Angels Of Aceh – Australian Aid Abroad – Sophie York

After the devastating Boxing Day Tsunami hit Indonesia in 2004, Australian aid was a key to the emergency effort. Among the volunteers, Defence personnel and government aid workers who rushed to the disaster scene was a team of medical specialists who worked for weeks in gruelling conditions to help survivors in Aceh. Sydney barrister and law lecturer Sophie York has given a compelling account of how her anaesthetist husband Paul joined this group, chronicling his experiences in her book Angels of Aceh (Allen & Unwin). On Tuesday 13 October 2009, Sophie York addressed The Sydney Institute, speaking about her experiences in writing, researching and living through the events of the book.

ANGELS OF ACEH – AUSTRALIAN AID ABROAD

SOPHIE YORK

Thank you for this opportunity to speak to you about my book Angels of Aceh and about Australian Foreign Aid.

There were a number of reasons why I wrote this book, and I will cover those briefly before going into some aspects of the book which I think will have relevance to a gathering of people like you, who are deep-thinkers.

It is a great privilege to speak with you, at the Sydney Institute. I want to tell you:

1. Why I wrote the book and about some of the themes which emerged;

2. the issues the team confronted;

3. Australia’s foreign aid involvement generally, especially in light of recent disasters in the last month; and

4. briefly, the role we give our Australian Defence Force, of which I am a member in the Naval Legal Reserves.

Why I wrote this book

It began as a thought that Australia’s response to the Tsunami tragedy of record proportions should not go unrecorded. The massive earthquake (9.3 on the Richter scale in Banda Aceh) was the largest earthquake recorded in 40 years. To give you an idea of its magnitude, because the Richter scale is not linear, it was almost 100 times more powerful than the 7.6 recently recorded in Padang. The Aceh earthquake, and the subsequent tsunami, knocked out all major infrastructure – roads, bridges, rail, water, health facilities.

Into this “hell on earth” an Australian civilian team of medical specialists were sent urgently. They were called CASTA – Combined Australian Surgical Team Aceh. They were all highly qualified in their different fields. From trauma surgeons to firemen, they were all highly experienced, highly-trained individuals, many were heads of their departments. They went into a disaster zone fully self-sufficient – they took 17 tonnes of equipment and supplies with them – including food, pharmaceutical and surgical supplies. As Australians, we can be proud that we responded so quickly and so coherently. This is not something which can be taken for granted – and it is unfortunately in stark contrast to how the US responded shortly after, to Hurricane Katrina.

Meanwhile back at home the whole of Australia was galvanising into action. Australians donated an incredible amount of money to Indonesia – a $1 billion aid package by our government. This sum was remarkable at its time, prior to the days of the GFC and stimulus packages.

The package was spread over five years under the Australia Indonesia Partnership for Reconstruction and Development (AIPRD). This Partnership included $500 million for grants and $500 million for loans to support Indonesia’s reconstruction and development efforts, and over $300 million was privately donated by us, to the tsunami relief.

Australia’s generous response was also noteworthy for its context. Remembering that we had had intense negative media coverage of Muslims – 9/11 in 2001, Bali Bombings 2002 (the sad anniversary was yesterday – 12 Oct), Iraq War 2003, Australia’s own embassy was bombed in Jakarta 2004, just three months before the tsunami. In spite of all this, Australians forgave – and gave. The tragedy of human beings’ suffering was the most important motivator. It was truly extraordinary, and worthy of being recorded for history.

Second, I wanted my four young sons to know what their father had been involved in. The book is dedicated to them: “For my boys who will one day be men. And for their father, who showed them what is possible.”

Role models are important, in my opinion as a parent, for the shaping of a future society. The team and its leader are living examples of ordinary people in extraordinary circumstances, who gave of their best. I didn’t want my children growing up to think that only other people or unusual people do special things in life.

Third, I had always wanted to write a book. As I told my husband Paul, I can die happily now.

The initial meeting with the publisher was slightly demoralising. He said, “Most barristers can’t write. Their style is pompous and boring. What’s yours?” I quickly sent him a first chapter and I am happy to say, he signed me up immediately. The style is called “dramatic narrative”,apparentlysomewhat different from legal advice. It was the end of January and the deadline was 20 May, which gave me 16 weeks to interview 35 people, from all over Australia, and write 70 000 publishable words. Having a young family – I was breastfeeding my fourth child – the only option was to write it between midnight and 5 am, and catnap at other times – whenever Paul could hold the fort. The sleep-deprivation was probably good; apparently you get the most creative thought out of a tortured mind.

