Think Globally: Experiences Abroad Provide Perspective on Life

It is human nature to get used to the routines of life. Commuting to work, the morning coffee, walking the dog, and hundreds of other daily rituals create a level of comfort within our increasingly hectic lives. Being born in America provides an inherent level of comfort. While there is poverty in the United States, most Americans are born into a system of privilege that is not accessible in many areas of the world. Our daily rituals and comforts become second nature, while in other parts of the world these “minor” parts of our day are elaborate luxuries. For example, the United States has a health care system that provides a high level of care inside pristine facilities that contain the latest health technology available to treat and prevent diseases. We don’t think about this, we expect it. We get sick, we go to the doctor, and in most cases we get well. We have a growing culture of preventative health care that promotes healthy living and leads to early detection and a higher rate of successful treatment with many cancers and other diseases. While many countries also share a strong health care system, there are millions of people throughout the world that do not have this luxury. Again, we don’t think about that when we are taking advantage of the health care system, we take it for granted that the system is in place and it will always be there when we need it.

Working in higher education, I see students of all ages, ethnicities, and races expanding their knowledge each and every day. The facilities and resources available to faculty and students in the United States are the best in the world. If you can think it and dream it, you can probably get access to an expert that will help you learn to do it yourself. Similar to our American health system, students and faculty often take this infrastructure of knowledge for granted. There is amazing comfort in academia in the United States with freedom to study and be whatever you want to be, as long as you can financially afford the dream. While our college students are learning in the traditional sense within the confines of this comfortable system, many of them are not learning with a global perspective. The experience that comes from visiting a foreign country and getting outside the umbrella of comfort in the United States provides a valuable perspective that will make a person grown not only in knowledge, but humanity and compassion for others.

While visiting Ethiopia as part of the Global One Health initiative, I was surrounded by many opportunities to see, hear, smell, feel, and experience things that made me contemplate my own realities and expectations. While meeting with doctors I heard stories about the growing epidemic of pediatric cancer patients in Ethiopia, how many cases of cancers are not being detected until it is too late, how access to the needed treatment is not available when needed, and I saw medical facilities that were inadequate to meet the growing demand of the population. While meeting with veterinarians I heard and saw cases of animal diseases that aren’t being treated because of a lack of awareness & understanding and instances of diseases transferring from animals to humans because of contaminated contact.

At the same time I saw and heard a spirited population that is passionate about life, with a rich culture and heritage that is beautifully embraced and celebrated. I saw a level of appreciation for collaboration and the sharing of ideas that I don’t see on a daily basis in the United States. Ethiopia is a country of 96 million, with a median age of 16, who are living in an environment of rapid growth, where building and expansion is outpacing the capacity of the infrastructure, which in turn causes issues from traffic gridlock to water contamination from industrial runoff. In the past seven years, the number of colleges and universities in Ethiopia jumped from three to thirty-three! They live a reality that is vastly different than that of the average American.

As I climb back into my own daily routines in the USA and at OSU, I do so with a different perspective and a greater sense of love for my family, my job, my country, and my beloved alma mater, The Ohio State University. It is my wish for all OSU students to take the opportunity to study abroad and for OSU faculty and staff to engage in global projects. It will truly change your life and open pathways to be energized by collaborating with others in a way that will make a huge impact on the lives of others. Go Bucks, Be Global!

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Ebola a stark reminder of link between health of humans, animals, environment

By Emily Caldwell
Ohio State Research Communications

COLUMBUS, Ohio – For many, global public health seems like an abstract and distant problem – until the Ebola virus is diagnosed among people in our midst.

Though no one would call the Ebola pandemic a good thing, it has presented an opportunity for scientists to alert the public about the dire need to halt the spread of infectious diseases, especially in developing and densely populated areas of the world.

