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Maximum learning, for all partners

By Wondwossen Gebreyes, DVM, PhD 
Ohio State College of Veterinary Medicine

As I said in my previous post, we learned many things from each other during this successful Summer Institute. Here are a few of my thoughts on specific topics.

Maximum flexibility and minimum expectations: This became the motto for the team members a couple of days after we arrived. Considering the resource limitations of Ethiopia, the high economic growth and resulting traffic jams, and limitations in communications, one may not be able to plan things well in advance, or keep your lane consistently in driving on the highways, or be able to arrive for meetings on time.

Crowded streets of Addis Ababa.

At the end of the day, we always achieve all the goals, and everyone gets to be happy, though not in the most efficient way.

The situation also made me realize how much building capacity in the area of effective communication could improve all the activities we conduct in this partnership, be it neurosurgery, nursing, or environmental health.

Effective communication and filling the gap within our partner institutes in Ethiopia is critical.

However, life in the U.S. made us become very sensitive. We often try to be perfect. Ethiopia was a great venue for most to realize the sky does not fall. It is OK to be a bit late.

Relax, and still achieve our goals!

Equipment. Equipment, Equipment: As we all witnessed during our several meetings at the various health science colleges of the two universities and also read in blogs, one key ingredient missing very much in the hospitals, research, and teaching settings is equipment.

During this trip, I learned first-hand that 44% of the patient cases at the nation’s premier referral hospital, the AAU Black Lion Hospital, were cancer cases. It was sickening to also learn that among these cases, 65% were pediatric. Yes, indeed there is lack of manpower, and so we launched the institute.

The partner universities are also building the physical infrastructures. While these address part of the issue, the lack of equipment is a major impediment for capacity-building. How can one radiotherapy machine can handle such a large cancer case burden for 85 million-plus population?

Equipping laboratories and clinical units remains a major challenge that partners in Ethiopia and Ohio State will have to tackle.

Maximum motivation: I never realized so clearly until this trip what drives my passion in global work, particularly the teaching aspects. Never fully understood what drives me to lecture several hours with only a short tea break and still have the full steam.

I observed my colleague, Dr. Bisesi, give his lecture on environmental health, and I saw the wide open-eyed trainees and their interaction. I noticed the high level of motivation by the trainees. The same was true for my course.

Dr. Wondwossen Gebreyes with faculty at Addis Ababa University.

Students were so highly motivated that they even asked me to teach a full day on a Saturday. Some even suggested we keep going on Sunday, but that idea created a bit of a stir. “True,” I said in my heart, “that is a big NO in Ethiopia.”

You have to respect Sabbath day more than molecular epidemiology.

The Ferenji Effect: Ferenji is defined very loosely as “a foreigner,” particularly referring to a rich Caucasian. Its connotation is very positive. Ferenji is often considered as a nice, generous foreigner whose pocket carries endless amount of treasures … well, we all know the truth.

Typically Ferenjis are magnets to Ethiopian kids in urban and rural areas of Ethiopia; they often have chocolates, coins, and all kinds of fun things. At a minimum they have a digital camera to snap kids’ picture and show it back to them. The kids giggle seeing their own image in this small window. They followed Dr. Bisesi and Mr. Harrison as we traveled in a suburb of Addis.

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During the Summer Institute, I witnessed the usual hospitality of the university security guards and others giving the due respect to our “guest Ferenjis” and I (the designated local chauffeur) also get a free ride.

Unlike what I stated above, about “Ferenji are magnets to local kids,” kids in the Woreta area acted differently. When we were collecting questionnaires for the rabies project, the kids would run away when they saw our giant, “tall-6-foot-some” great athlete and health science student, Korbin Smith. “They might have considered him as Goliath,” I thought to myself. I also hoped one of those little shepherd kids would not be like Dawit (David). Thankfully, we left the place with all fun and no fighting.

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Ohio State in Ethiopia: A great experience overall

By Wondwossen Gebreyes, DVM, PhD
Ohio State College of Veterinary Medicine

It has been wonderful working with all the Ohio State and Ethiopian faculty and students during the One Health Summer activity that run from June 7th to this week.

First off, I am very much proud to be a Buckeye. Everyone from the Buckeye nation (Ohio State) showed wonderful professionalism throughout the Summer Institute.

I heard all positive words from our partners in Ethiopia. Students and faculty from five of our seven health science colleges and also School of Environment and Natural Resources have all been great to work with.

I am also proud to be born Ethiopian. I am sure all my colleagues tasted the ultimate hospitality and motivation both in classrooms and social settings and learned a great deal of variations in traditions.

Lunch at Addis Ababa University.

The commitments from both student trainees and partner administrators has been unsurpassed. It gives me a great pleasure seeing the trainees’ eyes wide open in the various lectures, sharing the Ohio State students’ excitement for service learning (even some requested opportunities for next year before leaving Ethiopia), and reading all the blog posts from our students and faculty members.

Importantly, personally, I also learned few more things about Ethiopia and partnership along the way.

