical student named Deogratias—Deo for short—arrived at JFK Airport with only $200 in his pocket and no knowledge of English. Behind him lay unimaginable horror: six months on the run through Burundi and Rwanda, witnessing genocide that would claim nearly a million lives. Ahead of him lay the overwhelming chaos of New York City, where he would soon find himself homeless, delivering groceries for $15 a day. Yet somehow, within a decade, this same man would study at Columbia University, attend Dartmouth Medical School, and begin building a medical clinic in his homeland. Deo's journey represents one of the most remarkable stories of human resilience in recent memory. Through his experiences, we witness not only the depths of human cruelty but also extraordinary compassion from strangers who helped him rebuild his shattered life. His transformation from a traumatized refugee sleeping in Central Park to a medical professional dedicated to healing others offers profound insights about the immigrant experience, the lasting psychological impact of witnessing atrocities, and the possibility of creating meaning from suffering. Above all, Deo's story illuminates how one person can transcend devastating trauma to create a life dedicated to preventing the very suffering he once endured.

Chapter 1: Escaping Death: Survival Amid Genocide

Deo's flight from death began in October 1993 at a rural hospital in Mutaho, Burundi, where he was working as a third-year medical student intern. When Burundi's first democratically elected president, a Hutu, was assassinated by Tutsi military officers, violence erupted across the country. Deo, a Tutsi, suddenly found himself in mortal danger as Hutu militiamen attacked the hospital. While his colleagues and patients were being slaughtered, Deo hid under his bed, trembling with fear, as militiamen entered his room. "The cockroach is gone. He ran away," one said, before leaving. When darkness fell, Deo crawled out and fled into the night. For the next six months, Deo moved through a landscape of horror. He traveled only at night, hiding in forests and tall grass during daylight hours. He witnessed atrocities that defied comprehension—villages burned, bodies floating in rivers, dogs fighting over human remains. He survived on raw cassava and unfiltered water, developing chronic diarrhea and intestinal parasites. His once-white sneakers disintegrated on his feet. He avoided all roads and human contact, knowing that a single encounter could mean death. The sight of machetes became synonymous with terror. When the Rwandan border appeared on the horizon, Deo thought he had reached safety. Instead, he had unknowingly walked into another nightmare. At the border, Rwandan militiamen were identifying and killing Tutsis attempting to cross. A Hutu woman—herself a refugee—recognized his peril and claimed him as her son. When interrogators tied a black cloth around his wrist marking him for execution, she surreptitiously removed it and guided him to safety. "Run!" she whispered as they reached a crowded refugee camp. This woman, whose name he never knew, saved his life through an act of extraordinary courage. For months, Deo lived in makeshift refugee camps in Rwanda, always in danger of being identified as a Tutsi. Then in April 1994, Rwanda's genocide began—a slaughter that would claim approximately 800,000 lives in just 100 days. Once again, Deo fled, this time back toward Burundi. He traveled by night, avoiding checkpoints and killing squads, and eventually crossed the border. By May 1994, he reached Bujumbura, Burundi's capital, only to find the city transformed into chaos—houses burning, bodies in the streets, danger everywhere. With the help of a wealthy medical school friend, Deo obtained a commercial visa to the United States under the pretense of selling coffee. The friend's French father paid for his plane tickets, and on May 18, 1994, Deo boarded a flight out of Bujumbura, a skeletal young man carrying only a small suitcase containing a stethoscope, a medical textbook, and a French dictionary—fragments of his previous life and tentative hopes for a future he could barely imagine.

