Tag Archive | One Health Summer Institute

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.

Research ethics in Ethiopia

By Karla Zadnik, OD, PhD
College of Optometry

ImageI was hosted by Dr. Seleshe Nigatu of the University of Gondar as I opened the research ethics class in the Summer Institute with a discussion of the Tuskegee Study. The study is the U.S.’s 1978 Belmont Report with its basic principles of respect for persons, beneficence/nonmaleficence, and justice. The class of almost 60 people from the University of Gondar and Addis Ababa University, along with other Ethiopian institutions of higher learning, had expertise ranging across medicine, veterinary medicine, economics, and pharmacy. The photographs depict the engaged students. In the late afternoon, the participants tackled their first two case studies, one on Image

reporting of results to an industry sponsor and the other an accurate analysis of a case of subtle plagiarism but plagiarism nonetheless. Tomorrow, the class tackles animal care and use in research and biorepositories (thanks to Donna McCarthy and Mark Merrick and their lecture materials).

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The transition from Addis Ababa to Gondar was ably assisted by advice from Dr. Jodi Ford from the College of Nursing, who taught research methods at the University of Gondar earlier in July.

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

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.

The Sounds of Ethiopia

Tim Landers of Ohio State’s College of Nursing shares this clip of what 5 a.m. sounds like in Gondar, Ethiopia, as he prepares for another day with the One Health Summer Institute.

Ohio State and Ethiopia: Building Collaborations

Here I am reviewing some class materials with students in the “Food Safety and Food Borne Diseases” course, as part of the Summer One Health Institute.

Here I am reviewing some class materials with students in the “Food Safety and Food Borne Diseases” course, as part of the Summer One Health Institute.

by Bayleyegn Molla, DVM, PhD
Clinical Assistant Professor and International Programs Coordinator
Ohio State College of Veterinary Medicine

Our hope is to establish ongoing collaborative relationships–not just during the One Health Summer Institute, but well in to the future.  We hope to be able to build a mutually beneficial partnership between faculty and students at Ohio State and University of Gondar, which will help leverage expertise and open opportunities for all.

For participants from Ethiopia, this experience can bring the world-class knowledge and expertise of Ohio State to address important public health problems, though training and ongoing working relationships.  Partners at the University of Gondar bring a wealth of knowledge about local priorities and infrastructure.

Research and practice priorities are well organized in thematic areas with an emphasis on team-based research.

For faculty from Ohio State, this partnership offers the opportunity to explore and help develop solutions to tropical diseases, wildlife and environmental issues, and to apply new approaches in a different culture and region.  This opportunity helps expand the capabilities for students trained through the University of Gondar and faculty to use this knowledge to address important issues in Ohio, in our country, and throughout the world.

It is very rewarding to see this partnership in action in the One Health Summer Institute.  Students and faculty from nursing, public health, veterinary medicine, basic sciences, and human medicine have been discussing important problems such:

  • Food-borne illnesses
  • MRSA prevention
  • Cervical cancer
  • Zoonotic diseases

More importantly, these workshops explore potential ways to work together in the coming months and years.

The “One Health” framework is an excellent foundation on which to build this partnership, because it relies on contributions from a range of scientific experts and the active engagement of students in workshop sessions.

Being from Ethiopia originally, and now as a faculty member at Ohio State, it is tremendously rewarding to see the engagement of both universities in an effort to improve health.

Making Animal Inquiries in Addis Ababa

I took this picture outside of the Jupiter Hotel in Addis Ababa. This is kind of how I felt trying to navigate  a busy street with an unfamiliar language.

I took this picture of a stray dog outside the Jupiter Hotel in Addis Ababa. This is kind of how I felt trying to navigate a busy street with unfamiliar language and surroundings.

By Tim Landers
Ohio State College of Nursing

One of the first people we met when we arrived in Addis Ababa was Daniel, our driver who took us around some of the sights.

Traffic is very bad, with pedestrians, loaded mules, stray animals and vehicles trying to share the same road.

Most of the dogs we saw were roaming the street, but as we wove through traffic, I asked Daniel if he had a dog.  He was happy to show us photos of “Jack.” We know that dogs are important parts of many peoples’ families, and this was true for Daniel as well.

We asked more about Jack – where did he find him, when did he go to the doctor, and what type of dog he was.  Expecting that he would tell us about Jack’s pedigree, Daniel seemed very puzzled by the this question.  “He’s a small dog, a nice dog.”

Daniel was concerned because Jack had some sort of infestation, and he did not know how to treat it.  Unfortunately, we had two nurses in the car and no veterinarians.  We did stop at a local pharmacy to see what treatments they might have.

While we were able to buy fairly high-end human antibiotics, but they did not carry veterinary medications.

During our tour of Gondar, we encountered this donkey, which in Ethiopia are seen as work animals.

I asked one of the veterinarians with our group about an ulcer on the back of this donkey.  He actually pointed me to a paper he had written about these “pack ulcers” –erosions caused by loading of the animal for transport of goods to the market.  They are generally non-infectious, but they look uncomfortable!

 

Ohio State Arrives in Gondar–Let One Health Begin!

By Tim Landers
Ohio State College of Nursing

We’ve arrived in Gondar!

Our traveling group from the College of Nursing arrived this morning and were greeted by officials from the University of Gondar and Baye Molla, PhD, clinical assistant professor in Ohio State’s College of Veterinary Medicine.

Dr. Molla is a native of Gondar and has been a wonderful guide and adviser as we have planned our trip to Ethiopia for the One Health Summer Institute.

Over the summer, we will be joined by 20 faculty and students from Ohio State, representing the colleges of Nursing, Veterinary Medicine, Medicine, Public Health, Optometry, and Food, Agricultural and Environmental Sciences, as well as faculty from Addis Ababa University and University of Gondar.

In addition, Robert Agunga, director of Ohio State’s Center for African Studies, will join us in presenting a series of short courses using the One Health framework.

The College of Nursing’s faculty contingent will begin the institute by offering a week-long course in research methods to students and faculty from the University of Gondar.