He had been trying to keep his body clean, at least a little, by washing in streams when he could. In the camps, he had made himself rub his teeth and clean between them with twigs of eucalyptus. Nevertheless, a back tooth had become infected and had come loose. It took some time and all the hand strength he could muster to yank it out.

  From the time when he had gone with friends to visit Butare, he knew that if he headed a little east of south he would pick up the paved road to the Burundian border, the road that ran on to Bujumbura. He aimed in that direction. So it wasn’t entirely by luck that after many days he saw headlights through the trees. From then on, he followed the road at night, keeping a safe distance from it, as he had followed roads when he’d been fleeing Burundi. There was a lot of traffic, and there were roadblocks, and he could hear the joyous singing of the militiamen, almost as terrible as the actual killing it euphemistically described. More terrible, maybe. The songs and chants made it seem as if in the world there were only insanity and the silence of corpses. When headlights and roadblocks ceased, and he came to the banks of a small fast-moving river, which had to be the Akanyaru, the border river, he saw the road was filled with soldiers in Burundian uniforms and army trucks. Clearly, the Tutsi army had heard that Tutsis were being slaughtered wholesale in Rwanda, and had known that refugees would be flocking to the border. Evidently, they had come in force to keep the Rwandan army from blocking the Tutsi refugees: to help people like him. He had been on the run forever, it seemed—for six months, in fact. Now running was over. He felt a moment of exhilaration. It didn’t last. Soldiers were pulling bodies out of the border river. There were crowds of wounded everywhere.

  When he crossed the bridge, a soldier approached him and asked where he wanted to go. The truck Deo rode in to Bujumbura was packed with refugees. “Packed like meats,” he would say. “In Burundi we don’t have sardines. So we say ‘like meats.’ ‘Like peas.’”

  The truck was large, with an open back. The refugees were pressed together in the middle and nervous teenage soldiers surrounded them, their rifles pointing out at the thickly wooded mountainsides. It was a long ride to Bujumbura, and tense, especially when the truck slowed down and bumped along over makeshift detours. He didn’t count the mountain bridges that had been blown up. There were several at least, and when he stood up in the crowded truck for a change of position, he saw corpses of cows and human beings by the sides of the road, more numerous, it seemed, on the last descent toward Bujumbura. The soldiers helped him down to the street in front of the Coca-Cola stand in the border district between Kamenge and Ngagara, across from the medical school and a half mile or so from his dormitory.

  The school had closed. The campus had been a killing ground, he was later told by the classmates he ran into. Some were still around because they had nowhere else to go; Bujumbura wasn’t safe, but it was safer than most other places. His dorm, when he first walked up to it, looked abandoned. Grass had grown up high around it. He slept in his old room on a bare mattress. The next day he came outside and ran into one of his closest friends, just by chance: Claude.

  Claude looked at Deo and did a double take. “Deo! Are you still alive?”

  Deo said he’d just returned from Rwanda. He sketched the story.

  Claude told him that he had managed to go back to the area of Butanza a while ago and had found that all of his own family had been killed. He said he’d heard that Deo’s family was gone, too.

  Deo had imagined this, but to hear it was different, of course. “God. Okay. Okay.” Deo started walking. He walked around and around the dormitory building, not knowing what to do or where to go. He felt as though he were cramping up from diarrhea again. He felt as though he might faint. Claude walked beside him, saying, “Hey, we can kill too. They also bleed.”

  Deo thought his friend was only speaking out of grief and anger. Deo couldn’t imagine Claude killing anyone. But who knew what had happened to Claude’s mind over the past six months? Deo avoided his friend for a while after that. He wanted no part of that kind of talk, and he didn’t want to hear about his own family again.

  Before they parted that day, Claude did give Deo some good news. Claude said he had been out at Prince Regent Hospital, not far from Bujumbura, and some of the students from the high school in Kibimba were there.

  “Yeah, okay,” said Deo.

  “Your cousin’s there!”

  Deo took a bus to the hospital the next morning. He thought it was dangerous to travel inside the city, and no doubt more dangerous to travel outside it. He told himself he didn’t care.

  Geneviève was disfigured. Beneath her bandages, one eye was gone, and part of her nose. Gauze covered burns on her arms and legs. But she recognized him at once. “How did you survive?” she asked.

  “No,” he said. “Tell me how you survived. I’m fine.”

  She said, as he later remembered her words: “Well, I went through a window when we were suffocating, in this thick smoke. The auditorium was locked, and the militia had all these clubs and they were smashing things, and everyone was trying to break through the windows and get away. But the thugs got so busy stealing clothes of these kids and their shoes, that they forgot about some of us, and we got away while they were fighting over the clothes and shoes, and I was able to squeeze through this window, and I ran, and this guy threw a spear right in my eye and I fell down and they left me for dead. But I was not dead.”