“What often seems like an abstract notion becomes very concrete when a deadly virus previously contained in Western Africa infects people on American soil,” said Wondwossen Gebreyes, professor of veterinary preventive medicine at The Ohio State University. “It does create a certain sense of urgency and awareness that this world is much smaller than we think.”

Gebreyes is the lead author of an article published in the Nov. 13, 2014, issue of PLOS Neglected Tropical Diseases that makes the case for accelerating efforts to put “One Health” into action. One Health refers to a strategy to more fully understand and address the links between animal health, human health and the environment.

Read more at Ohio State’s research news site >>

Patience is a virtue that can be learned – in Africa

 

By Jacquelyn C.A. Meshelemiah
Associate Professor, Ohio State College of Social Work

“This is Africa!”

I have heard the expression, “This is Africa!” repeatedly over the last week while conducting research here in Gondar, Ethiopia.

I came here to collect data from Key Opinion Leaders (KOLs) on Tenofovir, a microbicide gel used to prevent HIV infection. It is in clinical trials in South Africa. The data collection is part of joint research project among Ohio State’s Colleges of Social Work and Nursing and the Department of Social Work at Gondar.

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Me (left) with Eden Begna, a 2014 social work graduate from the University of Gondar.

We most certainly hope to pilot Tenofovir in Ethiopia should the second trial in South Africa confirm the original results.  It will be a few years in coming, but we are conducting the research here to assess Ethiopia’s readiness for Tenofovir gel in the future.

The people I’ve interviewed include social workers, nurses, public health personnel, internists, HAPCO workers, OB/GYNs, health extension workers, and other relevant personnel. My colleague, Mr. Semalegne Kendie Mengesha, and I collected a lot of data!

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I’m interviewing Dr. Mengistu Mengesha

What I received was far more than rich data. I received an important lesson on time and patience.

Gathering rich data from 12 KOLs in Gondar took months of proposal writing/IRB prep work,  weeks of pre-scheduling semi-structured interviews, contacting more than 25 potential KOLs, double and triple confirmations of appointments to complete the interviews, and then bracing for the “Wait.”

Despite confirming appointments just hours or even sometimes just minutes before a confirmed appointment, Mr. Semalegne and I often found ourselves waiting, waiting, and even more waiting more than 50% of the time for participants to arrive at the agreed upon destination.

I found this pattern to be very surprising and initially very frustrating. My reference to the Biblical character Job became a daily ritual. (Job is known for his extreme patience.) Although the demands for my patience were nowhere nearly as intense as what was required for Job, I had to dig deep for my patience.

At the same time, my waiting resulted in numerous fruitful conversations about norms related to Ethiopian culture.  So, rather than perseverate over what I was repeatedly exclaiming as “Loss time!!!”   I decided to spend time trying to understand why time was relative and how waiting could be used constructively.

Eventually, I decided it was best to stay put  when a participant was running late, even if it meant waiting 20, 30, or 45 minutes for the participant to arrive.  Besides, it did not make sense to shuffle back and forth between the hospital and Taye Belay hotel in a bajaj.

Again, many participants were on time.  It was the other 50+% who showed up late or not at all that resulted in contact with more than 25 participants just to get the 12 I had intended to interview. All of the no-shows did eventually text or call within one to six hours after our appointments. That gave me some comfort and increased my patience, just a bit.

By the end of my research week, I was psychologically prepared to wait, and with patience.  I knew, based on the earlier interviews that we had completed, that we were going to get rich data and the undivided attention of the research participants once we were able to sit before them and start the tape -recording.

Now back to my point: “This is Africa!”

Yes, it is. Time is relative for most. It is not an attempt to be disrespectful or inconsiderate. It is what it is.

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From left, Solomon Getu, me, Ajanaw, and Semalegne Kendi Mengesha

I got the research done, formed some new relationships, developed some patience and learned what “This is Africa!” means.

I love Africa – all of it – even the part that makes me want me to scream and say, “Let’s start on time,” but then again, what is “on time” for me is not always the same thing for others.

“This is Africa!”

