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Wayne Ramsey
Archive number: 2461
Date interviewed: 25 August, 2004

Served with:

CO Australian Contingent
CO Force Medical Office UN Headquarters
Rwanda

Other images:

  • Looking south to Burundi border

    Looking south to Burundi border

  • At refugee camp near Goma, Zaire

    At refugee camp near Goma, Zaire

  • At refugee camp in Cyangugu, Rwanda

    At refugee camp in Cyangugu, Rwanda

  • With international and Australian senior doctors (centre)

    With international and Australian senior doctors (centre)

Wayne Ramsey 2461

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Transcript

Tape 01

01:00:42:00

I’d like to ask you to give a summary of your service, starting with when you joined.
I first joined the CMF [Citizen’s Military Force] in 1969 and served

01:01:30:00

for three years in the CMF. And I did that as a youngster. I was interested in doing something slightly different and other people were doing it, and I had no other good reason for joining the CMF. I joined a signals squadron and I was a truck driver. That took me through into my first couple of years in medicine and it was really interesting, I can recall that I was always being queried, “Wayne you’re doing medicine, why are you a truck driver in the CMF?” And all I’d say is,

01:02:00:00

“It’s good fun.” And it put me through the first couple of years of medicine. So I would do my hundred days a year, so for me that was my part-time job. It started to become too difficult though, and the commitment of time and I decided to leave the CMF. But then I was still put under pressure of finances. I was living at home, I didn’t have a part-time job doing medicine and I ultimately decided that I knew a bit about the army so

01:02:30:00

I joined the army as a medical undergraduate. And I did that at the end of my fourth year and the army sponsored me through those last two years of medicine. And I say, these days, and I think even then that I was basically, I was around being an economic conscript. I had no long term aspirations out of the army and I was merely going to be sponsored for two years and do my three years return in service and then go on into a

01:03:00:00

medical career, in other fields that I hadn’t really determined. After the two years, as an undergrad, I graduated, moved into the regular army but took my first two years as leave without pay and that allowed me to do my internship and residency in Launceston General Hospital then. That was interesting because that was around the economics, the pay differential, between the military and civilian doctor intern resident working very long hours was huge, and I just couldn’t see the

01:03:30:00

financial reasons for being on service, when I was going to earn a lot more just as a civilian; so even at that stage it was very much the economics of service. My first posting was as RMO [Regimental Medical Officer], 1st Armoured Regiment in Puckapunyal, and that’s where I started really enjoying my military career. So I spent two years there, posted to Singleton as a young doctor, first sub- unit command, OC [officer commanding] of camp hospital, and spent my two years there, the first- the end of the first year -was the end of my

01:04:00:00

return of service and at that stage I made the decision that I was going to continue with the military career, and I accepted a permanent appointment. From Singleton, I was posted to Canberra, did the first of my staff jobs there. Two years in Canberra. And by then I was truly committed to a military career and I was becoming very interested in the operational side of the military as well as clinical medicine. Especially with my previous postings.

01:04:30:00

And I was fortunate to be selected to go to army’s command and staff college. So I did twelve months at staff college, did very well there and actually had the choice of postings out of staff college, either a posting in Germany with the British Army on the Rhine, or in fact a posting with a field ambulance in Townsville with our operation and deployment force. For a number of reasons, some personal, I chose the Australian posting, and it was probably one of the highlights of my career.

01:05:00:00

Having come out of staff college, having a really good understanding of military, I spent two years in Townsville with the operational deployment force, the commander at the time was Brigadier Arnason and I served together on a number of occasions, so it was really good to serve with him and it was a really exciting time, it was a time when the ADF [Australian Defence Force] was just starting to get some teeth and was starting to do things of potential operational deployments, the first potential deployments since

01:05:30:00

Vietnam and in fact, a small force from the ADF sailed around Fiji – ’86 - and were put on stand-by to go to Vanuatu at the time because of a potential coup there, so it was really just starting to think about operational service for the first time in Australia. From there I was posted to field hospital in Ingleburn – originally a two year posting was extended to a three year posting.

01:06:00:00

That was a very demanding posting. It amalgamated a field hospital and the old second military hospital, so there was not only the operational side of commanding a field hospital, but integrating two units, and that was a pretty difficult task. I was awarded a CSC [Conspicuous Service Cross] out of that job. And a lot of hard work went into it. From a military perspective, the operational

01:06:30:00

side of it was really interesting, the field hospital had been very run down, poorly equipped, and I took over at a time when it was being reinvented, re-equipped. That also was the time of the first Gulf War and as a unit, we were performing well, we had high credibility and when it came to Australia’s offer of military [assistance] to that – to the war in the Gulf in fact -

01:07:00:00

1 Field Hospital was offered; probably the most viable option that our government was prepared to accept. The government didn’t accept it so we didn’t deploy, but for us it was a fair amount of credibility as a medical unit, to be chosen as the one that might deploy operationally. After those three years, I was provided the opportunity of long term schooling and

01:07:30:00

I chose a medical administration. I did a Masters of Health Administration with the University of New South Wales. Twelve months off, it was great. Really fabulous to have a break. And go back to being a university student again and having responsibility only for myself and all the things that go around being a student, so it was a really wonderful twelve months. From there I stayed in Sydney, it was (UNCLEAR) what

01:08:00:00

posting I would receive at the end of that time and I was originally posted into the military district as the SO1 [Senior Officer, Class 1] responsible for medical services in New South Wales. I only did that for six weeks, and I was quickly picked up, promoted to colonel and posted to land headquarters, Victoria Barracks, where in fact that other position was, as Commander, Land Command, Medical Services. And on

01:08:30:00

and off I spent five years at land headquarters, and saw a whole series of changes in that particular position. Along with retitles, from Commander, Command Medical Services, to Commander, Land Health Services, and while that sounds like it doesn’t mean much from a symbolic point of view, I felt that that change was really important, demonstrated that we were all around health and it wasn’t just medical led. And during that time I was selected and posted as

01:09:00:00

commander of the Australian contingent to Rwanda. So that actually occurred in the middle of the posting and was posted back to land headquarters, for another couple of years. From land headquarters, a new organisation was created to oversee the health services that were being delivered within Australia, joint health support agency, and I was posted as director of that so I established the Joint Health Support Agency

01:09:30:00

firstly in Melbourne, where I spent twelve months, and then moved my headquarters to Canberra, spent another twelve months there and was eventually promoted brigadier and appointed the director general of defence health service. And I did that appointment for two years before retiring.

01:10:00:00

And at that stage, resigned from the military, rather than retiring into inactive service, made a conscious decision about that, and it was very much because I feel that, you see old soldiers hanging around and it was my view that that would be very inappropriate for my successor and others, there had been a bit of a history of that in the medical corps and I felt that that was inappropriate. So it allowed me to make a clean break and move

01:10:30:00

on with my life. So that’s my military story.
What did you do after you resigned?
I went through a military appreciation. You’ll find that I’m a fairly structured person, I had to make a decision about what did I want to do with my next working career. And for me, I enjoyed a working in the health sector, I enjoyed management or the oversight of management I had

01:11:00:00

a real interest and passion around quality and safety systems. So from a work point of view, I decided that I’d stay in the health sector. I toyed with the idea of private sector, and consulting in that field, but at the end of the day decided that my real interest was in populations, the delivery of healthy populations, so that really pushed me down a public sector line. I then had to decide where I wanted to live, I’m a single person so I

01:11:30:00

could have moved, but at the end of the day, I was enjoying Canberra, nice social environment, plenty of sport, rugby and all the other sorts of things that you can do here, good wineries and restaurants, my option was to move to Melbourne; but for me it was just as easy to stay in Canberra and not move and having been in the military and moving so often, decided a bit of stability would be good in my life. So I stayed – decided to stay in Canberra and then I had to find a job. And I talked around with some of the health

01:12:00:00

circles in Canberra, went and saw the chief executive of the Canberra hospital, was interested in the quality – the way quality and safety was being worked in the Canberra hospital. He offered me a job, I became the deputy chief executive there, very quickly got immersed in organisational management. He left, I took over as acting chief executive, retitled to general manager, and

01:12:30:00

did that for about eighteen months, both jobs. And in the end decided that I’d really had enough of serious organisational line management, same problems coming around again, and I’d seen that in my military career so I resigned. ACT Health [Australian Capital Territory] were very good, came back to me and asked me if there was some other sort of work that I would be prepared to do with them, and negotiated with ANU[Australian National University] as well, and I now have a conjoin appointment with ACT Health and the ANU Medical School

01:13:00:00

as senior fellow in clinical governments. So I oversee the clinical governments' arrangements, quality and safety systems in ACT Health. I co-chair the personal professional development theme in the ANU Medical School, that’s a new medical school, so involved in curriculum design and teaching around quality and safety to the young doctors of the future, so that’s where I am today. So for me, I’ve ended – finished, I think almost finished, a very interesting journey.

01:13:30:00

At the end of the day it’s been a medical career but stepped into and worked around all sorts of different things.
Now, I’d like to go back to your childhood, and ask you about where you were born and where you grew up?
I was born in Sydney, my father was an engineer. We moved from Sydney to Port Lincoln, in South Australia, I was only young, I was only

01:14:00:00

two or three. And we only spent a couple of years there, and from there, moved to Tasmania, to the west coast of Tasmania, so I was about four when we moved to Tasmania, and I spent nine months at Rosebery and I guess some of my first recollections of life was the rain in Rosebery. I recall, many times my father saying, years hence, that we lived there for nine months and it rained for

01:14:30:00

every day. He moved from the job that he had at Rosebery with a mine and he became the chief maintenance engineer for the Hydro [Tasmanian Hydroelectric Authority] and we moved to a little town called Tarraleah in the centre of Tasmania. And that’s where I grew up through my primary school years. We then moved to Hobart, for education reasons, and we

01:15:00:00

moved to Taroona, to the Friends' School. I have a sister two years younger, so we both did our high school years at Friends, that was pretty tough on the family though because Dad stayed in Tarraleah and commuted. But putting your kid through private school is expensive and the work for him was in the highlands of Tasmania, so Dad used to come back at weekends, so that saw me through my high school. Interesting time, Quaker school, Friends' School,

01:15:30:00

and that affected me through the rest of my life, my views on life and while I’m not a religious person, but the Quaker attitudes have influenced me. And it’s interesting to think about that and the dichotomy of coming out of a Quaker environment and eventually joining the military. And I guess that’s one of the dichotomies in me and through my life, and how I managed to deal with that sort of thing. I actually left the Friends' School

01:16:00:00

at the end of high school and in Tasmania at that time there was a transition called matriculation for two years before university. And I did it on philosophical reasons that it was during the time of the Vietnam War, and there were a couple of instances where the school was being very supportive of what to us, was in those days, the enemy, the other side, the Viet Cong, and they were supplying the North Vietnamese. And it was a very proactive move on their part

01:16:30:00

and it really jarred with me that there was this – a pacific group who were actually supporting one side and I had real difficulty with that and I made the decision that I wasn’t going to stay there. And I went to a public school, Elizabeth Matriculation College, where I matriculated before I went to university.
How old were you when you discovered this?
Sixteen, sixteen going on seventeen.
And how did you find out that.?.
Saw it on television,

01:17:00:00

there were news footages and to this day I can recall there was a particular piece of footage of a ship sailing into Hanoi Harbour and there was a lot of hoo-ha in the press and papers around the Quakers supporting the North Vietnamese. Then it was raised at school as well, by the principal of the school about right and wrong and what we should do and not do, and I really – I couldn’t understand, how could you do that for a group who had always been

01:17:30:00

even handed and turned the other cheek, then my feelings were they should have been supporting both sides equally and not to be so overtly supporting one side and not the other. They had come out fairly strongly anti the war in Vietnam, and the way they demonstrated that was by supporting the north. And I just couldn’t understand that rationale.
Did you discuss it with your teachers?
No, I didn’t. I found it – no I didn’t.

01:18:00:00

Or I can’t recall that I did. But because it was such an overwhelming influence within the school that this was their philosophy and this was what they were going to do.
Did you discuss it with any of the other children?
Yes, oh yeah, I discussed it with my parents. That and there were other things going on that I was ready to move on, I felt somewhat constrained in the school but it was more around this – the philosophy of the school and what it was trying to achieve at the time.

01:18:30:00

Perhaps you could tell us a bit more about the philosophy - the Quaker philosophy of that school, that left its mark on you?
It’s being a pacifist. The notion of not being able to kill, not being able to take someone else’s life, of turning the other cheek. Of being even handed. It’s a very interesting religion

01:19:00:00

the way they run their services. It’s very communal, anybody can have their say, everybody’s allowed to have their say and while there is a leadership hierarchy as I saw it, as a youngster, it really wasn’t an overt leadership hierarchy, it was very inclusive and I – to a little extent I think about my management style and how I run things and some of that really rubbed off on me, just the way they managed themselves

01:19:30:00

as a group. But it was very much the philosophy of being a pacifist, why take a life? And that had a profound impact on me, later –when I served operationally it really made me, at the end of the day I really made decisions about myself, on operational service that were quite clearly tied with that philosophy that had come from my younger days.
And why did you go to that school?

01:20:00:00

Because it was the best school. It turned out good students. Having come out of a public school, a very small public school in the middle of Tasmania where the standards were low, my parents were very keen to ensure that my sister and myself got the best education we could, they were very keen for us to go to university where they had both really struggled. Dad had gone through night school to get his diploma at the time.

01:20:30:00

They wanted for us to have a much better chance and at that time Friends School was reputed to be the best school in Tasmania. And from an academic point of view, I have no doubt that it set me up where I had struggled, when I started there I had to repeat a year and I struggled through a few years, but gradually picked up my grades and by the time I went to the public school, Elizabeth Matric, I got my Commonwealth scholarship the first year round

01:21:00:00

and only did my second year at Elizabeth Matric because it was felt I was a little bit too young to go to university and so they really did give me an academic grounding, but they stayed with me for the rest of my life. A grounding of industry, to study. And yeah, – I found, from an academic point of view, it really set me up.
Just going back to your primary school days, where was

01:21:30:00

your family home?
We lived in Tarraleah, it’s a little settlement in the middle of Tasmania beside two mighty power stations, has a ring road around it and we lived in one of the houses on that ring road, the school was in the centre of this ring road and by ring road I mean, several kilometres around,

01:22:00:00

so my sister Kris and I would walk to school and can recall during winter time, walking through the snow to school and those sorts of things. It was a really interesting upbringing. Not always pleasant but my father was the boss. So there was the antithesis of often between some of the children and my sister and myself about the boss’s kids versus the worker’s kids, so there was some of that interplay at times. But it only occurred some of the time.

01:22:30:00

And still have a lot of very fond memories of those formative years living in the countryside, being taken fishing, trout fishing and fly fishing, and just walking in the bush. Because my father was responsible for all the dams and canals around there, going out with him and just seeing the wilderness, it was just really remarkable part of the world.
So you lived quite close to the

01:23:00:00

a dam?
The power stations at Tarraleah, there’s one on either side of the valley that run right down into the valley and the township was built up on a plateau that abutted the first big pipelines that ran down the power stations that were at the bottom of the valley. So there’d be times, like we were pretty much free range then and kids would just go off and do things and it’s very safe. We’d walk around and

01:23:30:00

kind of walk up to the edge of the pipelines and look down this huge valley at the power station below. Walk on the pipeline sometimes. Breaking all the rules, kids do that. It was just a really interesting place to be brought up. It was tough to some extent, it was good for my sister and myself – we were forced to spend a lot of time together, miserable weather in the wintertime,

01:24:00:00

spent a lot of time inside – kids would play up, we’re pretty fortunate that we get on well together. So it actually built the bond between she and I that sticks with us today too.
So this was quite mountainous countryside?
Yeah, in some areas, the plateau of central Tasmania is just that, it’s a plateau with deep ravines down to river

01:24:30:00

gorges. Some mountains, we really didn’t do any mountain climbing or any hiking through mountains or anything like that. I can’t remember doing any of that sort of thing, it’s pretty rough country though. Like, you’d get off the road within a hundred metres, it was virgin bush, Tarraleah’s – might know the book, “The Sound of One Hand Clapping.” That was based on Tarraleah, and the single men’s quarters at the back of the village. I can recall times when there’d be a bit of strife

01:25:00:00

in the single men’s quarters. And Dad’d say, “Going up the bloody single men’s quarters, get the cops.” And they’d be up there, they’d be shooting or something and there were times when the lads would bring the prostitutes in for a weekend and it was still pretty rough and ready sort of town. And I still have recollections of that, that book was written I guess about a time five or ten years before we were there because that was at the era when they were building the dams and pipelines so it had moved on

01:25:30:00

a little bit, but it was still pretty rough and ready.
So what sort of house were you living in, a brick house?
No, wooden- fairly small. Three bedrooms, open fire. I know that in winter time it was bloody cold when you went to the toilet. Yeah. So it’s – it was a nice, pleasant place, everybody had the same.

01:26:00:00

So, yeah they were fine.
And was the toilet inside?
Yeah, it was. Yes, that was the only saving grace.
How did you manage to get through the winter that was during the cold weather, what did you do?
Television started and years later my sister and I could recall pretty much every old British film ever shown. And we knew

01:26:30:00

them off by heart because that’s all they’d show. All Saturday and Sunday, and we used to watch the old films, yes, so there was a lot of that. I don’t know we just played, we were just kids just playing and just a couple of us, we might have a couple of friends over , but it was all pretty much indoors sort of stuff.
What was your mum like? What sort of character was she?
Yeah, Mum was a mum, she wasn’t a working person.

01:27:00:00

Although years later she went back and did a degree in education, and became a teacher, when we moved to Hobart. It was a very social scene for families, like my parents they were always out doing things. There was a rifle club, so they’d all go to the rifle club shooting and they’d socialise and then there was a golf club – my recollection, it was a real whirl of social activities

01:27:30:00

around community.
Was she strict ..?
No I don’t think so, father was stricter. We had a fifth member of the family and that was my father’s mother. Who lived with us. Her husband died just around the time that my parents got married, and so we had my gran and she lived with us, right through until her early

01:28:00:00

eighties. There was always somebody in the family and she was I guess more of the matriarch, so while she wasn’t strict, she was the one who provided a bit of guidance to my sister and myself. Dad was strict, I think. My mother wasn’t, I don’t remember Mum being strict. My recollection of their behaviour when I look back was pretty much their behaviour was pretty much the norm of behaviour of parents that

01:28:30:00

I’ve heard or seen about of that particular generation.
And where did your Nan live, was she in the house?
In the house, yeah. So she was always there, she was always – like from my memory, she was always a member of the family, never without her. Think it must have been pretty tough on my parents, when I look back now, think about it, I think that was a pretty brave call on their part to have

01:29:00:00

a parent living with them for their whole life. Actually commend my father for that. And my mother, but a big decision to make, to keep somebody with you.
Could you tell us about your dad, what sort of man was he?
Where do I start? Dynamic.

01:29:30:00

Yeah, and I miss him. Can I take a second?. That was a tough one. I think because there was a lot of the time he wasn’t there because he was travelling, so he would only come down to Hobart on weekends. So it was for us, he was a really important figure for us, my sister and myself, and he wasn’t always there but when he was he was really important to us and

01:30:00:00

he’s always been a really important figure in my life. He had a lot of illness, which is really unfortunate for him, that really affected his life. He had a heart attack when he was 40 and a cardiac arrest three times. We thought he was going to die and that was a really interesting part of my life because I was a third year med student then – no he might have been 43, a little bit older - and I had really bad glandular fever, so bad they were going to put me into hospital, but no quite

01:30:30:00

and we recuperated together. I had six, eight weeks of uni, third year medicine, and Dad had come back from hospital with his heart attack and I can remember that every day we had an exercise regime and we’d walk one extra telegraph pole; and our mission at the end of the time was to get to the Beach House Hotel, which was a kilometre away, and have one beer, and walk home. So we spent

01:31:00:00

interesting time together. Through that. But because of his illnesses and I was always away, I was never home and it was one of those odd ironies of life that really bad things happened to him when I either couldn’t be contacted or I was in some awful part of the world. I can remember with a major military exercise in 1989, I was in the Northern Territory and that was the time of the airline strikes and Dad ended up with some cardiovascular catastrophe and was

01:31:30:00

in ICU [intensive care unit] and I couldn’t fly back. But where I was I was able to patch through from radios to phones to him in ICU and to talk to him; but it was pretty sad that that kind of kept happening and I was never there. We talked about that afterwards and he always said the last thing he ever wanted to see was me at the end of the bed.
And his job – you said he was a civil engineer?

01:32:00:00

Yeah. Civil engineer.
So what were his responsibilities..?
Well he was responsible for the maintenance of the power stations, dams, canals, anything to do with hydro-electric system in Tasmania. Based, as I said, in Tarraleah. I guess he had a staff of – would have been a couple of thousand. It was big business. There weren’t only the staff in

01:32:30:00

Tarraleah, they were in other places. Yeah it was a very responsible position he had. My recollections of it was a really full on job. And again, my recollections of my perceptions as a youngster, and seeing what other people thought about him, was that he was a really dynamic, kind of 'in your face sort' of leader that made things happen. And the stories I hear afterwards in

01:33:00:00

years gone by about him was always in a very positive light about his work and what he achieved there. He eventually left the Hydro and it was really to come to Hobart and settle. Moved into a job as a municipal engineer and really didn’t hit it off, it wasn’t his cup of tea. Did that for a couple of years and he eventually went back to the Hydro based in Hobart, and moved into a senior management position there.

01:33:30:00

And that saw out his working days. He was always a company man. And always a Hydro man. The thing about Tasmania ,that’s a pretty significant statement.
When your family took the decision to move to Hobart, how did you feel about that? Knowing that he would have to stay?
I don’t know

01:34:00:00

as a youngster, it was tough. Only in the separation, I didn’t see anything bad about it. For me it was very much the education and even as a youngster I understood what we were doing and why we were doing it, the fact that this was to allow me and my sister to go to school so it had been well explained to us

01:34:30:00

I didn’t have any real difficulties with it. I can remember every Friday night, Kris and I would sit outside the house, counting the cars. “Is this his car? Another fifty cars.” That sort of thing, waiting for him to turn up. Obviously when you look at that sort of recollection – this is really important to us, "Here comes Dad".
So he was able to come..?
Yeah, he drove down every weekend. It was a two and a half, three hour drive – it

01:35:00:00

was a fairly taxing drive, the roads weren’t sealed at that time, but he’d come down every Friday night and drive back every Monday morning, so we saw him all the time – with that respect. And come school holidays, I don’t think my sister did it as much as I did, but I’d go up and spend school holidays with Dad up at Tarraleah. And just kind of little kid hanging out with his Dad. Really good. Threw me in the back of the car and he’d go around and look at the dams and do all this sort of stuff yeah.

01:35:30:00

So, from that point of view we still had plenty of contact, plenty of social interaction. Probably better than other families because – you know the intensity of once you’re separated once you get back together again, a little bit more commitment to do things. And I know we would always do lots of things.
And would you go fishing with him?
No, my Dad wasn’t a fisherman. But Dad had a lot of friends who were fishermen.

01:36:00:00

And they’d take me out. Which was good. Dad was into other things, but my father was an interesting man. He always had different sorts of hobbies. He had a bit of an arty bent to him and at one stage he got heavily into painting, still got a couple of his paintings, and he was a pretty good artist. Got into amateur films, little 'super 8'[8mm film] cameras and he did that for a number of years.

01:36:30:00

I recall my sister and myself being trotted out. “Okay, you’re going to be actors.” “Dad’s going through a filming phase.” So we’d be kind of child actors for my father, so we went through that. And then later in his life he got into sailing. Bought himself a reasonable sized yacht and sailed off-shore so he was always doing something really different. Very eclectic group of hobbies that he followed.

01:37:00:00

Which was good.
Were they religious, did religion play any part in your childhood?
Dad went through a religious phase. And I think he probably did it for us, Church of England, and he ensured that my sister and I went through the communion sort of stuff with the Church of England and that would have been just after we left Tarraleah and just started at Friends.

01:37:30:00

And he went to church every weekend and did the whole thing. Which was really interesting because up until then, religion really hadn’t played a part in our lives and for that short period of time, it did. And I think afterwards, Dad went to church a little bit, but from a family point of view Christianity really didn’t play a significant part, other than for Kris and I, “Yes we’re going to go and learn the stuff, right we’ve learnt it, you’ve done that. Tick

01:38:00:00

move on, they’re okay. They’re Christians now.” Sort of thing. And that was about the only part it played. From my point of view, it really didn’t influence me at all and we talked about the Quaker influences that came up later, from a religious perspective, I found them much more profound, but again, it was still wasn’t so much around Christianity but it was more around a philosophy of life and I think that’s probably what I got out of the Quaker education and the Quaker religion, it was more a philosophy of life

01:38:30:00

rather than a religion, and what religion means to me. I’m an atheist, I guess some of the things I’ve seen and done, I stopped having a requirement to believe in a God that’s vested in all the religious notions, and things like that.
So you went to a high school at the Quakers' school, did that set you apart from other kids in the neighbourhood?

01:39:00:00

It did, but because of geography. We lived in one side of the city, and the school was on the other side of the city and I used to commute, so there were always two buses, so the other kids in my neighbourhood actually didn’t go to the same school. So that did to some extent, socially isolate us. My sister spent the first couple of years at the local primary school which was just over the road until she started at Friends as well.

01:39:30:00

So through her, we ended up with a bit of a social network. During those years, I guess I was somewhat socially isolated and mainly through geography, it was very difficult to go and socialise with the other school kids because most of them lived around the school.
So during your high school, what sort of subjects

01:40:00:00

did you become interested in?
History. I enjoyed the arts. I can remember at Friends we had a choice between, at one stage art or woodwork. Wayne chose art, didn’t go for the woodwork. So I guess that was, not so much my father’s influence, but I think it’s probably that genetic code that saw me move down a similar sort of path.

01:40:30:00

I did art, French, history, I backed it up with all the sciences, the maths and the sciences. And when I went to matric [matriculation, university entrance] in the first year round, did all the sciences, physics, chemistry, high level maths, but I did history and geography as well. I got my grades out of the sciences to allow me to get my Comm [Commonwealth] Scholar [Scholarship] and pretty much choose whatever I wanted at university. Enjoyed the history and geography and my second year I did history, geography. And it was an interesting dilemma for me about what was I going to do next. And father was very keen, “Wayne, you’re going to go to university.” Yeah, right, I can take that as given. What am I going to do? And it was pretty much, okay, you either do engineering, law or medicine. And that was pretty much what spun out in those days. Law, I wasn’t particularly interested in, father was an engineer, wasn’t going to do that, so medicine was kind of the third choice.
Interviewee: Wayne Ramsey Archive ID 2461 Tape 02

02:00:31:00

Your aspirations to go into medicine, when did they develop?
Only when I had to make a decision about what I was going to do at university and as I said, there were limited choices that were obvious choices, engineering, law, medicine and out of those I discounted engineering,

02:01:00:00

my father had been an engineer and I actually didn’t want to follow in the engineering footsteps, not particularly interested in law which is interesting because now, law does play an interesting part in some of the work I do, but I couldn’t see myself as a lawyer. And it was really medicine – not so much a default but yeah, medicine’s what you do. But it was more the discounting of history with it, was interesting for me because I did very well at it – got the prize in history and stuff like that. And

02:01:30:00

it’s a sad irony that I had a talk to my history teacher, about, “I’d love to do history.” And he said, “Oh Wayne, you don’t want to be a bloody history teacher, don’t do history.” And for that reason I didn’t do it, didn’t follow it through. And now I reflect, if I’d gone down that – there would have been so many other things you can do and my sister has a young daughter, who was going through reflections about what am I going to do? And she was doing an arts law degree. And really interested in history.

02:02:00:00

And she said, “Oh I’m not going to do that one, because I’ll do law and get a job afterwards and I’m not going to really follow the path of the history.” And I said, “You’re mad.” And she said, “Why?” And she said, “Oh, I’ll just become history teacher.” And I said, “No, no, no.” So I told her my story and then said, “Well there are other things you can do with history.” And so I rattled off a whole raft of things you can go to if you follow through with history and.. “Okay.” So she’s doing history now, which I think’s good. So that’s how I ended up in medicine.

