Ayalew Tilahun (MD) is head of the Medical Department at the Ministry of Youth and Sports. Currently, Ayalew is the only medical practitioner in Ethiopia who is an expert in testing for doping and banned substances in sports. Recently, the athletics world is shocked by news of major doping scandals which even extends to the helm of IAAF. Ethiopian athletes were among those who were suspected of doping; while some six athletes were reported to have tested positive for banned substances. Tibebeselassie Tigabu and Dereje Tegenaw of The Reporter caught up with Dr Ayalew to talk about the current doping scandal and the potential implications for Ethiopian Athletics. Excerpts:
The Reporter: Currently, some Ethiopian athletes are rumored to be implicated in a doping scandal. Can you tell us what you know so far?
Dr Ayalew Tilahun: Yes, some athletes are under scrutiny after they tested positive for the suspected use of banned substances. The International Association of Athletics Federations (IAAF) sent the test results of six Ethiopian athletes together with the necessary documents to the Ethiopian Athletics Federation, the respective athletes and their managers.
Some of these athletes were examined while in training in the country and others were tested during competitions. Those who were tested locally were administered a random urine test in accordance with the working protocol of the IAAF while the others were tested in competitions following the international procedure.
The Ethiopian Athletics Federation, as you may know, is a major stakeholder in this ordeal; so we have to respond to the IAAF enquiries at every level. The first thing to do was to carefully examine the documents and make sure that the substances found are indeed under World Anti-Doping Agency (WADA) 2016 banned lists.
After confirmation, the next thing was to inquire more on the details of these banned substances such as their adverse effects, the justification behind the banning and other relevant information. After the Federation completed the investigation, we approached the athletes to ask them if they are willing to be investigated.
Basically, the IAAF procedure for testing athletes requires giving two urinal samples called sample A and B. These are very important and complicated procedures; especially for Ethiopian women athletes who refuse their first urinal test because of the presence of a supervisor while the sample is being procured. As per the IAAF regulation, an athlete will be assigned one watchdog in line with their gender to make sure that the urine sample is really procured from their sexual organs. This process is not culturally acceptable for many. The crime is very sophisticated where in some instances, for your surprises, some athletes go as far as using artificial sex organs to fake urine samples. Hence, the inspection and the investigation process should also be on par with the sophistication level of the crime. One surprising examples is the recent Russian case where 90 percent of the athletes were found to be using a banned substance. Who would have thought they were cheating?
After sending the results there is a 14-day gap so athletes can reconsider what they have disclosed in the form regarding usage of any substances. IAAF sends a form of questionnaire that has to be filled by the suspected athletes. We facilitated in investigating and also asking questions such as if they take these substances, the location they took it from, the identity of suppliers and so on. We cannot even add a single phrase or a suggestion to this; every word has to be their response. After completing it, we sent their answer to the IAAF with their respective signatures. The process of inquiry did not stop with one request, however; the IAAF then sends us two more letters and we cooperated until they say the information we provided was enough. One thing that should be clear in this case is all these processes are handled with a very strict confidentiality. These are suspects and they are not guilty until they were proven otherwise. WADA has a clear guideline which states that if the athletes’ rights are violated they can take them to court. on the other hand, if the Federation decides to reveal their identity and disseminate the information in connection with the investigation before it was concluded, there will be harsh consequences up to suspension of the federation. So, many requests from various stakeholders came through to the federation to reveal the identity of the athletes under investigation and this created a misunderstanding.
In our case, the first response came from IAAF regarding three of our athletes and the decision was passed to issue provisional suspension. This means the athletes cannot participate in any local or international competitions until the IAAF reaches final decisions. We delivered the news to the athletes by mentioning the IAAF decision. The B sample period is not known yet; the B sample will put this case to rest and will be a basis for the final decision. There is a clear and specific date for the B-sample testing; so the athlete or the agent can witness this process. These procedures are carried out exhaustively in order to avoid complaints. After the result of the B-sample, the punishment will be decided by considering the degree of the violation. Apart from suspension, there will also be random checkups every now and then. The IAAF requests every athlete who has been suspended to reveal their every training schedule if there is any. Suspension time is a war time.
How is Ethiopia working with WADA?
WADA is a giant organization which was established in 1999. It is funded by the sport movements and governments with a mission of leading the global movement for doping-free sport. Ethiopia is one of the signatories. Apart from the international coalition, in Africa, there are six zonal anti-doping agencies. Ethiopia is a member of zone five which consists of nine countries in the East Africa region with its regional office located in South Africa.