Chapter 2: Homeless in New York: A Refugee's Struggle

When Deo arrived at JFK Airport, he spoke not a word of English. A baggage handler from Senegal named Muhammad took pity on him and offered temporary shelter. Muhammad brought Deo to an abandoned tenement in Harlem where squatters had taken up residence. The building, covered with graffiti including three large letters "PEN," became Deo's first American home—a filthy, rat-infested structure with no running water, no door on his room, and a completely stopped-up toilet at the end of a dark hallway. Within days, Muhammad found Deo a job at a grocery store on Manhattan's Upper East Side called Gristedes. For twelve hours a day, six days a week, Deo pushed a shopping cart filled with groceries through the streets of one of the world's wealthiest neighborhoods. His pay was a mere $15 per day. His boss, a man everyone called Goss, took an immediate dislike to him and used a long wooden pole to prod him toward tasks or simply to humiliate him. Deo would struggle to navigate service entrances and basement deliveries, often receiving no tips from wealthy customers who barely acknowledged his existence. The cultural and linguistic barriers Deo faced were overwhelming. When the subway token seller laughed at his attempt to bargain for a reduced fare, when doormen treated him with contempt, when he couldn't understand a simple instruction from his boss—each interaction reinforced his isolation. Once, police officers mistook him for a drug dealer, pointed guns at his face, and forced open his mouth to search for hidden narcotics. His limited English meant he couldn't explain himself or defend his dignity. "I just do not deserve to use an entrance like that," he thought bitterly about the elegant canopied doors of Park Avenue buildings. "And yet I am bringing them their food." When Muhammad returned to Senegal, Deo's situation deteriorated further. After being robbed at knifepoint in another tenement, he began sleeping in Central Park. He would carefully scout locations away from other homeless people, find spots hidden by bushes, and lay his blanket on the grass. Looking up at the stars, he sometimes felt almost at peace, reminded of nights spent in the mountains of Burundi with his grandfather tending cattle. But the park was dangerous too. One night, he witnessed a murder just outside a building where he'd been staying, watching from a window as a body collapsed in a spreading pool of blood. Despite his desperate circumstances, Deo found small sanctuaries. He discovered bookstores where he could sit and read, teaching himself English from dictionaries. He found peaceful corners in Central Park and quiet moments in churches like St. John the Divine and St. Thomas More. Each day became a struggle for physical survival and psychological preservation. He would tell himself, "No one is in control of his own life," a thought that sometimes brought strange comfort. Yet beneath this fatalism, Deo maintained an inner resilience. His mind remained active, curious, and determined despite the degradations of his daily existence.

Chapter 3: The Gift of Sanctuary: Finding Family in Strangers

In the maze of Deo's early struggles in New York, an unexpected encounter changed everything. While delivering groceries to a church rectory, he met Sharon McKenna, a former nun who worked at St. Thomas More Church on Manhattan's Upper East Side. Something about the young African man caught her attention—perhaps his remark that he was "very interested" when she mentioned the building was a church. Despite his broken English, Sharon sensed there was more to this delivery boy than met the eye. When Deo later sent her a carefully composed letter requesting help for intestinal parasites, she arranged for her doctor to examine him free of charge. Sharon became Deo's first real advocate in America. With quiet determination, she contacted dozens of agencies, shelters, and religious organizations seeking housing for him. Her notes, saved on the backs of envelopes and church announcements, revealed her tireless efforts: "Manhattan Valley St. John the Divine Youth Project," "Emmaus House," "Hope House," and many more. Some attempts led nowhere; others brought momentary hope before collapsing. Through it all, Sharon persisted with a kind of stubborn faith. For Deo, her friendship became a lifeline, though their relationship wasn't without tension. He sometimes felt infantilized by her help and would avoid her for periods, only to return when circumstances became desperate. Through Sharon, Deo met Nancy and Charlie Wolf, a married couple who lived in a loft in SoHo. Charlie was a reformed academic, a sociologist who had worked across Africa, and Nancy was an artist whose work explored urban landscapes. During their first dinner together, communication was difficult—Deo struggled with English while Sharon attempted to translate. Yet something connected them. Charlie later recalled sizing Deo up as a "serious" person with "depth." When the Wolfs learned that Sharon's latest housing plan involved placing Deo in a halfway house for recovering addicts, they made an extraordinary decision: they invited this stranger from Africa to live with them. The generosity of the Wolfs transformed Deo's life. They gave him a room in their loft—the "Black Hole," as they called it, a windowless space lined with books. They provided weekly spending money, encouraged him to quit his job at the grocery store, and most importantly, treated him with dignity. Their dinner table became a classroom where Deo learned English idioms and American customs. The Wolfs weren't merely offering charity; they were sharing their lives. When Deo asked Charlie what he needed to succeed in America, Charlie replied, "This is a country of second chances." The support Deo received from these strangers—Muhammad, Sharon, Nancy and Charlie, and others—revealed an unexpected side of American society. Their actions stood in stark contrast to the indifference and occasional cruelty he had experienced elsewhere. Each in their way demonstrated what Sharon called "undifferentiated help"—assistance offered without expectation of return, motivated by compassion rather than calculation. For Deo, their kindness was both healing and challenging. He struggled with feelings of dependency and sometimes wondered if he was becoming a "parasite." Yet gradually, these relationships helped restore his faith in human goodness after witnessing its absence in the killing fields. The sanctuary provided by the Wolfs became not just physical shelter but a place where Deo could begin rebuilding his identity. In their loft, surrounded by books, art, and kindness, he began to imagine a future again. Though his nights were still haunted by nightmares, he now had a safe place to recover. As he later reflected, the fact that strangers would take such risks for someone they hardly knew seemed almost miraculous—or as Sharon might have said, providential.

