Rhipicephalus appendiculatus

A naive vet

In 1988-89 Sudan, the same as Ethiopia, was undergoing a civil war between the predominantly black south (now South Sudan) and the mainly Arab north (now Sudan). That was the environment in which I was running a development project dealing with ticks and tickborne diseases!

I will briefly refresh your memories on the situation in Sudan at the time.

During the First Sudanese Civil War (1955-1972) [1] Gambela received many refugees but it was when the Second Sudanese Civil War began in 1983 that the number of refugees increased dramatically, and it was then that several refugee camps were established.

The Second Civil War, between the central Sudanese government and the Sudan People’s Liberation Army (SPLA) lasted until 2005. It was basically an extension of the First Sudanese Civil War and it lasted for twenty-two long years with a human live cost estimated at two million! It is believed that war was basically over the oil fields located in the border between Sudan and South Sudan and eventually the latter became an independent country.

After three years of conflict, the Sudan government started negotiating peace with the SPLA, led by Col. John Garang [2]. There was eventually a constitutional conference and in 1988, a peace plan was developed. It called for the ending of military pacts with Egypt and Libya, the freezing of Sharia law and an end to the state of emergency among other issues. A cease-fire was reached but, unfortunately, the then ruler of Sudan, Sadiq al-Mahdi refused to approve it. He was soon deposed by Omar Hassan al-Bashir and the war re-started. This was the time we were there.

As usual, a number of refugee camps were established in Ethiopia to hold the people displaced by the war and Itang, the main camp, grew in size to reach officially 200,000 people displaced in 1988 although later, in 1991 the official estimate came to 280,000 making it the largest refugee camp in the world.

In mid 1988 we were informed that there was a significant movement of Dinka and Nuer refugees and their livestock mainly from the Upper Nile and the provinces of Bahr and Ghazal and that they were crossing into Ethiopia. It was also possible that some refugees would also be coming from further South, nearer to Uganda. This would not have been relevant for our tick and tickborne disease project except that it was just possible that the cattle could be carriers of theileriosis, a deadly disease caused by a protozoan parasite of the Theileria spp., transmitted by Rhipicephalus appendiculatus, the Brown ear tick.

Theileria schizonts inside white blood cells and “bursting” into the lymph/blood.

Ethiopia’s geography and the fighting spirit of their inhabitants kept the country unconquered throughout the colonization of Africa. This, and the absence of the Brown ear tick, also helped to stop theileriosis from establishing there although the environmental conditions were suitable for it. As usual, Nature filled the Brown ear tick’s niche with a very similar tick species (R. bergeoni) that was not able to transmit theileriosis because of its different life cycle.

Heavy infestation with Rhipicephalus appendiculatus in a heifer.

Despite this apparent long-term stability, a mathematical model had just been developed that indicated that the Brown ear tick (and Theileria) could get established in parts of Ethiopia if they were introduced. This was of concern to the animal health authorities of the country. Up to that point, the possible entry point was through imported cattle flown to Addis but now the refugee influx opened up another possibility.

The results of the prediction model that indicated good suitability for R. appendiculatus in Ethiopia.

Because we were working on the subject in South-west Ethiopia, we were asked to do some “detective” work to see if the disease and/or the vector were indeed moving in. That is how I found myself traveling to the Sudan border in the Gambela area in search for theileriosis and its vector.

After studying our options, we decided that the large refugee camp at Itang could be a good place to start our work, provided that we would be allowed to get to the incoming refugees and their cattle and to bleed them and check them for ticks. We would then send the serum samples collected to International Livestock Research for Animal Diseases (ILRAD), now the International Livestock Research Institute, where they would be tested (free of charge) for antibodies against theileriosis.

We planned our trip as well as we could. Luckily, we managed to get the needed supplies for blood collection and I found a couple of large United Nations car stickers that I placed on the doors of our Land Rover as to be easily identified, just in case. We were not so lucky with the trip arrangements, always the bottleneck of our work, but this was expected with civil wars in both countries!

The trip, we were told, was difficult and even dangerous and a special travel permit from the Political Chief was required to leave Bedele and this took some justification, particularly to go to work at a refugee camp. After a couple of days, the permit was eventually granted and the negotiation for the acquisition of the necessary fuel, although protracted as usual, was also successfully and we were ready to go. A team of technicians would accompany me, including one that was the political delegate of the ruling party in our project. This was very good –I thought- as I would get the Government support if needed.

