An Irish Aid worker’s life: ‘I was face to face with human tragedy you don’t think exists’

“Just to paint the picture a little bit,” says Anne O’Mahony. “It was this area covered in black plastic shelters, you know, the plastic we use to cover silage pits here in Ireland. Each shelter, black plastic around the sides, accommodated about 300 people. There were 20 or 30 of those.”

O’Mahony is describing her first visit in 1984 to a tented feeding village for 10,000 famine victims, eight hours north of Addis Ababa in Ethiopia. It was one of the unforgettable moments of her 38-year career as an international aid worker with the humanitarian organisation Concern.

Now Concern’s international programme director, O’Mahony retires on Christmas Eve, having witnessed some of the worst humanitarian crises of the past four decades. It has been a career and a life unlike most.

These people were too weak to actually make a noise. Even the kids, they weren't crying, they weren't playing around. Just that eerie silence

“The abiding memory of my first visit to Ethiopia was, you walk in, there’s thousands and thousands of people there. I came from Bandon which is a town of 3,000, which is fairly lively. This was much bigger than the town of Bandon.”

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She grins, then changes beat. “But there was a silence that was tangible, and uncomfortable, almost. These people were too weak to actually make a noise. Even the kids, they weren’t crying, they weren’t playing around. Just that eerie silence. Our job was to tend the sick, to feed them, to get them on their feet and try and make them well enough to go home. And well enough to be able to come back weekly to collect a dry ration to take them through to the next week.”

The Ethiopian famine brought “almost life-defining change” for her, “because it brought me face to face with a level of human tragedy you think doesn’t exist in the world. And yet there it was in front of me. Real people, these sort of stick people walking in front of me.

“When I see the [Irish] Famine memorial down on the [Dublin] quays, I think: that was Ethiopia in 1984.”

Each week they discharged people from the feeding camp to take in others. Part of her job was admissions and she describes walking among thousands waiting outside, deciding who was in most need. “The camp was for people starving to death, to enable them to get on their feet, then to discharge them so they could go home to recover and plough and plant. Because something had to happen for the next season.

“It worked very well. Over 100,000 people passed through the camp and recovered.” But there was a high mortality rate. “Some days [were] good and some days weren’t. A measles outbreak was quite disastrous and killed a lot of people.”

O'Mahony has witnessed atrocities during wars and famines, depths of deprivation and hardship, saved lives and improved others' quality of life

One day, December 27th, 1984, it rained very heavily and the black plastic shelters gave way. The camp was washed out and people got very cold. “The rain tipped people over the balance. We lost 127 people by the next morning.”

With two years’ experience in Concern, O’Mahony was managing that huge camp, leading a team of international and Ethiopian aid workers. “You just do it. I didn’t even think I was young at 27. I was mature and experienced and thought I knew everything!” She laughs. “The more you learn, the more you realise what you don’t know.”

She talks about changes since then: President Meles Zenawi Asres’s ambition for three meals a day for everybody, a hunger safety net in the early 1990s; war with Eritrea; prime minister Abiy Ahmed Ali, who won the Nobel Peace Prize in 2019. Last month conflict erupted again in the fragmented country.

Through the 1990s, O’Mahony worked during the famine in Sudan, in Somalia and in the aftermath of Rwanda’s genocide, later becoming country director for South Sudan, Kenya and Somalia. “I do think it’s the best job in the world. It’s stimulating, motivating. It is out there.”

She has witnessed atrocities during wars and famines, depths of deprivation and hardship, saved lives and improved others’ quality of life. We’re talking at a distance in the conference room of the now sparsely-populated Concern headquarters on Dublin’s Camden Street, where 250 people support a team of 4,000 aid workers worldwide.

O’Mahony is a good storyteller, evoking atmosphere and humanity but also the wider context from a lifetime of making a difference. “You have the highs and the lows of the work.”

A few years later in northern Ethiopia, in the face of a deadly meningitis outbreak, Concern organised a mass vaccination. Needing to keep the medicines at a low temperature, they helicoptered vaccines into the mountains. O’Mahony describes it like a movie scene: how they landed on a shelf on the side of a mountain and waited, hoping people had got the word. Nobody was there.

Then, “in the valleys and the hills all round, they streamed down the mountains with their umbrellas and their kids and their colourful gear.” Many had spent time in the camps the previous year, recovered and were home and healthy, farming. “They had come for the vaccinations but also to acknowledge that we had come, almost to visit them. It was happy. That was a high.”

