Appreciation
The Healing Heart of Annalena Tonelli
Humanitarian Gave Her Life to Helping Others
By David Brown
Washington Post Staff Writer
Wednesday, October 8, 2003; Page C01
We live in an age of the hidden motive. Every action has a shadow life where its real truth lies, and we're told the wise person would best be on the lookout for it from the start. In many ways we're especially suspicious of selfless deeds. Even when goodness doesn't bring money, status and power, doesn't it pay off richly in some other egotistical currency?
Perhaps this is true, although it seems as naive a view as the one it purports to overthrow. But even if it is, there are people who are in some essential way exceptions to this weeding of human agency. Annalena Tonelli was one of them. Tonelli spent her adult life rescuing, treating and curing people with tuberculosis and other diseases in Somalia and Kenya.
She was a fearless and tireless person who also seemed incapable of discouragement. She was unsentimental and calculating when necessary. She eschewed organizations except for ones she created and could move -- or abandon -- at will, like the collection of desert people she so loved and admired. In her life -- 60 years, more than half of it spent in East Africa -- she saved thousands of lives. Three days ago, she lost hers.
According to wire service reports, Tonelli was shot twice in the head Sunday night when leaving a hospital for tuberculosis patients in Boorama, a city in northern Somalia. It is hard to imagine what the reason for this crime might be.
I met Tonelli 10 years ago when I went to Somalia to report on the late stage of the disastrous famine accompanying civil war in that country. I spent three days at an institution she established in Merca, a city on the Indian Ocean south of Mogadishu. She called it Koch Hospital -- a reference to Robert Koch, a German bacteriologist and early tuberculosis researcher -- rather than a more obvious name that would draw attention to the wasting and stigmatizing disease of its occupants.
At the time, it was the only place in Somalia treating tuberculosis patients correctly and adequately. She had 700 under her care, and 1,500 diagnosed and awaiting treatment, when I was there. The most ill, including about 100 children, stayed in three adjoining houses with courtyards she had refitted as open wards. Around town she and her assistant had rented more than 100 houses where patients, and often whole families, stayed while taking six months of antituberculosis drug therapy -- the essential, indivisible requirement for cure, and one especially difficult to apply in a country of nomads and people displaced by civil war. Tonelli fed them and treated them entirely for free. Patients came from the entire southern half of Somalia, most arriving emaciated and near death.
"If they die they die in the first or second day," she told me as we walked through one of the courtyards one morning. Under awnings skeleton men lay, or, if they were strong enough, sat on woven mats. At their heads were their few possessions: shoulder bags, hollowed gourdlike satchels, tea kettles. Each had a small earthenware spittoon that was given a layer of fresh sand each day at dawn. "If they take drugs for two weeks, it is done. Almost nobody dies then."
Done, but of course not over. Curing TB takes time and patience, and Tonelli had both in portions hard for an American to comprehend.
She grew up near Bologna. Her father was an economist and authority on cooperatives, her mother a homemaker. She was the second oldest of five children. A brother, Bruno, now a physician, still lives in their home town of Forli. It is the hub of several networks that raise money for his sister's work.
Tonelli was a bit of a child prodigy. She trained as a lawyer but most of all wanted to go into the developing world. "My family did not want it. So I took the first chance."
She arrived in East Africa in January 1969 and has worked there on and off ever since.
For many years she treated TB patients in northern Kenya. Most were ethnic Somalis, dry-land herdsmen. The patients would not stay in hospitals, and their families would not wait for them. Tonelli didn't try to change their ways. She built open-air treatment centers called manyattas, where people could stay for the half-year course of treatment. When it was time for a person to leave, she put the word out and the patient's family would magically appear in a week or so and pick him up.
She performed this work largely out of public view until 1985. That was when the Kenyan army was sent in to kill members of a local tribe with links to Somali guerrillas in Ethiopia. Hundreds of people were massacred and the wounded left to die.
"She took her Toyota, painted a red cross on it and went out into the desert with water," said Barbara Lefkow, 76, of Chevy Chase. At the time, Lefkow was the wife of an American diplomat in Nairobi and was also a physical therapist who worked on and off with Tonelli. "She and a few of her assistants picked up the survivors and brought them back to the rehab center. She saved some of them, and she made a list of the dead and gave it to me to smuggle out."
Tonelli's action and the publicity surrounding it led the Kenyan government to expel her. She returned to Italy, received training in Liverpool on treating tropical disease and eventually returned to Somalia to take up the work again.
The logistical difficulty of that work is hard to imagine. In Merca she supervised the purchase of fresh food for hundreds of people each day. She had a large local payroll to administer. And the key to curing TB is directly observing treatment -- watching every patient swallow his or her medicine every day. If she did not do it all personally -- she had helpers including trained physicians who worked with her for long periods -- she was nevertheless the person everyone wanted to see, the one who faced down the brigands when they snooped around, and heard the numberless personal supplications of patients.
As I followed her one day she moved with something beyond the self-preserving patience that clock-watching Westerners adopt to keep from going crazy in the developing world. It was an ability to see individuals at every moment. She refused to carry a radio that would interrupt her.
As one American aid worker who knew her in Merca said, "She has time for everybody. She is not easily distracted. It is a very saintly characteristic."
She lived with aesthetic simplicity, her chief source of pleasure several children, abandoned by their families, whom she adopted. Them, and the silence of the deep night when everyone was finally asleep.
"I was a small child when I felt like this," she said of her desire to find all she wanted in the service of others. "Many people speak of sacrifice, but for me it was never a sacrifice. I often felt there was nobody on Earth who had such a privilege as to live like this."
If pressed, she would admit she was religious. "I always feel the presence of God," she said one night as I quizzed her on the subject over dinner. She also would admit that her goodness was hard work.
"The reason that more people don't feel this way is that they don't try hard enough. You have to give time, you have to be patient; and then, year and after year, you'll see that what matters is only love. But if you're impatient because people are not grateful or you were full of limits, you will not be happy. You need time."
Annalena Tonelli had time, but not nearly enough.
© 2003 The Washington Post Company
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