Chapter 4: Reclaiming Education: The Path Back to Medicine

Education had always been central to Deo's identity. In Burundi, he had been at the top of his medical school class, a young man with dreams of healing the sick in his country's impoverished rural areas. Now, with the stability provided by the Wolfs, he began to contemplate returning to his studies. Charlie helped him enroll in Columbia University's American Language Program, an intensive English course. Nancy and Charlie paid the tuition—about six thousand dollars—a sum that stunned Deo with its enormity. The transition to student life came with challenges. Deo had to prove he'd been to school before, but when his records finally arrived from Burundi, he found among them a photograph of himself with a black cross drawn over his face. According to the medical school's files, he was dead. He had to take the SAT and several placement exams. During one test, a distinguished professor observing the room asked the proctor about Deo: "Is he done, or did he just give up?" When they graded his calculus answers on the spot, the professor looked up in surprise: "De-oh-Gratias! Well done!" Columbia became Deo's sanctuary. He embraced his studies with extraordinary dedication, particularly drawn to philosophy. When asked why he chose such an impractical major alongside biochemistry, he explained, "I wanted to understand what had happened to me." In philosophy classes, he sought answers to questions that haunted him: How could human beings massacre their neighbors? What did such violence reveal about humanity? Where was God during genocide? Though he didn't find definitive answers, the intellectual journey absorbed him. In the university's libraries and classrooms, he felt his mind awakening again after the trauma that had nearly destroyed it. News that his family had survived the war reached Deo during his sophomore year. After years of believing them dead, he learned his parents were alive in a refugee camp in Tanzania. Subsequent phone calls revealed that while many relatives had perished, including two brothers, his parents and several siblings had survived. The joy of this discovery was complicated by new responsibilities. Deo began sending money home, often skipping meals to save more from his student loans and the weekly allowance Charlie provided. He arranged for his father, who had become suicidal, to see a psychiatrist in Rwanda. Despite occasional setbacks—nights when memories of genocide kept him from studying, weeks missed during family crises—Deo maintained excellent grades. He read voraciously, particularly drawn to W.E.B. DuBois's "The Souls of Black Folk." The passage "To be a poor man is hard, but to be a poor race in a land of dollars is the very bottom of hardships" resonated deeply with his experiences. Yet Columbia also provided normalcy and community. He loved sitting on the steps of Low Library, hiking to the Cloisters, or spending hours in Butler Library. "I loved it here," he would later say, walking across campus. "Gosh, I really miss being here." Deo graduated from Columbia in 1999, but his dream of returning to medical school remained elusive. Without permanent residency status—his green card application was stuck in bureaucratic limbo—he couldn't apply to most programs. Still, he stayed as close to medicine as possible, working at a hospice unit and taking additional science courses. His determination never wavered, even when the path forward seemed blocked at every turn.