Its main activities include scientific research, education, development of anti-doping capacities and monitoring of the World Anti-Doping code. So as a WADA signatory country, we are expected to execute these activities. For us, the main difficulty has been domestic testing. According to WADA, each country has to perform at least 200 domestic tests a year. A single test cost 700 USD and Ethiopia does not have that kind of budget apart from a grant we secured from WADA. Ethiopia also contributes 3300 USD annually to WADA. Domestic testing of doping is almost non-existent; not only in athletics but also in football. These are challenges we are facing and it is compulsory. The other necessary input to the anti-doping movement is researches to identify the vulnerable groups in doping, the push and pulling factors, the available drugs in the country and so on. The other important requirement that the Ethiopian chapter has to fulfill is capacity which entails its own office facility and staff. This office cannot be under the ministry or the federation; rather an office which has a status equal to the federation with its own judiciary power. This means that the Ethiopian Athletics Federation has to pass its decisions on important matters including suspension to others. For example, while testing for doping, we send the tests to the internationally accredited laboratory in Bloemfontein, South Africa. If these results are found positive, before it reaches IAAF, the Ethiopian Athletics Federation has to decide on the form of punishment that is applied. Being a signatory to WADA is not enough; they supervise the applicability on the ground. As part of their evaluation program, the African Areal Managers and supervisors came to Ethiopia on October 2015 to conduct a study called complacency and non-compliancy. Prior to their arrival, they gave us fifteen days to prepare a report. Our report was a bit exaggerated and there was a huge difference between what has been done on the ground and what we indicated on the report. According to their evaluation, the organization did not have the skeleton, was not independent and had no allocated budget.
What do you mean when you talk about independence?
It should be independent from the Ministry and this should be declared. It should have a judiciary power and no one should dictate terms to it; it should be free from any influence. If it is under the ministry, when it passes a decision there might be a repeat of the Russian doping scandal. What happened in Russia was that when the Russian anti-doping agency decided to punish the athletes who tested positive for banned substances, the president, Vladimir Putin, intervened and allocated some amount of money for the agency to sway its decision. Following that, IAAF suspended the Russian Athletics Federation. After their assessment, WADA people were emphatic about our case especially in connection with Ethiopia’s huge legacy in athletics and the minor cases of doping that is reported. They gave us a time-frame up to November 2016 to fulfill the requirements. Following the evaluation, the agency is moving forward quickly to fulfill the necessary requirements. After a month, the regional Areal Manager will visit us to check if we are on the right track. If we do not fulfill the prerequisite that WADA has set, it (WADA) can decide to suspend us and we will be out of the international competitions for good. Who would have imagined Russia, one of the giants in the world athletic, will be suspended? Kenya is also on the edge and if we do not strive hard we shall not be the exception.
What would be the fates of these athletes? In relation to this, what are the substances they used? There is leaked information claiming that steroid, testosterone, ephedrine, and the diuretic furosemide were among some of the banned substances which tested positive in Ethiopian athletes’ samples. Can you elaborate on that?
At this stage, it will be difficult to disclose this information since it is part of the classified, confidential information we have to keep. In general, the athletes took banned substances that are strong including sex hormones and those which enhance performance. Looking at the six athletes’ case, it was a cocktail approach some of them took; some of them took the substances during the course of their trainings while others targeted only the competitions. The athletes should have known better. These are dangerous substances which have adverse effects of weakening the cells, attacking the DNA and genes, causing cardiovascular complications, causing ulcers and poisoning many of the body organs. Some of these substances will stay in the bloodstream and leave a lasting dangerous imprint in the body. We will disclose the information regarding the details once the final decision is reached. We want the health practitioners to have extensive information about these substances.
The common perception regarding Ethiopian athletes is that when it comes to using banned substances, they lack the basic information or use it unknowingly or because they were fooled by medical professionals and managers. Looking at the background of the athletes and the reality on the ground, what do you say about that?
Looking at this from the perspective of IAAF or WADA, these things are inconsequential. It is the athlete’s responsibility to know about what he/she is consuming. What amazes me about Ethiopian athletes is that they are not transparent at all. In the pre-testing stages, there is a questionnaire form to be filled and in the form it asks the athletes if they take any kind of medication. Maybe it is because they are less educated, but whether they have taken the medicine or not their answer is always no. IAAF gives 14 days to reconsider their answer but the athletes are persistent in saying no. One of the recent case out of the six athletes still under investigation which was made public is the case of Sintayehu Mergia. He claimed to have taken Typhus and Typhoid medication and accused the federation for not backing him up against IAAF. He denied doping so we requested a proof of medication from the clinic. We then attached the document from the clinic and send it to IAAF. The result turned out to be different; what was found in his sample was not what he claimed to have taken rather it was a banned substance. On the other hand, the other five athletes were cooperative and they gave every detail of information including suppliers of the substance. In the past, there have been more than five athletes who have been suspended but this is the first time when we get all the detailed information about the testing. With the exception of one athlete, Shitaye Gemechu, who was suspended in 2009 for taking Erythropoietin, many of them denied taking any banned substances. Surprisingly, theses five athletes had the information of their suppliers even voice recordings, photos of the substances and other information. This genuine response fully satisfied IAAF.
Doping is a very serious issue all over the world and there still seems to be lack of awareness in Ethiopia. What is the way forward for Ethiopia in tackling this issue?