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From left, me with Addisu and Asmech.

Collecting samples from camels in the Awash Rift Valley

 

By Kelsey Gerbig
Veterinary Medicine student at Ohio State

Our summer research projects with Addis Ababa University took us to the Rift Valley in the Afar region of Ethiopia.

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Kelsey Gerbig with a giant tortoise at the Awash National Park.

My focus is on Trypanosoma evansi and diagnostic techniques for practical and efficient identification of this blood parasite in camels.

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Used for meat, milk and transportation, camels play an important role in the lives of the pastoralists in the Awash Rift Valley, and results from this project will provide an idea of the prevalence of this disease in camels in the Afar region.

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Map credited to Kmusser, used under Creative Commons Attribution-Share Alike 3.0 Unported license

We left our hotel room early on Thursday to travel east to where the pastoralist tribe was currently living. The pastoralists are a nomadic people, who move with their animals to find grazing land and water throughout the year. On our way, we admired the gorgeous views.

Wildlife in Awash

The tribe that agreed to let us sample from their herd owned cattle, goats, and camels. We were quite taken aback at the size of their camel herd – close to 200!

Camels and Pastorals

We geared up to collect samples. Disposable gloves, shoe covers, and N95 respirators were donned. Even though we had limited contact with the camels, we wanted to take as many precautions as possible to avoid contracting zoonotic diseases.

Currently, it is fasting season for many in Ethiopia, and our helpers from the pastoralist tribe grew tired as the morning went on.

In the end, we were able to collect blood, feces, and respiratory secretions from 51 camels.

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Camel Fecal Sampling

At the end of our work, I couldn’t resist taking out my digital camera to document our experiences that morning. As soon as I began snapping pictures, the kids started posing so that they could see themselves on the digital screen. Even some of the men joined in, posing with their weapons and camels!

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We would like to say thank you to Dr. Nigatu Kebede and his laboratory technician, Nega Nigussie, for arranging our sampling trip and assisting with sample collection. Our summer research projects would not be possible without their help!

 

Q&A on animal care and vet students in Gondar, Ethiopia

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Dr. Sintayehu on the far left, Christine second from right, during Christine’s visit to Ethiopia earlier this year.

Introduction: Christine O’Malley and Dr. Sintayehu Mulugeta are friends who work on collaboration between Ohio State and the University of Gondar (UOG), Ethiopia. This summer, Ohio State sent a team of students and faculty to partner with UOG on a spay/neuter program and dog inventory as part of a rabies elimination pilot project. Below is a transcript of a Skype conversation between the two friends. Sintayehu, a veterinary medicine faculty member, describes the field training UOG provides its vet students.

Christine: Now that the Diamond Jubilee is over, what’s going on at the University of Gondar? Is it summer break?

Sintayehu: Well, I am out of office for field work with students on their clinical field experience. Most of the schools are on summer vacation now, but students in Medicine and Health College, Vet Faculty and freshmen in various departments are still in campus.

Christine: What kind of field work do the vet students do?

Sintayehu: To support clinical medicine course and help them develop confidence and get acquainted with the real picture at clinics out there in working place, students take a course called off-campus training. The students will have about two weeks’ time exposure to different districts’ government vet clinics where they work as clinical vet students with close supervision by one faculty staff from UoG, and the district’s vet.

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Sintayehu: They also engage in community services and help the clinics in every capacity they are capable of, like cleaning the clinic compound, providing recommendations on potential shortcomings, etc. After completion of off-campus training, they are supposed to present a field practice report about their stay and will be evaluated based on that.

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Christine: Do they provide direct care to animal patients?

Sintayehu: Yes, with supervision. That is why I am currently with them here in field.

Christine: I bet they learn a lot from that.

Sintayehu: Sure. That is the best way of learning from practical courses. And this is witnessed by them. However, because of small amount of budget they sometimes come back to campus earlier than planned. This is really a continuous challenge to the faculty and to them.