02:02:30:00

Then it was really interesting because it was difficult to get into medicine in Tasmania, small school. And the selection process was a pretty tough one. What they did was, you had to be selected so you had to have the equivalent of a Commonwealth scholarship to start first year, and there were 108 of us and the selection actually occurred at the end of first year and they took 36 – there were 36 places so we had to do

02:03:00:00

five general science subjects, well I can’t remember now, chemistry, biology, I can’t remember, a number of others, and it was those subjects that were used as the measure and the grading you got out of them to get into second year medicine. So I came in 32nd so I did pretty well, and from there then medicine started. So that was the first of three undergraduate

02:03:30:00

years the three pre- clinical years, three clinical years, and away we went. Struggled through the first three years, it – medicine is high volume, it’s just a lot of what I call, dross to learn and one of the things I’ve realised these days is I’m now a kind of a part-time academic, is the poor way medicine was taught. Like here, you must learn

02:04:00:00

all of this. Why? What’s the point? You’ve got text books, why do you have to know the anatomy of the body – most of the parts of the anatomy of the body I’ve never used. So it was a real volume overload of just rote learning. Struggled through that. I didn’t really enjoy it all that much. And then came into contact with patients and really understood what medicine was all around. And from then on, I’ve had a passion for it, although I very quickly realised through my medical career that I preferred

02:04:30:00

what I call population health, rather than the health of individuals. And at one stage I was considering becoming general practitioner and decided that just wasn’t for me. And it’s interesting, people say, “Oh but you’re just in management.” I say, “Yeah but in management I’m managing populations.” And when I was running a hospital I was actually looking after 500 patients in that hospital, so my bent is always around systems ensuring

02:05:00:00

a group of people get the right care. I don’t provide individual care, I care for groups of people, and that was pretty much the approach I took through the military as well, that I was always interested in running hospitals, running health care systems. My philosophy has always been around why am I doing this, is to provide health care to a group of people so I’ve never seen myself as a health bureaucrat and I think ultimately that’s why I’d left the Canberra hospital

02:05:30:00

into the job I’ve got today. I was being sucked into worrying about finance, and even through my military career I always found that pretty tedious, the management bureaucracy of finances and this and that. I was always interested in the quality of care, the skills of people, the competence of people to do the job, so that you would provide an appropriate quality of care, standard of care. And on a number of occasions I’ve reflected back on papers I’ve given during the years, it’s really interesting, it’s always been around health care

02:06:00:00

systems and the quality of care, standards of care. Never around health care funding and operational models and things like that, so I guess that’s where I’ve ended up today, still with that focus on health care systems but in the delivery of care to populations. So that’s how my bent in medicine is applied.
So

02:06:30:00

you left school and you started your medicine degree. And where did your CMF years fit into that?
The last year of matriculation, and the first couple of years of medicine, I was in the CMF. So that was 1969 through until ’71, ’72. The year, I got out of the CMF the year before the Vietnam War finished so I was in the

02:07:00:00

second last national service ballot in ’72. And I was a second year, third year med student at that time.
So why did you join the CMF?
Knew a couple of people who were in the CMF and it was more to do something different. It was a job, a part- time job and I don’t

02:07:30:00

know, must have seen ads on the television or something and there was a barracks not too far from home, it was in the middle of Sandy Bay, it was a simple drive. I wanted to go into a signals unit, I’m not really sure why. When I went to a recruiting centre they tried to push me into signals in an infantry unit and I thought, “Oh no, that’s not good, not going to walk around carrying a radio on my back all the time. I want to go - trucks need radios.” So I moved into the signals squadron – bigger radios and moved them round on

02:08:00:00

trucks and Land Rovers [4 wheel drives] and things like that. I don’t know, a young fella’s fancy to do something different. And we did, went on all sorts of exercises in and around Tasmania; it was, a really enjoyable time, really enjoyable. And I think it was the fact that I enjoyed it so much was probably enough of an impetus a little while later for me to say, " I didn’t mind that army life, I can put up with it for a few years, when I graduate from medicine".

02:08:30:00

So had you been a boy scout or anything like that?
No, I hadn’t done anything like that. No. Not at all. It was interesting too, like we were talking about coming out of a Quakers' school and then moving into a military environment, I actually never saw it as the military environment, go out to shoot and kill people. We used to play with radios and drive around and spent a little bit of time on a rifle range – but it was always, from my point of view, my

02:09:00:00

recollections a very benign environment, it never really felt like, “We’re going to war," or anything like that. It wasn’t much; it really never had that sort of focus or feel about it. And when it came time to make a decision about where am I going to get some money to put myself through the rest of medicine, – for me it was a pretty easy decision," I’ll join the army, that’ll be okay"
So when you joined the CMF in your last year of high school were

02:09:30:00

you receiving any pay?
Yes, yes. It was okay, it was as good as being a barman, which was what some of my mates were doing. Like so for me it was, okay this is my part-time job and as I said, I used to do my hundred days a year so that went right through the Christmas holidays I worked for the CMF. And then there were the odd weekends during the year but not a lot, so

02:10:00:00

what allowed me was I didn’t have that onerous part-time work commitment during the year, because I was able to do it during all of the holidays.
And you said that you did drive trucks around as well. When did you learn to drive?
Well, driving trucks with the army you have to have an army licence. So I did all the army courses and drove big trucks, it was really good fun, yeah. And it was kind of, it was just good fun, it was kind of

02:10:30:00

it wasn’t taxing at all. Intellectually taxing, I think that’s what I enjoyed about it, it’s just good fun driving a truck. And you don’t have to worry about anything and I was a uni student, I drive a truck. And I eventually got promoted to lance corporal, and I can remember they wanted me to go off to officer training and do all these sorts of things but I don’t want to do that. I’m not particularly interested and I couldn’t see how I was going to fit it in with medicine and with my study, it was never programmed right that their courses would always occur during term,

02:11:00:00

so there was no way I was going to do it. And I wasn’t particularly interested in doing it anyway. For me it was just a pretty fun part-time job, that allowed me to do, not mindless things but things that weren’t all that intellectually taxing. And completely different from medicine. From study.
This was a time of later in the Vietnam years when..
Yeah, this was right towards..
When the public opinion and

02:11:30:00

the tide had turned. Did that affect you at all?
Not personally. No. And in Tasmania, very conservative state, there were a couple of marches I recall that were anti war marches but I can’ recall an instance where anything was said or done that involved me and anti war – I can remember I always wore my uniform

02:12:00:00

too – when I was going to parades and things like that. We didn’t have any qualms about being seen in uniform, so there was no real negativity – quite a few of the people in the unit I was serving in had served in Vietnam and there was still regular service people there who had come back just from Vietnam, so there was a lot of understanding of what the Vietnam war meant to the Australian military. Which I found enlightening.

02:12:30:00

But there was no serious antithesis to the war. I think everybody appreciated that we shouldn’t be there and it was, amongst the servicemen who’d been there, they’d say, “Stupid war, don’t know why we’re doing this, we’re not going to win it.” So there was very much that attitude. But there wasn’t the same negativity that was occurring in other parts of Australia. I can’t recall ever feeling that.

02:13:00:00

Which is interesting.
So then you left the CMF, continued with your medical studies?
And was still living at home. And into my early twenties and receiving pocket money from my parents and I thought, "This isn’t right. This is not right, I’m going to have to do something". And

02:13:30:00

it was a decision about, "Okay, do I get a part-time job?" and medicine is a very taxing demanding sort of study, and I saw some of my friends who were doing it and they were kind of working pubs on a Friday, Saturday night, and I thought, "There must be another way, there must be an easy way." The army were advertising for undergrads, and it was a really simple solution for me. They sponsored me through the last couple of years of medicine, I was

02:14:00:00

able to move into the officer’s barracks, officer’s mess in the barracks in Hobart. There were only two or three of us living in, so it was a really quiet environment. I was able to study there, the couple of other fellas that were living were nice guys. So for me, it allowed me to not only earn money also allowed me to move out of home and had the social network that came with the mess environment.

02:14:30:00

So it was really good. Through the army, through the director of med services at the time, Dick James, I was able to use my elective term to go to England and stayed in London, spent three months over there, with the British Army in London and down in Netley to a psych hospital, so I was able to use the military to do things that I would never have been able to

02:15:00:00

have done any other way. So for me, those couple of years, those sponsored years, worked out really well and it was really- not a godsend but it made those couple of years of medicine, much easier.
And what had your mum and dad thought of you and your military interests and joining the regular army?
I think they were quite happy that I did it. I don’t think they had any qualms about me doing it.

02:15:30:00

They were very supportive, it was my decision. And I can remember talking to them about it, “I’m going to do this.” I remember they were both pretty happy with it, neither of them had any difficulties with me making that decision. So it was quite supported. I think they could understand my rationale, and accepted it. Maybe they were happy for me to leave home.
Where was your barrack, in Hobart, whereabouts was that?

02:16:00:00

Right in the centre of the city. It was only a ten or fifteen minute walk to the hospital to Royal Hobart, so it was a really great location, right next door to the old DVA, Department of Veterans Affairs Hospital, and I remember we used to have a term where we’d go up to that hospital and it was literally next door, so I’d get my group afterwards and used to finish early on – might have been a Thursday, and we’d go over to the officer’s mess and we’d play billiards on the big billiards table. So we thought it was pretty good.

02:16:30:00

And it was interesting too because none of my colleagues through medicine had any dramas with it. It was all, “Okay, Wayne’s decided to join the army, that’s his business.” And we just got on with life. So it was interesting, it was – the whole thing was quite benign. And when you look back as we were reflecting on this now – I guess it’s surprising isn’t it, that the time of Vietnam and not long afterwards

02:17:00:00

and the real antithesis that people felt about the military that at that time, and in Tasmania it really wasn’t an issue. Not that I felt.
So you didn’t get any stick from other medical students?
No. No, I didn’t. Not at all. I know in other parts of the university people did, but yeah, not through medicine. I think that’s because we were a fairly small group, as I say, by second year, only 36 of us and we – as a

02:17:30:00

small group you know each other really well, and we were living in each other’s back pockets all the time, like during our clinical years, we would spend half the year away from Hobart in other hospital and there’s a group of eight or ten, we just lived together all the time so it was very much, “That’s your career decision and away you go.”

02:18:00:00

So when you graduated from medicine do you remember your graduation?
I sure do. Yep, it was great. It had been a long hard slog and I’d failed second year so I had to repeat a year. And it was partly because as I said, after first year in, in second year you’re in so we all had a pretty comfortable time in second year. Partied pretty badly. And paid the

02:18:30:00

penalty for that. So I was always kind of, "okay you can’t afford to stuff up again, put your head down and slog away," which is what I did. So I was yeah, at the end of it, it was a good feeling to know that I’d actually achieved something that was pretty profound for me. I can recall going back when I left Friends, the headmaster had said, “Oh well you’re making a bit of a mistake leaving here and you’ll never get to university and you’ll never be able to do this or that.” And I’m thinking, “Stuff you!.”

02:19:00:00

"Look at this mate, I finished medicine." Yeah. So it was a good feeling to know that I’d got through and had achieved that and then really to think, "Okay, well where to from here?" And I knew that in the military I needed certain sorts of exposures and practical hands on experiences, and that’s why I made the decision of going to Launceston for my internship and residency; it was the second hospital behind Royal Hobart so it was slightly more

02:19:30:00

smaller hospital, much more hands on, I knew the residents there, I would get a lot more practical experience which is what I was looking for because I knew that from there I was going to go into the military for a few years and I’d be expected to be able to do a lot of things and work autonomously. So I was keen to make sure that I was as well rounded practically as I could be. And that’s the way it panned out for me that at Launceston, those couple of years, were really full on, like we worked really long hours, it was just

02:20:00:00

they were the days when I can remember there was one stage –they were doing a census. So this census woman came round and I ended up on one of their lists that they were surveying, had to fill in the number of hours we were working, she came back and on the last day and she said, “This one can’t be right.” I said, “Why?” She said, “120 hours, nobody can work that.” I said, “Yes, I did.” The shortest working week we would have is 60 hours. Our average working week was

02:20:30:00

80 or 90 and then the bad week in the month was usually around 100 hours and that was working and it was just so full on.
Was this casualty?
Well, most of it – you would do your normal term, so that would be your Monday to Friday, if you were on surgical term then you’d go and take over the weekend and you’d just work the weekend through. And then the following week you’d be back on work, but just not on call and then

02:21:00:00

on top of that you would be rostered on for casualty. The hospital was short of doctors so it meant the rest of us had to work longer. And it was just a really intense experience. Made mistakes and also learnt a lot. It’s not right, you shouldn’t work those sorts of hours. It’s interesting today to sit back and look at how the young doctors today are training. I’m actively involved in that, now it’s an interesting dilemma that we’ve got, about

02:21:30:00

having to increase the amount of training they do, to actually get the same experiences. So for us, it was all compressed, but from a health and safety point of view, really bad and counterbalanced that against the increased length of training to turn out a similar sort of product. But some of the things we did, again without supervision, or minimal supervision, just wouldn’t occur today – would not

02:22:00:00

happen.
So, you were still in – this is an army posting?
No, well at this stage, I’d taken leave without pay, and the military were prepared to – you only had to do an internship one year in hospital and then at that time, you were fully qualified to practise medicine. I’d made the decision that I actually wanted

02:22:30:00

to do a second year, to ensure that my skills were adequate to do whatever I was going to do into my future life. The military pay was significantly less than the hospital pay, and by the time I put on overtime, and that was only quarter time overtime, not time and a quarter, it was a huge difference in money. So I applied and got leave without pay for the first year and rolled it over into the second year. Eventually the military changed

02:23:00:00

their remuneration formula to allow people who were in my circumstances to keep the difference between one or the other, it was just a stupid anomaly. I was pretty angry about it. I put in a redress of grievance because it just didn’t make sense to me. Just arcane bureaucracy that was forcing me to do this. And it actually had significant financial detriment to me as well. I didn’t realise at the time, it impacted on superannuation,

02:23:30:00

long service leave, all those things, it’s just stupid. Early in my career, I’m a classic, "yeah here goes the military" and through my whole military career saw so many of those stupid decisions and you think, God, huge industry, why can’t they get some of these things right? And it was a classic right from the start, "No, didn’t get that one right".
So at the end of that two year internship why were you still interested in going back to the army?

02:24:00:00

Well, I had no choice, I could have bought myself out but I actually, I never considered that. As far as I was concerned I’d made an obligation that I was going to do this and I decided to do it. And it would have been interesting to have seen where I’d turned out, because in my second year I spent most of second year working in a critical care area. First term was in general practice and then I did three months of anaesthetics and then eventually did six months of intensive care

02:24:30:00

and really enjoyed it. I can remember the consultant there was saying, “Wayne, do you want to stay on next year as a registrar, intensive care, one day’s going to be faculty specialty in its own right. And you could get into that and….” It was really, oh I really love this and I still do, I still have a real interest in critical care and how it works. But as far as I was concerned, “Sorry, I have an obligation, I have three years of service.”

02:25:00:00

And that was it. And I really – I never really thought twice about buying myself out and I didn’t.
Now you’re out making mistakes, as you say. When you reflect on some of those mistakes what were they connected to?

02:25:30:00

I made two significant errors, in my two years, that I recall that are stand-outs. One was an incorrect drug dose, medication error, drug was vincristine/vinblastine. Similar names and the dose for one was one tenth of the dose for the other one. And so Vinblastine my recollection is, you should give ten milligrams

02:26:00:00

and the other a tenth of the dose. But one drug is much stronger than the other one, and I got the doses back to front. And that ablated the patient’s white cells and for about a three week period, I was on a cancer unit at the time, I sat and watched this poor man nearly die because I blocked all of his white cells. Interesting because here I am today, looking at systems issues around quality and safety

02:26:30:00

and at the time, as far as I was concerned I just made a mistake, like stupid, stupid error, but what you’d do today, is you’d say, “Why was that error made?” And from a systems point of view it’s really obvious, like drug with a similar name, drug with similar doses, easy to make the mistake, what would they do about that today? Change the label, change the name of the drug, change the dose so that that error wouldn’t occur, it’s not as if I don’t

02:27:00:00

reckon I’m the only person that has ever made that error. There’s a systems problem there, and today what I’m about is, okay if an error occurs how can you fix it? The other one was a mistake, the other one was around a little kid who had a fall, head injury and I looked in the ear, but didn’t test the fluid coming out of an ear that was a CSF [cerebal spinal fluid], fractured basis skull. "Wayne, that’s a mistake!".

02:27:30:00

Individual error, and it was a mistake that I made. I didn’t do everything, I didn’t follow the protocol that should have been followed with that particular patient. Fortunately the consultant on call saw the patient the next day, and he did the right thing. Called me down. “Wayne, have a look at this, this is the mistake you made.” So it was a very positive way of dealing with what was a clear cut individual error. He closed the loop really quickly. So again, I reflect on that from a

02:28:00:00

systems point of view, about the right way of dealing with individual error. So you make mistakes, errors occur these days I think about, okay, how can I stop that happening for the patient or for the clinician who’s practising. I guess partly it was around the responsibility of providing individual care that I struggled with, I found it really emotionally taxing, having to make all these individual decisions all the time.

02:28:30:00

And I didn’t stop practising clinical medicine because of that, and through my life up until the time I was posted to the field hospital I would always maintain my clinical skills, always spend weekends in ED [emergency department] the public hospitals, to make sure I could do what was expected of me in a military setting. I was happy to give up clinical medicine and people say, “Don’t you miss it?” And I say, “No

02:29:00:00

not at all.” I have a different career and I’m following a different path of medicine.
So after your internship you were back on the payroll of the regular army and you went to Puckapunyal? How was your time at Puckapunyal?
Fabulous, it was, yeah it was a really great time. First Armoured Regiment as they would say, "The premier regiment in the army" and they acted

02:29:30:00

like it, their view was, “We’re the best.” And they were really good, they were highly professional, and a really great bunch of guys, and I had a fabulous two years there, I’d been there for about six weeks and discovered that they were going to send one of the squadrons to Germany. I inveigled my way onto it so I spent a couple of months in Germany with a tank squadron on exchange with the British Army on the Rhine and did all sorts of really interesting things, that’s really where the adventure of the military

02:30:00:00

caught up with me. And it was just really great fun. We went on adventure training – I went out with the recon [reconnaissance] troop and we took Land Rovers through the big desert in sunset country of Northern Victoria into New South Wales, South Australia. It was just amazing sort of thing, places to go and that’s just the sort of thing that you did. Did a series of military courses, some of them fairly benign mundane, others

02:30:30:00

interesting, it was – yeah, just a very enjoyable lifestyle, interesting medicine. Responsible for the regiment that was five or six-hundred soldiers and officers, so responsible for their primary health care. There was a small military hospital there for any of them were sick, I’d look after them in the hospital. So from a medical point of view, it was pretty interesting as well. It was not complicated

02:31:00:00

young people, if they get sick, pretty obvious what’s wrong, they don’t have the (UNCLEAR comb?) morbidity, so you don’t have the worries of complicated medicine, so it was from a medical point of view it was simple but interesting. Bit of trauma, we’d be on call for the area, vehicle accidents and things like that so – bit of trauma call. I enjoyed the medical side, enjoyed the military life.

02:31:30:00

You’re a medical man, so how much of the military duties did you have to..?
I did medical duties. Figured that out pretty quickly in my life that the best way to do it. It’s a real dichotomy being a doctor, being a medical person in a military environment, and it’s a fine line between, am I here to care and cure or am I here to kill?

02:32:00:00

And I think a lot of medical people don’t articulate it in their mind of "What am I here to do, of where do I sit? Which side of the fence do I sit on?" It was interesting to see how I fluctuated through my career about where do I sit on the fence? Now when I say on the kill side, not so much in kind of the hands on killing but I was always interested in military history

02:32:30:00

at staff college. I did very well at staff college, eventually selected to be the enemy commander on one of their big war games, so I was the first medical person to ever do that sort of thing. For my infantry colleagues they were all really miffed that, "Why is a doctor doing this?" Well for me it was just tactics were interesting, how do you manoeuvre tanks and these sorts of things. But for me it was all pretty much a game. And I always viewed it pretty much as a war game. And always took that approach to it. But

02:33:00:00

through my life I’ve always looked and thought of things, as an intellectual challenge. Okay, how do I do this? This is an interesting challenge, how do I address that challenge and it was more around the intellectual challenges and I guess that’s how I got through many of the difficult situations I’ve been in. When we talk about Rwanda we’ll come to that because it was, how did I deal with it there, it was actually how do you look after three million refugees? Well there must be some principles you apply.

02:33:30:00

Apply the principles. Okay, that’s interesting, that works. So that’s how I managed to deal with those sorts of things and that’s how I dealt with the military. But I’d have to say through my military career I started off as a doctor in the military and I ended as a doctor in the military, but in the middle I think I stepped over the line for a period of time-where I was more interested in the military than being a doctor. I guess that came around the time of

02:34:00:00

staff college, where a little bit before I’d done an infantry company commander’s course. Not too many doctors do that and came up with a certificate, ticket saying, "Rightio, you’re good enough to command an infantry company." Did an intermediate operations course, did very well at that, done a basic parachuting course, so I’d done all the military sort of stuff and was achieving really well, that’s probably – that’s one of the reasons why I was selected to go to Rwanda as the commander. I’d demonstrated

02:34:30:00

I had all these command skills and all of this military knowledge I knew I could apply, even in an operational setting. I was actually moving very much down the pretty typical military officer’s career, and my background was in medicine, and other’s was in engineering and other’s was in different things. But for a period in my career I think yeah, I saw myself as a military officer, and by the way, I’m a doctor as well.

02:35:00:00

As I reflect on that, it allowed me to do a lot of things, I achieved a lot, is it right? At the end of the day, it worked for me at the time. But as I said, at the end I actually finished up back on the side of the fence where I believe you should be, that is, "You’re a doctor in the army, you’re there to do good. You’re there to save lives – not just the lives of your troops, but other troops". So that was the real the hangover

02:35:30:00

from the Quaker, the pacifist around providing care. And again, we might touch on that in Rwanda, because there were circumstances there where it was my decisions were really easy about being even handed in circumstances where some would say, "No, you don’t treat them, they’re murderers," and but "No, you treat everybody, that’s our role in life".
And so did this leaning

02:36:00:00

towards the more military rather than the medical, play out when you were posted to Townsville, when you elected to go to Townsville?
Yes, that’s when it played out completely. From there, I was very much seen to be in a military role and the sorts of problems that were posed to me, it escalated my career. Very quickly because

02:36:30:00

I had this background and several postings happened in a very short period of time. Just because of my ability, my military ability, so the two years in Townsville, three years at the hospital and then straight in land headquarters on promotion. Much of that happened because of my military nous [knowledge] that I had. And the fact that I had a lot of street credibility, with the non-medical people, in fact my sponsors during my career were non- medical.

02:37:00:00

I can remember when I came up for promotion to colonel, I’d been cleared quite lowly, amongst the cohort of other doctors in the army but I was picked up over quite a few of my peers and superiors at the same rank and I know that occurred because of the military understanding of skills.
I’d like to reflect on that time

02:37:30:00

at Townsville and why you decided to choose that as an option?
A couple of reasons, I married when I was an intern and my wife’s family were elderly she wasn’t too keen on leaving Australia, and so there were personal reasons for not leaving Australia

02:38:00:00

from a military point of view. I knew that the operational deployment force in Townsville was the place to be from an operational exposure, experience, that’s where all the resources were, that’s where the best troops were, that’s where the best units were. And the unit that I went up there to command was a new unit. Part of it had been moved out of Brisbane, it moved to

02:38:30:00

Townsville, integrated with an army reserve unit and I went up as 2IC [2nd In command] of the army reserve unit and then OC of the ADF detachment of 3 Brigade, so this was a new position, a real challenge and I could just see that there were going to be so many opportunities out of going there that for me it was a no-brainer [easy], go to Townsville. And that’s the way it panned out. It was

02:39:00:00

a really exciting time to be there. Because we were new and committed to supporting the brigade, they were very keen to have us on board, we were only a small number, and only 40 of us, providing support to a whole brigade when there should have been three times that number and what it meant for us was that we would just go from exercise to exercise. I can recall that during one period, we went out with one of the

02:39:30:00

battalions on exercise. So we spent three weeks with them, and it was all up and down outback Queensland and that was just great. I drove from Mount Isa up to the top of the Cape and back over a few weeks. Came back, had a weekend off, went out with the other battalion and we went to the tropical rainforests of the Daintree, we spent three weeks in a rainforest. We were back for a week and then we were in

02:40:00:00

Shoalwater Bay with the whole brigade for another three weeks. And it was just full on, really intense and again, as a small group, we got on really well together, worked out how we should operate, kind of really proud of the work we were doing. Saved a few lives, and by doing that, built a reputation for being not only a good in war fighters terms, war fighting unit in

02:40:30:00

support of them, but also highly professional and doing the job that the warriors wanted of us to be there and to save lives. And that was pretty hands on. I was till practising clinical medicine at that time, while I was doing all that military stuff, every weekend – I did every Saturday in the Townsville Hospital in the ED. Whenever I was in town, I’d be there for a twelve hour shift

02:41:00:00

just making sure that my clinical skills were alright, that my acumen was there. And I saw – on personal professional development and training responsibility to keep my skills up and in the field, and saw all sorts of things. Treated malaria, soldiers coming back from New Guinea, really sick people. So it was, not a lot but really when it occurred,

02:41:30:00

it was acute, had to look after it properly.
Interviewee: Wayne Ramsey Archive ID 2461 Tape 03

03:00:31:00

What were the kind of casualties you were seeing coming out of those training exercises?
Vehicle accidents, always. Interesting medical problems, things that you might not expect. Indicated a case of malaria, every exercise we went on up there there’d be a case of malaria because the battalions would often have

03:01:00:00

troops rotating through exercises in New Guinea, and they’d come back and they’d stop taking their malaria, chemoprophylaxis or whatever, and they’d turn up sick, with high fever and all the other bits and pieces and it was really interesting because we kind of got used to it; and I relate stories to some of my colleagues, you know, “I’ve treated malaria in Australia, and I’ve treated it in the field.” And I know I’ve worked in large hospitals and somebody’s come in with malaria and they’ve admitted them to hospital and done

03:01:30:00

all this sort of really fancy stuff. And, they’ve only got malaria. And we were treating, I can recall we treated a number of cases of malaria in the field and we had a fairly basic pathology so we were able to make the diagnosis, and because we were comfortable with managing it and military is exposed to malaria, it’s one of those diseases that we’re aware of, so we have pretty robust protocols around managing it. So I was always comfortable managing malaria.

03:02:00:00

Did you have to do additional training in tropical medicine for yourself and your group?
Depending on where we were going, we would consider what sort of problems we might encounter. So we’d do some preparatory training around what sort of issues might come up. So if we knew there was potential that there were going to be infective diseases, tropical diseases, then we would consider what to look for.

03:02:30:00

That’s how we would prepare for it. Probably the most vivid case that I personally managed - we had soldier who, the young doc who had seen the soldier thought he had malaria, transferred him back to the treatment section where I was, I was there by myself in – I was the only doctor there, my offsider was off somewhere else, so I came back late at night and I looked at him and I thought, "This isn’t malaria, he’s much sicker than that".

03:03:00:00

And he had meningococcal meningitis. And he was profoundly ill and we put up the drips, put in the antibiotics and we were halfway between Mount Isa and the Gulf. Couldn’t move him at night and that next morning we flew him back in a [Pilatus] Porter which was just a single pilot plane and I went back with him – we flew very low because of fear of pressure effects on him.

03:03:30:00

And got him back to Mount Isa and he survived, which is pretty lucky. High mortality rate with the meningococcal meningitis anyway. So it was that sort of thing that we would do. What else did we see? No, I’d be guessing.
Were there many accidents with live fire?
A few. We didn’t see many. A lot of parachute accidents

03:04:00:00

and exercise at Rockhampton, we ended up with 30 or 40 speared in, fractures, head injuries, so parachuting would probably have been the – from our point of view – the most common way of ending up with large numbers of casualties. And then followed by vehicle accidents.
And also while you were there in Townsville, you were a part of a potential deployment to Vanuatu.
Yeah, that all happened around the same time as

03:04:30:00

Fiji. I think the Fiji deployment occurred one year and then the next year – there was a coup in Vanuatu and the government seriously considered deploying troops. It was so seriously considered that at one stage we were on four hours' notice to move, confined to barracks and had our equipment packed and on the back of aircraft. It was really interesting because this was all supposed to be super secret and nobody in Australia

03:05:00:00

was supposed to know that Australia was going to send troops to Vanuatu, and all the families knew. They lived in Townsville and they’d all drive past Garboard Airport all the time and they all saw all the planes lined up so, so much for security. It was interesting though, I guess because it was a military town, nobody said anything. So it never got onto the press that actually the military is ready to go. And that deployment didn’t occur. It was one of those, it was a real let down, because we were all ready to go and I had my seat on the first plane

03:05:30:00

with the brigade commander, I was there to do the medical reconnaissance to identify the hospital where we were going to establish ourselves.
What was the purpose of that deployment?
It would have been, in military terms today, I guess it would have been peace enforcement, we were there, it would have been a peacekeeping role to keep the warring factions apart to allow return of democracy and things like that. I can’t recall that we ever really had a clear

03:06:00:00

mission statement other than, "we’re going to go there and we’re going to stop what’s happening". A little bit like, the same time when they sent those ships to sail round and round Fiji because of the coup that occurred there. We were pretty naive in how to deploy forces in those days around these sorts of, what we would call today, peacekeeping missions.
What kind of preparation did you do for that potential deployment?

03:06:30:00

The infantry did a lot of work up around checkpoints, and the management of crowds and things like that. From a medical point of view, it was pretty easy for us, because we knew what sort of preparation we needed. But when I say, we were naive, we were poorly prepared as a military. We were going to send me and a medical unit some four flying hours away,

03:07:00:00

we didn’t have any surgical support, we weren’t going to take a surgical team. Because the Australian Army didn’t have a mobile surgical team at that time. So I can remember saying to the commander, land commander, health services in Sydney at the time. “Where’s my surgical support going to come from?” “Oh, you’ll be right, Wayne.” “Yeah, right, I might be right but what about the poor bugger who gets shot?” “We’ll evacuate them by air.” But in this day and age there’d be a really robust plan around that and

03:07:30:00

it really started to reshape the way our whole defence force was structured and equipped to allow us to do that sort of thing. So it was those really first formative steps into going to war again. Remembering that this was the first time anything had happened since Vietnam so it was, there was a whole operation who hadn’t had operational service.
That’s funny that there was no surgical team involved because I was about to ask you what kind of

03:08:00:00

casualties were you expecting, or how many?
Well, I was expecting a number of casualties, and so I’d done my planning and felt there was a possibility of casualties. The decision in land headquarters was, well yeah there’s medical services on Vanuatu now, so you can use them. But in this day and age there’s no way that you would go into a war zone relying on the civil infrastructure. That almost invariably is being kind of

03:08:30:00

decimated. So it was – yeah, pretty scary, I was amazed.
So when the deployment was called off and you didn’t go, did you take a step away to reflect on preparation..?
Yeah, we did and we put in a pretty caustic post- activity report around it and the sort of support that we thought would have been appropriate for that sort of mission.
And where did those recommendations go?