Douglas MacArthur said, “There is no security on this earth, there is only opportunity.” Apparently there is a book in all of us. The fear of failure probably stopped me from starting to write one sooner. I thought, “If a world-wide tragedy in which my husband was personally involved doesn’t trigger any action, nothing will.” It was a risk. It was frightening, because you expose yourself to criticism, scorn, and failure. You challenge people’s image of you. As my sister said, “It is like running naked at a family function.”

To produce a creative work, you search in your heart for your innermost thoughts, feelings – and talent you hope you have, and you put it out there; on the walls, on the bookstands, wherever. I think you do it every day in some professions, even if you are not a book-writer. As a barrister, judge, member of the clergy, politician, and as a journalist. Your work is public and up for scrutiny and criticism. It takes courage.

But risks must be taken because the greatest hazard in life is to risk nothing. As Dr. Leo Buscaglia wrote in his book Living, Loving and Learning:

The person who risks nothing, does nothing, has nothing, is nothing.
He may avoid suffering and sorrow, but he cannot learn, feel, change, grow or love. Chained by his certitudes, he is a slave. He has forfeited his freedom. Only a person who takes risks is free.

The whole experience was scary. We all know the advice: “If at first you don’t succeed, destroy all the evidence that you’ve tried”. It is a bit hard to do with a book. It’s a bit hard to do when you run for a federal seat in parliament too. I wanted to craft the book as a piece of art. It had to have colour photographs, maps, even a poem at the start, a poem which would summarise the real thinking behind why people go to disasters.

Why do they go? It doesn’t make sense economically, it doesn’t make sense from a risk perspective. When Paul was telephoned to join the mission, the thought “Ask not for whom the bell tolls” immediately entered my mind. When I was putting the book together after his return, I told him that I was thinking of using this John Donne poem.

John Donne wrote his Meditation Seventeen in the 1620s: Let me give you a few lines from it:

No man is an island, entire of itself

[…]

Any man’s death diminishes me, because I am involved in mankind.

And therefore never send to know for whom the bell tolls, it tolls for thee.

I asked “Do you think that poem would work?” Paul looked at me a bit strangely, the hair on the back of his neck stood up and he muttered something like “white witch” as he went and grabbed something out of his bag. It was the one souvenir he had brought back with him. He had found it in amongst the tsunami wreckage, in a kindergarten which had been completely demolished. It was a little bell.

Donne wrote this in the Renaissance era, contemplating the idea that people are not isolated from each other, that mankind was interconnected, that a person’s actions had an impact on others’ lives. His thoughts, which now sound obvious, were profound in their day. Human life is important. Remember he wrote in a time when life expectancies were low, premature death was a constant part of the human experience. Infant mortality, death during childbirth, prisoners being executed, death from disease – and even battle – were common phenomena. Religious executions were real and personal to Donne. John Donne himself was born a Catholic in 1572 and was Jesuit educated. He lived in an era when it was quite dangerous to be a Catholic. Elizabeth I was on the throne and did not like Catholics. Donne’s own uncle was hanged for being a Catholic. Yet through his words we see that he realised that all human life was of value. And he bridged a gulf between two major faiths of his time, when he became an Anglican, and the Royal Chaplain to King James I.

Issues confronted

Nowadays, it has never been easier to feel removed from others’ suffering, because we are so affluent, so healthy, live so well and for such a long time. And we are conditioned to watch lives being played out on a screen.

It is a tribute to the charity of people, since the days of John Donne, that there is greater understanding and respect of others’ beliefs, and this was nowhere more evident in the Australian relief effort in the devout Muslim province of Aceh. Aceh is a predominantly Muslim community, being 98 per cent Muslim and the remaining 2 per cent a mix of mostly Christian and Catholic, with a smattering of other Eastern religions such as Buddhist.

There is a very good reason why we respond to disasters and Donne captured it. When our doctors and nurses were asked by the injured Acehnese, “Why are you here, why are you helping us?” Team members told them “You are our neighbours, you need help – of course we would help you.“ This response, so ingrained in Australians, is something which we probably regard as normal and everyday. But it is not commonplace world-wide.

Australia’s government aid package to the tsunami appeal was worth $1 billion and we gave over $300 million in private donations to charities such as World Vision, Caritas, CARE, Oxfam, The Red Cross, and so on. In contrast, the oil-rich nations of the Middle East were not as generous to the affected nations. Two months after the tragic event 8 such nations gave a combined total of $145 million. Compare this to Germany’s $600 million, or to Japan, or Britain, Netherlands, Norway – all of whom gave hundreds of millions each.