Chapter 5: Building Hope: Creating Village Health Works

The turning point in Deo's professional life came when he discovered a book called "Infections and Inequalities" in Columbia's library. The opening sentence—describing a Haitian peasant woman who died from tuberculosis—resonated so deeply that Deo exclaimed, "This is all about me!" The author, Dr. Paul Farmer, wrote about poor people suffering from curable diseases and about an organization called Partners In Health (PIH) that was bringing modern medicine to impoverished communities worldwide. Deo resolved to meet this kindred spirit. In 2001, Deo enrolled at the Harvard School of Public Health and moved to Boston. When he saw an advertisement for a lecture by Dr. Farmer, he attended, got his book signed, and obtained Farmer's email address. To his astonishment, Farmer replied within an hour to his message. Soon after, Deo was sitting in Farmer's apartment, conversing in French about global health inequities and the possibilities for meaningful intervention. Farmer and his colleague Dr. Joia Mukherjee created a position for Deo at Partners In Health, where he helped care for Haitian patients brought to Boston for surgery. Working at PIH transformed Deo's understanding of what was possible. "Walking into that building was like a whole world opening for me," he recalled. "It was like opening my own house." He found himself surrounded by people who shared his vision of healthcare as a human right and who were actually implementing solutions in some of the world's poorest communities. For the first time since fleeing Burundi, Deo felt professionally at home—part of a community dedicated to addressing the very injustices he had witnessed. Yet even as his professional life stabilized, Deo continued to struggle with the psychological aftermath of trauma. He sent emails to colleagues at odd hours of the night, filled with information about atrocities in Burundi and Rwanda. When asked to research pharmaceutical policies, he became incensed at the injustices he uncovered. As Joia observed, "It's just like he has no skin. Everything just penetrates so much." Deo seemed compelled to tell his story repeatedly, as if trying to purge himself of memories. Both Paul and Joia worried about him but recognized that conventional psychiatric treatment might not address the particular wounds of genocide survival. In 2006, Deo returned to Burundi with a bold vision: to build a clinic in Kayanza, a remote village where his parents had resettled after the war. Though PIH couldn't expand to Burundi immediately, Farmer encouraged Deo's initiative. Starting with little more than determination, Deo began assembling the components of a healthcare system—securing land, organizing villagers to make bricks, designing buildings, drilling wells for clean water. He established a women's committee to help govern the project, recognizing that women and children constituted the majority of the community. The challenges were enormous. Materials had to be transported over nearly impassable roads. Workers needed training. Government officials required persuasion. Funding had to be raised dollar by dollar. Yet Deo persevered through what he called "pushing the rock"—his reference to the myth of Sisyphus. When a Belgian construction company estimated it would cost $50,000 to make the road to the clinic passable, Deo shared this news with the villagers. A woman with a sick baby on her back replied, "You will not pay a penny for this road. We become so much sick because we are poor, but we are not poor because we are lazy." The next day, 166 people appeared with hoes and machetes and rebuilt the entire six-kilometer road by hand.