  Riding back to Bujumbura in the bus, Deo thought, “Okay, the rest of my family is gone. They are dead.” He could not live on here alone, with only a cousin for family.

  He spent the night in his dorm room. The next day his old friend Jean appeared, looking for him. He’d heard Deo was back. Jean said it wasn’t safe here at the university. Deo should come and stay with him in his apartment. It was situated on the way to the airport, in an area the army had so far managed to secure.

  When he had left for his internship in Mutaho, Bujumbura had seemed loud and disorderly just because it was a city, full of vehicles and strangers and mysterious energies. Now it was a chaos. Everywhere he looked he saw cows. Farmers fleeing to the city had brought their cows. Of course they had. He understood the impulse. Bujumbura had become a city of refugee cows, pastured in impromptu United Nations camps for the internally displaced, and also lowing on streetcorners, trudging along on sidewalks, herded into narrow vacant lots behind gas stations. Propriety had been abandoned. There were people squatting in public. There was manure and human excrement on the pavements, and in the mornings there were also fresh bodies—on the streets and in the river, the Ntahangwa, that flowed through town. He didn’t see nearly as many corpses as he had on his long escape, but the supply seemed steady. Usually one day’s bodies would be gone by nightfall, but every morning there were new ones. It rained every day, heat and humidity following. The city steamed. On the run, he had mostly lost the ability to smell, and at moments he regretted its return.

  In the imposing, once green hills above the city, the forests burned. The smoke was so thick at times you couldn’t even see the hills. There was war up there, and something like war down here. Gangs roamed the streets, urban youth gangs essentially, some Tutsi and some Hutu. Most of the city had been divided up, into sections where a Hutu would be hunted down and sections where a Tutsi would be crazy to go, but it wasn’t as if ethnicity, so hard to determine anyway among strangers, guaranteed anything. Kids and adults walked around carrying guns and grenades. He tried to avoid both them and the occasional corpses. Many killings, he thought in retrospect, were probably the result of armed robberies.

  Deo’s friends said that everyone was trying to leave the country or saying they wished they could leave. His friends from school said that most of the faculty was gone or about to be evacuated on special flights, on Air France or Sabena. Jean and his parents would be flying to Paris, but Jean didn’t see how they could take Deo with them. Everyone who knew anything about politics—and Jean was nothing if not worldly—knew that
France was the staunch ally of the Hutu regime in Rwanda. If Deo went to France, if Jean could somehow manage to get him on the plane, he’d probably be deported. They talked about other options. The Congo wasn’t far, just across Lake Tanganyika, but how would Deo get there, and what would he do then? Deo even wondered about going overland to Uganda, but it was a very long way, with a third of Burundi and all of Rwanda in between, and he’d never make it. No, said Jean, Deo should leave Africa. He should go to the United States, to America.

  Sometimes it is better not to know what is impossible. To Deo, the name meant vast wealth, a country that probably looked like Kiriri, the tree-lined part of Bujumbura where the ambassadors’ residences were situated, mansions behind tall stone walls. Why not America?

  Jean knew some of the ropes. Deo would have to get a visa. First he’d have to go to a municipal office and get a new identity card, then to the U.S. embassy, for a business-visitor visa. Jean’s father would provide the letter that said Deo was going to America to sell coffee. “I don’t know anything about coffee,” said Deo. The little library he liked was still open. Deo spent the better part of a week there, reading about coffee beans.

  For days the smell of cooked food sickened him. There was still running water occasionally in Jean’s apartment. Deo was able to bathe. His generic sneakers had made it all the way back, but they were full of holes and stank. He was notorious among his friends for pinching pennies and never throwing anything away. Jean chucked out those sneakers, and bought him another pair. The abscess on Deo’s back had resolved, leaving just a scar. His feet were a fungal nightmare, and there was nowhere to buy medicine for them. He could brush his teeth properly now, but he knew he had cavities, because it was painful to put anything hot or cold in his mouth. He had scars on his arms and legs. Also a scar on one cheek. He hardly recognized himself in the mirror. He had always been thin, but wiry, farm-boy thin. Now he was emaciated. The clothes he’d retrieved from his dorm room were at least one size too big. He made himself as presentable as he could. Jean walked with him to the American embassy downtown. Jean was a muzungu. The gangs didn’t mess with muzungu as a rule—from fear of the unknown, Deo guessed.

  A woman received him at the embassy, a middle-aged woman. She spoke to him in French. He gave her 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.”

  PART TWO

  GUSIMBURA

  TEN

  Boston,

  2003

  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.