the letter from Jean’s father and delivered his lines about selling coffee, but she didn’t ask him any
questions about that. She gazed at him from behind her desk, and asked, not unsympathetically but in the
way a worried aunt might, “Where have you been?”
The woman behind the desk was reading him, he felt, and he thought he was reading her. She didn’t
press him for an answer to her question. He sensed that she already knew the answer generally: that he
was a person on the run.
“How much money do you have in your bank account?” she asked.
He’d never had a bank account, but Jean had known that Deo would be asked this question and had told
him the right response. “Two thousand dollars,” said Deo.
She presented him with his visa the next day. Then she stood up and offered her hand, and as he took it,
she said, “Good luck in New York.”
Chapter TEN
Boston,
I first met Deo in Boston, about a decade after he had fled Rwanda and Burundi. The moment I was
introduced to him, I knew he wasn’t American. It wasn’t his accent; I hadn’t yet heard him speak. And
there was nothing foreign about his clothing, which was merely colorful—he wore, I recall, an orange
sweater. I think I sensed something missing: the protective opaqueness that many Americans, maybe
especially black Americans, learn to put on for strangers, certainly by the time they are thirty. Deo’s face
jumped out at me. It was a night sky full of lights, a picture of eager, trusting friendliness. He seemed
younger than he turned out to be. This impression of innocence lingered, even after I knew that it was
mostly inaccurate.
A mutual friend introduced my wife and me to Deo. Our friend told Deo he should talk to my wife,
because she was interested in refugees, and just like that, Deo began to tell a fragment of his story.
Afterward, my wife told that fragment to me. It lingered in my mind, the secondhand memory of
someone else’s memories, as strange and unresolved as the memory of a dream. Three years later, I saw
Deo again. I had arranged to meet him at a coffee shop in Hanover, New Hampshire, and I asked him for
the story of his escape. He told it briefly at first. His six months on the run, with all their horrors, went
by in only minutes. But then, once he was safely out of Africa and had arrived at JFK, his accounting
grew detailed. As he went on, telling me how he had stood alone in line at Immigration, I began to sense
he was no longer in the coffee shop with me. He was describing the moment when he understood that
the Russian journalist wasn’t going to help him. His voice was steady. He didn’t seem to realize that
tears were rolling down his cheeks.
Deo told me details of his story gradually, over the next two years. I’m sure that the account of his
escape suffered here and there from memory’s usual additions and subtractions, and there was no direct
way to verify a lot of it—no way to find the Hutu woman who had saved him at the border, for instance;
he never even knew her name. But his story was consistent—and sometimes slightly, reassuringly
inconsistent—with the facts that I could find. The story of his escape seemed the most difficult for him
to repossess. He told it to me in bits and pieces. The memories seemed to come at him that way. Some
returned repeatedly, such as the rainy day in the banana grove when he had seen the baby at its dead
mother’s breast, staring at him. He had lived long enough, he would say, to have committed sins that
might have warranted punishment. But what had that baby done? It was a memory, he seemed to say,
that challenged the belief of his childhood, not in the existence of God, but in a God who practiced
comprehensible, human justice. And it was a memory, clearly, that challenged his belief in himself, as
once again he staggered away from the baby, so as to avoid its eyes, knowing the baby would die.
Deo said that when that memory sneaked up on him, he would try to reason with himself, to think, as he
put it, “in a political way.” He would tell himself, “Oh, well, it was not my fault.” He’d speak to himself
as he remembered doing at the moment, in the corpse-strewn banana grove: “I just can’t help that baby. I
can’t.” All this was futile, he said. “It’s there anyways. You can try to make yourself feel comfortable,
but it’s there.”
We often speak of moments we will always remember, in order to keep them. Deo would say, of walking
away from the baby, “It is one of those things I will never be able to forget.” The words didn’t sound
self-pitying, just realistic. A third of his life had passed since that moment. If he hadn’t shed the memory
by now, he probably wasn’t going to.
But he had found antidotes. Mainly, he had found a purposeful community.