Christine: What are the most common illnesses or conditions that you see at the district clinics?

Sintayehu: Well, I can say we have all sorts of diseases. For instance, in the place we are now working are Infectious (Pasteurellosis, Black leg, Anthrax, Lumpy Skin Disease, Sheep pox, Rabies, Newcastle Disease), Parasitic (helminthes, arthropods: ticks, lice, mange mites; protozoans: Trypanosomes, Coccidia), Metabolic and nutritional, and reproductive disorders in cattle, sheep, goats, donkeys and chicken. I was surprised to see dogs as well in the clinic.

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Sintayehu: However, to be honest with you, there are no laboratory facilities for confirmation of cases, so the diagnosis is almost always relied on history and clinical findings. No single laboratory diagnostic aid and there are only few drugs available.

Sintayehu: I saw a new building for the clinic and I was told that it has been built from the World Bank fund. Mr Nigussie, the vet technician working here, told me that it is now completed and will be furnished with basic clinic facilities from the same fund. Then it can have better veterinary service.

Christine: Why were you surprised to see dogs?

Sintayehu: I mean not to see them, but the awareness of the community, most of which are poor farmers, to get medical care for their dogs.

Christine: That seems like a good thing.

Sintayehu: Definitely! I was told by Mr Nigussie that the community has good awareness about the importance of bringing their animals to clinics whenever there is ill-health to their animals. That shows there is a big demand for vet service.

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Christine: Also a good thing for the rabies project, perhaps? Showing awareness of needing to take care of their dogs?

Sintayehu: Yes. You know, I also asked about the status of rabies in the area. It is terrible to hear that there is high prevalence of rabies in the countryside. This is worsening by strongly rooted perception of the community that traditional healers can cure the disease. It is challenging human/animal health care.  There is no rabies vaccination at the clinics. The only thing the vets in such districts doing are advise farmers to be careful of suspected dogs.

Christine O’Malley: Yikes! What areas will you visit next?

Sintayehu: This is the last field work for this academic year.  Koladdiba, the place we are now working in, is not that much far from Gondar, about 35kms, but the road is rugged and may take you about an hour or so. I love having seen the countryside. I wish I could visit such places more often.

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Group of students with Dr. Sintayehu, their mentor, in the middle wearing the blue jacket.

Public health course ends with a conference lecture in Gondar

By Armando Hoet
Associate Professor and Director of Ohio State’s Veterinary Public Health Program

Gondar Ethiopia, day 6

I am still not sure what happen, but I blinked, and there I was in the front row of the largest conference center in Gondar at the Medical School, seated between the president and vice-president of Gondar University , as one of the main keynote speaker for the 24th Annual Research Conference of Gondar University.

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This year the conference was even more special, which explain the large number of journalists and cameras, as it was the 60th anniversary of the university (Diamond Jubilee).

Before the conference started the President shared with me his career path, starting as a sanitarian doing pre- and post-slaughter inspections, later becoming a Public Health official, studying part-time to become a physician and in the last 8 years he has been the president of the University of Gondar; leading a 30,000-student institution of higher education.  He is in his own words “one of the strongest advocates of One Health.”

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I believe the presentation went well based on the amount of interesting questions and post-conference trading of business cards.

As I am leaving tomorrow, I would like to thank my guide in Gondar, Professor Tamiru, who showed me the best of the city in this and my previous visit in 2012. And who took me today to the best view in town: The Goha Hotel.

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Everything ended well, except for the Spanish team (5-1 to the Netherlands in the world cup) …

Finally, one of the best ideas I am taking back this trip is the unisex open bathrooms. I am sure they will pick up really fast at OSU.

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Why misuse valuable space in duplicating men and women bathrooms, when we can share one? I am sure that we can use the extra space for additional offices. Right?

