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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.

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

Environmental health is a priority for Ethiopia partnership

By Michael Bisesi, PhD
Ohio State College of Public Health

Since my arrival on July 7, we have accomplished several activities. As an environmental health scientist, I was able to teach applicable modules to a wonderful group of grad students, clinicians (veterinarians, physicians, nurses) and scientists.

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Addis Ababa University students listen as Dr. Bisesi lectures.

The modules included lectures and discussions regarding the properties of various environmental matrices (air, water, soil) and the fate of microbial and chemical contaminants that can adversely affect plants, animals, and humans.

An extension from the classroom included a field trip and qualitative assessment of the waste water treatment facility for the city of Addis Ababa. This was very enlightening since it demonstrated a system that has insufficient capacity for the volume of polluted waste water originating from municipal, industrial, hospital and runoff sources. The surrounding adjacent areas had fields growing crops, animals drinking and feeding, and humans using this area as a resource.

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This river runs through the Kera region of Addis Ababa. People use the river to irrigate crops.

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Field hands work near a large amount of foam caused by water pollution in the Kera region of Addis Ababa.

I also visited the slaughterhouse and tannery which have some pollution control technologies and practices in place. Observation of the river and surrounding land confirms suspicions that multiple sources are contributing to environmental pollution that impacts animal and human health. Our integrated approach to address this will bring results, but much work lies ahead. Our Ethiopian partners are wise to have included this work as a priority for our partnership.

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Hides are stored before processing at the tannery in Addis Ababa.

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

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.

Second team of Ohio State faculty arrive in Ethiopia

Eric Sauvageau is all smiles at baggage services.

Eric Sauvageau is all smiles at baggage services.

By Wondwossen Gebreyes, DVM
Ohio State College of Veterinary Medicine

The second team of Ohio State faculty arrived in Addis Ababa yesterday after 18+ hours of flight and airport transfers. While our travel was overall smooth, some flight glitches occurred. One of our team members, Mike Bisesi, had his first and last name switched on his ticket, and TSA and United made it a big deal worth a thousand USD to correct his ticket. Two team members, Eric and I, did not get our luggage on arrival. Despite the long flight and the mishaps, there are still lots of smiling faces. This morning, we are at the Akaki satellite campus of Addis Ababa University, gearing up to begin the environmental health course module led by Bisesi. We will keep you all posted with more updates.

University of Gondar graduation

By Ally Sterman
Student, Ohio State College of Veterinary Medicine

Yesterday was a day of celebration here in Gondar. The university graduated over 45,00 students today. Students graduating were from a variety of fields and disciplines including undergraduate, masters, and professional students. The University of Gondar also graduated three PhD students in the field of public health from the College of Medicine and Health Sciences, which was a first for the university. Most of the students were undergraduate students with close to 1,000 students from the Faculty of Social Sciences and Humanities. Next was Faculty of Natural and Computational Science with 850 students. The Faculty of the Veterinary Medicine will graduate their first class next year though there were students who graduated today with a degree in the field of veterinary public health.

Though a majority of the graduation process was similar there were a few subtle differences between graduation here and at Ohio State. In the states it is typical for graduates to enter to the song Pomp and Circumstance. Today they entered to a different song that seemed to be much shorter and strictly keyboard-based.  Another big difference, here in Gondar they announced and gave awards to students with the highest grades in their respective fields as they graduate. Though we acknowledge them in our programs, with cords or other visual means, we do not announce their names.

There were also a lot of similarities. They had speeches including one from their president and then a special guest speaker. Very similar to Ohio State, they awarded the speaker an honorary degree from the university. They also dressed very similar. Students and faculty were in the black graduation robes with hoods if they were from a degree program that we would hood for, but the undergraduates had sashes where we would have nothing to distinguish the different undergraduate majors.

Below is a video taken while graduates are walking in. Many are seated while quite a few are still walking past. In the background you can hear the music they are entering to, cheers from graduates/families/friends. You can also see some of the professors and external examiners that came to help give exams or determine if candidates were eligible to graduate.

Data collection in Debark

By Karissa Magnuson
Student, Ohio State College of Veterinary Medicine

For the past two days we have been in Debark, a town about 100 kilometers north of Gondar. Debark was our second data collection site for our rabies research project.

It is a common resting place for tourists who wish to visit the Simien Mountains. On our two-hour drive up to the city, we passed stunning scenery. The countryside is full of lush, rolling hills and looks like a patchwork quilt of rich coffee brown fields and vibrant green countryside.

We passed many farmers out plowing their fields with oxen and an old-fashioned plow. It was idyllic, and I felt like I had stepped back into a different time.  It was hard to go five minutes without seeing a shepherd out with his flock of goats or sheep, and there were always cows, goats, and sheep grazing in the distance. Our van had to stop or slow down a few times as wandering goats, sheep, and cattle crossed the road.

The people of Debark were very friendly and accommodating. For the project, my team was in charge of urban adults and children. It was truly a privilege to be able to walk their streets and be invited into their houses, especially since they knew nothing about me. Every house we went to, I was offered a chair or a place to sit, and a few times, they roasted a snack for me over their fire for me to eat. The hospitality here was truly amazing.

Our last day of data collection, we went up to a small neighborhood on a hill. Immediately we were surrounded by a huge group of children, all probably under the age of 10. They were all extremely friendly and asked me my name.

As my Ethiopian team members told them about the study and asked if they would like to participate, one of the little girls grabbed my hand.

All the children were eager to participate in the study. As we followed them back to their houses, my other hand was grabbed by a little boy, and I was led off down the dirt road to their homes.  Walking from one house to another, my hand was never empty. At one point, two of the children had a little disagreement about who actually got to hold my hand.

When we finished our data collection and were saying goodbye, all the children who had followed us around came over to me and shook my hand, and we touched shoulders. In Ethiopia, when you greet someone you shake hands and touch shoulders with the person. There must have been six or seven kids in line to say goodbye to me. It was truly a heartwarming and memorable experience that I will carry with me forever.

Whether Ethiopia or U.S., independence is a global value

imageBy Ally Sterman
Student, Ohio State College of Veterinary Medicine

Traditions and holidays are important wherever you are and know no boundaries. This holds true for the four of us students working here in Ethiopia. As July 4, neared we thought of the best ways to celebrate this holiday while abroad. Through Ethiopia was doesn’t officially have an Independence Day as we do in the states, they celebrate Adwa Victory in February. This is in memory of the Battle of Adwa, when they freed Ethiopia from Italian colonization.

We were in luck when we found our local convenient store ( a very small one room store with items on all the walls and one very small row of cookies, cereals and juices) at the end of our street had fireworks and sparklers. We purchased a few to celebrate and help make it feel like home.

We decided to try to find something very American for dinner and since our luck with cheeseburgers wasn’t going to well, and hot dogs aren’t common, we all agreed pizza was our best option. We celebrated our Fourth of July as best we could with pizza and fireworks. It wasn’t a traditional picnic cookout with the family and ending the evening with fireworks however it came pretty close.

We have all become close here like family, and our pizza and sparklers were just as much fun as a picnic and fireworks. All in all it was a successful Fourth of July celebration here halfway across the world.

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