An attitude of caring, and desire to help, is not automatic. This is not a criticism, just an observation. People who believe that a society based on other than Judeo-Christian values, would result in Australia having the same incredible national character, I believe are mistaken, as they do not realise how much of what makes Australia a wonderful nation is grounded in the colonial origins of our country.

The largest percentage (of the founding population of 1788) upheld Judeo-Christian values, which had an impact on the formation of Australian traditions, and the formation of law, education and government over time. The rule of law as it is understood and respected in Australia, which is upheld by the courts and generally guarded at every layer of Australian government, in every club and association, and which abhors nepotism, favouritism, corruption; and desires fair play, disclosure of conflicts of interest, reasonableness and predictability, is able to be sourced in our founding origins.

This came up as a question from a pre-selector recently – what distinguishes Australia, makes it so great? I felt that the fact that we demand of everybody, from our local footy club when it votes on its office-holders, to our political parties when they run a preselection, that they abide by the rules – of fairness and respect for human dignity – and the rigor with which we insist on these standards, is what makes us great as a nation.

It also explains why there were thousands of people gathered outside Parliament House on Sunday 27 September 2009 – in a rally lamenting the Death of Democracy – the treatment of people in our state is not just an issue about high-rise, it has become an issue about saving what matters to us most – our respect for the rule of law, for transparency, for ethical process, for citizens having a voice – and for not having lobby groups donating money in return for favourable treatment. The rally was a recognition of our great Australian culture. A culture worth defending.

If I could return to our tale…

When the team arrived in Banda Aceh they were operating within 24 hours of landing. They worked in three different hospitals.

The team members provided life-saving critical surgery and medical care to many injured & sick. About 300 people presented per day. The team also assisted in immunisations and a public health watch which prevented the outbreak of diseases such as measles, cholera and typhoid. They set up a functioning pharmacy. They ended up departing on good terms with hierarchy and medical staff, leaving a positive legacy of goodwill which facilitated a smooth transition for incoming Australian teams. They were leaders. And leadership is about service, above all else.

There were many issues and  I have grouped them into six main ones: religious, medical, cultural, political, media-related, and nature. In every situation, the team built up trust, using respect and tact.

First, religious: There were religious sensitivities which had an impact upon medical care. Some of the patients refused life-saving amputations because they believed such an operation would render them imperfect and unfit for a heavenly after-life. They would rather die, dying intact. The team was respectful of their beliefs, even at one point assisting in recovering a discarded amputated limb out of stinking garbage, to allow for a whole-of-body burial. This difference first became known to the team when they spotted cats with no tails. They had been docked to prevent heaven being over-run. Imperfect beings – cats or human – could not go to heaven.

Second, medical: A recurring issue was the differing medical practices ranging from basic, essential pain relief to the treatment of wounds. In Australia, pain relief is considered a basic requirement, but it was not so in Indonesia. Also, pus-filled wounds were being sown up, whereas in Australian medical practice you would flush out the wound and allow it to heal. But the team could not be autocratic, as they were guests in a foreign country.

Third, cultural: The Australians were entering a private hospital where the owner was unsure of their intentions, and there was an early gender issue between the Australian female surgeon and one of the male Indonesian surgeons. The female surgeon was thrown out of theatre, and was not able to operate. It was incredibly demoralising for her, and counter to her entire upbringing and training. The team resolved it quite cleverly – you will find out how.

Fourth, political: There were political tensions. The team was surrounded by armed personnel at all times. Men armed with AK-47s. You didn’t stare at them. There had been thirty years of war between GAM (Gerakan Aceh Merdeka – The ‘Free Aceh’ Movement) and Indonesian government forces (TNI). The tsunami itself and the momentous relief effort provided an impetus for peace. So, after thirty years of war, and 15 000 deaths from the fighting, within 8 months of the tsunami, peace was achieved and a formal treaty signed in Helsinki.

Fifth, media: The team worked under constant media scrutiny and had to provide interviews. There is nothing quite like operating with a large camera shoved under your nose. But they did the interviews, with incredible results. The coverage of the team’s work triggered charitable donations internationally of record proportions, which have been funding reconstruction programmes for the future, facilitating the recovery of a devastated community.

Six, nature: Some of the most abiding issues were basic human needs. Rest and food are essentials of life. But fatigue, heat, long hours, ration-packs and physical exertion were unavoidable. They were set against a backdrop of terrifying and recurrent earth tremors, day and night. All these factors had an impact and had to be taken into account. One of the main issues was the emotional overload on the team members. They were only human, but they were saturated with the smell of death, and surrounded by sorrow, screams of pain, and weeping by grieving relatives, day in and day out. There was no way to shut it out.

