Tag Archive | Rabies

The initial journey of the University of Gondar-Ohio State rabies project: my perspective

By Tamiru Berhanu Denka, DVM
University of Gondar, Faculty of Veterinary Medicine

I was voluntary and happy when requested to be part of the Rabies Knowledge Attitudes and Practice assessment in and around Gondar. The University of Gondar team was established ahead of the arrival of Ohio State teams, and was made up of lecturers and assistant professors from College of Medicine and Health Sciences (CMHS) and the Faculty of Veterinary Medicine (FVM).

Tdele Atnafu form the School of Pharmacy, and myself form FVM went to two districts: Debark and Woreta, 105 km and 120 km respectively away from Gondar.  Dr. Reta Tesfaye (FVM) and Debasu Damtie (CMHS) went to different places in Gondar. The mission of our team in these different places was to contact responsible government bodies and to discuss and debrief the rabies project objective in Gondar particularly, as well as Ethiopia at large, before beginning work.

The Faculty of Veterinary Medicine, UOG, Welcoming Ohio State students at Hotel Lamergeyer.

The Faculty of Veterinary Medicine, UOG, Welcoming Ohio State students at Hotel Lamergeyer.

After the arrival of the Ohio State team, Dr. Wassie Molla, coordinator of the project from UOG, held a meeting to allow the teams from Ohio State and UOG to meet and discuss the interview questions, recording on the ipad, and consent of interviewees at the meeting hall of FVM.

The next step was to start the job– interviewing various individuals and professionals as per the project proposal. Interviewing individuals is not an easy thing to do. However, our prior communication and discussion helped us to interview efficiently. Everyone was welcoming and eager to participate in these interviews. As we continued on, I began to see how important the issue of rabies is, and how much it affects my country. Everywhere we went people stopped their daily activities to meet with us, allowing our groups to finish interviews more quickly than originally anticipated. Due to our efficiency, our teams were asked to take on the challenge of an additional city and we did so in stride. In total we surveyed four cities and conducted approximately 280 interviews in eight days.

Because, it is cultivation season, the periurban community leaders and communities were super busy plowing. At this critical time, it was necessary for us to meet this group of people for the interview. Then we decided to participate in plowing! (Ally, Ohio State 3rd year Vet Med student).

Because, it is cultivation season, the periurban community leaders and communities were super busy plowing. At this critical time, it was necessary for us to meet this group of people for the interview. Then we decided to participate in plowing! (Ally, Ohio State 3rd year Vet Med student).

We then went to Addis Ababa to attend the rabies stakeholders workshop, held July 18-19. I am having an immense experience working in a team, appreciate  learning about a different culture, and developing more friendships among the Ohio State team and from the University of Gondar as well.

Mr. Berihun (lecturer, Department of Nursing) did well plowing. The farmers were surprised when he started pushing the oxen.

Mr. Berihun (lecturer, Department of Nursing) did well plowing. The farmers were surprised when he started pushing the oxen.

Dr. Tamiru Berhanu (lecturer, University of Gondar, Faculty of Veterinary Medicine)

Dr. Tamiru Berhanu (lecturer, University of Gondar, Faculty of Veterinary Medicine)

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The UOG–OSU rabies project team members after successful interviews of various target groups of the study at Debark, 105 km from Gondar, where UOG is located.

The UOG–OSU rabies project team members after successful interviews of various target groups of the study at Debark, 105 km from Gondar, where UOG is located.

Dr.Baye Molla and the OSU students (Laura Binkely, Karissa Magnuson, Korbin Smith and Allyson Sterman) before getting to attend the graduation ceremony of the UoG  on July 6, 2013.

Dr.Baye Molla and the OSU students (Laura Binkely, Karissa Magnuson, Korbin Smith and Allyson Sterman) before getting to attend the graduation ceremony of the UoG on July 6, 2013.

The MPH-VPH program started admitting students in 2012. The program was made successful due to the significant contribution of Ohio State professors. From Left to Right: Dr.Achenef Melaku- Dean of FVM, UOG. Dr.  Sileshi Nigatu- Head Department of Veterinary Public Health and Epidemiology.

The MPH-VPH program started admitting students in 2012. The program was made successful due to the significant contribution of Ohio State professors. Dr.Molla (Ohio State professor) with two of the first batch of MPH-VPH graduates on June 6, 2013. The MPH-VPH students have green striped graduation gowns.From Left to Right: Dr.Achenef Melaku- Dean of FVM, UOG. Dr. Sileshi Nigatu- Head Department of Veterinary Public Health and Epidemiology. 

University of Gondar graduation ceremony

University of Gondar graduation ceremony

Rabies In Ethiopia And The Way Forward – Stakeholders Workshop

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

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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.

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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!

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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!

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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.

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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!

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

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.

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.

Ohio State in Ethiopia: Now the students’ work begins

By Ally Sterman
Student, Ohio State College of Veterinary Medicine

With the start of the both the new week and new month our Ethiopia summer project really begins. Though we four students from various colleges at Ohio State arrived near the end of last week in Ethiopia, we did not begin our field work until July 1.

Our project takes us into both the rural and urban communities interviewing local adults, children, policy makers, community and faith leaders, as well as health care workers about rabies and dogs. We are set to travel around to three different areas before a workshop is held in Addis Ababa to discuss rabies further in mid-July.

However we do not go out alone. Each Ohio State student has two wonderful Ethiopian University of Gondar partners. These individuals are primarily faculty and staff at the university from a variety of fields/disciplines. They not only serve as interpreters for our project but tour guides of the city and historians for Ethiopia’s culture/traditions/history. They are quickly becoming lifelong and treasured friends. I know I can speak for all of the students about how grateful and appreciative we are for their help and how much fun/enjoyable they are making this experience.

The picture below was taken before one of the interviews conducted by my group. My group’s main focus is community leaders which include teachers, faith leaders, elders, and other various leaders in both the rural and urban settings. This picture was taken of one of the churches we travelled to in the city of Gondar where we had the opportunity to meet and talk to the priests about rabies and the dog population here in the city.

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If generosity equaled power Ethiopia would control the world

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

As we began our interviews with the locals I was amazed how easy it was to get people to volunteer. Everybody in this country wants to talk and help.

My group consisting of Dr. Atnaj Alebie and Tadele Atinafu have been more than helpful. They are brilliant professionals as well as very kind and humble people.

Together we were able to collect our first set of data in rural areas successfully and efficiently. Hearing what the rural adults and children believed caused rabies was truly incredible.

While many answers cause me to be concerned about their safety in an area where rabies is prevalent, it is inspiring to know that our work is needed.