Deo had graduated from Columbia without permanent residency, without a green card. His lawyer,
James, had been trying ardently to get him one, but the waiting list seemed interminable. And without a
green card, it was all but impossible for him to apply to medical school. He tried several times anyway,
filling out the forms on his computer, each time reaching the same dead end: the question that asked for
his permanent residency number.
But Deo refused to give up. In the two years after graduation, he stayed as close as he could to medicine.
He took a course at Columbia in biochemistry, and corrected his grade in that subject from his
sophomore year’s C to an A. He worked at a hospice unit in a New York hospital. And, in the summer of
2001, he enrolled at the Harvard School of Public Health, and moved to Boston.
Near the end of his time at Columbia, prowling the stacks in Butler Library, Deo had come across a
book called Infections and Inequalities. He later learned, after recommending this book to a dozen
friends, that the title alone could turn some people away. Deo took it off the shelf and as he read the first
sentence, he felt, he would later say, “This is all about me!”
Early on the morning of her death Annette Jean was feeling well enough to fetch a heavy bucket of
water from a spring not far from her family’s hut.
The case study that followed told of a Haitian peasant who had died from tuberculosis. Similar stories
followed, about poor people suffering and dying unnecessarily, from curable diseases like TB and newly
treatable diseases like AIDS—from diseases, indeed, that most of those patients wouldn’t have
contracted in the first place if they hadn’t been desperately poor. The stories were set in the slums of
Lima, Peru, in the prisons of post-Soviet Siberia, in the famished and deforested central plateau of Haiti.
But Deo felt that the author could just as easily have been describing deaths from intestinal parasites and
malaria in Butanza or Sangaza or Kayanza or the slums of Bujumbura. The author could have been
writing about Clovis. And the analyses of the cases read like Bishop Bududira’s discourses on the ways
that poverty gets into the bodies of people. But this was a vastly expanded discourse, on the
maldistribution of all the good fruits of modernity, especially of medicine and public health, a discourse
that was both scholarly and passionate.
Could anything be done to redress these inequities? Of course! the author said. And he wasn’t merely
talking. The author and others had an organization, called Partners In Health, which wasn’t just trying to
build a little clinic as Deo once had in Sangaza, but had actual projects in a Peruvian slum and in a
Russian prison, projects that aimed to stanch epidemics of drug-resistant tuberculosis—to prove to the
world that this could be done, and to teach the world how to do it. The organization also had a big
hospital in Haiti, which was bringing modern medicine and decent public health to some of the poorest
people in the world.
There are degrees of loneliness, Deo once told me. The worst he knew was to be a poor person
“oppressed by diseases.” He said, “You can’t afford to see a doctor. You can’t even talk about ‘This is
how I feel,’ because you may be called a weak person. So you make your pain your friends.” And there
was the loneliness he’d often felt in New York, the loneliness of feeling that only he understood the
plight of the indigent sick back where he came from, the loneliness of feeling that he understood
something vital that no one else around him could fully understand. But the author of this book
understood. As he read, Deo paused every few paragraphs to think: “Okay, I know that someone is
writing about this. I don’t know him, but somewhere there is a circle of friends that I wish I could talk
to.” The book’s author was named Dr. Paul Farmer. The dust jacket identified him as “a physician-
anthropologist with more than fifteen years in the field.”
Deo resolved to meet the man.
He got his chance about a year and a half later, after he had moved to Boston. One day, heading to class
at the Harvard School of Public Health, he saw an advertisement on a bulletin board for a lecture by Dr.
Farmer. By then Deo knew a lot about the man: Farmer was an infectious disease specialist at the
Brigham and Women’s Hospital, a professor at Harvard Medical School, the principal founder of
Partners In Health, and the author of several books, all of which Deo had read. On his way to the
auditorium, he bought another copy of Infections and Inequalities—an unusual extravagance for him,
but he had left his own copy at Nancy and Charlie’s in New York. After the lecture, after waiting his turn
in the crowd around Farmer, Deo got his book signed and also Farmer’s email address, which Deo used
only about fifteen minutes later, composing an email and to his astonishment receiving a reply within the
hour. Soon after that, he was sitting with Farmer in the doctor’s apartment at Harvard. There were
interruptions—phone calls, other visitors—but Dr. Farmer turned out to be able to answer emails while
he talked. They stayed up all night talking, while Farmer worked. They spoke to each other in French.
