Challenging in every way
Rwanda was the most extreme operation WGCDR Tracy Smart has been involved in to date, but she would do it all again.

AFTER the genocide in Rwanda in April 1994, Australia sent two contingents of 300 peacekeepers to Rwanda from August 1994 to August 1995. The first Australian personnel comprised the 2nd Battalion headquarters, a rifle company and administration company of No. 2 Royal Australian Regiment and a medical company of personnel from the three Services.

The second contigent consisted of more than 300 personnel drawn from the three Services, mostly Army but also five Navy and 21 Air Force. Although we were organised primarily to treat UN troops, we were now in a country whose health infrastructure had been largely destroyed in the genocide.

Most Rwandan health professionals had either been killed or had fled the country. Consequently, about 75 per cent of our efforts were directed towards our humanitarian role.

We treated many UN soldiers, mostly from African nations, but the majority of our work was with the local population. We also provided medical support to the orphanage run by Mother Teresa’s order and these victims of the genocide were without doubt our favourite patients.

By treating such large numbers of the local population, we were able to increase our clinical knowledge and saw many illnesses we would not see in Australia.

These included:

• tropical and infectious diseases, including lots of HIV and AIDS, and other diseases we now rarely see in Australia, such as tetanus;
  
• strange and exotic tumours such as Burkitts Lymphoma and an inoperable congenital tumour in a young boy; and
  
• old wounds inflicted during the genocide.

WGCDR Tracy Smart treats one of the people at the Kibeho camp.

We were able to save the life of a young mother who had lost both her legs as well as a pregnancy after stepping on a mine.

We also had some great success stories like Uwamariya, an eight-yearold girl whose leg infection spread throughout her body despite antibiotics. Everyone expected her to die. After many weeks she began to improve and although an amputation looked probable, the leg was saved.

The mission was a great lesson in resource management as the amount of support we could provide depended not on the cost of medical supplies as it might back home, but simply on their availability. Often this called for some tough decisions.

So overwhelmed were we by the broad range of exotic medical and surgical conditions that confronted us that the medical offiers in my contingent had T-shirts made up with a logo that expressed our predicament: “Médecins Sans L’Idée” (Doctors Without A Clue).

Rwanda was an incredible experience for ADF health services personnel. We were fully tested in an operational environment and gained invaluable experience.

For me, this six-month tour was undoubtedly the highlight of my career as a military medical officer and yes, I would do it again.

WGCDR Smart is the CO of the Institute of Aviation Medicine at RAAF Base Edinburgh.

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