Chapter 6: Return to Burundi: Confronting the Past to Heal the Future

In June 2006, Deo returned to Burundi with a writer who was documenting his story. This journey forced him to confront sites of trauma he had avoided for years. As they drove through southwestern Burundi, Deo grew quiet when they approached the mountain called Ganza, which he remembered from childhood hikes with his brother. The landscape triggered a flood of memories—both of innocent boyhood adventures and of his desperate flight during the genocide. "I had to bite my heart," he would say of such moments, using a Burundian expression for suppressing emotion. The most challenging visit was to Mutaho, the hospital where Deo's flight had begun thirteen years earlier. Despite warnings from their driver about potential danger, Deo insisted on seeing the place. When they arrived, he discovered the hospital had been renovated but remained essentially empty—a shell painted mustard yellow instead of white. As Deo walked through the concrete hallways, now streaked with bird droppings and hung with wasps' nests, he pointed to spots where bodies had lain. "Around here on these grasses, packed with bodies," he said quietly. "They were really just coming down these hallways and knocking down the doors and killing the people inside." In Rwanda, Deo visited genocide memorials including Murambi, where approximately 50,000 people had been massacred. There he met Emmanuel, the site's caretaker, who claimed to recognize Deo from twelve years earlier—they had crossed paths as both fled for their lives. Whether this encounter was coincidence or providence, it seemed to make the world feel less lonely for Deo. At each memorial, he took photographs and often wept quietly. These visits represented both a confrontation with trauma and an act of witness—bearing testimony to atrocities the world had largely ignored. The most meaningful part of Deo's return was his visit to Kayanza, where his vision for a clinic was taking shape. His parents, dressed in their finest clothes, greeted him warmly. His father, who had struggled with depression and alcoholism after losing nearly everything in the war, had become engaged in the clinic project, helping make bricks and regaining respect in the community. The villagers had organized themselves to collect foundation stones and prepare the site. A crowd of hundreds gathered to welcome Deo and hear about his plans. For Deo, the clinic represented more than healthcare; it embodied reconciliation. Though he was a Tutsi in a predominantly Hutu village, the project united people across ethnic lines. One former militiaman, after making several trips to the construction site, approached Deo in confusion: "Ninety-nine percent of Kayanza is Hutu, but you are a Tutsi, aren't you?" When Deo confirmed this, the man walked away scratching his head. Later, he returned to volunteer. Another elderly patient who admitted to "fighting and killing Tutsis since 1965" told Deo, "I wish I had spent my life trying to do something like this." Through this return to Burundi, Deo discovered that healing required not just escaping the past but transforming it. By building something positive in a place of trauma, he created what he called "neutral ground"—a space where ethnic divisions could be transcended through common purpose. When a woman approached him to apologize for unspecified actions during the war, Deo simply replied, "What happened happened. Let's work on the clinic. Let's put this tragedy behind us, because remembering is not going to benefit anyone."