Evidently, Paul Farmer didn’t sleep much either. But he had a choice, Deo figured. He imagined that
Farmer’s sleeplessness, unlike his own, was self-imposed and purposeful, and therefore admirable.
Deo went to work at Partners In Health, becoming, in the organization’s vernacular, a PIH-er. Actually,
they didn’t have a slot for him at the time, but Farmer and the organization’s medical director—a doctor
named Joia Mukherjee—created one. “He needed a job, any job,” Paul Farmer remembered. “And we
needed someone who could speak French and wade through documents in that language, and by then we
knew he was plenty smart.” They kept him busy, looking after Haitians whom PIH brought to Boston for
surgeries, and performing whatever other jobs needed doing to support the work in Haiti.
Deo liked all his jobs, and he relished being around Paul Farmer, listening in on his conversations,
listening to him talk while answering email. At the moment, in the high councils of international health,
there was great debate as to how the world should address the AIDS pandemic, not in the United States
and Western Europe, where the disease seemed more or less under control, but in places like Haiti and
sub-Saharan Africa, where it was still growing with terrifying velocity. On one side were those who
argued it was best to spend all the available resources, which were still meager, on strategies to prevent
the further spread of the disease—that is, on prevention. On the other were people like Paul Farmer,
insisting that the distinction between prevention and treatment of AIDS was artificial, that the world now
had a lot of drugs to treat the disease effectively and must begin to employ those drugs everywhere,
along with measures for prevention, especially in the places with the greatest burdens of AIDS. This was
what PIH was trying to do in Haiti. At the school of public health, Deo had heard the term “prevention”
used repeatedly. But if there was someone who really understood prevention, he thought, it was Paul
Farmer, and prevention not just of disease but of catastrophes like genocide. In his mind, Deo distilled
the PIH message this way: “By all means, let’s do prevention! Prevent people from suffering! Don’t wait
for people to feel like their lives are not worth living. Once they feel that way, how are they going to feel
about another person’s life?”
Paul was always going somewhere. Sometimes at the end of a long day and night, Deo would drive with
him to the airport. The first time Deo did this, he sat beside Paul in the backseat of the car. He noticed
Paul was dozing off. Then he felt Paul’s head fall onto his shoulder. Deo shifted slightly, trying to make
his shoulder a more accommodating pillow. He thought, “This is a wonderful, unusual person. I’m so
lucky to be with him at this moment.” He told himself, “I am responsible for protecting him. If I had the
power, I would have the obligation to keep him alive forever.” The only feeling he knew that resembled
this was the feeling of falling in love. When they got to the airport, Deo sprang into action, not on
Farmer’s orders, but all on his own. He took control of Farmer’s passport. When they found that the
flight to Haiti was delayed, Deo hurried off and bought Paul a sandwich and a bottle of water. Paul said
to him, “I wish you could fly with me to Haiti.” But, Farmer added, this would be a bad idea, because
Deo didn’t have a green card.
Deo soon was given a more substantial job, as Joia Mukherjee’s research assistant. But unlike many of
the other young PIH-ers, he wasn’t sent to Haiti. There was the matter of his immigration status, and
besides, Joia thought that sending Deo would be risky. Some people visited the PIH hospital there and
spent most of their time in tears. The experience might be hard on Deo, and if so, he might add to the
burdens of the Haitian staff. In retrospect, Joia felt she had been unfair to Deo. “We underestimated
him,” she’d say. They had their reasons.
As soon as Deo started working as Joia’s research assistant, she began receiving emails from him. Many
were full of information he’d found on the Internet about dreadful events, past and current, in Burundi
and Rwanda, and, rather alarmingly, she’d see that he had sent them at two or three or four o’clock in
the morning.
Joia was working on a scholarly paper to show that treatment and prevention were a single indivisible