To get to Gambela, we followed the “food relief route” that I already described and needed to go through a large number of movement control barriers that existed along the way while swallowing the dust of the lorry convoys loaded with food and supplies for the refugees.

Dusty and tired we arrived at Gambela where we spent the night. The following morning, we spent a long time getting the next travel permits. Traveling from Gambela to Itang required a special safe-conduct as it was regarded as a politically sensitive area. In addition there was a need of a local delegate of the Communist Party to accompany us as well as a military escort in the form of a couple of soldiers who joined us in a now full Land Rover. Things were shaping up and I was happy not to have come in a smaller vehicle.

We started the journey later than I wished as we needed to wait for the various members of the group that now numbered six and I was getting rather anxious to get going. So it was that while reversing after collecting the Government’s political delegate, I hit a tree and bent the back door in with the consequence that the large window literally exploded. While cleaning the glass shards that were still attached to the door, a large one got embedded in the back of my leg and this needed some first aid but it was soon under control and we managed to clear all the glass.

There was no hope of panel beating the door in Gambela within the short time available so we needed an emergency repair to keep going until we could do it once we could take the car to Addis. The trip was off for now and we started to consider ways of repairing it. Eventually we found a carpenter that cut a plywood “glass” that, after a few tests, perfectly covered the hole and it was secured well. After sending a message to the camp for the cattle to be released, it was back to our hotel. After a wash I did an inspection of my leg and noticed that the glass had buried quite deeply into my calf but I could see or feel no glass inside. So, I washed the wound as well as I could and left it at that.

Next morning, we managed to gather all members of the party in time and we departed much earlier and arrived at the camp an hour later after driving the 47 km non-stop but swallowing lots of dust from a great number of relief lorries. I was happy to see that, although opaque, that the “back plywood window” held most of the dust out. More importantly, our soldier escort was not needed…

The camp was much larger than I had imagined and looked like a town with lots of people moving about. Although there were rows of tents, I noticed that there were also buildings that seemed to have been there for a long time. We drove to one of those to meet the Camp Director and discuss our work. Meanwhile, the soldiers parted company to get back to Gambela on another escort job.

The Director was pleased to receive us, and he listened to our brief attentively. He had clearly been informed of our arrival, and we were soon taken to a makeshift enclosure full of cattle. Clearly, it was going to be quite a job to bleed animals with no crush pen, but we would not let the opportunity pass. The cattle pen was rather chaotic. In a cloud of dust, apart from the rather tame cattle, there were the usual retinue of herders and other people attracted by the animals and their mooing.

We decided that before the work could start, we needed a meeting with the owners to explain the purpose of what we were doing and also for them to leave their AK47s under a tree so that they could work more freely with the animals. In fact, their guns were almost an extension of their bodies so leaving them aside was mainly for our own safety! They agreed and we soon had gun stacks all over the place! I was somehow surprised to see that almost all of the cattle owners had guns but did not think much about it and focused on the work.

We worked hard as the animals needed to be roped and held by the owners while we recorded their origin, took blood samples, numbered them and collected any ticks we saw on their ears. The work progressed well as there were many willing cattle owners. At some stage I noted that my leg was bleeding again but I decided to ignore it and continue with the work.

At some stage I felt my shirt being pulled from behind. When I turned around, I found myself looking up to a young, leggy and half-naked Dinka boy grey with dust that was pointing at my leg. I looked at it and I saw dry blood that has gone down from my wound to the sock and shoe and, I must admit, looked quite dramatic. I looked again at the boy and shrug my shoulders, but he extended his hand and then I saw that he was pointing at my leg and offering me a plaster to cover my wound! I looked at him and he was smiling at me.

I stopped the work and walked with the boy to a water tap where I washed my leg and applied the plaster while the tall boy, only wearing a pair of green shorts, watched me attentively. Once I applied the plaster, he made a thumb up sign and departed. Maybe I am making too much of this gesture, but it became one of the most memorable moments of my vet career!

By early afternoon we had examined well over one hundred animals and we called it “a day” as we were planning to return for more in a few weeks. We packed and went to thank the Camp Director and to get our army escort. While driving towards the Director’s office we stopped for a drink and a bite in the more established area of Itang. Then, I saw a small group of truly beautiful cattle walking past and I took a couple of pictures of them.

An example of a zebu animal like the ones I photographed at Itang.

Unfortunately, my picture-taking was a bad move! Instantly, four armed men in green uniform surrounded the car and asked for my camera that I handed over to one of them. He knew how to open it to remove the film ignoring my protests! My Ethiopian companions, including the Gambela political delegate, looked as confused as I and they kept quiet. I imitated them expecting that my camera would be returned, and this would end the incident.

