Tag Archive | Ethiopian culture

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.

bisesi_and_kids

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.

rabies workshop 13

3interview

Advertisements

Rabies In Ethiopia And The Way Forward – Stakeholders Workshop

By Mary Jo Burkhard, DVM, PhD
Ohio State College of Veterinary Medicine

banner

I had the privilege of facilitating a 1.5 day workshop for stakeholders committed to the control and eradication of rabies in Ethiopia. We had approximately 70 registrants including representatives from a number of agencies such as the Ethiopian Health and National Research Institute (EHNRI), Federal Ministries, Center for Disease Control (CDC); partners including conservation, environmental, research and vaccine development groups, as well as a host of faculty and students from the University of Gondor, Addis Ababa University, and The Ohio State University.

Mamo Gebreyes

Dr. Hailu Mamo, Research Coordinator from ENHRI and Dr. Wondwossen Gebreyes from OSU, two of the meeting organizers working on details before the start of the session.

While not everyone could make it for all of the sessions on both days, we had 45-60 participants in each session which demonstrated the importance of rabies control in Ethiopia. Particularly when you consider that the session was held on a regional campus approximately 23 km outside of downtown Addis Ababa that required navigation through substantial traffic!

Image

We utilized a very powerful workshop format that we at the College of Veterinary Medicine like to call “Focus Forward.” This format included overview presentations, facilitated small group discussions, identification of common recommendations by a “theme team,” and prioritized voting through participant clickers. Dr. Tamiru Berhanu, a veterinarian and lecturer at the University of Gondor (UOG), served as one of our small group facilitators. Dr. Tamiru Berhanu is one of the partners for the rabies collaborations between the University of Gondar and Ohio State. I learned that in Ethiopia, it is common to refer to doctors by their first name, so Dr. Berhanu rapidly became known to me as Dr. Tamiru. Once I figured out the Ethiopian way of addressing people, it became a lot less confusing to sort through our excel spreadsheets of the participant list!

Image

Tamiru Berhanu, a partner for the rabies collaborations between the University of Gondar and Ohio State, and Mary Jo Burkhard.

We had four main topics to cover in the workshop: surveillance and reporting, how to identify people exposed to rabies and develop standards for immediate care of bite wounds, controlling rabies in the dogs and other animals, and education for both urban and rural areas. During the breakout sessions, diverse teams of experts discussed these critical topics. One of the strongest themes that arose in all of the sessions was the need to include traditional Ethiopian healers in the process by combining culturally-accepted, traditional methods of treatment and training of traditional healers with rabies vaccination programs and current medical treatments for bite wound care.

Image

Here, Dr. Debasue Damtie (at right, taking notes on participant responses), a professor from the University of Gondor, leads one of the breakout sessions.

Even though I spent nearly all of my time in the workshop rooms, I learned a lot about Ethiopian culture just from listening to the discussions and hearing the recommendations. However, I am also looking forward to seeing more of Addis Ababa over the next couple of days now that the conference is over and personally experiencing more of the Ethiopian culture!

Scenes from Ethiopia

5soccer

A soccer match is played adjacent to a neighborhood near Addis Ababa University’s Akaki campus.

Friends walk hand-in-hand on the Addis Ababa University Akaki campus.

Friends walk hand-in-hand on the Addis Ababa University Akaki campus.

A young boy rides a horse-drawn cart in the city of Woreta, South Gondar.

A young boy rides a horse-drawn cart in the city of Woreta, South Gondar.

Photos by Rick Harrison, Ohio State University Communications

It’s all in the herbs: How traditional medicine shapes rabies treatment

By Karissa Magnuson
Student, Ohio State College of Veterinary Medicine

During our time here in Ethiopia, we have been surprised to find out how often people, especially in rural settings, believe and prefer a traditional healer instead of modern medical doctor. My curiosity on this subject led to me to do a little research online into the prevalence of traditional healers in Ethiopia as well as traditional treatments for rabies proposed by these healers.

Traditional medicine dates as far back as the 15th century in Ethiopia and consists not only of herbal remedies but also of animal and mineral-based concoctions as well as spiritualistic rituals and aromatherapy. Most traditional healers have learned their trade from a family member, and like doctors, these healers go through both a physical exam and history when they examine their patient.

Not surprisingly, many modern health care workers do not support traditional medicine; however, there are some that feel collaboration between traditional and modern healers could provide the best treatment for patients.

