Ethiopia 1974

One Sunday in early January 1974, we were enjoying the usual family roast lunch watching a BBC Panorama program,  reported by Richard Dimbleby, about the unfolding famine in Ethiopia. It was a very moving account of the plight of millions of Ethiopians who had by then suffered three years of drought. The situation in the rural communities was critical and many thousands had died.

A week later,  the Adelaide Sunday Mail ran an article on the Ethiopian famine which included an appeal by the Australian Red Cross for volunteers to join a medical team to work there.  Interested persons were invited to contact Dr Robert Beale, Director of the Red Cross Blood Bank in Adelaide.

To me Ethiopia was still an exotic land from biblical times. The land of the Queen of Sheba, who beguiled King Solomon, and the land where the very early Christian church had taken root. In January 1974 it was still being run by an autocratic leader, Emperor Haile Selassie, the head of  the feudal aristocratic elite that had been ruling ancient Abyssinia, now Ethiopia, for centuries. He claimed his family could be traced back to King Solomon. All this added to my sense of adventure.  I decided to volunteer.

I’d just graduated with my degree in medical laboratory science and was unemployed. I called around to the Red Cross Blood Bank the following day.  The director Dr Robert Beal was out, so his secretary asked me to write down my particulars and a short CV on some lined notepaper on the spot. Citing my qualifications (RDA and BAppSc – med.lab.sc) and my experiences as a National Serviceman, my war experience in Vietnam at the 1 Aust Field Hospital, plus Scouts, bushwalking, Duke of Edinburgh Award, my school life-saving proficiency awards, and any other thing I could think of, including my bush fire relief work in Tasmania with two school mates in 1967.

All this somehow must have impressed Dr. Beal, who was a Colonel in the RAAMC Reserves and had spent time in Vietnam.  The Red Cross phoned on Wednesday afternoon and I was on the team.  I spend the next few days at the Red Cross headquarters on North Terrace with the others who had been selected getting briefed on our mission. I also visited the Institute of Medical and Veterinary Science where I was given a field microscope, stains, and other basic lab gear for field lab work. There were only four of us in the team: Dr. Jim McKay, the team leader, Bob Owens, a full time St John’s Ambulance professional and ex Vietnam army medic, Dave Horlin-Smith, a motor mechanic, and myself.

Our small team departed for Rome on an Alitalia flight from Melbourne on Friday, 25 January, just ten days after being recruited. This was my first trip to Europe. We then flew on an Air Ethiopian Boeing 707 to Addis Ababa and were met by an Australian consular representative, plus the Chief Delegate of the League of Red Cross Societies and a Red Cross administrative officer from Genève. They took us for a barbeque lunch at the luxurious Addis Hilton. I thought a some- what inappropriate way to start a disaster relief mission, however I still managed to enjoy the meal .

The relief effort was being organised by the League of Red Cross Societies, which is the arm of the Red Cross that conducts relief operations in purely civil disasters where there is no military conflict. Although we’d volunteered, we were in fact paid a generous salary into a bank account in Australia.  In addition we were paid a per diem of US$170 per week to cover personal expenses. As we were camping most of the time, these expenses were small so at the end of my three months I had accumulated a handy sum.

We were to be a small mobile relief assessment and medical team operating in the Borena sub-province, a very remote area in the southwest of Wollo Province in the central highland region of Ethiopia.  We flew first to Mekane Salam, the principal town in the sub-province of Borena, eight days after arriving in Ethiopia. We were greeted by a group of officials who included a young and energetic district health officer,  Dr Kiflu Ghebre-Egziabher. He was one of the new type of Ethiopian doctors who’d completed a shortened, four year medical degree in Addis Ababa – a bloke who was very knowledgeable and easy to get along with. We could not have done our job without him, being our interpreter, explainer of local customs, our community liaison officer and friend.

Another person who joined our group at that time was Dave Bourne, from Albuquerque, New Mexico, USA. Another great bloke. He was an American Peace Corp Volunteer who’d signed up for two years service. He was on a one-man immunisation mission, travelling around the Borena sub-province on foot, vaccinating people against small pox. He’d been doing this work for a year, mostly on his own with only a local guide. His Amharic language skills were basic but more than OK, so this was an extra bonus for us. When he arrived in a village or town, he would ask about recent small pox outbreaks and then walk to the location (there were virtually no roads) and vaccinate the people in the surrounding area. This was a WHO proven method of small pox  control, used later in other disease eradication programs. These days, in the current Cocid-19 pandemic, we would call this ‘ring-fencing’ , controlling or restricting a disease outbreak by isolating an infected area and diagnosing, treating and vaccinating all people with in it.

We were all in awe of the task given to Dave and the fact that he had been out in the bush, alone apart from his guide, for a year. He readily accepted our offer  to join us.