03:09:00:00

I was eventually posted to land headquarters as the colonel, land headquarters and we do a lot of work of our own around restructuring the way the Australian army’s medical services would do its business. So for me, it was a lesson that I learned, that I carried with me. For example, when I moved from there to the field hospital at Ingleburn I ensured that the field hospital, a very big organisation, very heavy to move – actually had the ability to deploy a light surgical

03:09:30:00

team on a mission and around that time, a parachute surgical team had been developed for 3RAR [ 3rd Battalion Royal Australian Regiment] I was – had responsibility for it as well. So we started to evolve, to make sure that we could support these sorts of missions.
So Vanuatu was a pretty big learning curve?
It was, yeah. For me too, it was really interesting because that was the first time we’d really got into the pragmatics of

03:10:00:00

operational deployment and it was prior to that, well you go on exercise and you take everybody and everything happens. But we were limited on aircraft, so what do you take? And eventually I was told, “Okay you’ve got this number of pallets, you can take this number of people. There’s no debate around that, that’s the size that we can give you because other people need their slice.” So I had to sit back and say, “Right okay, well that’s the case, what’re we going to take off and how do we structure ourselves to provide health care?” So we

03:10:30:00

did a lot of reflection about the capability building blocks of a medical unit, so what are the building blocks? What are the core elements that you can’t do without? And what do you leave behind?
What are those core elements that you can’t do without – looking at a deployment like that?
The ability to resuscitate a casualty. So a resuscitation team. So that’s

03:11:00:00

okay, somebody’s been injured, we can save their life by way of stabilisation, so that’s the first core building block. An evacuation team, so somebody who can move a casualty from A to B and provide them with appropriate medical care during that evacuation. A preventative health, everybody thinks about, okay, go to war you get casualties, the flipside of it is, it’s better to prevent casualties, than get casualties

03:11:30:00

so a preventative health team. Who can focus in vector control and knock down mosquitos, so you don’t get malaria and dengue and all those sorts of things. The debate we had was around support to resuscitation, so do you need support teams? By that I mean, technical support, do you need pathology services, do you need X-ray and they all come at a price. Because they have a lot of equipment. Not many people but a lot of equipment, and

03:12:00:00

it was really those sorts of trade-offs. How much additional medical logistic support do you take with you? What sort of a pharmacy do you have? Or do you take a risk? What do you put into your pharmacy? They are the sorts of decisions you make by way of that initial response and then sitting behind that, do you have a surgical team? Do you have somewhere to care for patients on a bed or a Stokes litter, so do you have the equivalent of an element of a hospital ward? So it’s

03:12:30:00

those sorts of building blocks, and the lesson that we learned out of that - we went on to implement through restructure the army’s land command health services - was identify those building blocks. Come up with a common building block, a standard building block that’s got clearly defined protocols and kind of procedures that drives it. And then bolt them together. And then once you’ve determined how many casualties you’re going to get, that tells you how many building blocks you

03:13:00:00

get, it’s all really simple but that hadn’t been done. So we reflected on that. Built our core building blocks, identified our core building blocks and then decided, okay, how do you bolt them together?
This was the first real deployment, it was only potential, but it was the first time that Australia was to be deployed since Vietnam.
Yeah, except for the Fiji where we had accompanied troops on [HMAS] Tobruk sailing around the island for four or five days.

03:13:30:00

So were you able to pull on the experiences or lessons of Vietnam?
No, we didn’t. Our military had, but from an operational deployment point of view, we didn’t. Our military had from a medical point of view, because we knew that malaria is a problem, so we knew about tropical diseases.

03:14:00:00

We knew about combat casualty care. So there was nothing new in that. And they’re the lessons that you recall – from every war, that’s the whole notion of medical history, military history so that you know what are the problems. But it’s more, how do you operate? And this was very different to any of the sort of operations that were occurring in, had occurred in Vietnam.
It was also a different context as well.
Yeah, well and by then, I’m just trying to think of

03:14:30:00

people in the brigade who had Vietnam ribbons, the brigade commander did. Think both the battalion commanders did, infantry battalion commanders, there would have been a smattering of others. Nobody with, none of the medical people did. So, there’s very little experience left by then.
You also mentioned there was a cyclone when you were in Townsville?
Yeah, interesting. I’ve been involved in the medical elements of disaster

03:15:00:00

responses my whole life. My whole career and kind of ended up here in Canberra a couple of years back with the [bush]fire storm we had here, where I was running the hospital and took up classic disaster response. And to actually – to be involved in a disaster, and a cyclone, I’d never been through a cyclone before, and to think about the response, how you go about that sort of response

03:15:30:00

and to be involved in the military preparedness for a disaster that was like that. The cyclone touched a little bit north of Townsville closed the town down. Was just, it was interesting, yeah, cyclones are interesting things to go through. I think because you have that build up, and then it hits and all of a sudden it’s stopped and it starts again. Totally different experience to a bushfire,

03:16:00:00

like bushfires, I went through the Tasmanian bushfires when I was a kid. Went through a bushfire in the Northern Territory with 1 Field Hospital that nearly burnt the hospital down and then the fires hit, bushfires come really quickly. There’s a bit of thought that there’s bushfires out there, and everybody, “Oh yeah.” Then all of a sudden, you’re in the middle of a bushfire and very quickly it’s all over. People think they last forever, no they don’t. A bushfire hits, stops and then you’re just left with devastation. A cyclone was quite an eerie thing

03:16:30:00

I think partly too, because they have a lot of cyclones up there, so you get "Cyclone Watches" so people would track cyclones, how far is it off the coast, which way is it going? It’s just a different experience.
Where were you when it hit?
We went home. Again, interesting approach. The brigades went down, everybody went home, and it was interesting philosophy that – look after yourselves,

03:17:00:00

look after your family and if the town’s devastated, keep looking after yourself, and others will come in and provide us with care. Interesting. Still not sure about that particular approach, especially having lived through the bushfires here in Canberra. We actually took a different approach at the hospital. Our view was, we’re here to provide a service, and we’ll provide a service, if you are afraid for your family then you can go home

03:17:30:00

and we didn’t stop anybody from going home, but we also had a lot of people who actually came into work, who wanted to work and we worked right through the bushfires, here and provided amazing service, like huge numbers of people who went through the hospital in about a twelve hour period. And without all our staff we couldn’t have done it. So it was an interesting approach. My thoughts were that the military probably would have had a part to play in the immediate aftermath. To stand people down

03:18:00:00

and not hold back some of the core elements. I was surprised.
So when the cyclone had gone through, who was there to provide support, if the brigade had stood down?
Yeah, I know, well that’s right
Did army come in from elsewhere?
Well the town wasn’t devastated, so at the end of the day we were never tested, we never found out was that the best approach or not. But that had been the standing order up there for a number

03:18:30:00

of years, that’s the basic approach that the military was going to take to a cyclone in Townsville.
So when was that? The mid-eighties?
Yeah, that was- cyclone I think was ’87. Either the beginning of ’87 or the beginning of ’88.
That is interesting because it’s just a natural response – with Cyclone Tracy [that hit Darwin 1974] the army went into it?
Afterwards, yeah, but came from without.

03:19:00:00

See, all the military flew up to Darwin, so the argument was, we will fly people in. I guess that the thought is, if the cyclone hits and we’re all devastated, then you’re just as devastated and anybody who’s been through a major cataclysm of any sort, can you function? Can you actually do your job? Again, from a military perspective if you look at lessons of war, the Germans during the Normandy landing,

03:19:30:00

stopped fighting. Because they were emotionally and physically overwhelmed by the catastrophe of being bombed. So they just stopped fighting. So if you think about that okay, if you go – if you live through a cataclysmic disaster such as a cyclone, are you actually going to be able to function afterwards?. Your house has been torn down around you and those sorts of things. I think it was probably that philosophy that came from military history that has been reflected in the approach that the military was taking.

03:20:00:00

After Townsville, you went to Ingleburn, what was your role with Ingleburn?
I was posted to 1st Field Hospital as commanding officer, so that was a posting on promotion. And 1st Field Hospital had been pretty badly run down, it was a poorly equipped, grossly understaffed and one of the outcomes

03:20:30:00

of a major review that had occurred into army medical services was that the operational elements needed to be boosted, so the unit that I’d been running in Townsville, with 45 staff, was increased to 125 to allow them to do the work that we’d been doing for two years with just 45, so numbers went there and they wanted initial numbers in the field hospital. The way they did that was by closing or changing the way

03:21:00:00

base health services were provided. So 2 Military Hospital – 2nd Military Hospital at Ingleburn - was sitting right next door to 1 Field Hospital, so the units were amalgamated so that staff who’d just been running the base hospital were posted into the field hospital, so that we had a field hospital to deploy, but the role then was also to provide support out of the base hospital – it was a really complicated mix about what’s your balance? Is your balance around preparing to go

03:21:30:00

to war on operations or exercise, or is it around providing base health support? So it was that kind of dichotomy of roles that we had to manage.
And with the amalgamation, was there some resistance?
It was huge. Yeah from those living in the base hospital. Because many of them saw it as a very cosy sinecure. That life was pretty comfortable, wasn’t all that hard, there were no hardships, they didn’t have to go out and do exercises and all of a sudden

03:22:00:00

they were being taken out of their comfort zone. Being posted into a field unit and there were all those expectations that yes, you will do all the normal military training that goes with being in a field unit. And then I guess, I complicated it by going in and saying, “And our raison d’etre is to be a field unit, that’s why we’re here, the role of the military is to go to war and support operations at war and anything that we provide in the

03:22:30:00

base area, is a secondary role. So I had a very clear focus that our primary role is the field role, the secondary role is the base role and I argued that what we would get out of the base role is training. That our medics, nurses and doctors day to day, would have a job to do to maintain their clinical skills and they would get that at the base hospital or other hospitals in the area, built an arrangement with Liverpool Hospital so that we’d rotate staff through there so that we’d

03:23:00:00

ensure that their clinical skills would be improved so that when we went on operations, they could do things. Because, previously the medics, doctors and nurses, who worked in the field hospital, just sat there. And they’d organise some ad hoc detachments so that they’d kind of work to keep their clinical skills up, but it was my feeling was they paid a lot of lip service to it and they kind of – they had a pretty cosy sinecure as well but they didn’t have any clinical skills, so the argument was to integrate the two, and you’ll

03:23:30:00

get the best of both worlds. But it was very difficult, yeah, a lot of resistance all round.
From the managerial perspective and having to lead this change, how did you deal with it? How did you go into this situation, personally how did you go in as a leader to conduct this change?
Okay, now you’ve got me thinking back a fair way.

03:24:00:00

Making sure that there was a clear vision. That it was clearly articulated, everybody knew what we were doing and why we were doing it. And to talk to people all the time about what we were doing, why we were doing it, and what we hoped to achieve. And we reshaped the organisation two or three times, in the first twelve months to get it right. Because you’ve got to get your management

03:24:30:00

arrangements right. And the first cut of it, wasn’t right, it was too complicated so we refined it until we ended up with something that was about as manageable as I thought we could get at the time, so it was around that. And then very quickly getting the field unit to do its job. And we received a whole lot of new equipment really quickly and within the first couple of months I took them

03:25:00:00

just to Holsworthy; we just put the hospital up at Holsworthy only twenty minutes away from where we were and we had an exercise. A short exercise. And everybody could see how it was going to work. So first of all I had to kind of test it so I could figure out in my own mind, can we make this work? How do we make – if we take all these people out and we’re going to go on exercise, how do we make the hospital left behind work? So had to force that separation early to see what are we missing. How do you bind services if that’s what you’re going to do?

03:25:30:00

Just pushed it. And really hard in those first six months. Ensured that the unit did have a field focus, we did battle PT [Physical Training] and people hated it, twice a week and every Friday morning I’d have them going through the lakes and stuff like that, it was arduous it was tough. My way of thinking, it had to have a really clear focus; we had to be fit to do the job that was expected of us

03:26:00:00

and many people weren’t, so it was kind of bringing the place up to a fairly high standard from a military point of view. And then we really cracked it and proved that we could do it on K89 [Exercise "Kangaroo '89"], which was that same year deployed on K89. Did a really good job, looked after many, many sick people and that really built the reputation of the unit. Came back from there and people could see, yes we can do this. And then from there on it was just hard work

03:26:30:00

but people can understand, yes how it is going to work. Took three years, so towards the end of the second year I wasn’t confident that I’d done all the work that needed to be done. I was given an extension – a third year on the posting to see through some of the beating down and by the middle of that third year we pretty much cracked everything that had to be done from a management point of view. But a lot of interesting problems. It was

03:27:00:00

the first time that an operational unit had significant number of women in it. Previously there’d been a few nurses we’d deploy operationally but the army had just moved into a lot more of the equal opportunities sort of things. So 70% of my officers were female, so a lot of issues around, how do you deal with women in the field?

03:27:30:00

How do you deal with the men with women in the field, kind of rural setting and things like that, it was a lot of kind of sucking and seeing and made a few mistakes along the way, my approach was, "You make a mistake, you own up to it." And I made a mistake on K89, the engineering unit had done a lot of really good work for us, said, “We’re going to a party, we want to invite your nurses across.” So yeah, okay. And it was kind of early in the exercise so a number of the nurses had a night out. The rest of the unit was really pissed off.

03:28:00:00

Like as in, "Okay, well why didn’t some of the boys go as well?" Engineers weren’t interested in the boys they were interested in the nurses. So very first thing, next morning, got the whole unit together, put up my hand, said, “Okay, I made a mistake. Bad call on my part, I let a number of our female staff go to this – they had a pretty social time, it was unfair on everybody else, I won’t do it again.” And owned up to the mistake and pretty quickly move on from there, if you do that, that’s what I’ve always found.

03:28:30:00

What other issues did you find with women in the field, or mixed gender in the field?
It was the first time that I had worked with large numbers of women, so I’d always worked in basically male only organisations. So that was for me, from a management point of view, novel. And my view is, you

03:29:00:00

don’t deal with women the same way as you deal with men. Like the emotional requirements are different. You have to think about how you’re going to deal with it. The first time I had a woman in my office crying, well didn’t have the tissues. Like, boys don’t come in and cry, little things like that, that over the years now, I’ve always got a box of tissues in my office, that’s kind of taken as given, you don’t think twice about that and when a woman comes into your office and they burst into tears for whatever reason, I just, "okay, fair enough". And deal with it in a sympathetic way and okay, so you learn how to deal with the different emotional requirements, women

03:29:30:00

deal with each other differently. The boys will, if they’ve got a problem they’ll kind of get pissed and they’ll punch each other’s lights out, soldiers. My feeling was that our female soldiers deal with their issues that way, that things fester and so it was a matter of do you intervene? Who intervenes, how do you intervene? And so I learnt kind of different ways of going around it. Used the padre sometimes

03:30:00:00

or just think, "Okay I’ve heard this, how am I going to deal with it? Who’s the right person to deal with the problem or the issue?"
Who did you use for support in dealing with those issues?
I wasn’t close to the padre, but I had one particular issue between two of our female officers, a senior and a junior officer, and as far as I was concerned, somebody had to mention something. And I felt

03:30:30:00

probably the best person was an independent who was seen to be trusted by both. Problems of command though that and one of the things that I’ve learned over the years is the value, and I didn’t have it then, of mentors. Of peer support, like I didn’t have any, none of my peers as commanders, had women with them, so I couldn’t go and say, “Hey, how are you doing this?” I was the only one. So

03:31:00:00

lessons that I’ve learned now, around how I go about dealing with people, how I deal with myself the sort of things I’m putting in place, for our medical student curriculum – I built in place things around peer review, peer support, mentorship, so that you’ve got somebody to turn to if you’re not really sure. They were some of the things that were lacking to support me during that time. And if they’d been there I probably would have taken a different approach to quite a few things.

03:31:30:00

Were you worried about fraternisation?
No, I’ve got a pretty firm view that it’s going to occur, you can’t stop it and as long as it doesn’t have adverse impact and by that, it’s overt so that you end up with tensions, then yeah, I wasn’t particularly bothered. I think that there’s too much goes on and the military’s a

03:32:00:00

very conservative organisation around fraternisation and the like. This is an issue that came back to bite me later in my career, but my view is that males and females are going to bond, that’s a fact of life. That happens and especially in stressful situations. So how can you prevent it? It’s going to occur. So if it is, then you need to make sure that it’s managed. To my way of thinking I built rules

03:32:30:00

around it. Like if a couple wanted to leave an exercise together, and go and do whatever they want, I was more than happy for that – go away. But back in the military environment, be sensitive to those around you. I think it’s just an interesting problem and I actually think the military deals with it very, very poorly. I look at organisations in the civilian world where I now work and others where I see, and we don’t

03:33:00:00

call it, “fraternisation.” They’re a couple and they have a relationship, yeah fine, okay. Move on, it’s not an issue. It’s an issue for others when it’s hidden. And when it’s not out in the public, but people don’t care. I think from an organisational point of view the only time it’s an issue is with direct subordinates. I think that can cause problems as I’ve discovered.
When did you discover

03:33:30:00

that? I’m just wondering about this issue that came back to bite you, what stage was that?
Towards the end of my career.
Going back to the amalgamation, and having to make some tough managerial decisions about how the two hospitals would work together, you noted that you create a very high standard and were there people that just weren’t cutting it?

03:34:00:00

Yes. And we moved them on. Yep.
Is that a difficult decision to make?
No. No. I didn’t find it a difficult decision, this was the stage of my career where I was kind of military through and through, and I had a job to do and yeah, I did it. There were hard decisions to be made, I’ve learned over the years, the best time to make the hard decisions is really early in a job.

03:34:30:00

It becomes more and more difficult, the longer you stay in a job, so make all your hard decisions quickly and then you have to deal with some of it later on, but do it as quickly as you can. Fortunately, one of the good things with the military is that they have posting cycle. So every two or three years people move on anyway. So to some extent I used the posting cycle to get some people to leave. But I also used it to my advantage to encourage some people to stay for an extra year so.

03:35:00:00

There were levers that I was able to apply.
And still thinking about this time in Ingleburn, but how would you describe yourself as a CO during that time?
I think I was probably hard. Yeah. I played hard and I worked hard. And I tried to encourage that sort of ethos in the unit. That I wanted them to be the best

03:35:30:00

not to be the best, just for the sake of being the best, but to be the best to do the best job. My thoughts were, if you were capable of doing your job well, then that’s what it was all about. So I didn’t expect them to be military morons and I encouraged a lot of social relief to counter balance the hard work and long hours and things like that .We work hard and we play hard and

03:36:00:00

what comes out of that will be an organisation that can do itself proud and that was pretty much the approach I took.
After Ingleburn you then went on to land headquarters. What was your role at land headquarters?
Title was commander, Land Command Medical Services, in the first place. I was responsible for overseeing the health services in land command

03:36:30:00

so the army’s operational so – that’s field hospitals, field ambulances as they were then, preventative medicine companies so kind of it was a very operational high level focus, we were the operational planning headquarters, and also responsible for operational force structure issues.
During that time, prior to Rwanda, what

03:37:00:00

operations were you able to implement in your planning?
By then, the Australia Defence Force was starting to commit troops operationally. And it was a pretty exciting time to be on that headquarters. We were in Somalia, Cambodia, Western Sahara, we had people in the Middle East so there were a lot of operations on the go and that headquarters was really just starting to get its act together as an operational headquarters, so it was a good time to

03:37:30:00

be there, a lot operational planning going on. And then kind of we were always there looking at, okay from a medical point of view, from a health point of view, how do we structure ourselves, how do we provide those troops with support? The medical people out there with support, and then look back at the resources that were available to us back in Australia and what do we need to do to them to improve their training, to improve their equipment yeah, to be operationally ready, so it was a – it was a pretty exciting job.

03:38:00:00

Each of those operations that you’ve just touched on briefly have different circumstances surrounding them, so how were you able to plan for each of the different deployments?
That’s the job of a health planner, I have difficulty answering that. To me that’s a taken as given, no two exercise or operation is the same. So as long as you apply your planning principals, you’ll come up with hopefully the right answer for the unique circumstances.

03:38:30:00

And you’re quite right they all took different sorts of health support, from I think at one stage we had seven engineers who were mine clearers in Afghanistan, how do you provide medical support to seven engineers? Well we actually sent an SAS [Special Air Service] patrol medic. So that they did have somebody with them who had other skills and then we had to figure out, okay well if somebody does step on

03:39:00:00

a mine or get shot, how do we evacuate them from the middle of Afghanistan? So we’ll talk to our US colleagues and yes, they had helicopters there and so we basically entered into an agreement with them that they would do the evacuation, so as far as we would go there was to provide our own primary health care. Then you look at Somalia, completely different again, we had a field ambulance treatment section with the battalion in Baidoa, again relied on the UN [United Nations] hospital

03:39:30:00

in Mogadishu, but we had staff in Mogadishu who were our liaison people so it was, yeah it was always forces for courses.
And prior to the deployments, were any staff sent out for reconnaissance?
Yes, every mission. Except for the really small ones. Where we couldn’t justify sending a medical planner, but in those couple of years, my staff got everywhere, in fact it was one of the things that was pretty well recognised around the

03:40:00:00

army at that time that if you work with Wayne Ramsey on his headquarters, you’d travel overseas. So yeah, we had people going everywhere, either as in the planning phase or once a mission was running to go in and make sure everything was flowing right, we didn’t have any problems, so yeah it was a pretty exciting headquarters to be on.
And were you able to gain a clear picture of what was happening on each of these deployments yourself without having left?
Yeah, I felt that I did. We had pretty good communication with people

03:40:30:00

and if need be you’d pick up a phone and you could talk to somebody. My preference was never, as the commander, was never to interfere so my staff did a lot of that for me. And we knew it was really important to ensure that there was somebody back in Australia, one point of contact and we actually had desk officers, okay you’re responsible for Somalia. You take all the calls. So one person would be the Somalia person. And it would only be if I was really worried

03:41:00:00

and I needed to hear something one on one, because I was going to impart something else that I’d start to talk to people. And that worked really well and was something I took back when I went to Rwanda myself, and by then land headquarters was working really well so it was, okay you know who’s going to be on the end of that phone. If something’s going wrong, you know that there’s somebody back there, who’s going to help you.
Interviewee: Wayne Ramsey Archive ID 2461 Tape 04

04:00:31:00

Just talking about land headquarters and all the deployments that you had going, how regularly did you monitor what was happening in the field for the people you had?
Daily, daily. All the time. While I was there it was clear to all of my staff that our prime focus was operational support. We had all these other things to do that the operational support took primacy every time. So

04:01:00:00

on the headquarters there were stages where the operational part of the headquarters would have daily briefs. And I was always there. And the key members of my staff who had responsibility were always there. And we really enmeshed ourselves in the headquarters. The headquarters knew if there were any health problems you knew who to talk to. I was fairly fortunate, by now

04:01:30:00

General Arnason had been my brigade commander, so I knew him very well and he had just taken over from Murray Blake so we were – the commanders there. I knew, we trusted each other, they knew what I would do for them, my staff were highly experienced and really good operators and we had a really good working relationship with everybody on the headquarters that made it, that’s what made it exciting because it was this really good big team.

04:02:00:00

And during that time were there any incidents that really worried you about your team out in the field?
Christmas Day in Cambodia, we came back to work the following day and heard the story about the young Australian signalman who was on the Thai Cambodian border, out there by himself, an outpost with a few Cambodians and he ended up on the wrong side of the fighting. And fighting

04:02:30:00

going around him and typical young signaller, he kind of phoned home. And first person he talked to, he chatted to his wife on Christmas morning so all this kind of stuff’s happening and he’s chatting away to him, saying, "It’s not real good here, I’m – "and like all the gunfire everything was going on, and she phoned land headquarters to say, “Listen I think that so and so’s in a bit of a problem.” And they phoned Cambodia, so we

04:03:00:00

actually knew through the wife before they knew in Cambodia that this young signaller was in real difficulty and like, he stayed there survived it through and came out unscathed. Those sorts were remarkable stories.
And that was Cambodia, were there any incidents with Somalia, because it was quite a horrific deployment in some aspects?
Yeah,

04:03:30:00

not from a medical point of view. There were very few Australians who were injured, I think we had a couple killed. I think, I’m not even sure about that, I know we had several injured. But we had right sort of resources there, we had a good medical team, Darryl Duncan was over there, guy I highly respect, Senior Major. He was running the show,

04:04:00:00

so I had faith in the people there who were doing the job. Did a good job. Yeah, so, not Somalia. Tragedy in Western Sahara, now I’m not sure if this happened before or after Rwanda, my memory lapsed. But Sue Felsh, army doctor we sent over there, was killed in an aircraft accident. First medical person who’d been killed since Vietnam so

04:04:30:00

that hurt.
I do recall that. How did that hit the team?
Yeah, that was pretty devastating, to lose one of our own and up until then we’d been pretty much immune. I mean it was tough personally, I can remember making the phone call, saying, “Sue, we’re looking for a doctor to send to Western Sahara.” She was newly married. And so I knew it was going to be a tough decision on her

04:05:00:00

part, so there was me kind of coercing her to – into going to the Western Sahara. Not that I felt guilty that it was my fault, but that’s some of the emotional difficulties that you get around kind of getting people to do things that you know you’re putting them into harm’s way. Can recall doing exactly the same thing before we went to Rwanda. Michelle Barrett, young doctor, in Ingleburn, I don’t think she’d even done a basic course,

04:05:30:00

I knew we needed a doctor. “Michelle, we’re going to go to Rwanda, what do you think?” And it was a sports weekend and her husband was there and they came up and saw me and I said, “I can’t make any promises but might be tough, but I think we’ll be okay.” And away she went and she got there and within half an hour she was doing an amputation. That’s kind of, that’s pretty tough and I know that mission was very difficult on a lot of people. That’s one I remember where I

04:06:00:00

and I spoke to quite a few people, but yeah okay, “We’re going to go here, I want you to come, just want to clear it with you.” Afterwards, hmm.
When you’re sending teams out to these different deployments, firstly do you actually do anything with a debrief of the

04:06:30:00

soldiers that are there?
Yeah, this was just the beginning of the days when people were starting to recognise that PTSD [post traumatic stress disorder] was an entity and so the early ‘90s the psychs [psychiatrists] in the international community were starting to talk about PTSD and I was responsible for the army’s operational psych unit, so he came under my umbrella. And we considered long and hard around psych [psychiatric] support, how do you go about

04:07:00:00

it? And we really kind of took the lead on how to go around providing psych support; we sent psych teams into mission areas, debriefed, afterwards, debriefed, and we were pretty much at the gold standard of what was accepted at the time. A real sad irony is, it’s 180 degrees out of phase with what you would do today. And it was actually counter productive.

04:07:30:00

At the time, we didn’t know that, we kind of – this is the way it’s done, everybody said, “This is how you should manage post traumatic stress disorder, mental health sequela of operational service", so we thought we were doing the right thing and it’s a sad irony that we weren’t. And then – now there’s a lot of evidence about how best to provide mental health support to people on operational service, those that have been exposed to trauma. And today’s approach is totally different to the approach that we used

04:08:00:00

then. So it was interesting when we talk about those building blocks of health support, one of our building blocks was a psych team. But the methodologies that they were using while they were best practice then, have been kind of tested and thrown out these days.
Just to try and flesh out, at that stage what was the methodology

04:08:30:00

what was the philosophy of debriefing?
Group interviews. Very few one on one interviews, there was no construct around team support or team debriefs. There was no effort involved in training junior leaders in how to – and by all junior leaders I mean from corporal up. If somebody’s been involved in an incident, or the team’s been involved in an incident,

04:09:00:00

how to manage it. Once it’s managed, if somebody thinks that, “Hey, so and so’s got problems.” The person who to refer them to, so there was no kind of tiered and escalated response around people who were identified as having problems. So none of that had been built into the army’s training programs at the time. The way that individual debriefs were dealt with, really didn’t reflect the way that

04:09:30:00

something like that would be done today. Then the follow ups, while we did follow ups there was no enforced follow up. There were – we weren’t looking for the right sorts of triggers. So it was a flawed system. Reliability was great. Validity was just not there and that was our problem with it.
And was there much resistance at the beginning to the whole notion of debriefing?
Yes there was, commanders

04:10:00:00

at that time was, “Okay we’re all macho [strongly masculine] people who don’t get mental health problems.” So there was little belief in it. But I think because it was starting to hit the press that our commanders started to think, "Okay, this is a problem". And I think there was still a few of them reflected back on their time in Vietnam and knew that okay, mental health sequela of operational service is real. Doesn’t matter what anybody says. Lots of troops get affected. And it shouldn’t be the accepted norm.

04:10:30:00

You should accept that there’ll be consequences but you should be doing whatever you can to mitigate it. So at the time, both land commanders, up until Rwanda that I had, were supportive and they were prepared to send out psych teams and it became pretty much a routine that there was no argument, “No we’re not going to send a psych team.” And in fact we started to consider, can you use risk management? To say these people are at risk,

04:11:00:00

so you should send a psych team. So we were just starting to think about how do you do it? Like we were sending a psych team to the Sinai, those guys, the only psych problems they were having were through boredom. They were sitting in the bloody desert for six months with nothing to do. Now, they don’t need debriefing, they might need debriefing but it’s not around PTSD, it’s around debriefing, it’s around preparing them for reintegration into society. It’s a totally different construct that you use, and

04:11:30:00

you prepare people differently so if you’re going to send them to a really boring post then you tell them it’s going to be boring. And you tell them how to cope with boredom, you tell their families how to cope with a spouse coming back with boredom, so it was that the whole team approach, family approach, to the management of the mental health sequela of operational service. We didn’t have that grip; we were just focussing on a little bit of it, which was stress, PTSD, and like PTSD as a continuum.

04:12:00:00

What about the medical support teams that were coming back from these operations? What psych support were you giving them?
They didn’t get anything that anybody else didn’t get. It was all pretty much the same. We’d spend a bit of time with them, talking to them about what happened and a debrief from an operational perspective. A bit of emotional support but nothing unique other than,

04:12:30:00

“Oh you’ve been to a bad place, how you going? How’s the family?” The stock standard sort of things that you would do for anybody.
As a CO and not ask you for specific names or anything, but were there a few that really did concern you from perhaps what they’d seen..?
Oh yes, yeah. Well, we had the psychologist who went to Cambodia, doing debriefs, who debriefs the debriefer? We hadn’t thought about that.