With respect to the scientific/ technical aspects of the Summer Institute, I am confident to say that we achieved the goals – in all aspects: coursework and trainings, pilot projects, and workshops. We were able to impact more than 200 professionals in these courses. And a number of scientific networks and new collaborative partnerships developed. Partner colleges were able to identify areas for further collaboration.

Both the Univeristy of Gondar (photo below) and Addis Ababa University partners as well as other institutes — such as the Ethiopian Health and Nutrition Research Institute (EHNRI) — were excited with the outcome.

U of G gate.

It was humbling to hear from the dean of AAU School of Medicine, Dr Mahlet, I quote: “We thought Ohio State would be similar to many, many universities we signed MoU with before and never heard from them again. You made us feel guilty by showing your commitment in a short period of time. Thank you and we are also determined to show our commitment.”

As we move forward, the Ohio State Health Sciences task force will resume its activity in full force. On behalf of the Ohio State Health Sciences One Health task force, thank you to all those who participated in the Summer institute! Some of the upcoming activities will include visits by the Ethiopia partner universities delegation; continued pilot projects on cervical cancer screen-and-treat, rabies intervention, electronic capacity-building, and service-learning clinical activities by neurosurgery and nursing teams. Please stay tuned and follow our blog.

In my next post, I will share some specific thoughts and observations on these activities.

Gondar hospital, present and future

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Gondar will soon have a new hospital. This photo shows the construction in progress. Below are some scenes from the current facility.

Women walk into the Dean's Office at the University of Gondar Hospital.

Women walk into the Dean’s Office at the University of Gondar Hospital.

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The hospital’s emergency room entrance.

A ward at the University of Gondar Hospital.

A ward at the University of Gondar Hospital.

Photos by Rick Harrison, Ohio State University Communications

Interviews and data collection

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Ohio State student Korbin Smith helps interview a farmer in the South Gondar region of Ethiopia.

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Ohio State student Laura Binkley and University of Gondar faculty Dr. Reta Tasfay and Mr. Dagnachew Muluye interview a health care extension nurse about rabies.

Photos by Rick Harrison, Ohio State University Communications

One Health Summer Institute: Class is in session

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Ohio State faculty arrive at Addis Ababa University’s Akaki campus. From left: Eric Sauvageau, MD, Andrew Shaw, MD, from the College of Medicine, Michael Bisesi, PhD, from the College of Public Health and Wondwossen Geybreyes, DVM, from the College of Veterinary Medicine.

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Dr. Bisesi lectures at the Akaki campus.

A student walks through Addis Ababa University Akaki campus on July 8, 2013.

A student walks through Addis Ababa University’s Akaki campus.

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Addis Ababa University students listen as Dr. Bisesi lectures.

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Dr. Gebreyes teaching class.

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Students listen during Dr. Gebreyes’ lecture on molecular epidemiology.

Photos by Rick Harrison, Ohio State University Communications

Images of Ohio State – Ethiopia hospital collaboration in neurosurgery

From left, Dr. Mersha, neurosurgery cheif, Dr. Ebenezer, Dr. Eric Sauvageau and Dr. Andrew Shaw enjoy coffee before making rounds at Tikur Anbessa (Black Lion) teaching medical center at Addis Ababa University.

From left, Tikur Anbessa’s Dr. Mersha, neurosurgery chief, and Dr. Ebenezer with Ohio State’s Dr. Eric Sauvageau and Dr. Andrew Shaw enjoy coffee before making rounds at Tikur Anbessa (Black Lion) teaching medical center at Addis Ababa University.

Eric Sauvageau, right, looks at a scan at Addis Ababa University hospital.

Eric Sauvageau, right, looks at a scan at Addis Ababa University hospital.

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Drs. Azarias Kassahun and Eric Sauvageau examine a patient with myelopathy, a spinal cord constriction.

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Signs reading “Good Luck” are posted all around the wards at the University of Gondar Hospital.

Photos by Rick Harrison, Ohio State University Communications

Learning from Ethiopia’s ‘MacGyver’ doctors

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From left, Tikur Anbessa’s Dr. Mersha, neurosurgery chief, and Dr. Ebenezer with Ohio State’s Dr. Eric Sauvageau and Dr. Andrew Shaw as they enjoy coffee before making rounds at Tikur Anbessa (Black Lion) teaching medical center at Addis Ababa University. (Photo by Rick Harrison, Ohio State University Communications)

By Andrew Shaw
Clinical House Instructor at Wexner Medical Center, Ohio State

Since returning from Ethiopia I am filled with excitement. The people there are incredibly welcoming, warm, and giving. They invited us to see their patients, wards, and hospitals. The doctors there exhibit such passion for medicine, learning, and are always wanting a lecture.

Establishing a long term relationship with the Neurosurgery Department at Black Lion hospital will be mutually beneficial.

Upon our arrival, I believed we would be the teachers, but I often found myself on the learning end. The pathology they see is often advanced and requires much skill to treat.

You might recall the show MacGyver. As Wikipedia says, “Resourceful and possessed of an encyclopedic knowledge of the physical sciences, [MacGyver] solves complex problems with everyday materials he finds at hand, along with his ever-present duct tape and Swiss Army knife.”