While Ethiopia was “the place of greatest learning and experience that impacted on me the most”, she also has a stark memory of Somalia, where she worked in the mid-1980s and again in 1992.

What had been a sleepy backwater was “changed by civil war that was particularly ferocious and vicious” and ensuing famine. Returning in 1992, O’Mahony arrived in north Mogadishu, a city divided along clan lines. She was shocked at the armed escort from the airport and grenades for defence of their base. “Oh God, this is not Concern. There were guns everywhere. We don’t do armed escorts.” But they were “absolutely necessary. We were in the middle of a war zone. It was a very violent place, the cost of human life was nil. The warlords ran everything.”

While hundreds of thousands were starving to death, warlords trapped food coming off ships, diverting it from feeding centres to their stores, to sell when prices rose.

It was incomprehensible to me that people could be so cruel to each other. To allow people to die in front of you when your store is full of their food

It was “incomprehensible to me that people could be so cruel to each other. To allow people to die in front of you when your store is full of their food. That was probably the most harrowing experience of my life. I could never equate that level of in-your-face greed and power, with no respect for human life, versus that huge need staring you in the face.”

O’Mahony has been in danger many times. In the wake of the kidnapping of her colleagues in Ethiopia in 1983, she recalls living in a tent next to a camp, debating for hours with a Concern friend what to put in their running-away bags; in pre-digital times photographs were prioritised. Pragmatic and brave, “we weren’t afraid of being kidnapped. It was just a reality.”

She grew up in Bandon, Co Cork, which had links to a mission in Peru. Her interest in aid was also fostered by her uncle, a priest in the UK, involved in development. She wrote to Amnesty prisoners-of-conscience at Christmas. “It gave us an external look at the world but also that bug to actually do something.”

O’Mahony trained as a nurse, planning to go abroad. Pre-internet, “leaving home for two years, getting on a plane to the other side of the world with no idea what’s there: it’s a big decision. There’s almost a natural selection in that. It is a leap of faith.”

Aged 25, she went to the Cambodian-Thai border in 1982. Most aid workers’ first posting makes the biggest impact but for O’Mahony, “it wasn’t what I expected. I was hugely disappointed!” She laughs. “I flew into Bangkok airport and it was much bigger than Cork airport! Then a seven-lane highway. I expected a mud hut in the jungle. I did have the mud hutbut it was on the Thai side so things were available.”

It wasn’t tough enough for her.

“Moving to Ethiopia was certainly the mud hut in the jungle; it was very much what I expected and it was the right place to be. It felt as if it was what I had signed up for.”

Her experiences are vibrant and evocative, still fresh. She didn’t keep a journal but wrote long letters home. Living out of a bag on the move and without thinking of their significance, she got her mother to burn the letters during a clear-out.

In 2013, O’Mahony returned to Dublin as Concern’s director of international programmes, responsible for work in 23 countries. “When you work overseas you’re a bit rootless and there comes a time.” It was a conscious decision to settle back in Dublin (“immediately you belong”), well before retirement. Or “What do you do when you stop work? And you know nobody.” But moving back, “I will be honest, it was a difficult transition.”

It takes a personal toll, not having a base, a family for so long. Opting to be an international aid worker has implications. “But sometimes these things are not conscious choices. They evolve. Over my lifetime, every so often you come to a crossroads. Do I come home to a permanent pensionable job, do I stay where I am? Do I go into a deeper relationship or do I continue this path? You weigh up the pros and cons, make these conscious choices and you move on. I’ve always been quite pleased with the choices I’ve made.”

She’s wistful about not being able to visit the organisation’s bases because of Covid. Her last trip was to South Sudan in January where work on the ground is, “gone, I think”. When travel is possible, “I have friends all over the world”. Otherwise, “I have no plan for the first time in my life. And I like it. When I need a plan I’ll make one.”

Over a peripatetic career – a couple of years in one country, then moving to another – she’s kept in touch, (“I read The Irish Times every day”), and came home to Cork every year, often at All-Ireland time. Her mother sent the Examiner wrapped around vacuum-packed rashers for years.

She recalls a daily abridged Irish Times in the early 1990s, and later, in Rwanda, slowly downloading the newspaper – it took half the day – and leaving printed copies around the office.

The world’s connectedness is important. In Lokichogio in Kenya, under a tree’s shade in 2002, she got chatting to a South Sudanese woman, returning after 12 years to her village of Wau, having left when it was under attack by government forces. As they fled, her husband took their daughter and she carried their baby son to walk to Ethiopia. They got separated along the way.