04:13:00:00

So this was a highly respected psychologist who came home with really bad PTSD. Really bad. Because we hadn’t thought about support to the supporters. It was those sorts of things that we were naive, because this was an evolving field.
And professionally it was evolving as well.
Yes, that’s right. Well there was no evidence behind it – in this day and age we talk about evidence based medicine, where’s the evidence? Evidence based practice, where’s the evidence that this intervention’s going to work?

04:13:30:00

And in these days, probably what we would have done – we would have done trials around it all and kind of, okay you could almost have run a double blind trial around this sort of thing around, "okay we’re going to do this for this group and that for that group", because there’s no evidence, let’s decide what comes out of it, which is the best methodology to provide support. But without decrying my psychologist colleagues there wasn’t a lot of effort at that stage around an evidenced approach, it was all pretty anecdotal and

04:14:00:00

we think this works so this is what we’re going to do.
So were the soldiers guinea pigs to a degree? Or was it just the practise?
It was practice. It was – this is standard practice, this is what we’re going to do. So yeah, no, I quibble with the argument that were they guinea pigs? No, it was accepted practice.
From

04:14:30:00

being commander of the health services within land headquarters, the opportunity came up for Rwanda or the posting came up for Rwanda, were you watching developments and how closely were you watching them?
Yeah, yeah. Really closely. We discovered where Rwanda was in December ’93, January ’94, because

04:15:00:00

of things that were happening at Burundi. Which is right next door and I can recall Burundi and went to the big map, “Where’s Burundi?” We didn’t have a clue where it was, like one of these shitty little countries in the centre of Africa and that was exactly what Burundi was, so we discovered where Burundi was, so we followed, there’d been a number of massacres in Burundi, the year before. And like several hundred thousand people had been killed. It was – up to that

04:15:30:00

over a period of time. So it was- bad things were happening in Burundi. And the UN was considering some sort of peacekeeping force into Burundi. So we knew about Burundi and then when the things started to happen in Rwanda we followed that really closely. Because [UN General] Dallaire in Rwanda kept asking for the UN to send in more support. UN kept saying, “No.” The international community wasn’t prepared to do anything. So we tracked that closely. We started planning around a potential mission there. And

04:16:00:00

land headquarters did that all the time. “Okay, something’s happening somewhere, what might we do?” And if we felt that there might be a requirement, we planned around it. So we planned around Rwanda as early as April and May knowing that the genocide started in April we were planning around it from that early. Took different shapes, at some stages the planning was around an infantry mission. At other stages it was around a medical mission. And we did heaps of work around the, what if?

04:16:30:00

So April, May and into June, we tracked that really closely and while we were still managing other operations and there were quite a few still going on, we were doing a lot of work around Rwanda.
So does land headquarters monitor world events and what is happening .?
At that time there was – a joint headquarters,

04:17:00:00

and headquarters ADF would do the same, so there were conversations going on around things that are happening .There were conversations, and there were conversations about, “Well, why don’t you do some preliminary planning around Rwanda, we don’t think it’s going to come to pass, but it will give your planners something to do.” So yeah, we would be planning around missions.
And in this planning –
Knowing that we’d been in Somalia which was not

04:17:30:00

far away, so while we had been to Africa and again, it’s really interesting, I don’t know why we’d go to Africa, Australia, to this day I still don’t know. But for some reason our governments have always had this kind of attraction to putting troops into Africa so it wasn’t beyond the realms of possibility that we would go to Africa, so for us it was, “Okay well let’s at least think about it.”
That’s where I was heading, that within your planning group,

04:18:00:00

even though the government hasn’t said you’re going to be part of anything, your planners, how much prior knowledge do they pull on, how far back do they go?
In what way?
When they’re planning, you use Somalia as an example but were there other African nations ....?
Not at that time. No.
And so

04:18:30:00

the planning was in place, and..
If you have a look at the history of Rwanda though, Rwanda had been in turmoil since it became independent. Been in turmoil for a long time, but from ’62, bad things had always been happening in Rwanda so if you have a look at what was happening in Africa, Rwanda was always the potential to be a flashpoint. And while it’s a tiny little country, it’s actually quite pivotal because it sits right in the centre of Africa so it’s kind of

04:19:00:00

it’s at all the crossroads and I think a lot of people don’t appreciate that Africa’s a big place but if you have a look at the history of Rwanda, and the sort of countries that have been there, the French have been there the Germans have been there, the Belgians had been there, during the ‘60s, the Chinese had been there, building roads, so a lot of people had always had an interest around Rwanda; so if you think about it in terms of geopolitics, it wasn’t surprising that Rwanda ended up a UN mission.

04:19:30:00

And when did you get the go ahead that Rwanda was going to happen?
Well, we didn’t. Through May, if you think about what happened, the press started to show some of the images of the genocide and we started to get a few of the clips of what was happening. The bodies going down the rivers and all those sorts of things. International community was really ambivalent and that was

04:20:00:00

basically because the Americans had had a bloody nose in Somalia so the Americans weren’t going to commit, and without the Americans really nobody else was. I don’t think anybody else was prepared to go because the airlift that was required was really only going to come out of the States. And again, a lot of people were like, “Who cares about Africa?” And then by the end of May, the UN really was starting to push for an international

04:20:30:00

contribution of some sort. And by June, it was starting to become apparent that there was a lot more happening in Rwanda than a civil war and a genocide, it was a real cataclysm, and the way the civil war was starting to unfold it was becoming

04:21:00:00

apparent that there was going to be a victor out of it. That was the Rwanda Patriotic Front, the Tutsi led army that invaded from Uganda. And a number of nations started to consider contributing to the small UN contingent that was there. The Canadians said that they would go, the British did, the Americans said that they would consider providing air lift. And a number of African countries said, “If you support us, we’ll put troops in.”

04:21:30:00

So by the end of June the government made a decision that it wanted a strategic reconnaissance to go through Rwanda to consider what role Australia could play if a decision was made. So I went across, left here 4th of July, ’94, with another four colleagues and we flew to Rwanda or flew to Nairobi. We met up with a couple of the other contingent commanders flying in and out,

04:22:00:00

the Canadians and the Brits at that time. Flew to the border, the UN picked us up, drove us in to Kigali, we actually got into Kigali the day that it fell to the RPF [Rwandan Patriotic Front]. So the war around Kigali basically finished the day that we got there. We spent 24 hours with the UN Headquarters, spent a lot of time with Dallaire, talking to him about how he saw the peacekeeping force

04:22:30:00

working, became pretty clear to us that there was going to be a peacekeeping force and we could see that there was going to be a real role for us. By then the decision had been made, if we were going to do it, it was going to be a medical mission. I flew from there to London, and got a view from the British about what they thought they were going to do. On to the UN, I spent a couple of days in New York with the UN, confirming how we saw our role playing. Back to Australia,

04:23:00:00

got in at eight o'clock in the morning and we’d spent seven days, travelled around the world and that morning, there I was, giving a debrief on the mission. And it was agreed – cabinet agreed I think, two or three days later. Not much more, maybe a week later. And then we started to prepare for the operation.
Just going through that whirlwind trip of yours, when you first went into Rwanda, what really struck you?

04:23:30:00

Well first of all the drive from the border down. Beautiful countryside, Rwanda is one of the most beautiful countries in the world. There’s one of the hotels there called, Milles Colline , “A thousand little hills.” And that’s what Rwanda is, it’s just rolling little hills everywhere, but from the north it’s savannah. And there were buffaloes, you know it was just like a safari park this

04:24:00:00

road, but no people and no nothing. And we drove down this road in a UN convoy, flak jackets and helmets and all that sort of stuff, with our UN protectors and into Kigali. And in Kigali, it was nothing. There was a few people on the streets and for me it was the void, the void of life. There were the horrors of war, like bodies on the side of the street, bodies in telegraph poles and

04:24:30:00

light poles and power lines and things like that. Not a lot but enough to know that a lot of bad things had happened but it was just the stillness. There was no wildlife, no birds, and all you would see would be roaming dogs and all the dogs were fat. And you knew these dogs had been eating off people and it was ghastly. And then into the headquarters, and the face of the staff -

04:25:00:00

there were about 50 of them. And this was a hotel, but this is a hotel that had been through a war, and they had no services, power, power then from generators, now water, they were eating rations that had come from the refugee camps from Somalia so it was really, really rough and ready and the look of the faces of these people. Like they were stressed. They’d been through a cataclysm and you’d look at it and

04:25:30:00

you knew it. And they were just so pleased to see somebody there who was there to help them. And it was kind of they were the emotional experiences, still gunfire, so there was still a lot of things happening around us, it was not a safe place to be.
How long had the UN staff been there?
They’d been there right through the civil war. There’d been a UN mission there prior to the civil war, so Dallaire and his people had been there

04:26:00:00

right throughout. Some of the them pulled out just as the civil war started and genocide, so they left, so Delair’s headquarters shrunk. So there’s him with his 50 odd staff, mainly military observers who could do very little to stop it. For him, he did as much as he could, I know, but the consequences for him came from the death of I think there were ten or a dozen Belgian troops and he took personal responsibility for their death. They’d been captured by government forces,

04:26:30:00

he made the decision to allow them to stay in captive hands assuming that they were going to be released, and they were all shot. I think for him, that was the final emotional consequence that pushed him into his state of despair. But having said that, he was a most charismatic and forceful leader and to survive all of that as he did, but you could see that he was on his last legs, every day, I was thinking, “Is he going to get through another day?” And when I returned

04:27:00:00

he was at the end of the mission, and it was interesting to be with him and to see how he kept forcing himself one more day, one more day until he left.
And then you went to London?
Went to London, spent some time with our embassy staff, some staff from the British military, talked to them about what they were planning on doing. I think we spent 24 hours in London. Then flew onto New York where we spent a couple of days with the UN planning staff.
And was –with the UN

04:27:30:00

was that a very diplomatic role that you were in there?
A little bit, a lot of it was with the UN peacekeeping operations headquarters. We’d been dealing with the UN for sometime so this wasn’t new to us. And we had staff over there, so we knew exactly what was happening. So this really for us, was more around negotiation about, “We’re going to do this, who’s going to pay?” So it was really that kind of hard nosed sort of bargaining,

04:28:00:00

about how are you going to support the force? What are we going to do? And then on top of that there was some of the diplomatic stuff.
I’m not sure how much you can say about that negotiation process but was there a large demand on Australia..?
If the UN could have had its way, we would have paid for everything. And more. Yes. So it was really, we weren’t after anything special, we just wanted to make sure that it

04:28:30:00

was fair, but everybody knew what the rules were about who pays for what. So it was really more negotiation around that – the size of our force, and that’s where they tended to game play, they felt that sort of force should have a very small contingent, they were only after 30 or 40 that they thought, “Oh there’s only 5000 troops there, you only need a surgical team. You can do that with 30 people.” Well hang on guys, where are we? We felt we needed a much bigger

04:29:00:00

medical force around 100 and we did. But then on top of that we said, “If we have that, then we need our own logistics support.” Our government wouldn’t have contributed a medical team without the rest of the – without its own protection. We had 100 infantry, and armoured soldiers with us, just there to protect the medical support, so where actually, they wanted 30 and we were talking 300. So there was this, okay well who’s going to pay for what part of it?
So did it come down to

04:29:30:00

crunching numbers in the end?
Yeah there was a little bit of crunching numbers, more of that happens in Australia, in the Australian military but I’ve never understood that. “There will be 30 people.” “But we actually need 31.” “No sorry, it’s 30.” A little bit like the story I gave earlier about Vanuatu, but here it’s a lot more artificial that government will make a decision on – there will be 300 and that was the decision for Rwanda. “There will be 300.” We actually need 308 to do the

04:30:00:00

job and we had to really work hard to get those extra eight and they were key players on the UN headquarters. So it was a lot of hard nosed negotiation occurs at those levels to make sure you get the sort of force that you want.
And so when the UN is saying, “Only 30.” Is that a cost factor that they’re looking at?
Part of it’s their own planning, they have their own planning methodology and for them, they have world missions and they just have a template and they say, “Okay, 5000 troops are going

04:30:30:00

to be in Africa, then it needs a medical support force of 30. Why do you need more? We don’t understand. We didn’t need more when we were in the Western Sahara, we only needed 30, why do you need more in Rwanda?” Sorry guys, there’s 3 million refugees, there’s a very tense stand- off between government forces and the population and it was a really difficult place.
Was that a difficult negotiation process?

04:31:00:00

Difficult but yeah,, in what way? It was, no, it was tough, yeah, we had to bargain. But that’s all it was.
And you came back to Australia and gave your recommendation?
Yes.
And a week later the government…..
Yeah government made a decision pretty quickly. That’s when it was starting to become really apparent that really bad things were happening, that’s when the press really started to pick up on the refugee

04:31:30:00

crisis in the north of the country where hundreds of thousands were fleeing across the border to what was then known as Zaire into Goma, around the active volcanoes, and there was a lot of footage of people falling by the wayside dying with cholera and it was just the graphic images of a mass exodus that really triggered the international community to finally say, “Yes, we’re going to do something here.” And Australia jumped on the bandwagon pretty quickly

04:32:00:00

I think the British and the Canadians both said, “We’re going.” Within days, Australia came out and said, “Yes, we’re going to deploy to in the next four or five weeks.”
So what was the population of Rwanda, prior to the civil war?
Eight to ten million. They lost – figures that are bandied around these days – is the genocide killed about 800,000 so yeah, they lost about ten percent of their population.

04:32:30:00

So while you’re waiting for the government to pass this legislation and –
Well it was not legislation it was just all they had to do was agree.
Agree?
Yeah.
Do you continue planning?
We knew we were going, we were very confident that the government were going to say, “Yes, you’re going.” So even while I was away, my staff were planning. I was in regular contact with them and we were able to indicate by secure means

04:33:00:00

what sort of medical support force we thought we should send. How it should be structured and it changed shape pretty significantly from some of our earlier planning, having been there. Which is not unsurprising so they then started to really do a lot of work about, “Okay how are we going to structure it, where are these people going to come from? Where are we going to do our pre-deployment training?” So they – by the time I got back they’d done a lot of preliminary work and we’d been working on it for some time, a lot of it was cut and paste, but then there was a lot of

04:33:30:00

amendments that were required.
And how quickly did you get the contingent together?
Within about ten days. We started to pull people together, so that was middle of July we came back. We started to – we did pre- deployment training in Townsville because

04:34:00:00

it was really interesting there were a lot of arguments about who should lead this mission, how should it be structured. The infantry company was agreed that it should go. One-hundred infantry troops, many of them were based in Townsville, where are all the medical people? They’re in Brisbane and Sydney, so what did we do? We moved all the medical people to Townsville because that’s where the infantry were because that’s where we decided it was easier to do the training, lo and behold, what sort of training should we be doing? Not infantry training, but it’s actually medical training. There was really interesting and inherent tensions

04:34:30:00

in the unit because of the mix and match between, this is a medical mission and we’ve got all of this security force around it. There was a significant compromise about how it was going to be led, so my appointment as the commander of the contingent and the UN force medical officer, was counter balanced by the CO of the unit. Being an infantry lieutenant-colonel who was CO of the battalion, that provided the company, so there was

04:35:00:00

a lot of interesting mixing and matching. He had no medical background so there was an infantry person who was going to run a medical unit, the logic behind that was, "Yeah, but we’re actually fundamentally worried about security and this is as much security as medical support, you medics can just get on and do your business anyway and with me as the commander of the contingent…..", was able to oversight the medical arrangement anyway. So there was, how does this all work?

04:35:30:00

And cobbling together a very complicated unit, because it wasn’t just as if we’re taking a field hospital and going to bolt an infantry company onto it, it is. We’re going to take building blocks and it was a very difficult set of arrangements that medical people came from a whole range of different medical units, air force and navy provided people, so we had to pull all that together so it was a monumental task to get them all together, and so okay.

04:36:00:00

None of these people had worked together before, so it was, we knew that there were going to be some real significant issues and for me the pre-deployment training should have been about melding the medical staff of a hospital and other elements, which was what it was all about. So that they could do their business, but at the same time that was counter balanced by, yeah but we’re going to a really dangerous place so you need to do all this security protection sort of training.
So what was the pre-deployment training, what did it consist of?
This is one of the real interesting ironies, I wasn’t

04:36:30:00

there. I flew to Townsville, at the end of July and I was only up there 24 hours, and the call came through from [UN Commander] Dallaire in Rwanda saying, “I want Wayne here, now.” Because we weren’t going to deploy for a couple of weeks, and he wanted a planner, he had here and now problems, so I left. And it ended up that

04:37:00:00

the pre-deployment training was pretty much run as a hotchpotch of, by the infantry for infantry, and a little bit of medical training to prepare the medical people. So to this day, I’m not really sure of what training occurred. I guess that’s a bit insular on my part because I never went out of my way to find out, I was too busy worrying about other things to worry about what training was occurring or the people that were going to go.
Was there any integrated training between infantry and the medical staff?
There would have been very little.

04:37:30:00

Yeah, there would have been very little. Better to ask other people who were there on the ground because I wasn’t there and yeah, all I would be doing is speculating.
So you landed in Townsville and then..?
I went straight back to Sydney. Yeah and got on a plane and flew to Rwanda. I took one other person with me, Reg Crawford who’s a

04:38:00:00

medical corps operations officer with a special forces background, and it was just an interesting anecdote. He was a captain, and I promoted him in the Qantas Club [Qantas Airways] at about ten o'clock in the morning before we jumped on a plane and flew to - I can’t even remember, I think we flew to London first and flew back and made him go and get a glass of champagne

04:38:30:00

at ten o'clock in the morning. I could see him looking at me and he sat down and I said, “Oh by the way, you’re a major.” And threw him his slides, he looked and he said, “Oh, thanks boss.” So we got on the plane and we got thoroughly pissed, [drunk] because we knew after a while that was going to be it and we changed planes, flew back to Nairobi and didn’t have another drink for six or eight weeks and into Nairobi flew

04:39:00:00

into Kigali and got into Kigali on a Sunday morning, must have been, we left 31st of July so yeah, 31st of July, 1st of August and got in on a Sunday afternoon and absolutely no people in the airport. Couple of UN people hanging around. Oh yeah, rightio.
Did Reg go over with you previously?
No he hadn’t.

04:39:30:00

So he hadn’t been there before.
So what did you tell him about what to expect?
We spent a fair bit of time talking about it, so I think he had a pretty good idea of what to expect, by way of kind of what was going to be there and how we were going to go about it. He’s a pretty easygoing sort of guy and I knew – I chose him because I knew that he’d just slot straight in and accommodate whatever it was without any thoughts.
So then you got to the airport…?

04:40:00:00

Yeah, so there was nobody there. And really nobody expecting us, it was Sunday afternoon, so we thumbed a lift, we didn’t have any weapons, like we – because we travelled Qantas business class, we had an echelon bag, we had a backpack, we had a bullet proof vest, I’m not even sure if we had helmets, so we were pretty light on, you couldn’t take too much. We had to carry all this bloody stuff. So we just, we thumbed a lift with a UN vehicle and said

04:40:30:00

“Take us to Amal Hai, the UN headquarters.” So they did and we get in there and there was nobody there either. And it’s Sunday afternoon, what the bloody hell’s going on? And the headquarters had been stood down, it was their first afternoon, the first time they’d had any rest. They had worked right through this whole war and the aftermath of the war and we got their on their first stand down day. It was just amazing. So –
Interviewee: Wayne Ramsey Archive ID 2461 Tape 05

05:00:31:00

Well the first task was to find somewhere to live. I mean somewhere to sleep. And it was as simple as that. In the first twelve hours it was the real basics of survival. First of all we had to find somebody to say, “Here’s a room for you.” So we had to first of all find a room. Then we had to find some bedding, because it was just a bare office with a couple of desks and a couple of chairs. We had to find some food. We didn’t have a stove, we

05:01:00:00

ended up getting rations and headquarters was really bare bones. They were living on rations that had come from Somalia, that had been prepared for the refugees in Somalia, and they’d just been keeping them in big containers over there and they’d ship them over so we were actually eating the same food that was being distributed to the refugees and it’s coming in these little red string bags, and every second one you’d open up would fly blown, it was just absolutely ghastly. We didn’t have a stove to heat the stuff.

05:01:30:00

We were eating these cold cans of tuna and oh, it was just awful. We didn’t have any water containers and we were on the first floor and then we moved up to the fourth floor. So we had to borrow jerry cans to get water, so we lugged the water up and down. And it was really interesting because you think, everybody thought, “They’re right, they’re living in a hotel.” Living in a hotel with no services, it’s really difficult. Like if you haven’t got water then

05:02:00:00

you’ve got to get the running water up there. Toilets don’t work. So you actually need to use the water that you’ve carried to flush a toilet and just by pouring water into the bowl of the toilet actually doesn’t make it flush. I had a flexible stick that I used to use to force the faeces round the U-bend. And a little later, when the first of the Australians arrived a really great mate of mine came into my room, so it was my office and I was in the bathroom,

05:02:30:00

and I was washing my clothes in the bath and he had a bit of a chuckle because we’d both been colonels together and he said, “Where’s your batman?” And I said, “Well there ain’t no batman here.” So I said, “Just doing my washing, first washing in two or three weeks.” And I went back into my office and he said, “Oh can I use the toilet?” I said, “That’s okay.” So he used the toilet and he came – “Wayne, doesn’t flush.” “No, know it doesn’t flush, that’s what the stick’s for.” And at that stage, I think for him, he started to realise this kind of isn’t quite as easy as people thought. And it wasn’t, it was

05:03:00:00

really difficult. Just living those really basic things of living. And in the first couple of weeks there, while we had really important things to do, a lot of it, or some of it was just all around surviving. I can recall there was one stage, we’d been eating these rations for nearly a week and we’d driven to Gitarama and it was a really difficult day, a really difficult day and just at the end, I saw an avocado

05:03:30:00

tree. And there were ripe avocados on this tree, inside this church and hospital grounds, and there was nobody around and I said, “Reg, I’m going to do a bit of looting.” And he said, “What?” I said, “Avocado, we need food, really bad.” And he’d never had avocado before, I had bit of a chuckle at that so I picked a couple of ripe avocados, put them in my pocket, and just as we were leaving, just driving up the road there were these little kids with tomatoes, so we actually exchanged some of these ration packs, for

05:04:00:00

a handful of tomatoes. And we went back, that night and we had avocado, tomatoes and out of one of these ration packs, we came up with some sardines and a little bit of oil and it was the most beautiful meal I can ever remember eating because we had this fresh stuff and we’d been eating crap for weeks and for the first time to have something fresh it was just. So there were a lot of things, just about surviving. And then we had a real job to do. In the first place, the major issue that we had was

05:04:30:00

where’s the Australian hospital going to go? On a reconnaissance we’d identified that the central hospital, Kigali the major hospital in the country, was completely empty, there was just nobody there, no people in the town. And we identified that it had a private wing. And it was really well built, it had been really badly damaged during the war, there had been a lot of fighting literally in and around the hospital, so we decided to take over the private wing as the military hospital.

05:05:00:00

And when we came back, the people had started to come back and a couple of doctors had moved back into the hospital and there were a couple of local doctors and a number of NGOs [non-government organisations] were working there. And it started to look as if we might not be able to keep the hospital for more than a couple of weeks. And that was going to be a real dilemma because there’s nothing worse than setting something up and having to move and not knowing where to move. So we thought about moving our location. And in fact we were forced into that sort of consideration.

05:05:30:00

So this is on our second day there, so we’d only just got there, so this is the Monday we’re doing this sort of thing, so we had a look at the hospital and then that evening, I spoke to a number of the senior officers on that headquarters about where might we go? And the way the force looked like, it was going to be acting, saw that there was going to be a significant contribution of troops into the south-west and we felt that it might be better to move the hospital because one of our

05:06:00:00

major roles was to support the UN forces, was to move the hospital into the south-west and in the first place it was suggested we got to Gitarama because it was actually going to be closer to the troops. Although it was away from the major air head at Kigali we could drive there, so we went to Gitarama and there was a hospital there, I’ll come back and relate that particular part of the story in a second. But it looked okay, we went back to

05:06:30:00

Kigali and that night we spoke to one of the government representatives, and this is one of the Rwandan government representatives, people don’t understand that as the war finished there was actually a Rwandan Government that took charge of the country. It wasn’t like Somalia where there was lawlessness and no government, there was actually a government that was recognised, was very quickly recognised by many nations. So we went back to the government and said, “We’re going to go to Gitarama.” And they became really angry.

05:07:00:00

And said, “No, you can’t go to Gitarama, you can’t stay in Kigali, if your troops are down in the south-west, go down there and we want you to go and have a look at Gitarama.” Which was another hour away. And we couldn’t really figure out what was going on, so the next day we did this even longer drive, to Gitarama, and it was a dust bowl and it was a desolate dark and dank place. And then we went even further we thought if we have to go this far we’ve go on to Vitara.” And we were right, by now we were three hours from

05:07:30:00

Kigali and in the end we went back and I decided to stand on my digs [dignity] with the government and said, “Hey, listen we’re here to help you, we’d rather be in Kigali, we don’t want to go that far, you’re messing us around.” And they came back and said, “Well if you’re going to be here, then there are caveats.” And I said, “Well what are they?” And they said. “Well first of all, you will rebuild the hospital. The part that you’re in, is damaged, when you leave you will reconstruct it completely.” I actually thought that was a reasonable call.

05:08:00:00

And then the second one was a really interesting one they said, “And you will look after Rwandan VIPs. [very important persons]” I said, “Right how do you define a Rwandan VIP?” And the Minister for Health said, “He,” and it was his offsider Doctor Charles, “will say, if they’re Rwandan VIP.” And I said, “Okay. You have a deal.” And I knew that this was going to create problems for us. It was always open to interpretation but if I hadn’t agreed that particular issue,

05:08:30:00

we weren’t going to get the place. So we agreed and that really took away one of the biggest problems that Reg and I confronted during this early days, about where are the Australians going to go? So we sorted that out at all up, it probably took us five or six days worth of driving here and there and negotiating. Really interesting thing about that was, kind of, these are the things you learn out of these sorts of missions and it’s around an understanding

05:09:00:00

of where you are. The culture. And kind of the values of these people. And we go into these countries with a very superficial understanding of what was going on. And the advice that we got from the UN people who’d been there for - right through the civil war, was wrong, they hadn’t appreciated that Gitarama was actually a really bad place, from a Rwandan, Tutsi point of view. Because there’d been a lot of fighting there and the Hutus had holed up there for ages and there were

05:09:30:00

it was actually a Hutu enclave. And there were issues with the church, with nuns supporting the Hutus, there’d been Tutsis exterminated and we go to Gitarama, there was no way the government was going to want us to go to Gitarama.They saw us as, “What side are you on? Don’t you understand?” They never said that, but it took a long time for me to appreciate what was going on there so what they did, they punished us. “Well, if you’re stupid enough to go to Gitarama, go even further.” So it was very much they were

05:10:00:00

playing games with us but as I get into their heads now, for really good reasons. We didn’t understand what was actually going on. And that was a lesson I didn’t learn right there, but afterwards when I reflected on it I could see what was going on and why. That then leads into exactly the same lesson and this was my real role in those first few weeks. Not only were we trying to sort out the medical support for the UN forces as they flew in and

05:10:30:00

built up to six, seven thousand, but basically my charter was to oversee the refugee effort and the medical support by way of the refugee effort. And we’d come up with the cunning plan, that there were nearly a million refugees in and around Goma and they’d fled from the country and they were predominantly Hutus and I flew up to the border with General Dallaire, the force commander, really early in the piece, and we flew along

05:11:00:00

the border and it was just devastation. We didn’t go right into Goma, into the refugee camps because we weren’t allowed to cross the border, but from the border you could see there were just blue sheets, which they used to form their huts and there was absolutely nothing around from afar you could see that they’d denuded all the trees, they were using the trees for fires, so there was just a smoke haze, everywhere and then on top of that look back, as you look there and

05:11:30:00

looking to the east was a huge volcano that was close to erupting, so there was all the smoke coming out of this volcano, there’s dark haze and the wind from the volcano, the smoke from the refugees and along the road, where these people had been fleeing, were all the bodies of refugees who had died from cholera. So there was this absolute devastation and all these people were sitting in this refugee camp, and our thoughts were, well, gosh, we can’t help them there, the country’s empty.