Chapter 7: Dual Identity: Bridging Two Worlds

In 2007, Deo became an American citizen. The ceremony affected him more deeply than he had anticipated. Walking out of the federal building afterward, he realized the feeling that had haunted him for years—"like you were hiding, like you were a criminal"—had suddenly lifted. "Hey, I'm like everyone around here now," he thought, looking at the crowded Manhattan street. Yet his American citizenship coincided with his increasing commitment to Burundi, creating a dual identity that both enriched and complicated his life. This duality manifested in practical ways. While pursuing his medical education in the United States, Deo spent most of his time in Kayanza, sleeping in a tent beside the clinic construction site. He negotiated between American donors and Burundian officials, translated concepts across cultures, and served as a bridge between two vastly different healthcare systems. His fluency in Kirundi, French, and English made him uniquely qualified for this role, but it also placed enormous demands on his time and energy. He often awakened in the middle of the night in his tent, the world so dark and quiet around him that he'd wonder, "Am I alive?" The psychological aspects of this dual identity were equally complex. In America, Deo was respected as a survivor and humanitarian—someone who had overcome incredible odds to build something meaningful. In Burundi, reactions were more varied. Some viewed him with suspicion, questioning his motives or fearing he represented foreign interests. Others saw him as almost mythical—one villager said of the clinic, "I came to see America." Most touching were those who recognized something extraordinary in his return. "Many others went abroad," one local observed, "but most of them have not returned to show us how we can improve our situation." Village Health Works opened on November 7, 2007, with three buildings, a pharmacy, and a water system capable of providing clean water for the entire village. Within its first year, the clinic treated approximately 20,000 individual patients, many of whom walked for days to receive care. The project expanded to include programs for AIDS treatment, vaccination, deworming, and malnutrition. Deo's vision extended beyond immediate medical care to addressing root causes of illness—providing economic opportunities, empowering women, and building community resources. Deo's dual identity allowed him to leverage resources from both worlds. Paul Farmer helped secure donations of solar panels, medical equipment, and free medications for AIDS and tuberculosis. American friends volunteered their expertise and labor. Meanwhile, Burundian staff provided cultural knowledge and continuity of care, while community members contributed their own solutions to local challenges. When Deo struggled with bureaucratic obstacles, his understanding of both systems helped him navigate complex terrain. Perhaps most significant was how Deo's dual identity influenced his philosophy of healing. From America, he gained access to medical technology and organizational strategies that could save lives immediately. From Burundi, he incorporated principles of community participation and cultural respect that ensured sustainability. The result was neither purely American nor purely Burundian but something new—a model that addressed immediate suffering while building long-term capacity. As one visitor observed, Deo didn't simply deliver resources; he facilitated a process by which the community could address its own needs. In 2009, Deo resumed his medical education, balancing his studies with his ongoing work in Burundi. His dual identity remained both a source of tension and a wellspring of insight. "If people say, 'Before he died, Deo became a doctor,' that would be all right," he once remarked, suggesting that completing his medical training remained important to his sense of self. Yet his greatest contribution might be his ability to stand in multiple worlds simultaneously—to understand both the desperate patient and the systems that created their suffering, to speak both the language of high-tech medicine and the language of village healing traditions.

Summary

Deogratias's journey embodies a profound truth about human resilience: that healing often comes through creating meaning from suffering. From the ashes of genocide, he forged a life dedicated to preventing the very conditions that enable violence—poverty, inequality, and lack of healthcare. His transformation from a traumatized refugee sleeping in Central Park to the founder of a thriving medical center demonstrates how personal redemption and social healing can become intertwined. When a former militiaman volunteered at his clinic, when families who had been enemies worked together to build a road, Deo proved that reconciliation is possible through practical action rather than abstract forgiveness. The enduring lesson of Deo's story is that compassion, when expressed through concrete action, creates ripples that extend far beyond individual lives. His experience suggests that we need not be paralyzed by the enormity of suffering in the world; instead, we can follow his example of starting with what philosopher William James called "the next thing"—the immediate, practical step before us. For anyone wrestling with trauma, seeking purpose, or working across cultural divides, Deo's journey offers a compelling vision of what is possible when we refuse to surrender to despair and instead channel our pain into healing others. As he once said of his clinic in Kayanza, "It's a small sunflower seed, no bigger than the tip of my finger, but it has the potential to grow into an enormous flower that is bigger and taller than any of us here."

About Author

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Tracy Kidder

Tracy Kidder is an American author and Vietnam War veteran. Kidder may be best known, especially within the computing community, for his Pulitzer Prize-winning The Soul of a New Machine, an account of the development of Data General's Eclipse/MV minicomputer. The book typifies his distinctive style of research. He began following the project at its inception and, in addition to interviews, spent considerable time observing the engineers at work and outside of it. Using this perspective he was able to produce a more textured portrait of the development process than a purely retrospective study might.Kidder followed up with House, in which he chronicles the design and construction of the award-winning Souweine House in Amherst, Massachusetts. House reads like a novel, but it is based on many hours of research with the architect, builders, clients, in-laws, and other interested parties.In 2003, Kidder also published Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure The World after a chance encounter with Paul Farmer. The book was held to wide critical acclaim and became a New York Times bestseller. The actor Edward Norton has claimed it was one of the books which has had a profound influence on him.

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