I was wrong! The door of the car was opened, and, in sign language, they told me to go with them, together with one of my technicians as an interpreter. A large wooden gate was opened, and we entered into the first army base I have ever visited. Apart from lots of armed soldiers carrying the ubiquitous AK47s there were also other heavier military hardware such as trucks and large guns to name what I could see walking past.

The moment I saw where I was, I knew I was in trouble. I was correct!

In the centre of the compound stood a very large tent that had been white when new and it was clear that there it was where we were being taken by our captors. We were roughly and thoroughly searched at the entrance and told to wait outside while some entered and others stayed with us, looking rather serious. I could see the face of my technician/interpreter and that did not improve my moral! We did not talk and waited for a few minutes until we were brought inside.

The large tent was very well lit and carpeted, with chairs on both sides of the entrance. There were people already seated there and we were also told to sit down and wait. To the right there were some desks or tables where what looked like clerks sat. At the back, towards the other end of the tent my eyes fell on an imposing seated figure, probably in his forties, dressed in a white robe with a leopard skin swung on his shoulders and clearly the Commander of the place. He was busy listening to some people discussing something in a rather agitated way that were dismissed shortly.

When our time came, the Commander was given an account of our incident by one of the soldiers that captured us. I could tell that it was my case because they were brandishing my camera and pointing towards us. My concerned augmented and I could now feel the sweat starting to trickle down through my back and it was not because of the heat! My leg was also throbbing but that was the least of my worries.

The talking continued and then the strip of film was produced and shown trophy-like to the Commander who still sat impassive. Then, looking at me, he said “You are being accused of espionage by my soldiers” and then added “they saw you taking pictures of our compound”. “This is forbidden, and you should have known that!” he added. I waited until he finished and requested to be allowed to explain what had happened.

I told him that we were a team from the United Nations, but this failed to make an impression. I then explained our mission in great detail, informing him of the risk of the cattle disease we were searching for and, suddenly, his expression softened when I said that I was a veterinarian. Clearly, he was a pastoralist as well as a Commander!

He became more interested and asked a few questions on the disease and its impact on cattle and then he spoke to his people for a while. Afterwards he told us that we could go and that we were welcome to come back to continue with the work. My camera was returned to me, we shook hands, and we were out of there much faster than when we came in!

Once in the safety of the car and when we were all more relaxed, my technician/interpreter said “do you know who this man was?” As I did not know, he went on “he was William Nyuon, the SPLA Field Commander, only second to John Garang! Although I did not know his biographical information at the time, I was aware that I had been in a tight spot and that I was lucky to had got off so lightly.

William Nyuon. Credit: Taken from https://paanluelwel.com/2014/10/31/thankful-to-cdr-william-nyuoon-bany-a-eulogy/ (No credit for the picture given).

Years later I learnt that Itang was the site of the founding of the SPLA in 1983 by Garang, a graduate in economics from the University of Iowa. Other founders of the SPLA were Salva Kiir Mayardit, Kerubino Kuanyin Bol and William Nyuon. The regime of Mengistu allowed the SPLA the management of refugee camps and gave them logistical support. In fact, it is believed that without the support of Mengistu and supplies for refugees, the SPLA could not have maintained the war with northern Sudan.

The refugee camps in Ethiopia stopped functioning as SPLA camps in 1991 after the fall of Mengistu and William Nyuon, the commander of the SPLA in the field continued to fight against the Government of Sudan and was finally killed in 1996 -ironically- by the army of South Sudan Independence, a dissident branch of the SPLA.

After our return to Gambela, the following day we drove back to Bedele without any further problems and our conversation throughout the journey focused on the incident at Itang although the throbbing in my leg reminded me of the kindness of the herdboy.

Regarding the blood samples, we found a small percentage of animals positive for T. parva but we did not find the vector neither during that trip, our first, nor in the ones that we did afterwards.

Unfortunately, the infection in my leg deteriorated in such a way that I need to spend a week in bed in Bedele undergoing antibiotic treatment until it finally healed.

[1] The war lasted seventeen years (1955 to 1972) and about half a million people perished. It demanded regional autonomy for the South that the British decolonization failed to implement. One of its consequences was the appearance of the Sudan People’s Liberation Movement (SPLM), the political wing of the Sudan People’s Liberation Army (SPLA).

[2] See: https://en.wikipedia.org/wiki/John_Garang

[3] See: https://en.wikipedia.org/wiki/William_Nyuon_Bany