05:12:00:00

Let’s encourage them to come home. So had this plan of – and Rwandans walk, so we thought, okay if we provide food stations and water points and medical points along the road from Goma to Ruhengeri right along the north and west of the country, we’ll be able to encourage these people to come home. So we deployed a Canadian field ambulance to Matara, half way between Ruhengeri and Goma, the British had a field ambulance at Ruhengeri so these were

05:12:30:00

big medical resources that could provide a lot of care. The NGOs [Non Government Organisations], provided small medical teams along the way, there were water points and we thought, hey, this’ll be a winner, by the time these people get to Ruhengeri we’ll start to truck them back to their homes. What happened? Trickle back a thousand, two thousand a day. And every day, like the military observers were counting and these numbers were really small. And the plan didn’t work. Why didn’t it work? Well we

05:13:00:00

didn’t get into the heads of the Rwandans trying to understand what was actually going on. Why did these people flee? Well they were Hutus. How do you kill 800,000 to a million people in twelve weeks? Well it’s more than one or two people doing the murdering, it’s more than a thousand, it’s more than ten-thousand. It’s hundreds of thousands of people had been involved, actively involved in the genocide and then Rwandans are very family centred. So if a member of the family had been actively involved in the genocide

05:13:30:00

and many were, then the rest of the family would stay with that person, they weren’t going to go back to Rwanda. They feared retribution, so these people had fled, there was no way they were going to come home. They were going to stay in the refugee camps. We didn’t understand what was going on. In Rwanda, in the minds of the Rwandan people. There’s no way they were going to come home. So that was an absolute failed plan. Where we turned it around though, and this is where I think we should take credit, and we

05:14:00:00

I mean the United Nations and particularly the medical players in it, was that in the south-west of the country, the French had deployed even before the UN forces started to build up and they created a French enclave right around the south-west of the country and including Kibeho camp where massacres occurred six or eight months later. And they put in a force protection. About a thousand troops they were really well trained troops. They were French Foreign Legion

05:14:30:00

and they provided security in the south-west. And it was really good security and they were hard nosed and they would, if need be, they’d kill people and they didn’t really care what side they were. It was,"We’re here to do our job". And they did create a stability in that part of the country but they were only there on a really short mandate from their government and for geopolitics, they withdrew precipitously. And I

05:15:00:00

mean we didn’t know when they were going to leave and they gave us about two days' notice. And they just left and we were left with again, nearly a million refugees in the south-west of the country who were predominantly Hutu, so they fled there because they feared the government forces were going to take out retribution on them and we were really worried that these people who were living in camps were going to continue to move, like they did in the north to Goma, seeking protection in Zaire. And we knew that if they

05:15:30:00

did that, if they fled to the west, there was no way we were going to ever be able to support them and we were actually worried that where tens of thousands of people had died in the north of the country as they fled the numbers were even going to be greater in the south and the south-west because the French pulled out. And what we did was, we actually deployed medical forces into the south-west right into the heart of the refugee locations. The Australians put a treatment section in Butare

05:16:00:00

but they deployed into Kibeho camp and the other camps. The British deployed the whole field ambulance down there and they also serviced the camps and we didn’t provide any support any further than the camps. So we didn’t provide them, like the reverse of the other lesson, "If you keep going, we’re going to help you". We just didn’t do that, so we said, you stay here, we will look after you. And they didn’t flee, maybe 20 or 30 thousand large numbers left but the majority stayed there. The Ethiopians

05:16:30:00

put an infantry battalion in, the Ghanaians put an infantry company so they weren’t big numbers but there was enough to create a feeling of security and most of that was round a medical mission. So it was really interesting to counter balance the lesson that we had learnt and we did learn it, into the plan around protecting the refugees, the majority were Hutus in the south-west to stop them from fleeing. Again, when you look at that though, there are some sad ironies around that because they

05:17:00:00

actually stayed in the camps and they just didn’t move. They weren’t going to go home. We tried many things to encourage them to go home, they weren’t going to flee any further because I think that ultimately they knew that they were doomed if they went into the south-west of Zaire, and they stayed and the Rwandan government from then on kept forcing the UN- “Close the camps. Close the camps.” And there were periods where the Rwandan Government sent in small numbers of troops and there were some massacres of Hutus in these camps

05:17:30:00

by RPA forces and it ultimately ended up with camp closures that happened with the big Kibeho massacre. That was actually what it was all about it, was about the Rwandan Government saying, “We are not going to have these camps, we will close them once and for all, we’re putting our troops in.” And that’s my reflection on the Kibeho massacre and it’s really not appropriate for me to say anything around what happened during the Kibeho massacre because that wasn’t my mission.

05:18:00:00

But from my part of the history I could see why Kibeho occurred. Because the government was trying to close camps left, right and centre during my whole time there. And they tried all sorts of things and it was the ultimate way for them to close the camps. So what did we do in those first four weeks? Well we actually came up with first of all a failed plan, and then it was about six weeks later when the French withdrew that we actually did the other major planning activity

05:18:30:00

of our mission. That was the redeployment of three major medical units, moving them into the south-west and out of my whole military career. That particular operation, that particular plan and to see it through. I would have to say was the highlight of my career, to actually come up with a plan really around something that was really profound and to look at the resources we had, to make a judgement that we would take these resources out of the north and

05:19:00:00

know the people would die because of that, but it was a classic, the greater good for the greater number, and the greater number were in the south-west. So it was one of those, "Let’s do a risk assessment, risks are greater in the south than the north, let’s move our resources around". And it succeeded and I look back at that and say, “Rightio, of all the things I’ve done in my life, that was probably the most significant decision that I made, or was actively involved in redeploying those troops.”

05:19:30:00

So that’s when you say, “What did we do?” It was around that. And thereafter from my point of view, there were all sorts of other, kind of operational highlights, but they were very small in comparison. It was, then it was into mission steady state and yeah, growing the way we did, provide our services, things happen in the camps. We

05:20:00:00

saw the beginnings of a meningococcal meningitis outbreak in Kibeho camp. And we got together, Canadians, Australians, British forces, a number of NGOs, Care Australia, Medicins Sans Frontieres, a Pharmaceutical Sans Frontieres [Medicine without Borders] provided the vaccine and this coalition of military forces and NGOs immunised nearly 30,000 kids in 48 hours, it was just absolutely remarkable to

05:20:30:00

actually get all of these people working together to do something that was really good. It was interesting talking to the NGOs about the involvement of military in provision of humanitarian aid and many of them had come from Somalia and they were really, really angry with the military and, "What right did the military have to be a humanitarian player?" All – their arguments were, all militaries are for is for security. And we’re saying, “No we

05:21:00:00

can do more than that, we can - by our very presence we’ll provide security, if by our very presence we’re providing security, let us do a little bit more.” We worked very hard to build a close working relationship with the NGOs and I think we did it really well. And that’s because we were even handed, we were non-judgemental. And we contributed to the relief effort in many ways. Pharmaceutical Sans Frontieres provided pharmaceuticals to the NGOs,

05:21:30:00

we assisted in distribution. We provided data back to PSF [Pharmaceutical Sans Frontieres] on our workload so that they had much better planning figures, so we worked really collaboratively with them. And we worked collaboratively with the whole of the emergency response organisation, and while we were in uniform we were very careful never to carry weapons when we were meeting with

05:22:00:00

NGOs. Wrong. Those who worked closely with me were very careful about that. I had very strong feelings about you have to be seen to be – you have to be accepted and if the way of being accepted is not to carry a weapon, then you don’t carry a weapon. That was counterbalanced a little bit by other elements of the Australian medical support force and this – my feeling again was very much the military and the infantry influence about, we’re here,

05:22:30:00

without a gun you can’t protect yourself. Well there are occasions where I actually felt safer without a weapon and for other reasons, okay I’ll relate the story now. Me and, “should I carry a weapon?” I got into Rwanda and the war had just finished, it was still a fairly hostile environment. And Reg and I drove all round that countryside for two weeks. And we didn’t have any weapons, we flew there,

05:23:00:00

via Qantas. And we survived for two weeks without a weapon. And I think that the most hostile part of that mission, was first to begin with, it’s during the reconnaissance then during the initial days when we were there and within about four to six weeks there were government troops on the streets everywhere and they were actually- they weren’t bad guys they were government troops. The RPA [Rwandan Patriotic Army] they were good guys from a government point of view, they weren’t RPF they weren’t bad

05:23:30:00

guys. Now, while they threatened us, and they shot some people we weren’t at war with them. So while it was hostile, it was not as if we were overtly at risk, I didn’t think we were. So for the first two weeks didn’t have a gun. Then the advance party arrived so – well here’s your weapons, okay fine. Give me a pistol. Carried a pistol.

05:24:00:00

and I think it might have been difficult for the contingent because Reg and I had just been driving round in a little Corolla [small sedan] - I think we had a Land Rover [4 wheel drive vehicle] to begin with, bullet ridden and stuff like that. Maybe it was that we felt safe, because we’d been there and we just felt safe so I think others thought we were taking risks by travelling by ourselves or only two in a vehicle. But because we’d been doing it we just kept doing it, we were always cautious

05:24:30:00

and there’s only one incident where I wasn’t as cautious as I should have been. The advance party had just arrived, they were just starting to set up in the hospital. I think it might have been their second or third day and it was just on dusk and I’d been there to see how things were going and I was driving back to the UN headquarters, it was about a fifteen minute drive, not a long drive, but and as I came out of the hospital and there was a major road that went down to a creek line, and I came down this road to a creek line,

05:25:00:00

and their president used to drive around in a convoy, their heavy hitters would drive around in a convoy and they’d just scream along the road and nobody ever got involved in one of their convoys, and if you did you were at risk. They shot people getting involved in their convoys and I came down this hill by myself in my car and these six vehicles just flashed by. And I stopped, knew what was going on. As I did, these kids in gumboots with their guns pointing out the side of their utes [utility trucks] all trained their guns at me

05:25:30:00

and I’m, “Okay, I know what’s going on, this is cool, I’m not moving, off you go, I’m not getting involved in your convoy, leave me alone. Just UN, I’m a good guy.” So they drove off and stopped there and I was a bit shaky. Because it might have been that morning somebody had got involved in one of their convoys and there’d been a bit of gunfire, so I thought, “Whew!” that was a risk and I stopped, and then I thought, "Okay keep going". Slowly started to drive up the hill, and I was only driving slowly. And another vehicle

05:26:00:00

another Rwandan military vehicle, came up first of all behind me and then beside me. And there were three guys in the back of this thing, all with AK47s [automatic rifles] and they all aimed straight at my head. And I’m driving by myself, and I’m seeing this going on and first of all I thought, it’s okay, I slowed down, they slowed down. I sped up they sped up and this went on for nearly 200 metres and then they eventually just sped off with grins on their face and I thought, "Bloody hell this is it….." It was a risky evening. And

05:26:30:00

a little bit further, by now it had just started to rain. And it was just past dusk so it was that time of night when it’s difficult to see and about two kilometres from the UN headquarters maybe three kilometres was the parliamentary building the government building. And I’d driven past there a few times and I knew that there was a checkpoint there and the checkpoints were nothing more than a couple of

05:27:00:00

boxes and a soldier. And you knew if you got to a checkpoint you had to stop. Because if you drove through it, and you were at risk and they shot people driving through checkpoints. They’d shot a couple of French journalists when I’d been there during the recce, who’d driven through the checkpoint, so I drive up to this thing, and I couldn’t see anybody so I drove through it, and all of a sudden I thought, that’s a checkpoint, stop. I stopped and I backed, back. And this kid came out with his AK47 and his gumboots and I

05:27:30:00

couldn’t turn the light on in the car so the only way I could get the light on in the car was by opening the door. And I wanted to show him that I had UN beret and those sorts of things. So I opened the door and he shoved his AK47 right underneath my jaw and he didn’t have a nice look in his eye and I lost it. I was really angry so I grabbed the barrel of this thing, pushed it out and I just pushed him and I just drove off. And as I did, I thought, "Fuck me, what am I doing?" And I looked up in the rear vision mirror and there he was aiming the gun at

05:28:00:00

the back of the car and I thought, "You stupid boy, Wayne". And he didn’t shoot. And I kept going and I got back to the headquarters and life went on. And I didn’t relate the story to anybody but what I did, I thought about it and I thought, what the bloody hell was going on? And I realised that as I left the hospital as I reflected back there were no locals on the streets. And there was something going on that night – there’d been a fair amount of tension between the RPA, the local

05:28:30:00

population and the UN for about 24 hours, I didn’t figure the warning signs. It was late in the afternoon, I was tired, I didn’t concentrate. And that lapse nearly cost me my life and if I’d concentrated I would have thought, something wrong here, it doesn’t feel right and if I had stopped, I could have stayed at the hospital overnight or could have got an escort or something, but I didn’t. So that was one of those lessons, the way I dealt with it, with the other members, by then we had

05:29:00:00

six or eight Australians on the UN headquarters, I got them altogether and said, “Okay guys, security let’s keep reflecting on how we do business. Two people in a vehicle, always have a radio, blah, blah, blah.” And that was fine and we went on. It had a profound impact on me though. The impact on me, was that at the end of it, I decided that there was no way I was going to use that pistol. There I was carrying a pistol with bullets in it

05:29:30:00

and here I was at one stage in circumstances one on one where my life was at threat and without rules of engagement at that stage, I could have probably shot him. But there was no way I was going to do that. There was no way I’d realised I couldn’t shoot anybody. If it was to protect my own life, and I reflected then of that kind of my upbringing in a Quaker school. That’s it, I can’t do it and I actually stopped carrying a pistol, my explanation to the others wasn’t around

05:30:00:00

“I can’t shoot anybody.” It was around, “Oh the bloody thing gets in the way and I’m going into the government buildings and I’ve got to leave it in the car and if the thing gets stolen, I get into trouble and you can’t have the commander getting into trouble because his pistol’s been stolen.” But that wasn’t actually the reason, it was that I wasn’t going to use it, it was more hindrance than an advantage to me. And from then on, the only time I carried it was when I was with other Australian troops because at that time I believed I had a responsibility to have a firearm because there were other troops with me.

05:30:30:00

And I had a responsibility to them, but for myself, there was no way I was ever going to be able to use it. And I actually told the story to my mother, but not the fact of why I stopped carrying it. And she wrote back and she said, “Just be careful, Wayne.” And I’m thinking, "Yeah righto, Mum". Yeah but it was interesting and as I think about my life, and kind of that – those dichotomies about being okay, a doctor, somebody with a very

05:31:00:00

pacifist background and counter balance that as being a military person, and where do you sit with both? What are you at the end of the day? And by the end of that mission, I knew clearly what I was. I was a doctor. I wasn’t a warrior, that wasn’t my bag, I could do all the warrior stuff but that’s not what I was all about. And for me, that’s what that mission, changed me profoundly.
How old was the boy?
Oh I don’t know, fifteen or sixteen I guess. He was only

05:31:30:00

a skinny little kid. Not real strong, not strong enough to let me stop him pushing him away and pushing him in the gutter.
And you said that there’d been tension for 24 hours, and in hindsight you should have been able to pick the signs. What were the signs?
Oh, there were a few bodies at the tip. So the Rwandans had been out. We’d heard that they’d started

05:32:00:00

a purge, amongst some of the local population, there was a fair amount of gunfire going on. The 24 hours beforehand and during the day it seemed, the town seemed fine but at night, is when they went, the RPA go out and do their cordons and searches of a street or a house or something like that. And when I drove to the hospital it was fine. There were people on the streets and it was a normal day. Things had been happening the night before,

05:32:30:00

but it was when I was leaving. It was quiet, it was unusually quiet and I should have realised, nobody on the streets, what’s going on? Be careful.
You said you got angry and that’s why you pushed him aside, but was it a bit of bravado as well?
No I was just angry. I was. I was angry. I thought twice, in about a ten minute period, that somebody’s going to shoot me and then the third time, when I really thought somebody was going to shoot me,

05:33:00:00

that’s when I was angry. “You are not going to shoot me.” And it was, “Don’t shoot me.” And it was that sort of anger, “Go away, leave me alone I’m not doing anything wrong. I’m here to help your country.” And it was very much that. It was that was what my anger was around, it wasn’t about him, but it was about, I’m not a bad guy, you’ve got no reason to do this to me. And that’s what my anger was.

05:33:30:00

That’s a very defining moment for you.
It was, yeah.
And that happened fairly early on?
Yes it did. Reg and I had been there for a couple of weeks, we’d driven through checkpoints all the time so like we were really used to them, we had no difficulty with them. We knew what – how it all worked. And the Australian advance party had only been in country for

05:34:00:00

a couple of days so it was really early in the mission. Then to go through that defining moment, but then, my psych debrief then I was one of the few had the one on one debrief, he said, “Oh Wayne, look we worry about the people who’ve been exposed to blah, blah, blah – been exposed to any of them?” And I said, “Yes, all of them.” And he looked and he actually didn’t twig [understand] that yeah, that the exposures of some of us had been quite profound in a lot of ways.

05:34:30:00

On about the second or third day, I drove in my car by myself and drove over a landmine. There was a landmine planted in the road and it was right on the crest of a hill, really clever place to put one, and as I drove up and over, I drove over and I thought, "Bloody hell, I wonder what was in that pothole?" And I stopped and walked back and it was a landmine. And I went, “Jeez! Wow!” And about six weeks later I was driving

05:35:00:00

with a really close colleague from the United Nations and we had representative of the US Embassy with us and we were driving up to the north of the country and we’d been really close and we’d done quite a few things together, Charles Petri and I. And we’re driving and exactly the same thing happened. We drive over a crest of a road, and we’d just been chatting away and this guy was just sitting in the back and he said, “Bloody hell Wayne, what do you reckon that was?” And I said, “Bloody hell mate, I reckon it

05:35:30:00

was a landmine.” Jibber, jibber, jibber and we just kept going. And this guy in the back he said, after a couple of minutes, he said, “Did I actually hear you say that we drove over a landmine?” Said, “Yeah, didn’t you see it?” And so it actually happened to me twice. Kind of drove over a landmine but you know, vehicle on either side of it. But yeah, so it was those sorts of experiences that yeah, they stay with you, that was a

05:36:00:00

for me that was an interesting one because after that, I was always very careful driving on the road and I wouldn’t drive over anything on the road like a piece of paper or anything. For fear of what’s underneath it and when I came home I continued to do the same thing. And would never drive over anything on the road and a really close friend of mine after quite some time, I was relating to him how I was going and had I recovered fully from the mission and I said,

05:36:30:00

“There’s only one thing.” He said, “What’s that?” So this was twelve months later, I’d been home for quite some time, I said, “When I drive on the road I get really worried if there’s something on it that I’m going to drive over a landmine. A piece of paper, anything.” He said, “Wayne, what do you think? Do you think there are any landmines in Australia?” And I said, “No.” And he said, “What I want you to do, I want you to go out there and see something on the road, drive over it. And do that a few times, and then you’ll be right.” And he was right and I did it a couple of times, I thought, "Hey there aren’t any landmines in Australia, it’s okay!"

05:37:00:00

But that little thing stayed with me for a long time, so it’s those sorts of things that you see, you experience, you’re exposed to, and then you come back with it.
Well it’s not exactly a little thing, had you expected landmines?
No, we hadn’t had any, I think there’d been one report of one vehicle hitting a landmine so there hadn’t been a lot of reports, there’d been reports about landmines floating to the surface, there were a lot of local kids being injured by landmines all the time,

05:37:30:00

so we knew there were a lot of landmines around. But we didn’t know any had been laid on roads. And a couple had in other places and it was just you know, one of those, one in a million chance that I was in the wrong place at the wrong time, and not once but twice.
And were you cognisant of who had laid them?
No, didn’t have a clue. No, no all I knew that was they were antipersonnel mines they were only little things, but somebody had picked one up from the road and put it in the hole.

05:38:00:00

The one on the road to the north, that could have been former government forces. They were still a little bit of activity at that stage and we were still wary of driving on that road, so you'd be a little bit more careful with what you were doing.
Very lucky. Twice.
Yeah it was, twice. That’s right.
Just going back a little bit, just in the first

05:38:30:00

stages where you’re negotiating with the Rwandan Government, two things that you mentioned, first of all where to put the Australian hospital, and then secondly moving the refugees, back into Rwanda. Who was doing that negotiating with you? Were you going into those

05:39:00:00

meetings by yourself?
Often by myself, yeah. Quite a few of them I did by myself. In fact the first three or four I did all by myself. Went and saw Doctor Karameera – it was a really interesting meeting, first time he was very cold, very frosty and this was when "You guys bugger off, we don’t care where you go". When I come back and renegotiated with him the second time at the end of that meeting, we stopped

05:39:30:00

by and he spoke good English, and we stopped and just did a little bit of personal reflection and we got to know each other. And it was really interesting that he was a doctor. He was a little bit younger than me, his job in the Rwandan Army was the same job that I had in the Australian Army and he’d lived in Uganda and worked with the RPF before it become the RPA when it moved

05:40:00:00

into Rwanda. And they won the war and he moved from that job to being minister for health and it was a really – it was quite a funny story because he tells the story and I told the story of my job and then I said, “Now you’re the minister for health.” And he said, “Yes.” And he said, “One day you will be minister for health in your country.” And I said, “No bloody way, doesn’t work like that in Australia.” It was, and it was good humoured and once he had sized me up and he could see that I really

05:40:30:00

meant what I was saying, that I was prepared to negotiate and we started to carry through, do the provide the goods, then we ended up with a really close and good working relationship. He tested us out, the very first VIP
Interviewee: Wayne Ramsey Archive ID 2461 Tape 06

06:00:32:00

The first VIP and the test that it provided you with?
Just at the hospital, yes they had a Rwandan soldier who had been badly injured and he was in their hospital, and they had a fairly small hospital immediately over the road from ours. He’d been injured a number of days before and he’d been really badly injured. And they

06:01:00:00

thought he was going to die and they couldn’t do anything more for him. So they said, “We’ve got a VIP for you. One of our soldiers.” And they carted him across and said, “Here he is. Look after him.” And it was really interesting within the hospital because there was argument about, “Oh these bloody VIP Rwandans what we should be doing, we’re not here to look after them, we’re here to look after the military and any Rwandans who should be allowed to pick and choose.” And I stepped in and I said, “They do.

06:01:30:00

And we will look after him to the best of our ability and we will save his life.” And we did. And it was a long hard road, this kid was really badly injured, a lot of surgery, we thought he was going to die. He sat in our intensive care unit for days and days and days and days. Much longer than we had some rules around how long we were prepared to keep non-UN people taking up resources of intensive care beds. And he was there for a long time. We eventually salvaged him and

06:02:00:00

he eventually went back. And they visited. They, being his Rwandan military colleagues and after that, we did get a few VIPs, but from my point of view, they were in most countries what you’d call VIPs. We had the wife of a minister – one of the government ministers who was having difficulty with a labour. And it was that sort of thing. And from my point of view, for the few number of people who they classified as Rwandan VIPs compared to the number

06:02:30:00

of Rwandans that we treated – I was more than happy to accept that this isn’t about total equity it’s not what makes the world go round. Sometimes you’ve got to play the game. And accept what some thought was a really harsh compromise, but from an organisational point of view I could just see that that was a no-brainer.
How long did it take you to break down that defence you came across with the contingent who were saying, “No

06:03:00:00

we’re here to help all, not just..?”
There was inherent tension in the contingent, almost for the whole mission, around what sort of support we should provide, how we should provide it. This is to the Rwandan people. Everybody could understand, we have a military responsibility to look after the UN but then it was, how do we look after Rwandans, which Rwandans do we choose? How do we look after them? Do we accept that there might be two standards of care, that is

06:03:30:00

we provide one standard, First World medicine to ours and Third World medicine to Rwandans. So there was a lot of philosophical issues around the provision of care. Even more so in the refugee camps, where we were treating, lots and lots of people every day. Thousand people or so and at one stage there was a debate – one of the nursing officers, was arguing for euthanasia [mercy killing]. And to have to step in and to actually go through those debates. And say, “No, we

06:04:00:00

will not euthanase, we have no right to even consider euthanasia, we don’t do that in Australia, we’re not going to practise euthanasia here. But we will provide some form of palliative [care for the dying] care.” We will consider what sort of care the Rwandans would provide to themselves. And one of the hardest things is not to establish a system that can’t be sustained when you leave, it’s practising, First World countries practising Third World medicine in a Third World country and it’s really difficult for

06:04:30:00

health professionals to get their head around that, that it’s – they’re not going to do it to the best of their ability, they don’t understand that when I say, “It’s not the same standard.” You would do as good a job as you can, but you will understand there are resource constraints. That you don’t have all the drugs, that we’re not going to provide all the drugs that we have, to care for these patients, because we don’t have them. We only have enough for ourselves. We haven’t been funded to do that. It’s not part of our

06:05:00:00

overt mandate. In the hospital, most of our Rwandan patients came from across the wire, from the public part of the hospital and they were usually the patients that the really sick and injured, who couldn’t be cared for, by the Rwandans or by the NGO, so we actually got sickest of the sickest and then it was difficult because it takes a lot of resources to look after a really sick person. Like when do you turn off the machine? How much of a trial of life do you give people? So there were a lot

06:05:30:00

of really confronting philosophical issues that the medical staff and nursing staff were being faced with all the time, and that was made worse by the fact that our specialists, our medical specialists, rotated every six weeks. So you get a new bunch in, and we’d never done this before as a country, and you’d have to start again, because they want to come in and do something different and, “Hang on, no, we’ve already thought that through, we don’t do this, we don’t do that.” So it was always quite confronting and always a lot of tension around what

06:06:00:00

sort of care do we provide, how do we provide it, where do we provide it? What are the expectations of us? And how do we cope with it?
Just on that question of euthanasia, were family pulled in for consultation when it came to things like that?
No. The families were there, but those decisions, we made decisions – and this is standard practice in intensive care, you do what you call, “ a trial of life.” So you allow a trial of

06:06:30:00

life of 48 hours and if the person’s going to live after 48 hours, they’re going to live. If they’re going to die, they’re going to die. We’ve done our best. We’ve exhausted our resources, we can do no more. There’s somebody out there who will live. And you’re going to have somebody who might sit on the ventilator for two weeks, and in that time, they might still die, mortality rates in intensive care units are high, or are you going to bring in another eight or ten patients to cycle through that bed, who will live? So it’s

06:07:00:00

the real argument, the greater good for the greater number. This is where in Australia, you’re not confronted by that, we hear about access block and intensive care are full. Yes they are, but you never turn anybody away. There’s some discreet activities around manipulation of resources – where we were it was much more profound, our resources were really constrained. We had people queuing up at the gates who we were turning away. So it was much more in your face about

06:07:30:00

who you treated and who you didn’t treat.
When you first went out in those first few weeks, what picture were you drawing here? What were you seeing were the major issues that had to be dealt with?
In the refugee camps, by then, it was old wounds, so old machete wounds, old gunshot wounds, so because that part of the war was over, and

06:08:00:00

by old, I mean some of these were a month old. So there’s a lot of infections, a lot of gangrene. So a lot of surgical support, a lot of amputations were required to sort out many of these trauma problems. So there was a lot of that and then on top of that, primary health care issues. Infectious diseases, people living in squalor, so cholera, all the endemic diseases and overlaid with malnutrition. Malaria

06:08:30:00

was endemic as well. So a lot of infective diseases. So a lot of it was around primary health care, public health sorts of things, what can we do to stop the spread of diseases? So our focus was very much on public health and primary health care for very large numbers but then we would use our surgical teams and they’d deal with as much of the trauma, simple trauma as they could. But he surgical teams that were put in and near the camps, they knew that they could only do simple things

06:09:00:00

like, they’d do amputations, they didn’t have intensive care beds, it was – you could either save this life here and now, or you couldn’t. So they’d only operate on cases where they knew they had a reasonable chance of success and survival.
Did they do amputations in the camp?
No– near Kibeho, we established a surgical team in Butare in the hospital. So we used the local hospital. In

06:09:30:00

Kigali, most of the trauma was either around vehicle accidents or mine injuries and I don’t know, we were seeing, one or two fresh mine injuries a day. And these from mines that were laid during the war that as soon as it rains, it pops up or kids would play with them so the mine injuries were one of the most frequent sources of trauma.

06:10:00:00

You went around the whole country and you started to see the problems that you faced, were there any things that really shocked you during that time?
Not shocked. Yeah, okay it was interesting

06:10:30:00

that you’d drive through villages, and there’d be nothing, village after village of no people, no animals, just literally nothing. And then all of a sudden you’d enter a place where there’d be a crowd of people. Some form of camp. Many of the camps with minimal support. A lot of orphans, a lot of children by themselves. Groups of children. I guess one of the most profoundly moving things that I saw in my whole time there

06:11:00:00

was in a school hall in Butare, the first time we went down there we walked through and there would have been, school hall full of kids. From small up until, I guess, ten or twelve. So they were all that sort of age, all caring for themselves. And they’d been fending for themselves, for a period of time. The nuns would crowd them in there, and a couple of locals were getting food to them. And I walked into this hall, and it was most

06:11:30:00

amazing experience. That these kids saw us, and they all came up and touched and that we had children all around me, I just walked through and they all cycled through and they all spent a couple of minutes, seconds, just touching and then they drifted back to let other children touch and it was just that being re- exposed to an adult. Walked out of that and just burst into tears. It was just amazing. To cycle through all these kids.
Do you think the colour of your skin made an impact on them?

06:12:00:00

No I think it was partly that they knew that we had uniforms on, blue berets so that might have been partly, yes this is good, because we now have security safety and these people are here, there Mzungus [Swahili for white person], so we’ll get food and water and they’ll look after us – there was probably that about it. That they felt safe. So I wonder if that’s what it was, but it was just a most moving experience.
And they’d come, touch and then.?.
Just come, yeah and look and just, I walked

06:12:30:00

through and a little child would hold your hand and then that one would stop and then another one would come on and kind of hold onto my leg so to walk along with a couple of kids holding onto my legs and a couple holding my hands, and one touching my back and they’d just share. It was just an amazing experience.
Who was with you?
I’m not sure. There were three or four other Australians and I’m pretty sure I was with a vehicle from Care Australia. So there were a couple of vehicles of us, I think Care Australia

06:13:00:00

had found out about this group of orphans, and because they’d established themselves at Butare and were down there on some sort of reconnaissance and they had just said, “Oh Wayne, do you want to come and have a look? Let’s see what’s going on?” So I’m pretty sure there were just the two vehicles, so myself and a couple of other Australians.
And when you walked of there and were overwhelmed..
Oh everybody was overwhelmed. Yeah. It was just absolutely amazing, I’d never seen anything like it in my life. I’d seen a lot of kids on the sides of the roads and

06:13:30:00

all this sort of stuff, but just – to feel that kind of that huge swell of emotion amongst all of these children, was – that were hidden emotion.
And what were you able to do for them?
We supported Care Australia and Care Australia took over with the support to the orphanage. And ran it as an orphanage.
Did you go back and..?
No. No.
Would that have been too hard?
No, I just either never passed my mind or too

06:14:00:00

busy or I was doing other things. I’d been there, seen that, done that, move on.
There were a huge amount of orphans that were there, was there a lot of childhood illness or a lot of illness amongst the children?
In different places there was. Yeah. Well, as I was saying before about Kibeho camp, the fear of meningococcal meningitis, outbreak

06:14:30:00

it was that sort of thing that we were afraid of and we’d do whatever we could from a public health point of view to look after that.
And there was a huge overpopulation in Rwanda for the size of the country..
Yes, very densely populated country.
So were there any kind of educational programs in the way of contraception or anything like that to try and deal with

06:15:00:00

the population issue?
See from a Rwandan point of view, they didn’t have a population issue. Very fertile country. They were able to sustain their population. Everybody had a little patch of ground, they all had little gardens, – it was a self-sustained society. So they actually, while it was heavily populated, I think that some of those arguments about, oh this genocide occurred because it was a heavily populated country and it was all around

06:15:30:00

population control. Not sure of that. I don’t know, I don’t think you can argue that as the case.
Who gave you this cultural advice, who helped you really understand the Rwandan culture?
Prior to deployment, we got the handouts that came from different places, of DIO [information office] and others, “This is what we think about Rwanda.” And then when we got there it was word of mouth, talking to others, talking to people who had been there, after a while starting to talk to the locals, get a feel

06:16:00:00

from them about what their society was like. And then just living there and just slowly starting to pick it up.
Well if I can go back to Kigali Hospital, and you mentioned a negotiation, but what kind of state was the hospital in ..?
Tragic. It was. Yeah, it was – it had been in the middle of a war zone. So mortar rounds had fallen through the roof, all the windows were shattered

06:16:30:00

the morgue still had bodies in it, and they’d been stacked high, so it was a mess. That advance party the work they did cleaning it up I understand why that group of people ended up so scarred by what they saw and did. There was a mass grave at the back of the hospital where some thousand bodies had been buried or something like that. There was actually a grave – we didn’t realise it at the time,

06:17:00:00

– there was a centre lawn area between the public hospital and our area, and we could never understand why the locals always walked around. The first time I got there, I saw it and I thought, oh there’s probably landmines in there or something, no, no, it was because there was bodies buried there. So it was just a fetid, awful place. So a lot of work went into cleaning it up so it could be used as a hospital.
And those mass graves and the bodies in the morgue

06:17:30:00

did they place issues of disease?
Yeah, that’s all taken as given. When you do that sort of thing. Our troops were always very careful we were very cognisant of health and hygiene, and all those sorts of things. We were very wary of needle stick injuries, HIV’s [human immunodeficiency virus] rampant in Africa, so we were very careful around all of those sorts of things. It wasn’t the

06:18:00:00

physical aspects of doing it, it was the mental and the psychological aspects of the work that they did.
How long were the advance parties there before the contingent arrived?
Two weeks, a bit over two weeks.
How long did it take them to get the hospital..?
Two weeks. It was – they worked right through. Until the main body arrived. And by then they’d done enough that it could be used as a functioning hospital.
Did the advance party then stay on?
Yeah. They then integrated into the rest of the unit.