Aceh province was the site hardest hit by the disaster. Its final death toll (buried bodies) was about 129,000. More than 36,000 people remain missing and are presumed dead. Half a million became displaced. The tsunami caused immense social, economic and environmental devastation to areas that were already poor.

Indonesia helped itself with its attitude to the help. With foreign aid, it is not always conclusive that outsiders will be allowed in to assist.

In May 2008, after cyclone Nargis in Burma, 22,000 were killed and one million left homeless, the Burmese military generals (the junta) resisted allowing other nation’s military planes to fly in critical supplies, and delayed the granting of visas for UN teams urgently seeking entry to deliver aid and medical services to the victims.

Aceh, due to the separatist war, it was under martial law when the tsunami hit. A framework which would not have allowed humanitarian agencies to provide assistance. So it was with great diplomacy and advocacy that the Australians were allowed to enter into what was an active war zone, and a credit to Yudhoyono and the relationship he had with our Prime Minister at the time, John Howard.

Australia‘s foreign aid involvement and the role of the Australian Defence Force

There are a number of key ways we Australians offer aid: via our government through AusAid and the Australian Defence Force, and privately through NGOs or charities. Sometimes the government partners with charities such as World Vision or Red Cross. There is a growing understanding that assistance makes sense from a number of viewpoints:

–       humanitarian

–       affordability

–       investment in relationships

–       a defence strategic viewpoint

There have recently been a number of catastrophic disasters, although not nearly on the scale of Banda Aceh.

On Wednesday 30 September 2009, there was an earthquake-triggered tsunami in Samoa, which killed more than a hundred people. There was an earthquake in Padang, Indonesia, which killed more than 1 000. Typhoon Ketsana struck the Philippines on the 26 September, and Vietnam on the 30 September. It then extended into Cambodia, Laos and China. As part of our humanitarian ideals, the Australian public support responding. We see the suffering and realise that it is horrific for the people involved.

We can afford it. Australia is a rich and prosperous nation. We are consistently in the top 15 economic entities of the world. We are well placed to assist other nations in times of distress, particularly those within our immediate region. In recent years, Australia has been able to deploy defence capabilities often to assist with disaster relief.

We also see that our Defence Force is well-adapted to respond – we have trained personnel who have equipment, and can get there fast.

The Australian Defence Force and aid abroad

The Defence Force, as stated in the Defence White Paper of 2009, acknowledges that the principal task for the ADF is to deter and defeat armed attacks on Australia, safeguard our critical commercial sea-lanes, our fisheries, population, and infrastructure; but also that the next-ranked priority task for the ADF is to contribute to stability and security in the South Pacific, East Timor, and parts of SE Asia. This involves conducting military operations, in coalition with others as required, sometimes to protect or extract Australian citizens, sometimes to provide disaster relief, and sometimes to intervene to support law and order – such as we have sent to the Solomon Islands, and so forth.

As the paper recognises, instability in our region, including internal conflict, and worst case scenario – failed states – all pose a security risk from the point of view of unrest and also present a resettlement challenge for those who flee the conflict or tragic situation. Ideally, the population remains where it is, with its own community, and the problem abates, with help.

The reportedly changing climate patterns give rise to potential security impacts, especially perceptions of weather-related events, and the import of food and energy scarcity. So yes it is from a humanitarian perspective, and from an affordability perspective, but there is also a considered pragmatic defence perspective, which supports a positive approach to aid. It makes sense to budget and train for this humanitarian mission component. It also creates bonds for life between our nation and others. This is priceless.

I give Indonesia as a case study. More than half of Indonesia’s 225 million people have incomes below the poverty line as defined by the World Bank. Their resources are congruent with a third world nation on many fronts – it translates into areas such as medical training, their ability to respond to disasters, even their ability to build homes, bridges and roads which withstand degrees of earthquakes.

Poverty and the impact of disasters can translate into a security issue for Australia because poverty has been identified as a contributor to the dissatisfaction and envy which gives rise to extremism and terrorism.

In April 2005, Australians went to Nias, Indonesia in response to an earthquake. My husband Paul was asked to go and we thought others should be given an opportunity, as he had only recently returned from Banda Aceh. A Sea King helicopter carrying 11 Australians crashed. Nine were killed in the post-accident fireball. The Services have had to adapt to co-operating with civilian agencies and NGOs. It is not a trivial matter when you consider that they are trained differently, and have differing priorities. The post-crash fire in the Sea King accident which took the lives of the injured survivors was attributed in part to the loading of an aid worker’s butane gas cylinders onto the military aircraft. The cohesiveness of the ADF and civilian agencies is thus critical.