In my research I was shocked to discover that up to 80% of Ethiopians use traditional medicine as their primary source of health care. (A historical overview of traditional medicine practices and policy in Ethiopia.) Being from a country where modern medicine is viewed as infallible, with Chinese and other traditional medicine slowly gaining some credence in the U.S., an 80% preference rate is surprising.

So is there any stock in traditional medicine in the treatment of rabies? In my search, I found remedies which have included the use of skullcap on wounds (This herb tends to have astringent effects, antiseptic effects on wounds, and anti-anxiety effects.) Garlic was also frequently mentioned for treatment. I was shocked to discover that garlic has been found to have some effects on paralytic disorders. The bark of Alangium salviforium, a flowering plant, has also been indicated as a possible treatment and has been proven to have anti-epileptic effects. The main question that I am left with is: Are these treatments and herbs effective or is traditional medicine hindering rabies eradication in Ethiopia? Or perhaps, it warrants further research and possibly future collaborative efforts in the cure and eradication of rabies within this amazing country. Only more research will tell.

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.

Endemenachu?

By Timothy Landers, RN, PhD
Ohio State College of Nursing

One of the things that has been most impressive in my visit to Gondar is the respect for people and for relationships that is present in every interaction.  Every conversation begins with a greeting, ሰላም, “Selam!”  Followed by some greeting such as “how are you”, “how is your day going”, or “how are you feeling?”  Or more often, all three.

In a typical conversation, each person in the group is acknowledged and receives a handshake.  The president of the university greets the department chair, the student, and the housekeeper.

There is a nonverbal conversation among Ethiopian men – what we’ve come to call the “ah-ha.”  It is a brief gasp taken with force which is usually uttered when another is speaking.  It says, “I am listening, I am interested, I am here.”

When I arrive at my office in the morning, I make it a point to say hello to the co-workers I meet – something I picked up from an airline pilot who told me he ALWAYS greets his flight attendants and co-pilot first thing.

However, it’s not the same kind of recognition and appreciation for the other person that I have seen in our visit to Ethiopia.

In the past two weeks in Ethiopia with each “Selam,” “good morning,”  “how are you feeling?” and “how was your day?,” I’ve learned more about my co-workers than I could have in six months in Columbus.

But, I’d like to change.

When I leave Gondar, I am going to be more aware of how I greet those around me – everyone.  It’s worth the time to let them know that I am interested in how they are doing.  I am hoping to let them know that I value them and am interested in them.

How are you doing today?  How are you feeling?  Did you have a good night?

After that, I will unlock my door and get to work.

And there is lots of work to do.

Landers: Nurses are awesome, say it loud and proud!

By Timothy Landers, RN, PhD
Ohio State College of Nursing
and Gennit*, 9th grader from Atlanta, Ga.

*Gennit is not her real name but the story is true.  Her mom gave us permission (from the row behind us) to use this story and photo.  Hopefully, this counts as her “What I did over summer vacation” essay when school starts.

I’m sitting on the plane with Gennit, a 13-year old girl who was born in Ethiopia, but now lives in Atlanta with her brother and parents.  Gennit is a nice and articulate 13-year girl, and we chatted during the 13-hour flight about our experiences in Ethiopia.

photo-2She had a lot of things to say, and I noticed that she was somewhat soft-spoken making it difficult to hear her at times.  I asked her about my observation that many Ethiopian girls and women speak softly and what she thought about that.

Gennit told me she thought is was more “ladylike” to speak softly and, in Ethiopia, children are taught that it is wrong for a girl to talk loudly.

She spoke in her own dialect – the American southern teenager — and said, “Like, it’s like wrong for a girl to speak like that.  Ok, like, it’s just like, everyone has, like, their own traditions and, like, it’s just how a girl is raised.”

At the same time, she had some very interesting and important opinions to share.  It’s, like, totally cool that a 13-year-old gets this linguistics lesson.

I started thinking about what this means for nurses and for nursing.  It is often difficult for us to articulate our contribution to health and health care.  We are trained to be reserved and deferent.  It’s considered respectful, but it means that our voices are not heard.  This can be especially true at the table of health care decision-making.

As we work with our colleagues from the University of Gondar, we need to encourage them to represent nurses in a way that is culturally acceptable and to advocate for nursing’s contribution to patient outcomes — to speak up for what nurses mean to patient care.

This is true for us in Ohio, too.  We should learn to make our voices heard.

REPRESENT!

What nurses do is, like, totally awesome!

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.

image-1

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.