06:18:30:00

Fulfilled what would then be their normal role for the rest of the six months.
And once the contingent arrived, and a lot of the plans were in place, what became your routine?
Morning prayers, on the headquarters. So every morning this is what’s happening in the country. So we’d receive

06:19:00:00

the overnight report about incidents that occurred around the countryside. I’d often have a routine call back to Australia, to land headquarters. On what’s going on. On a daily basis I’d drive across to the hospital to see what was going on. There were a lot of problems in the first weeks around the way it was established, the way it was going to run, not having a senior doctor as the CO of the contingent,

06:19:30:00

I ended up having to take on a lot of that responsibility from a technical point of view, about how the hospital should be established, how it should be managed, so that became quite time consuming in the first four to six weeks. Did a lot of routine meetings with the NGOs, there were two meeting a week in the late in the afternoons, that would go on for hours around 150 NGO groups and they all had to have a say and so there was

06:20:00:00

a lot of meetings with NGOs. Regular meeting with government officials, that would occur on a weekly basis. So that was the routine in Kigali, and then pretty much on a second daily basis, I’d get out of the city and go and visit one of the other contingents. Go for two or three days to the north of the country, visit British and the Canadians and to see what was going on, see what problems they had.

06:20:30:00

So I guess the first – for me – we were there before the advance party – advance party and then the next month, was probably the most demanding time of the whole mission and we were working sixteen hour days, you’d stop, go to bed, get up the next day, go to work, and it was after about six weeks we really started to burn out and started, okay we’ve got to have these half days off on a Sunday sort of thing, understand why the rest were doing it and then after I think around two or

06:21:00:00

close to the three month mark, I took leave. I took a couple of days and went across to Kenya with a couple of guys. I was the first of the Australians to take leave but I’d had it and I couldn’t keep going without a break.
What did you do on those Sunday afternoons off?
After about four or five weeks, we had been living in the UN headquarters, in our office. We moved into a place called,

06:21:30:00

Belgian Village. And it was an old tourist resort that was not too far from the headquarters or the parliament but it had been pretty badly shot up, and messed around so we moved into a series of bungalows so there were five of us per bungalow, and over a period of time we kind of upgraded our bungalow – looted doors and furniture and stuff like that, so for me on my Sunday afternoon, most of the other guys would go off and I’d just put the feet up, sit

06:22:00:00

in the sun an listen to a bit of music and read. Just sleep. Just switch off.
And was it easy to switch off when you were there?
Went straight to sleep. Yeah. Yeah, I was just tired. After about three months I was just profoundly tired. I was starting stutter I was so tired, I just couldn’t keep going.
What kind of hours were you keeping during the day?
All up

06:22:30:00

at six, into the headquarters at seven, clear the mail. Prayers at eight, that would take us through until the evening meetings would start at five, they’d go through until seven, you’d grab a bite to eat at either end of the day, back to the headquarters, wrap up anything that had come through during the day, call it quits at nine, maybe ten o'clock, back to the house

06:23:00:00

put your feet up. Have a snooze, get up the next morning and go again. Pretty much that was it.
So over twelve hour day.
Every day, yeah, yeah.
You mentioned 150 NGOs there, what was the relationship like with them?

06:23:30:00

I found it quite interesting, I didn’t mind it. I actually found working with the UN, reasonably enjoyable as well, many of my colleagues had difficulty with the bureaucracy, they had difficulty with the NGOs, what are they doing? Once you understood what they were all about, and knew that they had different values, different belief sets, different philosophies, different objectives and as long as you could identify those that you could align with then I didn’t have too much difficulty with it. I pretty quickly

06:24:00:00

really early in the piece, went out of my way to spend a bit of time with Medicins Sans Frontieres [Doctors Without Borders], and while they are very anti military, I found them a highly professional and a really well sorted organisation. I had a lot of time for the work that they did. And we actually collaborated on a number of projects. ICRC, again, very professional.
Who is ICRC?

06:24:30:00

International Committee for Red Cross. So the big players were really professional. The interesting thing with the NGOs was that they actually put in their best people first, as you would expect and then they started to rotate and over a period of time they’d bring in less and less experienced people and after a period of time they’d have what I used to call their kids, who came in idealistic and, “You bloody military bugger off, what are you here for?” But those that had been through the really hard times, were the ones that we respected.

06:25:00:00

And respected us so it was interesting to see this transition amongst the NGO community. The professional NGOs for a lot of time for the amateurs who’d blow in blow out. For six, eight weeks or something like that. They had a lot less time.
You were meeting with them quite regularly, so the amateurs are still providing a certain amount of health care ..?
Yeah but they didn’t do very much. It was really interesting, at the end of the day I looked

06:25:30:00

at the amount of resources that are committed through NGOs and then you see what actually ends up on the ground, and say, "Hang on, you Australia, you put in 20 million dollars, and what’s it bought here in Rwanda? An ambulance and a couple of medics, right." That’s exaggerating, but it was that sort of thing that I guess left me somewhat disillusioned about the way NGOs work. That’s why I was happy with the big ones, because the big professional NGOs they provided a range

06:26:00:00

of services. They knew what they were there for, they knew how they were going to do it and they were the ones who were there through the really hard times. Like ICRC, they had a hospital operating in Kigali in the middle of the war. They had people killed while they were doing surgery and they had mortar rounds falling through the roof of their hospital, they’re the ones that I truly respect. Ones who came in afterwards and then even further down the track, the amateurs who were there just for whatever reason, yeah. They were the ones that I struggled with. There’s no form of accreditation, that’s the trouble

06:26:30:00

although after a little while the government started to take on that role, of what I call accreditation, and they kicked a few of the NGOs out who they weren’t satisfied with the work that they were doing.
As a medical practitioner, and also as commanding officer of the Australia medical contingent that’s there, you are there for the health care of the Rwandans and I’m just wondering if

06:27:00:00

it really concerned you, some of the things that you saw them doing, from a health and medical perspective?
And I’d have a chat to the minister for health. And say, “Are you aware that one of those NGOs is doing this? I wouldn’t do that.” And he was a doctor. And that was the advantage that I had, that I was moving in circles where I could shape and influence, and where I had no direct responsibility for NGOs, and we didn’t have, our primary mission was around looking after Rwandans, it was around

06:27:30:00

the UN and whatever we could to support the Rwandans we would, but because of the levels that I was working at, I could influence and say those sorts of things and I did.
Back to the Australian contingent and you touched on the pre-deployment time, working with the infantry and the medical contingents, how did that relationship pan out through your time there?
I found it always

06:28:00:00

pretty testy. On the – first of all from the medical contingent’s point of view, it was a very disparate group of people who were pulled together and that’s always difficult. And I was aware, like of experiences in my time with 1 Field Hospital and 2 Mil, pulling together two units and how long that took, so in my mind, I felt it would probably take it six weeks to bed down this group of people and it did take about that time. But in those first weeks it was really, really difficult because these

06:28:30:00

people had never worked together. You can practise but to actually do a job and to throw people in so while people could do their job, like, "Okay I’m a nurse, I’ll provide nursing care. I’m a doctor, I’ll do this". It’s – how do they all come together?. Who makes them gel? Who sets the standards? Where are our protocols? Because they’d all come from slightly different backgrounds, so it was that – creating a sense of harmony amongst the workforce and then knowing that your specialists were going to come and go every six weeks,

06:29:00:00

so there was always that confusion about, here we go again, what are the rules that we’re going to apply for caring for this sort of patient. So there were difficulties. And they started to smooth out, I think as people became tired of, oh here we go again, I can’t be bothered fighting the fight, so people were emotionally beaten down. And just went into that, I’ll accept it and not so much days to go, but it started to get to that –

06:29:30:00

after about the halfway mark, we’re at halfway mark, three months to go, and that and that and that. Then on the other side was the infantry angle to it. And that was an interesting one because we talk about security earlier on and my own personal thoughts about security, after a little while, like did we really need an infantry company? Did we need four APCs [armoured personnel carriers] and the machine guns that went with those APCs to provide us with security? And my feeling was, that as it unfolded,

06:30:00:00

we were actually creating a rod for our own back. Because we had around the hospital and the barracks where the troops were living, we had machine guns, and troops patrolling and all this sort of stuff, and the Rwandan military was just over the road and it was very confronting to them, like, here are all these Australian troops out with their weapons and doing all this sort of stuff, hang on, why are we doing that? This is a hospital – I struggled with the idea of, why do we have

06:30:30:00

all of this security to look after 100 medics? Other contingents didn’t have that. My feeling was, on deployment, it wasn’t overkill. On deployment it made sense. But I think that our warriors were more than happy to keep having warriors there and even with the second contingent they kept the same sort of numbers there and while I put up my hand and said, “Maybe we should think about the size of the security force.” My warrior

06:31:00:00

colleagues weren’t going to have a bar of that. Meant that another 120 of them were going to get medals on the second rotation. And I think that it didn’t help us having that number of security forces on the ground.
What was the ratio? How was the contingent made up?
We had 300, so we had 100 on the medical side, 100 on the security side, and then 100 supporting. So

06:31:30:00

a third was medical, a third was security and a third in the middle and if you’d cut the size of the security force then you would have cut the administrative support force, so you could have actually tailored it back a little bit and I – if you wanted to be rational about it, and I argued that the second contingent could probably have been smaller, but our military’s slow to change. Once it gets into a mindset, that’s it and we continue to live on with it and

06:32:00:00

what I couldn’t see a reason for fighting it. As a big fight, it wasn’t one that I was going to win. When somebody posed the question, how big should the medical contingent be? We actually seriously rationally looked at it, how could we change the shape of it? And identified some slots that we could give up. Once that happened, “Infantry are you going to give any up?” “Oh no, we still need 100.” Give up, what’s the point?

06:32:30:00

In hindsight with the Kibeho massacre, did you think – did that change your opinion that the infantry could have been smaller?
I was actually surprised that we had troops at Kibeho, full stop. I was surprised that we had the number of troops that we had down there. I wasn’t there, so I’m not in the mind of the commander at the time about why I had troops at Kibeho. But we didn’t have, during my time, we tried not to put too many troops

06:33:00:00

into the camps. It was my feeling it was better not to be there. Better to go in and come out rather than be there. So why be there at all?
Whilst you were there, the medical staff that were at the refugee camps, how was their security maintained?
Well they would drive in by day. And stay back somewhere else. Most of ours were living at Butare and it was about an hour, hour and a half drive, they drove in every day and came out at night.

06:33:30:00

And were there any infantry with them?
Yes, they had security element with them but it wasn’t a large one.
You also mention working with the UN, you found that okay, whilst others found that a bit difficult, why did it work for you?
I guess because I could see

06:34:00:00

how they worked. And I understood how they worked. I was prepared to accept the fact that they made compromises that they were very slow, I accepted corruption, not by saying I condoned it, but I acknowledged that it occurred and if we know it occurs, and we can’t do anything about it, then how do you work around it? I accepted that they’re a huge bureaucracy, absolutely huge bureaucracy, if you’re working with a bureaucracy things are going to turn slowly. So if they are, don’t fight it

06:34:30:00

see how you can work with it and just accept it. You might try and short cut it, but it was just a matter of acceptance. So I just basically didn’t fight against it. I just accepted, "This is the way they do business, and I’m going to make it work as well as I can for me". And I went out of my way to ensure that in New York they knew what we were doing. And I was constantly on the phone to New York, not as much as I was back to Australia, but I kept

06:35:00:00

them well informed about what we were doing. And that ended up to our advantage. Because the UN in New York appreciated the work that we were doing and we got a lot of support. They also castigated us for some of the things that we were doing, like the amount of refugee effort that we were involved in, they didn’t support that at all. But then it was pretty easy, for me I just faced the bureaucracy and just said, “Tough.” Yeah, “We’re doing it.”
Why didn’t they think it was a good idea to give that much support to the refugees?

06:35:30:00

They didn’t see it as our mission. It was as simple as that, our mission was to support the UN forces and then do whatever else we could but within the resource constraints that we had. They were worried that we were using resources to support the refugees that – who’s paying for this? It was basically, “Who’s funding this?” And we actually sorted them out in the end because most of the drugs that we were using, we were sourcing from NGO, from Pharmaceuticals Sans Frontiere, so actually we did it on the cheap.

06:36:00:00

The UN wasn’t paying for it and once we told them that they weren't, “Oh, okay we don’t care what you do.” So it was just an interesting way of dealing with it.
Does having a presence at the UN headquarters to your advantage?
Absolutely pivotal. Yeah, – we ran the medical headquarters, myself and there were another three, we had the chief planner and two of the senior logisticians, so

06:36:30:00

we actually covered all the key areas on the headquarters, and there were all up, eight or ten of us on the UN headquarters and that was really, really important – to ensure that from our point of view the mission was being well managed, but from a medical point of view, it was going the way that we wanted it to go.
And it was a multi-national force that was there – you made mention of going out and visiting the other – who else was operating in the various areas around you?

06:37:00:00

At the beginning of the mission, the Canadians had a field ambulance and they deployed for 100 days. The British had a field ambulance and they deployed I think for 60 or 80 days, they both had very specific mandates around humanitarian relief. Our primary mandate was around support to the UN. And then the Canadians had a pretty substantial medical contingent. Who else? A number of the

06:37:30:00

African countries had reasonable sized contingents. The Ghanaians, Nigerians – the Tunisians, the Indians eventually deployed and they had a really high quality medical unit. Racking my brain, a number of other smaller ones, there was a Franco-African battalion made up of the French speaking African countries

06:38:00:00

Senegal, a couple of others. Quite a large number of medical contingents. Really great group of people. Really – highly respected them, had a lot of time for all of them. Was interesting how they all coalesced as a group and were really happy to work together. I found that really, really endearing, no long term friends out of it, kept in contact with a couple for a little while.

06:38:30:00

But at that time, to see this group of people, prepared to work together, and to as I said, coalesce into an integrated team, I found really interesting, it was great.
Did you learn anything from these other cultures that you were working with?
Oh you always do. Yeah. Tunisians had health promotion, was really big for them. Preventative health. That was their whole emphasis.

06:39:00:00

Which was really interesting, like at the front door, big sign, “HIV Kills.” With a box of condoms for their soldiers. I didn’t know that there was a country that had this real culture and a culture of prevention. The quality of the surgeons, a surgeon from Senegal I think, just outstanding, he was a really great urologist. And there was a bit of trauma went through

06:39:30:00

Kigali Hospital and one of the surgeons said, “Oh jeez, we need a urologist.” “Well, we’ve got one on the border.” And we flew him across to do an operation. Yeah, I think just the fact that medicine’s a common language. Not a spoken language, but there’s enough common in it that there are shared values and beliefs and I think it was that – the shared value of compassion, caring

06:40:00:00

that a group of people who want to do good and the fact that they all had the same issues around, “The bloody warriors hate us.” For all of them they all had this same inherent tension between, we’re here to care, and the rest of the contingent’s here to kill people. And how do we work with them? And so it was kind of – it’s a universal issue in militaries.
Interviewee: Wayne Ramsey Archive ID 2641 Tape 07

07:00:31:00

Just still staying with managing, the different politics with so many different countries involved. What sort of challenges did that pose for you when it came to the rules of engagement?
The most important thing was to know what national rules applied to that contingent.

07:01:00:00

Like for me, the first thing I had to figure out, what are my rules? And I knew how important those rules were. It was pretty seriously imparted in my head, before I left, “Wayne, thou shalt not do the following.” And it was, you won’t do this, and I got a letter – might have been the land commander, saying, “You won’t do the following things, you can do this but you cannot do that, unless you seek national approval.” I couldn’t use the infantry for anything other than self protection. There were

07:01:30:00

a series of rules like that. I wasn’t allowed to cross the border, I had to stay within Rwanda. If I was going to move troops into a particular area, more than a certain number of troops, I had to seek permission so we had really clear rules of engagement around what we were or not allowed to do. So to me, I knew that, absolutely. And it actually created a few problems as we went along. So having known that, I realised very quickly that the other countries must have similar sort of rules so

07:02:00:00

what I found out really quickly was, “What are you allowed to do? And what are you not allowed to do?” So once I knew that, it was really easy. Next thing for me then – for me to assess, what’s their capability, how good are they? Early in the piece for example, the British and the Canadians both really high quality units, really outstanding units, the Canadian unit – had been cobbled together a little bit like the Australian one, was really heavy, field ambulance in name only.

07:02:30:00

British one was a Parafield ambulance. Light scaled, highly trained, highly mobile. When it came to which one of those two am I going to move to the south-west? It was a no brainer, 23 PFA [Parafield Field Ambulance] British, do you want to go? And as well as that, the Canadians had a mandate that said, “You must stay in the north of Rwanda unless you go back and get national approval.” Well, it wasn’t worth my while doing that, when I knew that the British unit was the right one to move. So I spoke to

07:03:00:00

Alan Horley and, “Hey mate, do you want to go down the south-west?.” “Oh yes, I’ll do that.” And away he went. So it was understanding their capabilities, so knowing what their rules, as you say, of engagement are and then deciding what are they capable of doing? Thereafter from a planner’s point of view it wasn’t all that difficult, it was just normal standard, health planning that we got into.
So what sort of problems did it cause you along the way?

07:03:30:00

I actually didn’t end up with any major dramas out of the medical contingents. I don’t know. Cultural problems, the Ethiopians when they arrived, they moved down to the south-west where the French were. And they had two doctors and one of them got killed in a road accident on day one. And so that was pretty tragic. So we had to repatriate the body back to Ethiopia.

07:04:00:00

What we didn’t realise was that they kind of had cultural mores, and the other doctor went back. So it left them without and medical support so we actually had to send a group of Australian medics and a doctor down to Team Gugu with the Ethiopians they weren’t prepared to go without medical support. I think out of the whole mission – we do a bit of cobbling together now and then, but at the end of the day, no different to any standard sort of operational planning that you would do anywhere.

07:04:30:00

Yeah, so that’s what actually made it, from an operator’s point of view it was a pretty easy mission it was really great, we had all these resources, a small country, not too difficult to move things round, so from an operational or from a military perspective, this was just one of those manna from heaven, you’ve got all these resources. Not enough resources to do all the work, but like, more resources than I’d ever had command on an exercise.

07:05:00:00

On that note of resources, were you also keeping an eye on resupplying hospital supplies?
Yes, one of my staff members ran the medical logistics. So he was responsible for all logistic resupply and some of the contingents managed their own resupply but most of it went through my office. We had a lot of troubles with resupply, that was a real

07:05:30:00

issue. It took weeks and weeks and weeks, for many of our essential supplies to start trickling in. We’d been aware of that from previous UN missions so we knew that it was going to be a problem, and it was a problem. But again, that’s a lot of people complained about the UN, “This is the UN blah, blah, blah.” And my response was, “Yes, this is not new, this isn’t just them getting at us. The UN has a problem when it comes to resupply. You

07:06:00:00

can whinge all you like, but we’re not going to make a difference we have to consider how we’re going to live with the resources that we have. And live within a resource constrained environment.” That created a lot of problems, especially for some of our medical specialists. Who were used to – snap the fingers, there it is. Well sorry guys, you can snap your fingers but it’s still in Australia and it’s not going to come here that quickly. So many of them the specialists had real difficulties with that and

07:06:30:00

some of them went to extraordinary lengths to get special pieces of kit sent across to Rwanda. To allow them to do certain things.
So they would bypass the..?
Yeah, that’s right. Have it mailed in, or whatever, they’d just – yeah.
So what did you understand was

07:07:00:00

the on the ground logistic issues of resupply? Why did it take so long?
I think a fair amount of it was argy bargy [dispute] between UN headquarters in New York and not specifically the Australian Government but the Australian Defence Force about who’s paying, who’s responsible for it? So it was a follow on from those earlier negotiations about who’s doing what and who’s going to take responsibility? And then

07:07:30:00

it was, because most of the stuff came from Australia, how does it get from Australia, to Rwanda? And a lot of it got to Nairobi, and it got stuck in an air head, and getting it from Nairobi into Rwanda, proved difficulties, so it was just a very tenuous resupply chain that it took many, many months before it was sorted out. Longer than it should, I’m not being an apologist for the system I think it was abysmal, the resupply support that we received, absolutely

07:08:00:00

but I know what was happening and why. It could have been fixed and in later missions I think Australia became a lot smarter about what sort of agreements it entered into with the UN, who was going to do the resupply and how it was going to work. I think kind of, in this one, Australia bit off more than it could chew by saying, “We’ll do all the resupply of medical logistics.” Not realising how complicated it was going to be. And you’ve got – some of the stuff’s got to be

07:08:30:00

maintained at the right temperatures so you’ve got a cold chain to manage, and it wasn’t as if the Australian air force was flying all this stuff straight into Rwanda, it’s kind of – some of it was going commercial air, and it was just a very complicated set of arrangements that could have been done a lot better.
How much of that was that budget or cost related?
No, a little bit, I think most of it was just

07:09:00:00

we weren’t good at it. By, we I mean the Australian Defence Force just wasn’t good at it. Not good at resupply. Not across such large distances. I wasn’t surprised though, jeez, I’ve exercised in northern Australia and had the same sort of problems. And you would have thought you would have sometimes a couple of exercises I did, I thought, jeez, you could put it on a truck and drive it up here and last it for a month without getting resupplies so it’s, a bit more a reflection of the same. Ten years ago, maybe they’ve improved today.

07:09:30:00

And another aspect of your resources that you had at hand, you mentioned – what were your coms [communications] like, the com system?
Fabulous. Absolutely fabulous. The only time we didn’t have coms, was in the first couple of weeks, when I went in before the advance party arrived and during that time I borrowed a sat [satellite] phone from a French Foreign Legionnaire, just down the corridor and he fortunately didn’t charge us

07:10:00:00

twenty dollars a minute or whatever. Once the advance party turned up, I had a sat phone in my office, I could pick up the phone and phone Australia, phone the world. And once we established coms, at the barracks next to the hospital, we could talk to the world secure and we eventually established Telstra came across, put in a satellite and we had payphones. So the communications system when we had it up and running was really great, it was the first major

07:10:30:00

mission where communications I suppose after Cambodia, had worked really well and the mail actually took longer to get working properly than the phone system. And so communications were fine. We found it a bit off putting though that kind of you had to use a payphone to phone home. Would have thought that our government would have said, “It’s okay guys, you can have a ten minute phone call every week and get in queue.” We all had to buy phone cards and put them through.

07:11:00:00

So yeah, some of the way we were supported around that, like it was great to have a phone but why did you have to pay? It’s only been in the last days where we discovered that our service was tax exempt, ten years later, you think, oh come on. What’s it all about?
So when you went out to regional areas, out from Kigali what sort of radios did you have?
We were on the UN band

07:11:30:00

and we were just using Motorolas, just little hand-helds. And they were all fine. Because there were repeater stations all round the country, small country, and you could pretty much talk to anybody through the UN network as we drove around. And as the Australian contingent drove around they had their vehicle mounted radios and all that sorts of things so communications in the country were fine. Yeah, it was tiny little country and that was one of the advantages of it.

07:12:00:00

Well now I’d like to go back to moving your resources from the north to the south, but first of all I’d like to ask you the failed plan that you’ve been talking about,

07:12:30:00

could you elaborate a bit more – you said you tried to get the message across to the refugees, to the Rwandans that they should come back to their country. How did you physically do that?
The UN had – typical UN, soon as you cross the border, people become refugees they’re not displaced

07:13:00:00

persons, so UNAMIR [United Nations Assistance Mission in Rwanda], the mission that I was with, had responsibility to the border. And once you crossed the border at Goma, it became UNHCR, the United Nations Commission for Refugees. So they were responsible for refugees who were actually Rwandans. And it was through UNHCR, that the word was put into the camps that this support was being provided and they did it with Rwandans. And they did all sorts of things, posted signs, spoke to the locals the

07:13:30:00

head chiefs of villages and all that sort of stuff. So the word was spread throughout those camps that we were there to support them. And word of mouth in that country, we used radio, the Rwandan people are addicted to radios, that was used to start the genocide. Radios

07:14:00:00

were used to promote our plan and how we saw it working. They were just afraid, they were afraid of moving back, to their villages. And they were afraid of retribution by the RPA.
I just wondered whether it was a concerted education?
Yes. Yeah, well but likewise we did the same in the DP [IDP - internally displaced persons] camps in Rwanda, trying to encourage the local population to move home, we brought in all the head people and we talked to them and we – well with some of the camps in

07:14:30:00

south- west Rwanda we actually took the head people back to their home villages to show them that it was safe. And try and encourage them to jump on trucks and drive them back and people just were really hesitant to move. So it was well understood – had to communicate with the local population. It was more this inertia of no they weren’t going to move.
So how often did you physically make those trips back to people’s homes with them?
Well, specifically

07:15:00:00

out of the south-west, the British got actively involved in trying to ship internally displaced back to their villages. And they had an operation called, “Operation Retour.” Where they took trucks to DP camps, they established staging posts, and they collected some of the head people, drove them back, they did that several times, with different groups of people from different camps. So it was, yeah it was a pretty active

07:15:30:00

process of encouraging people to move home.
When you made that decision , moving the resources from the north to the south, you mentioned that was one of the biggest decisions that you ever really made professionally, could you

07:16:00:00

take us through how you finally arrived at that decision?
I’d driven up along the road in the north-west several times, flown it a couple of times, and flown over the camps in the north-west to know that mass of population and the fact that very small numbers were moving. The feedback that we were getting from the military observers on the border

07:16:30:00

around kind of debriefing locals who were all going home and around what was happening in the camps, there was a lot of unrest in the camps, there was still quite a number of former government forces there who were violently discouraging people from moving home, and there were actually refugee flows further into Zaire away from the border rather than coming back. It was pretty obvious at that stage that the population we were going to move home en masse, what we were hoping was that it was going to be a huge exit

07:17:00:00

a mass relocation, back to their home locations and to have numbers of 500 or 1000 a day moving back was just, they were minuscule numbers. At the same time, I first of all drove down to the south-west when the French were there and to see the numbers of people that were there and how they were living, and to get the feedback from the French who were also indicating that these people were threatening to move;

07:17:30:00

then to drive from where the camps were, through to the border and it’s through what was colloquially known as, forest, but this forest was a serious rainforest and a very steep mountain road and it was going to take them about five days to walk. So this was going to be a really difficult walk and once they got to the border and crossed the border there was just nothing there. So having done that drive and having had a look at it, – and trying to figure out, okay well if these refugees

07:18:00:00

in the north aren’t going to move and they’re not going to come home, then maybe we can apply the same logic to those in the south-west – where they are, they’re not going to move, they’re not going to go home and the worst case is that they’re going to exodus out of the country – they’re not going to go home, they’re actually the same population, they were Hutus, vast majority of them in these camps were Hutus, same as in the north, that’s why they weren’t going home, they were fearing retribution

07:18:30:00

they weren’t Tutsis. So it was a matter of – if they’re not going to move in the north, and they’re not moving in the south, then what we have to do is consider how we can at least secure them in the south and protect them so that they don’t continue to flee where they can’t be supported. So it was pretty much that logic flow. How did I come – well I was actively involved, I did a reconnaissance to the south-west with a group of NGOs several of the key players. Charles Petrie,

07:19:00:00

who was the head of UNREO, the United Nations Rwanda Emergency Organisation, a couple of ladies from USAID [American government aid organisation] the biggest donor – what I figured pretty quickly was that the US Government was sponsoring most of the US NGOs [United Stated non government organisations], to be there and it was direct sponsorship and it was coming from the government to NGOs to be there, and over two thirds of their money was government money so the USAID office was actually responsible – they could pretty much tell the NGOs, “We’re paying you, do this

07:19:30:00

sort of thing.” So I went down there with them and one other person, can’t remember who, so we actually drove down there had a look at the camps, went on to the border, and on the way back we actually talked through this, kind of this solution that what might we do? They didn’t realise that I was prepared to move the military they were just saying, “Oh we’ll try and get some NGOs into the camps when the French leave.” And at that stage, I’d started to say, “Well yeah.” They were contemplating putting

07:20:00:00

a lot of medical support, even further towards the border, so they said, “If these people leave, then at least we’ll give them some support when they get there.” And I just said, “Well, why don’t you be a little bit more definitive and don’t do that, just support them in the camps, keep them in the camps, so that they don’t leave.” And that was basically the way the plot unfolded. We had a meeting back in Kigali, with about twenty of the major NGOs. They all agreed, the strategy. Bar one or two.