The relationship between Australia and Indonesia had been greatly affected in a positive way by how speedily and generously we had responded to their tragedy of the Boxing Day tsunami. We now had lost nine young lives to help this country. President Yudhoyono bestowed posthumous medals of valour on the nine servicemen and women, recognising that they had been killed for their service to his countrymen. This is immense.

President Yudhoyono said at the time: “We are overwhelmed by the Australians’ generosity and we will never forget it. Your presence means so much to us in Indonesia. It means that you care. And you care deeply.” And, now, 96 per cent of the AIPRD package which we gave after the Boxing Day Tsunami has been almost all spent, both in and beyond tsunami-affected areas.

Basically, Aceh was reconstructed from the ground up, and was all but finished in 2008. Houses, schools and health clinics, roads and bridges have been rebuilt or repaired and people have been able to return to work to earn their livelihoods and support their families.  Australia is also providing longer-term support to build capacity in emergency preparedness.

By June this year, 1706 of 2000 planned junior secondary schools have been built with Australian support across Indonesia, 922 are already operational. These 2000 schools will provide places for around 350 000 students. We are also helping farmers to improve and market their produce. We are working with government ministries to improve public sector management and are providing 600 scholarships across a range of disciplines to study in Australia. The people of Indonesia know that they are the beneficiaries of our generosity.

On 2 October 2009 we sent our hospital ship HMAS Kanimbla to Padang with medical personnel and engineers. We had already sent an urban search and rescue team from Queensland, which was used in the early stages to rescue survivors. My husband was asked to join the Kanimbla mission but we have taken on a foster family as a two-year commitment. The boy is about to do HSC, and also apply for the Navy, so we are helping him prepare for those.

So we Australians continue to respond but the great question of whether we do enough is always asked, and whether one-off responses are good enough.

The G20 represents around 90 per cent of global GDP and about two thirds of the world’s population. One of the constant items on its agenda is how to alleviate world poverty and how best to achieve it. Disaster relief is a separate issue to the poverty issue, but coping with disaster becomes so much harder, if you are a poor nation to begin with.According to the government’s AusAid information source, two thirds of the world’s poor, some 800 million people, reside in the Asia Pacific, which is our region and thus has a direct impact on our national interests.

Tim Costello (CEO of World Vision) has argued, as has the UN, that nations should peg aid to GDP, or GNI (Gross National Income). The UN target is 0.7 per cent. We are heading there. At the time of the tsunami we were at about 0.25 per cent. We gave at 0.32 per cent in 2008 and we are forecast to give aid at a 0.34 per cent in 2009. About $3.8 billion.

At the UN’s Millennium Summit in September 2000, Australia, as a member, confirmed a commitment to the Millennium Development Goals: to help eliminate global poverty and hunger, to improve health, gender-equality, education, and environmental sustainability – and to create a global partnership for development. The idea is to promote sustainable, broad-based economic growth, reliable trading systems, and independent law and order, education, and medical systems.

Conclusion

I will finish by telling you a few things about the process of writing my book Angels of Aceh. It was one of the tougher things I have done in my life and I was encouraged during the process by learning about Eric Hoffer. Eric Hoffer was an American writer and philosopher who was awarded the Presidential Medal of Freedom by Ronald Reagan in 1983. He had been blinded by a fall down stairs in his mothers’ arms at age 5. She died a few years later. His sight came back at age 15 and he read – as though his life depended upon it. He was a humble dock-worker, but wrote amazingly well. His work The True Believer was his most famous, about the philosophy behind mass movements. Hoffer was among the first to recognise the central importance of self-esteem to psychological well-being. He wrote these words, which I still have on my wall.

They who lack talent expect things to happen without effort. They ascribe failure to a lack of inspiration or ability, or to misfortune, rather than to insufficient application. At the core of every true talent there is an awareness of the difficulties inherent in any achievement, and the confidence that by persistence and patience something worthwhile will be realized. Thus talent is a species of vigour.

The secret is that the book wrote itself. As you know, it was written in an incredibly short time, in the middle of the night. What dragged me out of bed each night to write was the knowledge that it had to be written. I had to record the work of this incredible team; and the bravery of the Acehnese. The force was bigger than my human need for rest. I have never felt such a compulsion before.

Writing it was very rewarding – I met some amazing Australians – and it taught me many things. One thing was that a stray comment can be very powerful. Without giving the story away, there is one moment where one of the doctors takes aside a Channel Seven reporter who keeps offering to help, and tells her: “If you really want to help, you will find the sole living relative of this little boy Zulfahmi.” You need to read the book to see what an effect his comment had. It was quite extraordinary.