 My role in the team was to be that of a ’relief nutritionist’. I would be responsible, together with the team leader Jim MacKay, for assessing the nutrition status of the people in the rural communities we would encounter in our area of operations.  

I’d had no idea of what a relief nutritionist did when I’d signed up. However, animal nutrition had been a particular interest of mine at Roseworthy Agricultural College, and I had a thorough grounding in the principles of nutrition from my physiology and biochemistry lectures at university.

Jim was very knowledgeable in this area from his experiences with the Red Cross in Biafra, Nigeria, in 1969. Because of my  agricultural and laboratory backgrounds, he wanted me to take on the job of interviewing farmers and village leaders to try to assess crop successes or failures and to enquire about grain reserves held by the villagers. I did this with the help of Dr Kilfu.

The people of Abyssinia were some of the earliest Christians and during our travels we  visited several ancient churches. One had been founded in 900 AD and  the priest showed us its holy relics. These included hairs from the brow of Jesus, and a chair that had belonged to King Solomon who, according to the Old Testaments, had married the alluring Queen of Sheba. The priest was a good salesman, and we duly gave him a good donation for the church..

The two brand new white Toyota land cruisers provided to us in Addis, complete with their Red Cross brandings, turned out to be of no use as there was only one partially completed and unsealed road in the Borena sub-province. Fortunately, we had access to three German Luftwaffe Iroquois (Bell UH-1) helicopters from the Bavarian Mountain Rescue squadron. Much better than driving.

I don’t think this was part of the original planning of our mission, as the Germans had not been expecting us. However, as they were not being fully utilized, they were pleased to be able to help us. The air-crew were great blokes, and all spoke good English. We had many good dinners and beer sessions with them at the Touring Hotel in Dessie, the capital or Wollo Province. The Dessie hotel was an imposing two-story wooden structure built by the Italians when they occupied Abyssinia in the late 1930s.

The Germans moved us to a new location in Borena, in the very southwest corner of Wollo Province. It was bounded on the west by the Blue Nile which flowed down a deep, wide valley from its source, Lake Tana. The valley was truly spectacular, with its wide valley floor, the Nile winding its way down the middle through dry bushy vegetation, and its steep sides rising up several thousand feet on either side. The plan was for us to move around every few days as determined by consultation with local officials. Each time, all six of us plus our 200 or so kilograms of gear, were moved from place to place by our German friends, spending 4 to 8 days at each location.

Often the local district governor and several of his henchmen would join us. The henchmen were all armed to the teeth, mostly with old WW2 Italian rifles, but some also had modern weapons, including sub-machine guns.  I think these local district governors were not particularly liked by the people they were governing. They ruled a semi-feudal society that had not changed much for thousands of years. I am certain this was not a good look for our team, but we had little choice.

Our work was largely confined to diagnosing and attempting to treat severe chronic disease, including TB, leprosy, glaucoma and ear conditions, amongst many others. We had little to offer these people, and this was distressing at times. We could also see that many of the locals were not impressed with our entourage of district governors and officials with their gun-toting security guards. I suspected many of the village elders Dr Kilfu and I interviewed where reluctant to divulge their levels of community-stored grain in the presence of some of the district governor entourage. In this semi-feudal society these stores  may have been seen as a source of taxation.  In effect the villagers were serfs to their landlords, who were represented by the district governor and his henchmen.

The task was made a little easier than it might have been as the drought had partially broken. In late 1973, the highland areas of central Ethiopia had received good rain. This had broken the back of the famine.  As a result we did not find wide-spread starvation in the communities we visited as some crops had been harvested that season. We did come across a few severely malnourish children and adults but this  could be put down more to poverty and individual family circumstances.  Poverty was everywhere.

In late February, our helicopters failed to appear as scheduled. After each day we were getting a little more concerned. Eventually we heard on my shortwave radio a BBC World Service news report about civil unrest in Addis Ababa. This was the beginning of the period of upheaval leading up to the provisional administrative council of  soldiers, known as the Derg  (‘committee’), seizing power from the aging Emperor Haile Selassie in September 1974.  We had been warned a few days before about the possibility of the helicopters being late for our next scheduled pickup, due to uncertainty regarding their fuel supplies. The Germans pilots had given us a hand-held radio directional location transmitter, plus additional batteries. There were no GPS’s in those days. At least the BBC World Service kept us informed about the goings on in Addis. Our families back in Australia weren’t told anything of our predicament by the Red Cross, and we wouldn’t have wanted them to. I suspect these days news of stranded Red Cross relief workers would have made big news.

Sometime in March  we stumbled across several communities that were in the middle of a local  small pox outbreak. Dave and Bob found 25 to 30 cases in one village and a large number of people were vaccinated. A few days later we came across an even larger number of cases. I reckon we vaccinated several thousand people over three days using Dave’s Russian-made  small pox vaccine. It was a freeze-dried vaccine that could be stored at room temperature. We would add about 3-5 ml of sterile distilled water to a vial of the vaccine powder, mix it, and use a 4 cm long bifurcated stainless steel needle to puncture the skin and introduce the attenuated live vaccine. After each person was immunised we put the needle in a special polypropylene jar for later sterilization by boiling and reuse the next day. Very simple and effective.