07:20:30:00

The rest came on board very quickly. The NGOs were really, they had difficulty moving that was the advantage of the military we had the logistics, and as the French were pulling out, the Ethiopian battalion landed and we just moved the British field ambulance and they moved within 48 hours. So they went in, filled the void. We put an Australian treatment section in and very quickly, this was having white faces. And the European white faced troops, on the ground, with security,

07:21:00:00

and for the DPs I think they could see, okay our security’s being replaced from the French into these white troops and by the way they’re providing medical support and it was pretty much how that unfolded. A couple of the NGOs established DP camps right down on the border. But very few of the refugees left. So at least that provided them with the support, then the real problem was, okay, we’ve stabilised the country

07:21:30:00

now how do we get the people to go home? And that’s where particularly the British transport regiment tried to kind of truck people back and –
So at that very important decision meeting in Kigali, the NGOs were there, but was there a representative from the Rwandan Government?
Yes. It would have been the second top, second head of – it might have been - it wasn’t the vice president but it was at that sort of level. They

07:22:00:00

always had their liaison officers at those meetings. And there were a number of very senior representatives there that day. They didn’t speak up too much, and they were – I think they were more angry that we were in their country, full stop. And that was the issue for them, like “Why are you doing all of this?” And we were saying, “Well we’re here – this is UN, our mandate is to protect the people. And we’re here to protect the people no matter what, we’re here to protect them from you, we’re here to protect

07:22:30:00

them from somebody else, we’re just here to stop genocide. ”And then we got into the genocide debate about, where were you bastards during the genocide? You weren’t here to stop the genocide, now you’re trying to stop this one and they’re the bad guys. And so it was, it became heated along those lines, but it wasn’t as if, “No, don’t do it.”
It would have been a very tense meeting..
It was.
I was wondering what the Rwandan attitude was and whether they cared.
Oh yeah, they cared

07:23:00:00

yeah. But for them, they didn’t want the Hutus to leave, they actually wanted the Hutus to go home. It was really interesting that’s what they wanted. They wanted the Hutus to return to their villages. They pretty quickly established a set of legal rules about what to do with perpetrators of genocide, and they were arresting them and they arrested about 20,000 people but they actually – it was an interesting approach, it was, they were

07:23:30:00

only after the really bad bastards. I found it fascinating, like there were circumstances where people were forced to kill people. Like, they just did, “If you don’t kill that person, I’m going to kill you.” So there was a lot of that was going on. So they weren’t after the people who were forced to commit murder, but they were after those who forced murder, and they were arresting them, so it wasn’t as if they hated all the Hutus, they just hated the extremists. And they wanted the extremists.

07:24:00:00

And they knew that there were extremists in these camps. They wanted them and they wanted access to them and that was much of their argument about, “We want to get into these camps because we know who we’re going to arrest.” And they had the hit list – “We’re going to arrest these people.” And they knew who they were about. So it was more around, "Okay, what’re you going to do with them afterwards?" So they didn’t want another genocide, and they didn’t want the people to flee and die, they wanted them to go home, because they wanted Rwanda to go back to being a normal country.

07:24:30:00

From their perspective.
In hindsight what do you think was the feeling at the end of that day? Coming to that decision. Do you think everybody was in agreement?
The majority of the key NGOs were in agreement. I think everybody knew that the pull out of the French was going to create real problems. Everybody knew that something had to be done, to stabilise

07:25:00:00

the south-west of the country. The real debate was, around, do we try and prevent the people from leaving these refugee camps? Or do we take one of the NGO views, we’re just there to support people no matter what they do. If they leave, we’ll be there to help them, if they don’t leave, we’ll be there to help them. And that’s one of the theories, it’s a bit of a UNHCR theory, we’re not there to determine what should happen, so our approach, we were being a little bit more decisive by saying, “We’re actually going to

07:25:30:00

encourage the people not to leave. And we’re going to encourage them by not supporting them to leave.” And that was the approach that we took, and I guess, it would have only been five percent of the NGOs who felt strongly against that approach, who made the conscious decision to establish something down on the border. I think MSF [Doctors Without Borders] was one. Although, what they did was, they prepared DP camps, refugee camps, but they only marked out sites. So while they were strongly

07:26:00:00

opposed, they didn’t actually overtly establish really significant presence in advance of the pull out of the French.
And that model that you’ve just described of getting the people to stay in camp, that’s sort of based on that you made an assessment that you could help them from a medical perspective better if they stayed in one place.
And where they were. That’s right. If they’d moved – well first of all if they’d moved into Zaire, across the

07:26:30:00

border, we didn’t have the mandate to go there. And it was logistically it was a nightmare to get to that part of the country, the only way you could get there was through Rwanda. It was just so isolated there was literally no way of getting resources in, there was no airports, resources couldn’t be flown in, there were no roads on that side of the country, so if they were going to flee, they were really going into

07:27:00:00

the land of death and dying. So for us, it was – and there was talk that they were going to flee. That was the talk that was coming out of the camps. Rwandans were going in and talking to them, saying, “What’re you going to do when the French leave?” And they said, “The French leave, we’re leaving.” So it was pretty clear that there was going to be a mass exodus.

07:27:30:00

Just that terrible feeling you must have had of withdrawing from the north, knowing that you were leaving people more or less to their own devices..
Yeah, I didn’t struggle with that, to be honest. Having been in both locations and seen the mass of humanity in Kibeho and those surrounding

07:28:00:00

camps and Kibeho was only one of them, there were a number of other camps almost as big, and just seeing all these people, who were going to be left to their own devices, with no support at all, I actually didn’t struggle with the decision, once I’d thought through the logic of why are we doing this, had talked it through with some pretty close colleagues, for me, it was yeah, that was it, decision made. And we just got on with it.

07:28:30:00

So then back to the south and when you got wind of the rumours going round that they were going to flee after the French withdrew – did you go about changing them around? How did you get them to stay?
By putting troops on the ground. By putting medical troops on the ground and that’s what we did. The British field ambulance drove

07:29:00:00

down to the south-west, they set themselves up on a tea plantation right near the camps. And they broke up into small groups and they sent out medical teams and they drove into the middle of each of the camps and they set up aid stations. And the Australian treatment section did exactly the same to the camps around But we divvyed them up, looked at the map and said, Brits said, “We’ll have these ones.” Australians said, “We’ll have these ones.” And the NGOs selected those closest to Butare so

07:29:30:00

they – it was fair enough, they took the easiest ones to get to, military had more resources, went in to the more difficult areas, and the less secure areas, and we just had presence in all of the camps and as soon as the French left, the very next day, we had a presence. And we did it that quickly. And it was just that, it was just a presence but it was enough for the DPs to know – that something had happened, but it’s still okay, we’re not being massacred and there was

07:30:00:00

still kind of – there are still troops here. And then very quickly the Ghanaians moved a company - infantry company into the area, they went into Kibeho, so they had – then they had infantry troops in there as well so we kind of replaced the French with our own. That’s how it made it work. But the UN had bugger all troops, the only troops they had, the only real troops they had were medical. That’s where this was really interesting. They only had about three battalions in the whole country at this stage

07:30:30:00

over half the force was medical so it was, “Let’s put medics down there.”
And did you visit after the relocation?
Oh yeah. Yeah. Regularly – during those weeks, I was on the road, half of every week. So I’d go down there for a couple of days, visit different spots, I sometimes I’d fly down, sometimes drive. And then continue to go up to the north

07:31:00:00

pretty much on a fortnightly basis just to see how things were going to make sure that it was still under control up there, the Canadians were still there. We relocated the Canadians to where the British were, they left a small element where they were, so it wasn’t as if we took everything out. But we took the major resources out.
And how did the DPs respond, once the British had set up a presence?
It was fine. Yeah.

07:31:30:00

I got the feeling, after about three months, I guess, you could tell the camps had become really stable. They were starting to set up shop stalls and things like that, they were flogging some of the food that they were being distributed, there were brothels there. They were big camps but there was shops, pretty rough and ready, but it was there, they were trading. And

07:32:00:00

at that stage I realised, so this was now quite some time afterwards. These places had really started to stabilise, I guess we’re now talking into October, November. This is now a couple of months, several months later and it must have been pretty much at the time, the British were thinking, was close to leaving and it was at the time the British left and that’s when I started to think and I guess that was towards the end of November, “What are we going to do with these camps?” And

07:32:30:00

what – like these people aren’t going to move, then it was, these people are here to stay. They’re not going to flee, they’ve got no reason to, they’re being supported, they’re not going home, and then we actually made the next big decision and I pulled the Australian contingent out. When the British left, I pulled the treatment section out as well and I said, “No, we’re not going to support the camps any more.” We moved back to Butare and then eventually pulled out and went back to Kigali

07:33:00:00

and did a lot of work around Kigali, but we stopped providing any support to the DPs in the camps. If we were staying there we were going to provide this forever and a day. And that wasn’t a pressure from the Rwandan Government but it was just, again, this was a self evident one, that something had to happen then to get these people to go home and they were starting to trickle home. The Brits were moving about 1500 a day , by trucks back to their home communes and

07:33:30:00

villages. But there was still large numbers and some of them were starting to walk back – they needed a trigger to move back. And it was about that stage that the Rwandan Government started to put troops into some of the smaller camps, and they started to forcibly close some of the smaller camps. And I’m not sure of dates, I guess October, November, that started to happen. We became aware of it, really early in the piece when we received

07:34:00:00

a call from maybe one of the military observers about a massacre that happened in one of the small and really isolated camps. And the reports of somewhere between 50 and 100 being injured or killed. And we’d actually just started to consider - it sounds a bit ironic, around our mass casualty plan, around, what do you do in the event that a large number of casualties occur and we’d actually been thinking about our own people and the operation had got to the stage where we were in steady state, so we were starting plan for

07:34:30:00

the really unexpected so we thought, okay, what happens if one of our trucks hits a landmine or something and we’ve got fifteen or twenty casualties, how are we going to evacuate them? So we’d come up with a disaster plan that we were going to fly a surgical team or at least a surgeon, a small team, into the site, do a reconnaissance and then decide how we’re going to evacuate them. So it was almost within days of us making this plan, this massacre occurred. So I flew down with the team – I said, “Let’s test the disaster plan.” We actually didn’t believe it

07:35:00:00

and when we flew in there, it was – yeah it was really bad, like I guess, it was a small commune – smaller than that, just a few houses. And then the camp –
Is this near Butare?
It was near Butare. Yeah. A few houses, and then there was a small camp I guess with maybe 10,000 not nearby and 20 or 30 bodies,

07:35:30:00

40 or 50 injured people in and around this place and they were really badly injured. We triaged first aid, flew half a dozen back to Kigali, trucked another ten or fifteen back to Butare where we looked after them. It was quite clear that the Rwandans had gone in and they were forcing people home. Just as an aside to that, a couple of Rwandan soldiers

07:36:00:00

were injured. And they were here at the same place and there were - a Rwandan officer, fairly high ranking, with I guess, about a section, and by this time, we’d flown in and some – I guess about, we had two or three vehicles from Butare, Australian vehicles it might have been an infantry section there. And the Rwandan said, “You’ll look after my soldier as well.” And everybody looked at me, and I said, “We’ll look after him.”

07:36:30:00

And that was a really for me it wasn’t a tough call, I knew we had no choice. We couldn’t look after one without looking after the other, that was our mandate. I didn’t care, I knew they’d done it, but we had to do it. It was interesting just as a post script just that out of all of the debriefs that went amongst the soldiers, there were a couple commented that they hated me for making that decision. How could you make that decision? And they were the infantry soldiers, they couldn’t understand how you

07:37:00:00

could make that decision to look after these people who had done it. And it’s interesting feedback I eventually got out of from the psyches about, “Well how did Wayne Ramsey perform?” Well the only negative – seriously negative feedback we got was around that one incident. Which to my way of thinking again, was one that we had no choice.
And your humanitarian views came to the fore?
They did, that’s right. Yeah. That was, we had no choice. But going back to the forced camp closures, that continued

07:37:30:00

on from then. That was the first and from then on every few weeks there’d be a massacre of some sort in or around one of the small camps and quite a few of them closed. The people – they went home. The Rwandan forces were actually forcing them but they were going home, they weren’t fleeing, anywhere else. A few crossed the border into Burundi and a few camps were established in Burundi. But most of these people actually went home. If you think about where that eventually

07:38:00:00

led, most of them closed except for Kibeho, and right at the end, Kibeho was the only one that was left standing. And if you think about it, well what happened, well the worst of the worst of the Hutus had concentrated there. And the RPA knew that’s where they were. That’s why they went into Kibeho and did the Kibeho massacre.
Well going back to the story about Butare, the massacre or large number of casualties at Butare,

07:38:30:00

It was a massacre.
I’m not sure whether this happened, but I was wondering – were you required to step in and help medically?
Yeah, it was the only time in the whole mission. That I really seriously did something hands on. It was interesting, Kibeho. We flew down, it was really early in the morning, and we were all tired and we got there

07:39:00:00

and we had a highly experienced orthopaedic surgeon who was going to do the triage for us and we had a couple of medics, air force medics, a nurse and another doctor as part of a resus [resuscitation] team and they all very quickly scattered, we could see that there were some pretty seriously injured people there. And this young air force medic, as I was walking around trying to get a grip of what was happening, this air force medic I could see that he was struggling with a Rwandan with a gunshot would to the chest, and it was through and through and you could just

07:39:30:00

see it. And he - I’m not sure what he was struggling to do, I could see gunshot wound, sucking chest wound and through my whole life it was one of those first aid things, how to deal with a sucking chest wound, so I’d practised it so many times, with a shell dressing, and I remember when I left my home I’d actually put a few shell dressings in my pockets. So I said to this young fellow, I said, “Listen if you wouldn’t mind I’ll have a go at this one.” And he looked at me and he said, “Okay.” And I could see he was pretty nervous and so I did the whole thing and put the bandage on and afterwards I said, “Jeez that was good.”

07:40:00:00

And I said, “Wanted to do that for 20 years, never had to treat a sucking chest wound, now I have.” And it was just, for me it was kind of - it was quite ironic. So treated my sucking chest wound and got the young air force medic out of the shit.
And it was that satisfying for you?
Sure was, yeah. That’s right, the fact that well, I was always confident that I could – okay pretty simple first aid, but I

07:40:30:00

knew it would work ,but I’d actually never done it in practice. And the fella lived.
Was that the only time that you helped out medically?
Pretty close to it, yeah, other than earlier in the piece when we started to sort out resus and things like that but I didn’t get involved hands on.
Interviewee: Wayne Ramsey Archive ID 2461 Tape 08

08:00:31:00

So how did the disaster plan work out then?
Worked well, we were quite happy. Bit ironic that we’d been there for months and took us all that time to actually write down how we were going to do it but I think from our point of view, we could see that things were starting to happen and while we’d been there, there had been no significant elements where there had been large numbers of casualties, like our own troops, we’d taken – had the odd vehicle accident

08:01:00:00

and odd mine injury but we hadn’t ever sustained anything more than ones or twos. I guess I was just starting to – at that stage, wonder about the stability in the country. So that was, okay if we do have a larger number of casualties, what do we do about it? And yeah, what sort of resources should we mobilise, how do we mobilise them? And it was more a matter of okay, if we say we have to do this really quickly can we do it? So it was just for me, let’s test it and make sure we can respond.

08:01:30:00

And how important was it to start reading the signs of what was happening around the country at that time?
All the time. Did that all the time. Every morning, what’s happening in the country? And as I reflect back and have a look at my diary, it was always around, what’s happening in the country, what’s the stability in the country and what’s happening on the borders, we were always very conscious of what was happening around us. Which, well that was our role on a headquarters. Interesting when I talked

08:02:00:00

to my colleagues who worked in the hospital, their whole view and perception of Rwanda is totally different because they were focussed in and around the hospital all the time, so many of them didn’t actually know in much detail what was happening around them. That was probably one of the real benefits of my position. That where I was, I really had that big overview and could see everything that was happening, not only from a military point of view, but also from a social and a

08:02:30:00

political point of view.
And so this massacre happened in Butare, but you also mentioned off camera that it nearly happened in Kibeho, as well.
Well, what happened after that, that was the first of a series of incidents where there were forced closure of camps and over a number of months, the RPA went into smaller camps and forcibly closed them. So that – there was just this heightened state of tension in the country.

08:03:00:00

And while, in and around Kigali, it was very safe. By then, early in the piece there would be gunfire every night. But by then, most of that had stopped. All the shops had opened and Kigali was pretty much as close to a normal African city as you could get, for one that had just come out of a war zone; but as soon as you got into the countryside there was a lot more tension. And especially around the camps. A lot more RPA presence,

08:03:30:00

a lot more activity and you could sense that the government was starting to become very frustrated with both the UN presence and the presence of their own people in these camps. And they want it resolved one way or another.
And that tension that was building, could you see that tension building between the RPA and the infantry soldiers that were there?
A little bit, there had always been tension. Between the RPA and the Australian troops. Right from day one

08:04:00:00

typical Australian troops, they wanted to be in anybody’s face and they were. Like, “We’re here, bigger, tougher than anybody.” And they weren’t going to take anything from anybody. So there was always that tension. It was an interesting problem, why was it like that? To my way of thinking the RPA were actually, they were the good guys. They’d won the war, and it was a just war. It was their country, and we were interlopers so for me, I actually, I didn’t see the RPA.

08:04:30:00

as anything more than a military; that some of the things they were doing, I didn’t agree with, I didn’t agree with massacres to close camps, but it was their country. But our troops, my feeling was very much, you go to a place like that, somebody’s got to be the enemy. So who’s the enemy? Well the enemy is those guys that we can see who have got gumboots and guns. So it was very much, okay we need an enemy, they’re the enemy and let’s deal with them like that, so that’s what created the

08:05:00:00

tension between I think our infantry and the government forces.
And you’ve been able to give examples of how you’d been able to exert influence in certain areas, but were you able to exert any influence in the way that relationship was handled?
No, no I couldn’t. No. At the end of the day and this is part of a military chain of command, the CO of the Australian Medical Support Force, Pat Macintosh, he was the CO, and it was

08:05:30:00

his job to provide security to the Australian troops. Not my job to tell him how to provide security. It was my job to ensure that security was provided and conformed to our rules of engagement, and there were a couple of incidences where he wanted to use our infantry to do more than provide security and I prevented that. Because we weren’t allowed to do that, but when it came to how did his troops operate? That was his call. And there’s no way

08:06:00:00

I would have been able to do that it just wouldn’t have worked. But it was no different to him – there’s no way he would have told me how to make sure that the medical side of the organisation was running. That was my job.
Can you give an example of where he wanted to extend that role?
Yes, we were approached to provide infantry into the south-west of Rwanda. It was either at the time the French were pulling out

08:06:30:00

or a separate incident and the UN wanted a infantry presence in the south-west. I’d been away for 24 hours, I think I’d been in the north of the country and when I came back, I met with Pat, pretty much on a daily basis. And he said, “Oh Wayne, I’m going to send a platoon to the south-west.” And I said, “Yeah, what’s their mission?” He said, “Oh we’re going to do some patrolling around..” It might have even been around Butare

08:07:00:00

I said, “You can’t do that!” I said, “We’re not allowed to do that.” He said, “Oh I’ve got clearance from Land headquarters.” And I thought, yeah right. So I made a phone call to Land headquarters and said, “Listen what’s going on? We’ve never been allowed to do this, who’s changed the rules?” And must have been really late at night back at Land headquarters and somebody said, “Oh no, so and so’s made a decision, it’s okay.” And I said, “Right.” So I went back to Pat and I said, “I’m still not happy with this

08:07:30:00

wait 24 hours, and then you can do it.” And fortunately, that very next morning, I got a phone call from might have been the Land commander it might have been higher, saying, “You will not do that, blah, blah, blah.” And decisions have been made on land headquarters with Pat, that the land commander didn’t know about and I didn’t know about and it was stymied really quickly. So that’s – that is one of the only examples where I stepped in and said, “No, you will not do it. Outside of your

08:08:00:00

mandate, outside of my mandate, I’m the commander, you won’t do it.”
What could you see as the political implications of sending a platoon out for those purposes?
Government had made a decision. There was a government decision that this was a medical mission. And it was not an infantry war fighting mission, if they’d got down there, and got in a fire fight with the RPA or somebody it would have just blown up in everybody’s face. The political ramifications of it

08:08:30:00

would have been huge. So for me, that was – "clearly don’t do it". There was only one time that we actually used our infantry in a security fashion and that was for a very specific mission and I got approval from the highest levels in Australia, and it was actually the Rwandan Government changed their currency over. And we provided our infantry, provided the escort to the new currency, as it was distributed

08:09:00:00

to the north and the south of the country. And it was a one off mission, and I agreed to it because of its political importance for the country this was, and it was such sensitive mission that the security was paramount, because if anybody knew this was going to happen the currency markets would have just gone mad with the old currency. So nobody knew, I think I’m guessing, but my recollection was that

08:09:30:00

the force commander and somebody very senior in the Rwandan Government spoke to me. And said, “Wayne, will you do this? Nobody else is to know.” And the only person I told was Pat and I said, “I’m going to agree to this and you’re not to tell your troops, but we’re going to do it and you’ll have troops at this location at such and such a time.” I spoke to the Land commander and it was a one on one phone call, he agreed and we did it. That’s the only time we used our troops during the whole mission in a non security

08:10:00:00

fashion.
Well we have spoken about some of the internal conflicts within the medical contingent, but how did the medical and the infantry contingent gel? [work together]
Reasonably well, it was really interesting there was always this kind of you know, medics and infantry sort of thing. I know the medics used to set up the infantry and bring them into the hospital and show them gory bits and try and see how many they could get to faint and all those sorts of things. So there

08:10:30:00

was a fair amount of that. There was a fair amount of the medics getting back at them saying, “You guys are just her to look after us, thankyou very much this is a medical mission.” And for the infantry, that was pretty demeaning. Their whole training had been around, “We are pre-eminent, we’re the war fighters and you guys are just here to support us.” So it was this role reversal that created I think, a lot of the tension that the infantry couldn’t understand, “Why can’t we get out there and do our job? We’re trained to go and fight and

08:11:00:00

not just look after you bloody medics.” And they were there just looking after medics, confined to barracks, it was very tight, very controlled environment. Very difficult for them.
And how did you help that relationship? How was morale and how was it maintained?
I didn’t actively intervene. I could see what was going on, it’s one of those real dramas, what do you do? Do you interfere? And you might make matters worse. Or do you

08:11:30:00

let it go? And if things are starting to get out of hand, intervene and through most of that I decided to play a pretty hands off – there was no way we were going to make a difference, this was a really confined space, the tensions were – the animosity wasn’t bad. There was no spite, there were not fights. So it wasn’t malevolent. And my reading of it was,

08:12:00:00

this is healthy. It’s tension but while it’s healthy tension, it’s not going to lead to the sort of problems where it rips the unit apart and that didn’t happen. So from my point of view, yeah, it was one of the foibles of this particular mission the way it was constructed.
And you’ve mentioned before that the rotating specialists that came through every six weeks, what was the purpose of having that rotation?

08:12:30:00

They wouldn’t go for any longer. They’re reservists, they’re all part timers. So I actually had to fib to them, to get them there for six weeks, because to begin with they were saying, “Oh we’ll go for a fortnight.” And I said, “Well how about if you go for four weeks?” And they said, “Yeah, rightio.” And then I started to stretch it out and said, “Well listen we’ve got all these problems, let’s make it six weeks.” So they were all agreed. What they didn’t know they were signing up to was six weeks in country, and it took nearly a week to get them there and a week to bring them back, so even

08:13:00:00

six weeks was stretching it for them. It’s a long time for a specialist, a reserve specialist to be away from their practice, a lot of them lost a lot of money, lost a lot of their practices didn’t stop but slowed right down. This had never happened before so it was – that was the reason for the rotation.
What skills were they bringing in? What areas were they specialising in?
Surgeon, anaesthetist, intensive care specialist,

08:13:30:00

what else did we have, there were six of them? Must have been two of each, two surgeons, two anaesthetists, two intensivists, cum physicians.
And did they do any training..?
Yes, they did short pre-deployment training, really short. A few days.
And did they do any in country training, passing on some of their knowledge to the medical contingent?
Yeah. After a little while when things started to slow down,

08:14:00:00

we started to run in-house training, once a month inviting all the doctors from the other contingents and ran medical training, gave presentations, papers, all the normal sorts of things that you were doing at a stock standard hospital, yeah. I thought it was really great. Sharing, have a look at case studies, present cases, lessons learned, all those sorts of things.

08:14:30:00

You mentioned that the Tunisians were big on preventative care, what role did preventative care play in Kigali Hospital and the refugee camps?
It was big, it really was. In and around the – just for the Australian contingent, keeping down mosquitos, both in Kigali and with the troops in Butare, like we were worried about malaria, malaria’s endemic in Rwanda and

08:15:00:00

other vector borne diseases so it was around that. And doing exactly the same but more providing advice to the other contingents around their infections diseases. And especially malaria, a number of the battalions lost a lot of troops, from malaria, the Ghanaians lost a lot, the Ethiopians did. So we’d send in our preventative medicine people as experts to provide advice to them about what they should be doing to keep their malaria rates down.

08:15:30:00

And then as well as that, in and around the mass graves, once the wet season started, lots of bodies started to pop out of the ground and things like that so there was a lot of work around yeah, preventative health and hygiene around the mass grave sites. Very, very difficult for the prev med [preventative medicine] guys, scarred a lot of them.
They saw, pretty much the worst of the worst

08:16:00:00

because they – and it was only a small group of five or six of them but wherever there were kind of large numbers of bodies or whatever, somewhere along the line one or two of them would be there to do whatever had to be done to make sure that the bodies were disposed of or covered or whatever.
And was there any body count undertaken?
Vaguely. Not – yeah at one stage a lot of tracking of mass graves occurred. And

08:16:30:00

there were teams sent out to track and I can recall on the large maps in the UN headquarters, it kind of pretty much on a daily basis, pins were being put up that would identify more mass graves so yeah, that – for a period of time, there was a lot of tracking of mass graves, estimations on the number in the graves and that’s kind of when the real figures of the genocide started to come out.
And with the preventative care, was any of the Australian contingent were they

08:17:00:00

going through regular medical check-ups?
No. We all had medical checks before we left. There was no requirement while we were there, nothing in addition to what we – no. Other than the check before people came home.
And did anything come up in those checks before people came home?
Nobody got HIV. Which I thought was pretty remarkable. We had quite a few needle stick [hypodermic needle] injuries.

08:17:30:00

By way of checks that was probably the most significant thing that we did. Other than that, out of the medical side, yeah I guess there were a few claims for different sorts of things, nothing as a major stand out. Major stand out of course, is around PTSD [post traumatic stress disorder].
You said you were surprised no HIV came out..?
Well, not surprised – I was happy. I think we were very fortunate that we didn’t. Nearly

08:18:00:00

100% of the patients in the Rwandan Hospital, the Rwandans had HIV. Between 80 and 100%. 30% of the population had HIV. So the possibility of exposure amongst our medical staff was high. A number of our staff with needle stick injuries, so that was very difficult for them. And a couple of the surgeons had needle stick injuries and they found that whole experience emotionally very traumatic.
This is early to

08:18:30:00

mid ‘90s, so we know now about the epidemic in Africa, but then were you..?
No, we knew then too. Yep, yeah. Everybody knew about HIV then so that wasn’t an issue for us we weren’t as well prepared as we could have been. And that was an equipment issue. The gloves that the surgeons were wearing, were normal surgical gloves and there are special hardened

08:19:00:00

almost like Kevlar gloves that they should have been provided with. And I think from the surgeon’s point of view, that was one of the things that made them most angry, that we weren’t able to provide them with protective equipment. That would minimise their risk. The way they dealt with it in fact was to inform their colleagues who were coming over on the next rotation, “Bring your own gloves.” And they did. And not long after we started to get a resupply through.

08:19:30:00

Were you prepared for the scale – I’m sure that you were aware of HIV but.. the scale of it?
Yeah, we weren’t surprised. We were aware of it from when we were there even on the reconnaissance talking to people that we knew that it was a major problem. And we were able to brief all of our people before we went that HIV was a major problem.
On a bit of lighter note, was there any hearts and minds

08:20:00:00

work or any type of community work that the contingent underwent?
Yeah, they supported and orphanage in Kigali, some of them supported the orphanages in Butare. Hearts and minds? I guess they were the major things. Yeah, bit of mine clearing around schools. Our

08:20:30:00

engineer troop did a fair amount of mine clearing, so schools and public places, so yeah that sort of hearts and minds we did. Yeah, orphanages were a really important, especially for the infantry, they decided to take on one of the local orphanages and I think provided for the marriage soldiers with kids that outlet they were looking for.
And what kind of work were they doing at the orphanages?

08:21:00:00

Built playthings and gave them stuff and ran functions and were just basically there they’d kind of go in once a week and play with the kids and do things with them. Yeah.
You also developed a close relationship with Ros Carr, while you were there. How did you get to meet her, how did that come about?
I had the opportunity to go to north-west Rwanda up near Ruhengeri, and I travelled

08:21:30:00

up with a couple of colleagues from USA. From the US Embassy. And we were going up there, primarily to have a look at a couple of the NGOs who were working up there, but as we got into discussions they indicated that Ros Carr lived up there somewhere. US Citizen, in her early eighties, and we didn’t know if she was alive or not. So we decided as well as checking out a couple of the NGOs that

08:22:00:00

we’d go and see if she was still there. And lo and behold she was. Amazing old lady.
You didn’t know if she was alive or not, so some anticipation about going there?
There were rumours that she was alive, in that there were no rumours that she was dead. So we went up there with the assumption that she was still there. It wasn’t easy to get into her home.