Months of walking later, the woman and her son wound up in an Ethiopian refugee camp, eventually going to the UK, where they settled. Years later the South Sudanese woman moved to Nairobi in Kenya to look for her husband and daughter. She heard he was dead but two months before O’Mahony met her, the husband walked into the woman’s office, by chance, 11 years after losing his wife and son.

After separation, he and their daughter ended up in north Sudan; the girl now spoke a different language. It was wonderful to find her family but after a difficult and searching life they had grown apart and had lost the family bond. “Now we’re friends,” the woman told her. “It was an eye-opener about what happens to so many people, forced out of their homes and scattered around the world. When they come back together again it’s not a fairy story, it’s hard graft.”

Choosing one thing that would make the world better, she offers: “I would turn all the guns in the world into jelly. If you take the guns out, the world could be such a different place.”

'I've been to places long before the tourists when you could hear the parrots in the trees. I went back a few years later and there were 10 flights a day, hotels all over'

She says it has been a privileged life. “I’ve been to places long before the tourists,” such as Angkor Wat in Cambodia, “when you could hear the parrots in the trees. I felt I was finding new territory. I went back a few years later and there were 10 flights a day, hotels all over.”

She’s hugely proud of the organisation’s work, particularly how it has changed the international humanitarian community’s approach to malnutrition, moving from centre-based treatment in camps to CMAM (community management of acute malnutrition), where people stay at home, visiting aid centres for training, monitoring and supplies, including Plumpy’nut peanut-based mix for malnourished children. Concern researched and pioneered CMAM with Steve Collins of Valid International; facing resistance, they proved the approach to be better and safer and persuaded the World Health Organisation to change malnutrition guidelines. Children gain weight at home, where their mother can work, and “not feel that huge sense of failure”.

It was, says O’Mahony, “a game-changer. We haven’t seen famine-relief centres since the 1990s.The numbers treated increased, mortality rates went way down. It’s a huge contribution. Everybody does it now. Now I go to meetings internationally and they’re using terminology we developed here.”

During O’Mahony’s career, technology changed how Concern works. Instead of massive food transport, Concern now transfers cash by mobile phone directly to beneficiaries, usually poor women heading households, who can then buy food from merchants. It’s more secure than moving food, doesn’t involve intermediaries or protection rackets, allows people more autonomy and supports local economies.

“It is impactful. A win in so many ways,” she says.

Coronavirus's worst effects are in densely-packed urban slums, in Dhaka, Nairobi and Haiti. Other challenges, such as not being able to provide online education, exacerbate it

Covid-19 has changed the dynamics of poverty in the developing world. In the places Concern works, “if you don’t earn a living, you don’t eat”. The crisis has not been the illness but its economic effects. “There’s been such joined-up thinking under the new sustainable-development goals and we’re in serious danger of seeing the gains eroded.”

She gives snapshot examples. The women in clothes factories in Bangladesh, whose jobs have gone with western shopping decline, can’t feed their kids. They’re cutting meals and food quality and getting into hock with moneylenders. Piecemeal flower-pickers and packers in Kenya live in slums: “If the flowers stop moving, they don’t get work, they don’t eat.”

Remittances are hugely important to many economies but have reduced because of the job contraction in the West. “If you take all these coping mechanisms people depend on away, they’re left with nothing.”

Coronavirus’s worst effects are in densely-packed urban slums, in Dhaka, Nairobi and Haiti. Other challenges, such as not being able to provide online education, exacerbate it. “We will probably see much greater inequality. The poorest get another knock-back.”

How does she cope? “We see the really bad stuff but then we see people recovering. Media get a snapshot of what’s happening today. But we’re there to see people recover, go back to their homes, grow and thrive as a result of interventions. That is more cathartic than anything.

“Over the years, Concern has gone into some pretty awful places but we’ve also left a lot of countries” that are well on the road to recovery, to focus elsewhere. Over her time the organisation has pulled out of Cambodia, India, Laos, Tanzania, Uganda, Mozambique and Zimbabwe. On the other hand, it has moved into the Central African Republic, Chad, Burkina Faso and has set up in Syria, Lebanon, Turkey and Iraq – “dealing with the Middle East debacle. These are man-made crises, you do really want to bang people’s heads together and say, ‘Lads, look at what you’re doing to your own people.’”

But “then you also see the unsung heroes”. She talks about those who provided shelter to others during genocide at huge risk to themselves. “There’s a human strength out there that’s a privilege to witness.”