In the Heart of Chaos: Dr. Alexandra Douglas’ Journey from Rwanda’s Frontlines

Thirty years ago, 612 Australian peacekeepers were deployed to Rwanda to assist in the United Nations peacekeeping mission.  Dr Alexandra Douglas MG recounts the role that the Australian Medical Support Force played.  

The image of children with their faces crushed up against razor wire, arms poking through desperately grasping for help, has stayed in the mind of retired Wing Commander Dr Alexandra Douglas MG, since she served as a peacekeeper in Rwanda 30 years ago.

So too has the memory of rescuing an orphaned child about to be shot – scooping the child into an ambulance, frantically covering the little girl’s pretend wounds in bandages; a quick-thinking ruse enabling the Australian medic to squirrel the child to safety.

The three-decade Defence veteran was one of 612 Australian peacekeepers who served in Operation Tamar. She deployed to provide medical support to the 7,000-strong international force of United Nations Assistance Mission for Rwanda (UNAMIR) II, the United Nations’ peacekeeping mission to Rwanda in 1994.

This August marks the 30th anniversary of the mission, which is considered one of the most difficult peacekeeping efforts ever undertaken by the Australian Defence Force.

The role of the Australian medical corps was to support UNAMIR II, which was tasked with trying to stabilise the powder-keg African nation, deep in crisis after civil war degenerated into the genocide of 800,000 Tutsi people during 100 days of bloodshed.

However, the Australians’ role became much more confronting when exposed to the horrific conditions in the aftermath of the genocide, surrounded by death and squalor, and constant outbreaks of violence. For Dr Douglas and those who served alongside her, serving in Rwanda changed their lives.

Rwanda gave me a deep-seated mistrust of humankind; a despair for the future combined with a desperate need to help the vulnerable.

DR ALEXANDRA DOUGLAS

Peacekeeper involvement

On 6 April 1994, decades of tension between Rwanda’s warring Hutu and Tutsi people exploded, after a plane carrying President Juvénal Habyarimana of Rwanda, a Hutu, was shot down over the country’s capital Kigali.

The Hutu blamed the Tutsi and within hours unleashed a murderous rampage across the tiny, troubled nation. Some 200,000 machete-wielding Hutu militia systematically moved from village to village, burning homes and slaughtering Tutsi families, mercilessly hacking them to death.

Historian Garth Pratten described these massacres as “an orgy of violence unparalleled in the post-war world”.

In August 1994, the United Nations accepted Australia’s offer of peacekeepers to help support UN forces trying to stop the bloodshed and bring calm to the nation. The first wave of support under Operation Tamar arrived soon after, serving from August 1994 to February 1995, with a second deployment from February until August 1995.

In February 1995, Dr Douglas was called up as a general duty medical officer to deploy with the Australian Medical Support Force, tasked with the critical role of restoring the hospital and surgical facilities in Kigali.

Call to duty

This wasn’t her first time in a troubled nation.

Dr Douglas was born in Johannesburg and at the age of 11, while visiting family in Zimbabwe, terrorists attacked a rural community gathering attended by her family and friends. After many hours under siege, the family was rescued by the Army.

Subsequently, her parents decided to move to Australia, to build a new, safe life for their three daughters. That day proved a major turning point in her life, when she vowed she would become a doctor – one who served those who put their lives on the line in the name of duty.

“I wanted to be someone who could help people in distress. So, I studied a Bachelor of Medicine and Bachelor of Medical Science at the University of Tasmania and at the same time, joined the Australian Defence Force. During my holidays and spare time, I began military training,” she recalled.

Three years after graduation, she was deployed to Rwanda.

Grenades, mines and guns still wreaked havoc on the streets, the capital’s crumbling hospital in Kigali had visible mortar shell holes through what was left of its roof, and the evidence of trauma and bloodshed was everywhere. With limited resources, and overrun with patients to treat, the Australians did their best under gruelling conditions.

Dr Douglas was also leading a small outreach team to set up a Casualty Clearance Post (CCP) at a refugee camp at Kibeho, 150 kilometres south west of Kigali, where 150,000 displaced persons were living in squalid conditions.

The Kibeho camp was a firecracker, and violent outbreaks were frequent. Adding to the precarious conditions, many of those in the camp were Hutu militia, responsible for the Tutsi genocide.

“We found the shell of an old medical facility crammed full of people, hundreds of them with all sorts of injuries, some holding their faces together where they’d been macheted down the middle.

“There were way more patients than we could have possibly anticipated, but we made a plan. Our ambulance became an operating theatre; we cleared out the truck carrying all our medical supplies and it became a makeshift ward and a triage area – which was effectively just a tarpaulin on the ground – and we got down to work,” she recalled.

“One day, we could feel a storm was brewing – not just the weather, but within the mood of the camp itself. The energy in the air could be described as ominous, and tension had been mounting for days.

“All of a sudden refugees started to run to break the boundary of the camp, and with that, the government forces opened fire… thousands were left dead, dying or maimed. We were in the middle of the camp, in the middle of it all. It was horrific but we continued, with even more patients now.”

Everything we did was under dreadful duress.

DR ALEXANDRA DOUGLAS

Under the rules of the UN charter, the Australian peacekeepers were unable to intervene. They had to concentrate on their work while a civil massacre was unfolding around them.

“We were surrounded by horrors that speak of depravity, hate and greed. With very few supplies and no military or medical support, my soldiers and I worked tirelessly to determine to whom we could make a difference.

“We made a difference to many, but not enough. These conditions changed all of us.”

The one glimmer of hope was smuggling the little girl out of the bloodshed.

For a long time, I denied my emotions, but I was suffering PTSD. I had nightmares every night and I thought that was normal.

DR ALEXANDRA DOUGLAS

“An innocuous trigger, many years later, prompted me to finally seek help – it took 20 years for me to accept that I was never going to be able to save everyone at Kibeho. There are many ways to get help for PTSD and I’ve been able to move on with my life.”

Recognition of service

Following Rwanda, Wing Commander Douglas MG served in East Timor and the Middle East.

She currently works as specialist anaesthetist and intensivist, regularly teaching Emergency Management of Severe Trauma through the Melbourne-based Australian and New Zealand College of Anaesthetists and the College of Intensive Care Medicine.

She was awarded a Medal for Gallantry for her actions during the Kibeho massacre, and in February 2020, all Australians who served in Rwanda were presented with the Meritorious Unit Citation for their ‘courage, discipline, and compassion throughout their deployment’.

Dr Douglas said the key to any service is compassion, and anyone can ease the suffering of another by choosing to care.

“I have seen people killed, slaughtered; I saw death. I was my own greatest disappointment. My actions, while correct according to our mandate, conflicted with my humanitarian values. I have lived with a sense of personal disappointment at a moral level for a long, long time.

“I couldn’t save everyone and by attempting to do so, the only way would’ve been by engaging and I have absolute confidence I would not be here today.”