The way forward needs a holistic approach. If the question is if we are late, the answer is yes. But the good thing is we have started tackling the problem. There have been some palliative sport trainings by the national anti-doping agency, which is at its inception currently. There should be radical change and a shift of strategy. A national action plan should be launched soon since Rio De Janeiro Olympics is a couple of months away; and Ethiopians loves athletics. It needs an aggressive approach and work at the grassroots level. Following this shocking incident, there was an intensive discussion but it should not be a temporary slogan. This needs the involvement of the Ministry of Health. Our health practitioners do not have a clue about doping. In addition to me, there is only one health officer and a nurse working in this discipline. Clearly, there is also a gap apart from the lack of knowledge of the doctors; the athletes do not know either. We can mention the unfortunate case of the two suspected athletes. Pharmacists gave them a medicine without prescription. One of the pharmacists deceived the athletes saying it is a vitamin. When confronted, he pretended not to know what the substance was, but I think he knows what it was. We have got information about foreigners who entered the country with a tourist visa and are living in Bekoji, Bale Mountain, Sullulta and like involved in supplying these substances. We have evidences that a Turkish national who was training Russian athletes was heavily involved in supplying these substances. It is still under investigation but another Russian guy is also implicated in providing these substances. Ethiopia seemed a safe haven for them where they can do anything. There are many foreigners who are training these athletes. Have we ever inquired about their identity or accreditation? Does the federation know them? In our last discussion, the athletes exposed who the suppliers were publicly; such as a Ukrainian national who lives around Bethel area.
Foreigners who are not medical professionals are engaged in practicing medicine. We are in a critical stage. It is like war is declared on us. We cannot afford to lose these athletes. Apart from foreigners, we also found out that retired athletes and Ethiopian health practitioners are involved in this.
In Ethiopia, another danger is vitamins consisting of minerals such as magnesium, cooper and other minerals which are imported massively with a label of herbals. I am not opposing these vitamins but it is not clear what these vitamins consist of. Now a days, athletes frequently ask me on what kind of vitamin to use. Sadly, what I can say is these athletes are going to be part of this drug consuming society. Quick and short schemes are coming to the athletics and football. One can see the changing area of the footballers abundantly covered with red bull cans. We are investigating these situations very carefully because behind these top athletes there are more than thirty thousand emerging athletes and 200,000 more aspiring whose life will be affected if things go in this direction.
The athletes get their supply from various channels. Which ones will be difficult to control?
It needs a feasibility study to determine where we stand. With our preliminary findings, the providers of the substances cover a wide group of communities which includes relatives, managers, trainers, athletes and the Ethiopian diaspora. Our findings show that the main suppliers are foreigners. The athletes are ready to disclose the names so that there has to be a channel which safeguards their protection.
We found out that some of them were banned from any kind of sporting activity by IAAF because they have been caught in other countries supplying these banned substances. One of them is the Turkish supplier. This shows how foreigners who enter this country should be carefully scrutinized. Ethiopian immigration law is very tight but in this case there seems to be a gap; a gap in implementation perhaps. Extreme measures should be taken for a greater cause even in approaching embassies to give us the information on the foreigners that have entered this country. I don’t oppose foreign trainers in this country, but additional information should be acquired from IAAF to proceed. Ethiopians are eager to win and they see expensive luxurious cars and they could be allured by the lifestyle of the rich. I have to honor the veteran athletes in this regard, even to give them Panadol for a headache was a struggle; they preferred to have coffee or natural resistance. They were against any medication. Those athletes should be the crusaders and talk about their experience. Their legacy is bigger than life and they should be reminders that it is possible without any abuse of substances.
Previously, there were athletes who were suspended such as Ambesse Tolosa because of Morphine, Shitaye Gemechu and Eyerusalem Kuma because of EPO, about whom the public is not aware .Were there any follow-up works after these athletes?
Honestly speaking, we were not sophisticated enough back then. The main thing we did was being shocked by the decision. Imagine what it means to be an Ethiopian athlete, who trains vigorously and is a symbol of heroism. So, we chose to cover up these stories. We were patriotic. I think that was our biggest mistake and we are paying the price now. We could have approached it from a different angle and make the public aware of the situation without mentioning each individual. We actually went far. We even gave reasons for their suspension so that their close people do not find out. There is even a criminal code in the country but we just passed them. We were scared that the publicity would damage us but we made it worse; we were wrong.
What are some of the commonly used banned substances amonng Ethiopian athletes?
It even surprises me; some of the substances are very expensive and inaccessible. One of the dangerous substances is EPO, which has the effect of boosting the number of red blood cells. Substances that got the former Jamaican born Canadian sprinter, Ben Johnson, suspended –Stanozolol was also found in Ethiopian athletes’ samples. There were high drugs such as sex hormone; there were medium drugs which only focused on winning. Though it is not our culture we are immersed in it.