I took many photographs as I knew at the time this was a unique experience. The WHO declared  small pox eradicated from the world in 1976, only two years later.

One day in mid-March we organised a BBQ to celebrate Dave Bourne’s birthday. Two days before, we’d sent two local boys as runners to the market in the town of Kelala, some 30 km away, to purchase four dozen bottles of St George beer, plus some batteries for Jim’s tape recorder. We gave the two boys what was probably equivalent to six months worth of local wages to buy the beer. We were much relieved when they returned three days later.  I purchased a young goat from a local goat herder, at an exorbitant price, and killed and gutted it in a very in-expert way. It had been some years since I’d done this at Roseworthy. The goat meat was barbequed along with half a dozen fat guinea fowl, provided to us by the local district governor who we’d also invited.

Dave’s party was a huge success. Even drinking St George beer cooled in the creek was OK. We invited our two runners to join us and rewarded them with a few of the beers. Our campsite was in an idyllic location under a few big African acacia trees in a large, nearly dry creek bed which still had a little crystal clear water in it. It reminded me of the Flinders Ranges in South Australia.

The barbequed meat  was a welcome break from our usual diet. This consisted largely of canned corned beef and dehydrated potatoes. Once or twice a week this might be supplemented with local hot red spicy chicken (called ‘doro wot’), together with ‘injera’, a fermented flat-bread made from Teff, an ancient small grained cereal. The injera was often filled with bits of offal and other tasty delights, occasionally supplemented by eggs and even a few vegetables. 

At our outdoor clinics we usually had several hundred people lining up for a clinical consultation with Jim and Kiflu, our two doctors. If anyone required further attention, they would be passed on to one of us for some cursory form of treatment which usually consisted of an injection of a long-acting antibiotic if they had a serious abscess or obvious acute bacterial infection. Sore ears were syringed out with diluted disinfectant. We also used Gentian Violet, a purple dye solution, which has some anti-fungal properties, on a chronic but severe condition of the feet called silicosis. Most people were so poor they couldn’t afford good footwear so silicone from the soil got into their skin, irritating the dermal layer. The body responded by causing the skin to thicken and harden, which then developed deep cracking down to the dermis. A very painful condition.

Our treatments were probably rather useless in the long run. We all thought this, but the people demanded treatment, and the government officials wanted us to provide it. Our real role was health surveillance work, which Jim and Kiflu did very well. Jim would write long and comprehensive reports which the German pilots would take into the provincial health office in Dessie. My short reports on  grain harvest estimates, food reserves, and crop growing conditions would be included.

The general conclusion of all these reports was that the situation in Borena was not as critical as many officials in Dessie had feared. This was useful to know.

Our team was out in the bush for 72 days, from February to April, but some  of us got to go back to Dessie for two or three days, usually for business meetings or to purchase supplies. For me, it was because I was feeling crook, due to what turned out to be a type of Amoebic dysentery, later identified at the London School of Tropical Medicine as Iodamoeba buetschlil.   There are frequent references in my diary to my diarrhoea. Most of the time, however, it was not too bad and I really only had one or two days off while out bush. Nevertheless, a few comfortable nights at the Touring Hotel was a welcome break from my sleeping bag on a low camp stretcher in a small orange tent I could barely stand up in.

As a team, we all got along well, apart from the very occasional moments of friction. I was very critical of our team leader in some of my letters home, complaining that he was unorganised and describing his tendency to run around shouting at people, half in English, half in unrecognisable Amharic. I felt this was the wrong way of getting things under control.

Reflecting on the whole experience soon after I left Ethiopia, I felt our mission turned out to be more of a gesture than a real and substantial benefit to the people we encountered. The rains that fell in late 1973 had ended the famine and done the job for us. For the next few years Ethiopia had good harvests, but famine was never far away. Even then climate change had started to take its grip on the world, and Ethiopia suffered another major famine in 1984. This attracted even larger worldwide publicity through the ‘Band Aid’ rock benefit concert staged by Bob Geldof, an Irish musician and political activist.

It was my experience in Ethiopia that led to a lifetime of similar adventures and a deep concern for developing countries and how they are to make their way in a world dominated by big business making profits and big countries looking after themselves first.  The current way the world seem to be rolling out vaccines for COVID-19 seems prime example with the wealthier countries signing contracts with big pharmaceutical companies to make certain their citizens are vaccinated first. Problems like this will not be solved until the whole world gets a fair share of the benefits.

Richard Turnbull

February 2020

Richard Turnbull is still involved in providing medical assistance in developing countries through his work with a medical charity in Indonesia.