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Strength Beyond Genocide

A journey from war-torn Burundi—and back

The New Physician January-February 2010
Strength in What RemainsIn the United States, you probably take for granted the peaceful environment in which you study medicine. Now put yourself in Deo’s place. Like you, the third-year medical student in Burundi was working hard and determined to succeed. But during his rotations, civil war broke out in the East-African nation. Genocide tore through the country and left him running for his life.

The next six months he stayed, only to flee and resettle in a country halfway around the world—displaced, homeless and alone.

In Tracy Kidder’s Strength in What Remains: A Journey of Remembrance and Forgiveness (Random House, $26), the author presents the triumphant story of Deogratias, whose life as a 24-year-old medical student was destroyed when the fighting erupted in 1994.

Deo survived the massacre and fled to New York City, penniless, without family or friends, and not knowing English. Once a top medical student in his home country, Deo finds himself working as a grocery deliveryman, sleeping in Central Park and on the verge of starvation.

With the generosity and friendship of strangers, he overcame the tragedies of war, poverty and homelessness to graduate from Columbia University and attend Dartmouth Medical School. After two years of medical school, he left to fulfill his childhood dream—to build a clinic to serve the poor people of his country.

Deo’s story offers much insight. But the lack of strong global health curricula at U.S. medical schools make stories such as his easy to overlook. Kidder’s book should be essential reading for all medical students, providing at least a small window to the struggles of care providers around the world.

Fans of Kidder’s past work, such as Mountains Beyond Mountains, will not be disappointed. That book chronicled the mission of Dr. Paul Farmer, a global health leader set on providing care for those who need it, no matter where they are. Farmer even mentored Deo before the latter entered medical school.

While barriers to health care are often seen from a patient’s perspective, Kidder’s book shows that barriers faced by those providing the care must be addressed as well. The author provides the necessary, but often overlooked, historical and political contexts at the root of many global health challenges. To this end, Kidder chronicles traveling with Deo, who has taken many trips back to Burundi, and weaves in Deo’s childhood memories with the history of the region’s ethnic conflicts.

It reflects Deo’s strength of character and conviction to humanity that he returns home to serve. Growing numbers of students and professionals from small and developing nations are leaving their countries to seek better and more financially appealing opportunities abroad. On a positive note, an increasing number of people are beginning to realize how such a “brain drain” hurts areas lacking critical resources and funding for care.

Strength in What Remains is captivating and candid, as well as inspiring and insightful. Deo’s story is a vivid reminder to all of us that determination, courage and allowing ourselves to accept help enables us to overcome even the most dire circumstances.

Laura Greisman is a second-year at the Albert Einstein College of Medicine.