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Annalena Tonelli, an inspired ally in the humanitarian effort in Somalia

© Jesper Strudsholm 2003

Nairobi, Kenya, 9 October 2003 – Italian aid worker Annalena Tonelli was shot to death on Sunday, 2 October 2003, on the grounds of the tuberculosis (TB) hospital she founded in Borama in northwestern Somaliland. The hospital was a facility in colonial times but has been supported by Dr. Tonelli’s friends and family in Italy who have raised $20,000 per month to sustain it.

Dr. Tonelli, whose doctorate is in law, devoted over 30 years to humanitarian work in Somalia and had been closely associated with UNICEF programmes. The 60-year-old Italian lawyer pioneered treatment of TB in Kenya and Somalia, worked for HIV/AIDS prevention and control and campaigned for the eradication of female genital mutilation.  She also ran a school for hearing-impaired children.

“Annalena was truly a visionary, a remarkable individual whose whole life represented service to others, healing the sick and helping the vulnerable,” said UNICEF Somalia Representative, Jesper Morch, expressing the sense of tragic loss shared by colleagues who knew Dr. Tonelli.

“When referring in some of her last correspondence to her request for the antiretroviral drugs she needed for her patients she wrote, ‘Am I dreaming?’ And then she answered herself by saying ‘Maybe, but how could I possibly survive without hopes and dreams?’

“Visiting her recently I was struck by the impact of her work across a range of crucial health and behaviour change issues. As just one person tackling daunting challenges in an isolated place on a minimal budget, her achievements in providing a caring environment for the terminally ill, a pioneering research facility for tuberculosis, hands-on support for HIV/AIDS prevention and control, and a concerted campaign for the eradication of female genital mutilation (FGM) are truly phenomenal.”

UNICEF consultant writer, Maggie Black, interviewed Dr. Tonnelli at length in June 2003. On learning of her murder, Black wrote a tribute, reproduced here courtesy of “The Tablet,” in which it was published.

The death of a nobody: Annalena Tonnelli, 2 April 1943 – 5 October 2003

In inhospitable and obscure reaches of the world, rare individuals still pursue a vocation among the poorest of the poor. Annalena Tonelli, who was murdered in the remote Horn of Africa, was the rarest of her kind.

Dr. Tonelli, a 60-year-old Italian, worked independently and with an almost surreal humility.  She wanted the fewest possible barriers between herself and those she lived and worked among, eating the same food as her patients and living simply. She avoided recognition, agreeing to accept the Nansen Refugee Award on June 25 from the United Nations High Commissioner for Refugees (UNHCR) to refocus the world's attention on the forgotten crisis in Somalia.

Dr. Tonelli spent 30 years tending tuberculosis patients, displaced people and social outcasts among the nomadic Somalis, first in Kenya and later in Somalia. She had a genius for organisation, and became a leading expert in the treatment of tuberculosis even though she was a lawyer by training. Her pioneering treatment of out-patient tuberculosis was taken up by the World Health Organisation (WHO), which supported her 250-bed tuberculosis hospital in Borama, Somaliland along with the Ministry of Health.

The hospital was also the hub for a range of health and social outreach programmes supported by UNICEF, the Office of the United Nations High Commissioner for Refugees (UNHCR) and Caritas International, among others. Dr. Tonelli worked closely with the community and was on excellent terms with many local mosque leaders, whose public support she obtained for health messages at Friday prayers.

Two years ago Dr. Tonelli began to campaign against female genital mutilation, still widely practiced in Somalia.  She respected the extreme sensitivity to outsider interference in a custom endorsed by centuries of tradition. In Borama, the team of three she established, a sheikh, a midwife, and a social worker, have persuaded almost all the local circumcisers to abandon their practice and take up other professions instead.

Most recently, she had begun to provide HIV/AIDS care and prevention. Because she welcomed all such patients, as did her staff, Somaliland authorities admired her efforts. But some in the community harbour fears towards the sick. Life-threatening illness in the desert can be a serious threat to group survival; in the past victims were isolated and even discarded. Some saw Dr. Tonelli’s programmes as dangerously contagious, which provoked deep hostility.

Despite her attempts to be close to the least advantaged, she was still a foreigner in a world where kin and clan are paramount. In one incident, her house was stoned and her life threatened because an HIV-positive mother and child from another district had been sent by ambulance to her hospital. Now it would appear some similar grievance against her nurture of the stigmatised sick has led to her murder.

In many African countries today, ethnic and religious wars have led to unprecedented levels of risk for humanitarians. Last year in Merca, in southern Somalia, a Swiss named Verena Karrer was shot dead in the compound where she ran a hospital and school. The reasons, as in Dr. Tonelli’s case, were unfathomable.

Although she was in her own mind the simplest possible person – “I am nobody,” she once said – Dr. Tonelli was extraordinary.



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