08:22:30:00

A really winding, difficult side road and there were quite a few RPA checkpoints along there, so they kind of we were actively discouraged from going on, but we eventually talked our way through. And when we got there, she just bounded out of the house, “Hello, how are you? I’m Ros Carr.” And one of the women said, “Yes, we know, how are you doing?” And she said, “I’m fine thankyou, I’ve got no staff, they’ve all been massacred.” I thought, oh right. And she survived the whole time.

08:23:00:00

An amazing old lady. Not long afterwards, we provided her – then the Australian contingent - with some support. Did a little bit of building work for her. Somebody put in some sort of a power, through her house, you know one of these bare cables with lights plugged into them. And she said, “I hate that power, I just can’t use my candles.” So she was this magnificent lady so we said, “We’ll take that out for you. Go back to your candles.”

08:23:30:00

“It’s fine thankyou.” So we did that and then some of our people got to work – she established an orphanage there so by the time we left she was looking after 20 or 30 orphans as well, so she needed some work around an outhouse that our carpenters did and she was really good to us because we sent some of our soldiers up there for a couple of days if they needed a rest; and it was just amazing peace and tranquillity in a country that had been through so much.

08:24:00:00

And she was doing work – was she doing any research work with the gorillas in the area?
No, no most of the things she did, she actually had a fascinating story. She drove across Africa with her husband, just before the Second World War and they got the Great Lakes in central Africa and he deserted her. So she drove on and ended up at Goma, in the centre of Africa and decided that she had to do

08:24:30:00

something for a living, so she decided to grow cut flowers, or flowers and cut them. And she did that right through on through the Second World War into second half of the century and established her property, ended up with about five acres of flowers and she used to sell flowers to all of the international hotels, major hotels around central Africa and that’s how she survived pretty much the rest of her life and then there’s the story about Dianne Fosse and the gorillas and –

08:25:00:00

Fosse kind of lived very close to Ros, they used to socialise and so she had stories about Dianne Fosse and all those sorts of things. She went through all the Fosse saga and then afterwards and then kind of lived through the genocide and the civil war as well.
So how did you get to go see the gorillas?
I did a – right at the end of the mission, in fact it must have been I think I only had a week or so to go. And it was just one of

08:25:30:00

those things I decided, you can’t come to central Africa and not go and see them. So I went up with one of my colleagues, one of the guys working with me, Stu Press and by then there were Rwandan guides who were RPA soldiers who would take you up and you had to meet at a certain location, you had to book in. And they were running, basically a tour. And they were charging top dollar – it was 100 US Dollars or something, it wasn’t

08:26:00:00

cheap and we got up to this site and there were, I think another three people and unfortunately one of them was a British anthropologist, who had said and had done things that had really pissed off the RPA. And the way it works is that the gorillas in the morning are quite low in the mountain and it’s only a short walk to see them an hour or so trek. But as the day goes on they move up the mountain.

08:26:30:00

And they eat, forage and they sleep on the top of the mountain, in the morning, first thing in the morning, go down the bottom of the hill and start again. So they just have this cycle. So the idea is to catch them early in the morning when they’re at the bottom of the mountain, anyway, we got messed around and we didn’t start to climb until twelve o'clock, so half the day had gone. And the top of this mountain’s twelve and a half thousand feet. And it was a really steep climb and it was tough. And we knew that you had to be off the mountain by four o'clock. So by

08:27:00:00

three thirty we’d just about got to the top of the mountain and mist was coming down, it was miserable and I was starting to feel nauseated from the altitude and I just didn’t think I could go on. And I called over the guide and kind of really laboured breathing and I’m shaking my head and he’s saying, “No, no, look there.” And I looked over my shoulder and literally there was this huge silverback and all of a sudden I looked around and there were kind of 20 or 30 gorillas and we were right in the middle of them. And I looked

08:27:30:00

up and the mist just came down. Wow. And sat there for fifteen minutes. One of those magical mystical experiences.
How did it feel, going out and after having dealt with everything that you had in Rwanda and seeing what you had seen and gone through all of that and then going away to this patch of paradise?
It was

08:28:00:00

the dichotomy of operational service and especially that mission was the bad was really, really bad and the good was as good as it could ever get. I guess how do you ever bring that together? And I think it’s probably I don’t know. The things we saw and did shouldn’t expect anybody to have to do. Some of those things, but then on the positive note – that fifteen minutes just before sunset, in Rwanda. Just a

08:28:30:00

beautiful, beautiful country, beautiful people and many of us had leave across the border and safari parks and the night train to Mombassa.
We took a picture of a photo that you had when you first got there, of a flower in amongst all of that. When you see images like that, does it make sense?
No. That didn’t. That’s why I photographed it.

08:29:00:00

When you were there and doing the work that you were doing, and feeling some of that frustration, how did you deal with that, the frustration that came about of that work?
At the time, you don’t deal with it, you just accept it. I did. I ignored it. Because you can’t, you just have to accept the frustration, you’ve got your job to do, let’s do it. So for me, I think they’re

08:29:30:00

the things that people bottle up. The photograph from Gitarama, that we had visited the hospital at Gitarama and there were patients left in that hospital, and they’d been left to die, they still had their drips up. For me, as a medical person, that was really difficult. How could you leave somebody to die in a hospital? Next door to it was the church. There’d been a massacre in that church. And it was ghastly, it wasn’t

08:30:00:00

just a massacre, and bad things had been done. How do you bring that together and then there was this beautiful flower. So it’s – yeah, at the time you just look, and then move on. And it was interesting too, because during my time there, I really felt that I was coping, but it was interesting too, because towards the end of the mission, I’d start to think, jeez this place smells. And the smell was always there and it was the smell of death.

08:30:30:00

And it wasn’t actually there.
When you came across patients left for dead in the hospital like that, did you do any treatment?
No, they were dead. They’d been there for weeks. They’d just been left them dead. Yeah. Whoever had been there, the doctors and nurses, they’d either been killed or they’d fled. So these people had just been left to die. But then that was the spot where I

08:31:00:00

took the avocados. So then, remember the joy that I got out of that. So it’s that, how do you put it all together? And at the end of the day, I don’t try. I just accept it that bad things and good things happen. And sooner or later, you have to – the bad things do occur, it’s interesting, before I went, I never would march on Anzac Day,

08:31:30:00

now I do. It’s that, being able to share with colleagues, experiences and I don’t think there’s anything wrong with talking it out with colleagues, you reminisce on the good and then you come out with some of that really dark humour, do you remember? Yeah right. And now I don’t think it hurts to recount those stories, especially with colleagues.

08:32:00:00

What were some of the humorous times that you had, humour is really important in situations like that, what were some of the really good times?
Once we moved into the Belgian Village, we ended up occupying – we had – the medical staff, we had a house and the other four or five (UNCLEAR aloggy) types had a second house, and we moved in and it was real mess, we had no furniture

08:32:30:00

all the doors had been looted. Windows broken, kind of no lights or anything like that and we moved in one night and that night we decided we’d better go and see if there was some furniture in some of the other places. So we actually wandered down to the – into the bungalow right behind us, the next one up and we walked through and it was dark and we saw this huge mahogany table, a twelve seater.

08:33:00:00

And we looted it. Took it back into our place. And the next afternoon, lo and behold there was all sorts of furore because that was the deputy force commander’s house. And we’d stolen the deputy force commander’s table. And not long afterwards, we decided to have open house, everybody come in so we thought, what are we going to do with the table? So we covered it up and pushed it to the side and when he came in, we sat around on the table so he didn’t know. So yeah, they’re the sorts of things..yeah.

08:33:30:00

So you didn’t fess up..?
God no, we were Australians. Nothing wrong with that. So we did lots of really interesting things. And it was – it was social. After the first weeks, when it was really difficult, we did start to have a social life. The Ghanaians had a band, military band, well they used to play in the Belgian Village every Friday night and they were a dance band as well.

08:34:00:00

So they’d play music and come midnight on a Friday night I was like, “Shut-up you buggers I want to go to sleep.” And the NGOs would come in and kind of it would be a social Friday night. And we ended up with a social life. And that’s what happens. At the end of the day we were – it wasn’t actually a war zone, it had been a war zone. It was a risky place to live, but it wasn’t still a war zone. Bad things had happened there, but that was past. Bad things were still happening in other places, but where we were and

08:34:30:00

in Kigali, it wasn’t like that and I think that’s where the rest of the contingent, the medical support force, actually struggled to come to grips with that they actually set themselves up in a barbed wire cage and defended themselves for six months when they actually didn’t have to, because after a couple of months, you could go out. As long as you were careful, thought about your safety, thought about your security, didn’t go by yourself, you went with somebody else, others knew where you were, you had

08:35:00:00

your radio, those that wanted to carry weapons and pistols they’d make sure they had it in their backpack. Some of the guys carried Stehrs [automatic rifles] and they’d break them and put them in their packs so they had their weapons. So I didn’t have any difficulty with the officers of the headquarters having a social life. And it’s interesting too that those with the Australian medical support force, always, “Oh UN guys on the headquarters, you had a great time.” Well, didn’t have a great time, they worked really hard, but also did interesting things. And others could have done that as well.

08:35:30:00

The rest did when they went on leave, because they all went to Kenya and far afield so it was a matter of what could you do in Nairobi. The only thing I did with our guys, I put a couple of the nightclubs off limits. Only in so far as I said, “If you go there, you’re fools, people get killed there. Don’t go to Kigali Nights, please guys.” So it was a matter of how did you deal with it? Right towards the end, the lads said, “Come on boss, we’ll take you to one of the nightclubs.” We went

08:36:00:00

to one of the nightclubs in Kigali and got there quite late, the boys obviously knew their way around, had a couple of beers there, walked out, got in the car, sat down and I was in the passenger seat, and it was amazing because even then, a fellow was escorting a woman out, and do you know what he did as soon as he got to our car? He pulled his pistol out, pointed it at us, and protected her as he walked across the road. Right. But okay, that wasn’t because it was a war zone, that if you were in New York or somewhere like that, that’s

08:36:30:00

the sort of thing that could happen. That sort of thing happens in some parts of Sydney. So it was – that was just a bad city and people being very careful.
That’s interesting that the social life was still kicking over. What was the nightclub like?
It rocked. It was great. Buy cocktails, buy beers. Good music, a lot of middle class Africans

08:37:00:00

who were really having a good time. They’d come back, they were wealthy, many of them had returned from other places, they’d returned from Uganda, some had come from Zaire, Tanzania, they were Rwandans who’d fled in the ’60s and they were actually kids of an earlier generation who were a middle class who were returning back to Rwanda. Some of them were locals who were just getting on with life.
You sound like you were very resourceful, and you tried to make do with

08:37:30:00

what you had, what personal items did you take from Australia with you?
I took a CD [compact disc] player, I took music, I took a few books. And not much more. Just enough for me, the bare necessities of the things that get you by.

08:38:00:00

And what luxury items did you really miss or were really difficult to find when you were there?
I don’t know, I was pretty lucky, I was married at the time, and my wife used to send me care packages, and she pretty much posted everything to me. I got salami and a couple of things didn’t work, like the cheese didn’t work. But the salami did. She posted me a pavlova. Through the mail, you can do a lot through the mail.

08:38:30:00

Yeah, so from a food point of view, once the mail started to work, most people were the same, if they had somebody who was had – showed a bit of ingenuity at the other end, you could get by with most things.
How did the pavlova get there?
It was fine.
How did she wrap it?
Well you know they come in a box, so you buy a pav in a box, and then just bubble wrapped it, just packaged it tight, turned up perfectly and it must have

08:39:00:00

turned up around Christmas time and we had a few people around and so I had the pavlova and I got a bit of cream and I got some fruit, so I put the fruit on the pavlova and had these people in, I think they were Americans. They said, “Wayne, fabulous.” I said, “Jeez, it took me a long time beating the eggs.” They were particularly impressed with the pav. So you can be resourceful. Yeah, for me it was, we were there seven nearly eight months. It was not a whole life, there are things that you don’t need

08:39:30:00

for that period of time. We were very busy and you don’t want for a lot. And as long as you’ve got the bare necessities, and for me, my bare necessities were around music and having something to read. I was pretty contented. Not that I would want to go back to that life again.
Was there anything that you really missed?
Yeah we missed the sport. Yeah.

08:40:00:00

Getting to sporting matches. I don’t know, for me I guess it’s too far back now, because these aren’t the stand out things that stick in your mind, what was really important, what did I miss? Yeah, no they’re not things that stand in my mind. I guess maybe that’s kind of my personality.
This is also the time before internet and immediate contact or even your phone systems, were they limited?

08:40:30:00

I used to phone home every week. So I’d use my ten minutes, I didn’t do anything that any of the troops couldn’t do so they were limited to ten minutes, I limited myself to ten minutes or not significant lengths of time. I wrote home, had a laptop, so it was pretty easy to knock up a letter and you do a bit of cut and paste so you can send mail to a number of people. We didn’t have internet access. So it was more mail that we were using. Yeah.
Interviewee: Wayne Ramsey Archive ID 2461 Tape 09

09:00:31:00

Just touching on a couple of other little things, how did you spend that Christmas, do you remember?
I do. Yes. We had Christmas in Rwanda in the Belgian Village and a couple of the guys had taken leave, and so there were I think, three of us left. So we had Christmas in Rwanda

09:01:00:00

we – now I’m just trying to put it all together, how did we do it. We had breakfast together, in the village and then we drove over to the hospital. And we had Christmas lunch with the rest of the contingent that took us through until early afternoon and then that evening we went back to the village and then we had our own private Christmas Day because in the military, Christmas Day is where the officers look after the soldiers and it was all very much

09:01:30:00

a traditional military Christmas lunch. Which was nice and fine and it’s kind of, that’s the way the military does it. So we did that but then the evening was very much our own social thing and we’d all had things posted over from Australia, so we had lots of goodies and we pulled out all of our goodies and we had a couple of people around that we also knew were in town and by themselves, must have ended up about six of us and we sat around that evening

09:02:00:00

we had a really pleasant evening, on a really nice Christmas Day. I think pretty much everybody enjoyed Christmas Day. I think though, New Year’s Eve, New Year’s Eve was more interesting. We went over to the military hospital again – there was a huge New Year’s Eve activity and at midnight, all hell broke loose

09:02:30:00

around the town and the RPA troops started firing everywhere. And it really looked like a war had started. It – like at one stage we looked outside and, “Shit! What the bloody hell is going on?” Midnight’s the start of World War III in Rwanda. Tracer fire, firing over the hill, machine gun opened fire right in front of us and straight down the road. And just the RPA celebrating. Went on for about fifteen minutes. And it was full on, it was

09:03:00:00

there were – the expended rounds, the bullets were falling out of the sky on the roof and it was just a clatter like rain of these spent rounds. Falling on our roof. I looked at Pat Macintosh and kind of said, “Well bloody hell what’re we going to do?” He said. “Wayne, I reckon what we should do is just have another beer.” There wasn’t anything we could do. Was just one of those, okay might have a car accident, you might get accidentally shot on New Year’s Eve and we just sat it out

09:03:30:00

and it was one of the most amazing light shows I’ve ever seen. You see New Year’s Eve with crackers going off and things, well, yep we had it live.
I’d like to talk about how your time came to an end.

09:04:00:00

And what did you have to go through to hand over?
Yeah, okay, our mission ended at the end of January, ’95, and a lot of planning had gone into the next contingent, we were starting to get a lot of contact from our replacements about what was going to happen, when was it going to happen. We were all starting to get pretty burnt out by then. People were tired. Just physically exhausted from being there.

09:04:30:00

And I recall that right towards the end we had a couple of parades, the farewell parading country and the other contingent flew in. It all happened pretty quickly we were very keen to have a very quick hand over, something around 48 hours, the last thing we wanted was a prolonged hand over, couldn’t see the point of that so we had a really short, sharp hand over. And that seemed to work pretty well.

09:05:00:00

So our counterparts on the headquarters came in, they lived with us, double bunked for a couple of days. While we literally did our hand overs on the headquarters, I brought in all the other medical people so they could meet my successor and it was, pretty much a stock standard, military hand over. From our point of view it went pretty smoothly.
Who was your successor?
Peter Wharf. Peter took over from me.

09:05:30:00

So they all came in all bright eyed and bushy tailed and all ready to go and we’d been there for seven or eight months and we kind of starting to get a bit jaded and yeah, just weary, so it’s a long time to be away, and although we had breaks, and I had two short leaves, I took a week off in the UK around Christmas time and so we did have our breaks, I always wonder at the people who didn’t take a break.

09:06:00:00

Surprised me anybody who would go away for that length of time and not take time out. But even with that and I had in my last couple of breaks were pretty close together, I was still ready to go home. On that last day we knew that we were going to be picked up by a 747, and we all went to the airport and kind of waited and there was a departure lounge and all that sort of stuff. And we waited,

09:06:30:00

and we waited and the plane was delayed and still wasn’t coming in and still wasn’t coming in and what do you do? You just hang around and some of the people were sleeping and again, I said to Pat, “Mate we might as well open the bar.” And we opened the bar and everybody had a couple of beers and because everybody was getting really frustrated I said, “The worst thing that can happen, is it doesn’t turn up tonight, the best thing that ever happens, turns up about now, everybody’s had a couple of beers, they’ll get on that plane and they’ll go straight to sleep and

09:07:00:00

they’ll sleep right through.” And that’s almost exactly what happened. It just on sunset, this – in it came.
Were you sad to be going?
No. No, not at all. I was ready to go. Some were. It was interesting, some of the guys, “This is lovely, want to stay here, stay here forever and a day doing this.” Oh no. I was ready to hand over and just stop.

09:07:30:00

And when you came back to Australia, how did you adjust?
To begin with, I only took a couple of weeks off which was a real folly, I should have had a real break. Went back to work. And yeah, I wasn’t right. Can recall that we got back on a something like a Saturday and the following day,

09:08:00:00

my wife said, “Wayne, let’s go into the city.” I’ve lived in Sydney, caught a train into town and really struggled. I struggled with the crowds, in the underground, in the subway station, became very claustrophobic, very tight. Had really difficulties with the crowds around me and felt very unsafe. And very insecure. And really struggled with just surviving.

09:08:30:00

And that really – I guess from then on I thought, "I’m not 100%". Worked it, "Okay how do you deal with that? Pretty simple, okay, re-expose yourself, typical doctor, treat yourself." And I got over those sorts of obvious signs that I wasn’t right. But it was around the six-month mark that my wife said to me, “Wayne, why the bloody hell do you keep sniffing?” I said, “Can’t you smell it? Can’t

09:09:00:00

you smell the dead people?” Oh dear. So at that stage I thought, now I’m not right. It was more when I was put under stress like the smells would come back. And I had a long hard think about that and I thought, you’re not right boyo, so again, I decided, okay well, I knew what was wrong with me, I had PTSD, so I thought, "Okay, how do you deal with this?" And it was really a matter of a catharsis. Talk it out

09:09:30:00

A couple of really close friends, who had medical backgrounds, so I was able to kind of I guess, slowly relate my story to them. And just talked it through. So while it wasn’t professional help, it was the right sort of help. And allowed me to I guess, eventually express my feelings about the frustrations. The story about the orphans, and what came out of that. And it was those sorts of things and it was interesting,

09:10:00:00

at the end of the day for me. It actually wasn’t the sight of death, as a doctor, you’re exposed to that, so you become immune to seeing bad things and PTSD isn’t about seeing things that you’ve been exposed to, it’s about things that you haven’t been confronted with before. Like, somebody threatening to shoot you. While in the military you were exposed to the thought of that, to actually have it occur, it’s worrying. Running over landmines, well that’s not normal. The incident

09:10:30:00

with the orphans, that’s not normal. And it was those sorts of exposures I think that got to me. And when we were there the smell of death did pervade in those first weeks. I remember the first time we drove down the south-west and I went down with the advance party we stopped by the side of the road. I wasn’t the lead vehicle, somebody else was leading, I was in the second vehicle. And I thought, "we shouldn’t stop here". But they stopped there because they thought it was a good place to stop, and I looked to my left on the side of the road and I thought, "There’s a fuckin’ mass grave.

09:11:00:00

Not a good place to stop." But they hadn’t been there so they didn’t know and young soldier with me, my driver, the guy who was driving, said, “Oh Sir, doesn’t smell good here, what’s that over there? What’s that material?” “It’s a mass grave and they’re dead people.” And he was just absolutely flabbergasted because it was just there and very quickly I went up to Simon Gould who was leading – I said, “Mate

09:11:30:00

can we just move somewhere I don’t really want to have my cup of tea next to a mass grave.” He said, “Okay.” But it wasn’t fair on him either, because I’d been there, I knew the signs, he was still in the learning curve about what’s bad stuff. So he was still learning around what’s bad stuff so it’s that poor soldier. So it was those sorts of things. Not easy. At the end of the day, for me, I confronted my demons, and talked

09:12:00:00

it through. And settled down, discovered that there were lots of others who were a lot worse and I knew that anyway. Because there were quite a few of the soldiers in my contingent who’ve been really badly hurt and in my own way I tried to help them. I’m happy to relate my story. That’s only fair. And yeah. So eventually, you recover.
Did you have nightmares?

09:12:30:00

No, I didn’t. I had intrusive thoughts, flashbacks, didn’t have nightmares. Disturbed sleep. What else did I have? Yeah the claustrophobia, startle reflex. Funny story, I was at a dinner with Pete Wharf, after he came back, and we were at this regimental dinner, and we were sitting next to each other and while he and I aren’t close,

09:13:00:00

we’ve had a lot of shared experiences, through our life. And the guy who was the dining president banged the gavel and we both, up through the roof. It cracked, just sounded like gunfire. And looked at each other, “Yeah right, okay.” So it was those sorts of things. But I think the good thing with, over time, kind of it heals. I don’t have a startle reflex now. I can drive over pieces of paper on the road. I am careful when things happen on TV.

09:13:30:00

I don’t watch stuff about Rwanda, if it’s on, and there’s a reason to have a look, I’ll cast an eye on it, but to me, I don’t, it’s – I know what happened, I don’t need to relive those memories. I look at what’s happening in the Sudan, and I feel really sad. But all told, we survived.

09:14:00:00

How did it impact on your personal relationships?
I’m divorced. Half the guys on my headquarters are divorced. That’s not unusual for operational service. Not only due to service, there’s always a whole lot of other things but seven or eight months away from home, that there are always issues that come out of that. I came back a different person. Not just with PTSD but I came back a different person.

09:14:30:00

My values had changed, while I always had a particular value set now they were – not extreme but had a different – my meaning of life is now different. I know the value of life. I know the importance of happiness and being contented. I think too, that you go through those – that sort of service and it’s easy to become insular

09:15:00:00

easy to be – to look after yourself, while you can do the camaraderie of colleagues, I find now, that I’m a contented single person and maybe that’s part of a protective mechanism, not sure. Yes, so I guess it was not long afterwards, a couple of years afterwards that I separated from my wife and as I say, quite a few of the other guys went through the same sorts of things.

09:15:30:00

And all for different sorts of reasons. At the end, what sort of person do you turn out? I think that’s the most important thing and I’ve always been an optimist, I always say, well you can always get good out of bad just got to figure out how to do it, and I guess, for me it was an experience that I wouldn’t wish on anybody although a lot of people are really keen to have additional operational service, and I commend them for that. I accept the

09:16:00:00

fact that if you agree to serve then you agree to take a risk. You’re agreeing to take a risk with your life. While I didn’t come back physically injured, I came back mentally injured and I recovered, and if I’d had a physical injury, hopefully I would have recovered as well so actually that’s the way I – in my own mind consider what happened to me and the others, but we were conscripts, and we agreed to serve our country and

09:16:30:00

you pay a price. Should you have to? Well, somebody’s got to. Did we make a difference? I think so. For me, I had a great military career. That was my highlight, I was more than happy to finish my military career. I wonder sometimes if I should have retired after that. Because even though I went on to bigger and better, that was probably the highlight of my career, although the

09:17:00:00

next couple of jobs actually set me up for the life that I have today, so it’s easy to say, I should have left then, but I probably wouldn’t be doing what I’m doing today, if I hadn’t had the next couple of jobs. Am I contented now? Oh yeah. Yeah, got a great life, got a job that I really enjoy, a lifestyle that I enjoy. Rwanda is always there, ten years later, if somebody says, “Oh come on we want to interview you.” Bloody hell,

09:17:30:00

ten years ago. I’m starting to rack my brain. But as you can see, the stories are still there. We had our ten year reunion, last Saturday night, which I thought was good, not a lot of people but then that didn’t surprise me. I still have my close relationships from that time. And I think they’re important. I don’t have a lot of close relationships out of the military but that’s the way it is. You move on, if I go to Brisbane, I’ll invariably catch up with one or two of my really close military mates

09:18:00:00

that’s always the way of the military. But when you’re there your military friends are there, when you’re not, it’s just a different life. So out of all of that, – for me it’s been an interesting journey. And I guess, you come back to where we started, with my very early history about that dichotomy between being in the military and being a doctor and the role of the doctor. And

09:18:30:00

I guess when I came home I clearly decided where I sat on the fence, but it was around humanity and the care of people and that’s what medicine is all about, and that’s what any medical people should be about. Be it on a military mission or whatever, you’re there to care, you’re not there to be involved in the killing. And I think as long as future generations of

09:19:00:00

doctors can think about that sort of thing, and about what their role is, then they’ll have a difficult journey in the military, but at least they’ll know what their journey is all about. And for me, it makes it really easy with my life today. It’s interesting too, because not long after I got out of the army it was quite difficult because all these people saw me as being tainted with a military background. “Oh you’re out of an authoritarian sort of organisational structure, and

09:19:30:00

you only do things by giving orders.” And there are only rare circumstances where I’ve ever given and order in my life. If you think about today, you recount I only ever gave one really in Rwanda and that was about Macintosh sending that infantry platoon and that was a, “No.” I think back through the rest of my career, there are only two or three direct orders I’ve ever given to anybody,– my civilian colleagues struggle but what’s really interesting now, is a couple of years down the track, my civilian colleagues now

09:20:00:00

recognise me for what I do in the civilian world, and now they’re starting to say, “Oh yeah, and Wayne, he was that guy who was in Rwanda. He’s really good.” So for me, now they actually see that as being important to them, as well as I’ve built my reputation in the civilian sector as an expert in my field of quality and safety.
So have you made peace with those demons?
I think so.

09:20:30:00

You’ve talked about the healing process but have you really..?
Yes. I get emotional about it. And I don’t see anything wrong with that because when you have a recollection and that’s all it is, for me now, this is a recollection of bad times and it’s a return of the emotional feeling that I had at the time. But I won’t go home tonight and I won’t stew on this interview, and I actually see my friends

09:21:00:00

and they’ve all been scarred one way or another and I actually worry more about them than I do about myself. I’m happy to listen to their stories, and know that it’s them still having their catharsis. I tend not to now, I don’t have to. And as I said, while I’m happy to share my story, and I think it’s important for others to know that it’s not only the private soldier who had to clear out the morgue who was affected but also the commander. And you go the next step and you look at General Dallaire and – he was the force commander

09:21:30:00

so, these things, nobody’s immune. I don’t think my experiences were harsher or worse than anybody else. I actually think that my experiences in their own right, were mild. And I look at myself and say, “Well yeah, that’s just you, Wayne. The things that you were confronted by, it’s affected you.” But I think some of the things that confronted others were much worse. and they’re the people that I really feel sorry for. It’s all a matter of human nature and no two people are the same.

09:22:00:00

And have you resolved that medical versus military dilemma or will it always be there?
It will never go away. It’ll never go away, I can’t resolve it, others won’t, it will always stand, you can’t – it just can’t go away. Doctors are there to cure, they’re not there to kill.

09:22:30:00

As we come to the end of our interview would you like to put down some thoughts for future generations to look back on in relation to your experiences?
Okay. I guess, from an international

09:23:00:00

perspective, I’d say we can’t tolerate genocide. And we’ve got to do something about it, it doesn’t matter where it is. I feel sad that what happens in Africa, the international community doesn’t respond. But when something much less cataclysmic happened in the Balkans, we deployed hundreds of thousands of troops and by, “We,” I mean the western world. And I feel sad about that. I suspect that that’s

09:23:30:00

racism. And I think, we as an international community, have to really come to grips with humanity and our responsibility to take a humane stance no matter where it is. I think Australia, as a nation, while we are happy to go to war, we were slow to go to war in Rwanda, we were slow to put our hand up. We eventually did and did the right thing. I commend the government for that. I see the same

09:24:00:00

thing happening in Sudan. I suspect, as we said before that the planners are planning on sending Australian troops there but we don’t hear our government saying anything about that, they’re too worried about winning an election here and doing political things, when they should be saying something, it shouldn’t be too hard to say, “This is wrong.” And we’re prepared to make a stance if others are. So I think our government’s got to take a stance on this. I think that at the end of the day, a military does have a place

09:24:30:00

and I think it’s a good place that it’s in peacekeeping, and I think it’s right and proper that our nation supports peacekeeping activities the way it does. I think as a good citizen of the world that we should be doing what we do. I think too that we’ve matured as a nation when it comes to the way we deal with our military and our troops. When you compare the way soldiers were treated during the Vietnam War, and when they returned home. And

09:25:00:00

now you see some of the missions that we’re going on where the community don’t support the mission but they still respect the soldiers. Who have served and I think that’s a good thing. At the end of the day, I think that we’re a very mixed community, different aspirations, different values, I don’t see anything wrong with that. I think it’s interesting too, that at the end of the day somebody who went to

09:25:30:00

a Quaker school can end up heading up the defence forces health service. So, that’s probably as good a place finish the journey.
Well, it’s been a pleasure speaking with you today. Are there any final words?
No, no thankyou.

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