Tag Archive | one health

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.

Watercolor inspirations in Gondar

By Karla Zadnik, OD, PhD
College of Optometry

Watercolor inspirations in Gondar!

Watercolor inspirations in Gondar!

Watercolored images of Four Sisters (restaurant) and the transportation van's dashboard chickens (by Karla Zadnik)

Watercolored images of Four Sisters (restaurant) and the transportation van’s dashboard chickens (by Karla Zadnik)

Dr. Karla Zadnik with the ethics course attendees at the University of Gondar

Dr. Karla Zadnik with the ethics course attendees at the University of Gondar

Ethics Engagement in Ethiopia

By Karla Zadnik, OD, PhD
College of Optometry

 

The Summer Institute’s research ethics course chugged along today. I started late, mostly because I didn’t realize most of my students were in the courtyard just outside the classroom in the bright morning sunshine, waiting for me to begin speaking. I lectured on the tenets of the Declaration of Helsinki (OSU faculty—you all remember those, right?) and the ethical use of animals in research (thanks Donna McCarthy!), but the highlight turned out to be the case study discussions.

I presented a case I’d heard at the 2008 Public Responsibility in Medicine & Research meeting. It weaves the tale of an imaginary city, Blovar, which is under siege such that its children are subsisting on an inadequate 400 calories. An entrepreneurial, mythical scientist who studies nutrition and brain function in children appears on the scene to conduct a purely observational study of the children. After carefully reading the case, the course attendees “went to town.” After their small group analysis of the case, I facilitated a discussion of the case. They didn’t need me. There were marked differences of opinion in the class. One attendee drew historical correlates, while another took the role of the Principal Investigator, cautioning the audience to assume that fellow scientists generally want to do a good job. The points made were lively, vehement even, yet collegial. All this before lunch!

The afternoon’s soundtrack was a thunderstorm of biblical proportions that hammered the roof of the classroom and lit up the sky. We all raised our voices in tune with the rain and created a chorus, celebrating the hard, thoughtful work of teaching and learning research-related ethics.

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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.

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

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.

Things I have not missed

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

I was on Skype with my Mom during our last week in Gondar. Back in Columbus, she was telling me about the new washer and dryer that arrived while I was in Ethiopia. The two were installed six inches apart. They are finding that this is just enough space for things to fall down and get lodged perfectly. It sounds like a hassle.

Then, they asked me what I thought it would feel like to go back home to Columbus.

I said I didn’t think I could go completely back home.

Of course, I have missed my wife and my sons Joey and Brian. I am looking forward to seeing my friends and sleeping in my own bed. I have missed our cat and dog.

But there are plenty of other things I have not missed. I have not missed how I let my day get off to a bad start because it took three extra minutes to park. I am not looking forward to returning home and obsessing about the invasive thistle plant messing up our lawn. I have not missed the conversations about washers and dryers in our air-conditioned homes that are six inches too far apart.

These things seem important to us – but I can see now, they are not.

I have no right to complain about a three minute parking spot hunt to the woman I saw in the asthma clinic who had wheezed and walked for three hours to get to her 9 a.m. appointment.

I promise not to complain about the thistle growing in my back yard. I’ve learned that because it grows so well in almost any condition, it is an ideal forage food for work animals in the Ethiopian mountains.

Finally, I pledge to think of my new friend and colleague, Charles Turner, who told me about mango fly larvae burrowing under the skin when clothes are hung out to dry.  I will think about his stories from his adventures teaching nurses all over Africa the next time I agonize over whether to pick “Whites – hot” or “permanent press – cold” on the washing machine. 

And if that fails, I’ve asked my friends to give me a good smack upside the head.

Or, I’ll think of my friends in Ethiopia.

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.