The organization began in 1994 as a small group of volunteers bringing health awareness to the pastoralist community. Then the Afar society was described as 2% literate (1994 Government Household Census) and had no access to health or education. The community was unvaccinated and the only assistance for a delivering mother was the traditional cutting knife (makiita) to open her FGM scar. The society had almost no contact with the Ethiopian cash economy living 93% by traditional herding methods, the remainder farming on the Awash River by gravity irrigation. Australian nurse Valerie first went to Ethiopia in 1973. In 1989 she married Ismael Ali Gordo, an Afar leader, and since then have been living with and serving the Afar people. In 1993 she and Ismael joined with other leaders to form the Afar Pastoralist Development Association (ADPA), which continues to be run by and for the Afar people. APDA was established because Afar leaders felt their needs, particularly around health and education, were not being met by formal Government services that did not take into account the unique geography, climate, culture and lifestyle of the semi-nomadic pastoralist Afar people. Over the years APDA has gradually grown from a core group of volunteers, to first taking on international assistance in 1997, and now operating with hundreds of field workers supported by assistance from international NGOs and agencies.