Our Ethiopian partners are the “MacGyvers” of medicine doing amazing things with limited resources.

Data collection, shoulder dancing, and tailored suits

By Korbin Smith
Student, Ohio State College of Medicine
School of Health and Rehabilitation Sciences

The initial data collection for the project has been finished.  Our group was unable to blog or access the internet over the last week due to traveling in small towns throughout Ethiopia that don’t have internet.  To catch up, we traveled from Gondar to Woreta where we conducted interviews before moving to Debre Tabor.  It is crazy how different the climate can change Imagehere with a 40 minute drive.  Woreta has a warm climate with temperatures probably averaging around 80 degrees.  A 40 minute drive to the highland in the mountains and Debre Tabor was probably around 55-60 degrees.

Luckily for me, this means I now have a cold.  I am beginning to think I have a weak immune system, as I am always the only one to get sick.  From Debre Tabor we met with Dr. Gebreyes, who brought a photographer and Dr. Sauvageau, a neurosurgeon from Ohio State. It was good to see others from Ohio.  We drove to Bahir Dar which is the city that borders Lake Tana, the biggest lake in Ethiopia.  Being a fishing connoisseur, it was very neat to see the traditional fishing methods.

We celebrated finishing the data by going to a traditional Ethiopian club in which we saw many styles of “shoulder dancing.”  I think I can dance better in Ethiopia than in the U.S.  As long as you can move your shoulders to the music you can be accepted as a dancer here.  People are less inclined to judge me on my overall lack of rhythm (or if they are judging me it is in Amharic and I can’t tell).

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Once we returned to Gondar I was happy to pick up the suit that I had ordered in the city aweek ago.  Since I am a rather tall, skinny, and lengthy individual, the suits already made did not fit me.  Dr. Tamiru, a partner we have been working with, took me to his tailor who agreed to make me a suit from the cloth of my choosing for 1,900 birr.  While that might seem like a lot in the U.S. that is equivalent to 100 USD.  This is extremely inexpensive for a customized tailored suit. The suit fits excellently.

In addition to completing the data collection, I have appreciated experiencing different aspects of the culture here in Ethiopia.

Dancing in Ethiopia

By Ally Sterman
Student, Ohio State College of Veterinary Medicine

After a week of traveling around the Gondar region, our travels brought us to a city named Bahar Dar. Here is where the Nile River begins, Lake Tana (the largest lake in Ethiopia) is located, and the Blue Nile Falls are located. Our partners wanted to show us what a traditional Ethiopian dance club looked like, so after dinner we headed out on what would be one of the most memorable nights of my life.

We arrived at the club and there was a small stage with four musicians. They were playing a few traditional Ethiopian instruments and a few modern ones like the electric keyboard. The more traditional instruments included a kraar, which is five- or six-stringed bowl-shaped lyre. There was also a masenqo which is a one-stringed lyre. The instruments supported the vocalists who came out and sang a variety of songs.

Ally Ethiopia pic

However, the highlight of the evening was the dancing. One set of dancers were two brothers who we had seen dance before in Gondar. During one of their songs they grabbed Laura (another student working on the rabies project) and took her up on stage to dance. After another few songs, a different dancer came out. We had the chance to watch him for a short period of time before he danced over to where we sitting. He again grabbed Laura and tied her to him, and then grabbed my hand. The two of us were pulled on stage to dance in front of everyone. Another gentlemen from Israel was also grabbed and brought ally dancingon stage. Laura and I soon found ourselves being tied together to have a dance-off (pictured left). This style of dancing is not quite what my years of dance had prepared me for but I tried anyways. After a few minutes it was over and we headed back to join the rest of the group. Our partners were proud of us going up there, though it was clear our dancing skills left something to be desired and more practice is definitely necessary. This was one of my most embarrassing experiences yet here in Ethiopia, but also my most memorable.

Winner Winner, no more cheeseburger for dinner

By Korbin Smith
Student, Ohio State College of Medicine
School of Health and Rehabilitation Sciences

If there was a competition for the first Ohio State student to get sick during the summer research project, I came out victorious.

I have tried many different types of dishes without getting sick. However, I figured I would give their American equivalent to a cheeseburger a try, and it was a bad decision. Unlike when I feel ill in the U.S., getting ill here is more serious. The majority of our Ethiopian collaborators have reached out to me in one way or another to make sure I am OK. They are all truly compassionate and caring.

Since the rest of our research team changed cities, I am the only one left in Gondar until tomorrow. I immediately noticed people are more willing to practice their English on an individual rather than a group. My waitress for dinner tonight was practicing with me and I could tell she was very excited when I understood and responded.

I understand what it feels like to try to have a conversation in a language you aren’t familiar with. Anytime I can say “Hello” or “Thank you” in Amharic, I do so.

I have also noticed that most conversation stops briefly when I walk into a room.  There aren’t a lot of 6’3” blonde, blue-eyed males walking around in athletic shorts and an Ohio State T-shirt.

All-in-all, as we continue our stay here in Gondar, I am constantly impressed with the class and generosity of the people of Ethiopia.