From the city of the Emperors of Africa

Thesis defenses and counting dogs in Gondar, the student perspective

By Ally Sterman, 2015 DVM and
Alexandra Medley, 2017 DVM and 2018 MPH/VPH
The Ohio State University

After a 13-hour flight, we arrived in Addis Ababa, Ethiopia. A thought that kept crossing through both of our minds was whether or not our 140 pounds of veterinary medical supplies would make it to Ethiopia, through customs, and with us to Gondar. After locating the correct baggage claim lanes (this airport has 4), we waited patiently for our oversized and heavy baggage. Thankfully we made it with no difficulty through customs and to our airport.

Flights to Gondar leave early morning and we stayed overnight at the Jupiter hotel near the airport in Addis. The view from our room was of a large abandoned field. By day this field was a grazing zone for various sheep and goats, but by night it was a parking lot for local vehicles. After exploring around the area, we ended up calling it an early night.

We arrived to the airport early and upon arrival in Gondar were greeted by our partners from University of Gondar and taken to our hotel. Soon after settling in we headed to the vet school. We had the opportunity to listen to senior veterinary students defending their theses, which is the final project necessary to graduate. There are some striking differences between Ethiopia and U.S. vet school training. In Ethiopia the students defend a final thesis project instead of a cumulative boards exam (USA NAVLE), they attend school for 6 years (USA, 4), and primarily focus on large animal medicine because that is the primary need in the country.

After listening to the defenses we had a meeting with the faculty who helped us organize our dog survey. For the next week we are walking 15 different paths we have plotted through the city to count the roaming dog population and do a brief visual physical exam on each dog. Data we want to collect are the number of dogs seen along the path, sex, age, reproductive status, and any other clues to their health status.

Something we have learned already is how mountainous Gondar is, so although the paths are short, they take a while and we get a great workout. To get to destinations we take buses or taxis which are far more crowded than the average taxi in the US.

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Taxis and busy city streets

We have seen many types of dogs so far, from a small Papillon cross to a large Mastiff. Our favorite dog is the mixed breed brown dog who resides directly outside our hotel, affectionately named Kino.

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Kino, the dog

2014 One Health Summer Institute brochure posted online

 

By Christine O’Malley
Executive Director of Health Sciences

I’m happy to share that the brochure for the 2014 One Health Summer Institute is now online.

More info about the institute can be found here: http://u.osu.edu/onehealth/projects/education/summer-institute/

Or you can download the brochure by clicking on this photo:

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Town-gown partners showcase Columbus-OSU ties with Addis VIPs

By Christine O’Malley
Ohio State University
Executive Director of Health Sciences

Last week, we had a tremendous visit by 11 delegates from Addis Ababa University. The delegates met with Ohio State’s university and health sciences leaders. Many potential collaborations were discussed as we explore ways to broaden our One Health initiative.

Some of the delegates were able to visit with City of Columbus representatives. Greater Columbus sister Cities International Inc. posted this on its Facebook page:

 

 

It’s so great to have a strong town-gown partnership when Ohio State brings international guests to Columbus!

 

The business of rabies elimination in Ethiopia

By Danielle Latman
Ohio State MBA student

Seven Master of Business Administration students from Ohio State’s Fisher College of Business will visit Ethiopia for three weeks in May as the in-country portion of our Global Applied Projects class. The class is taught by Kurt Roush and advised by Professor Scott Livengood.

We are: Javed Cheema, Katie Fornadel, Carla Garver, Alejandra Iberico Lozada, Daniel Meisterman, Niraj Patel, and me, Danielle Latman. Combined, we are from three different countries, have traveled to almost 70 countries, and have 65 years experience in sales, marketing, operations, financial services, nonprofit and military industries.

From left: Katie Fornadel, Alejandra Iberico Lozada, Daniel Meisterman, Danielle Latman, Niraj Patel and Carla Garver. Not pictured: Javed Cheema.

From left: Katie Fornadel, Alejandra Iberico Lozada, Daniel Meisterman, Danielle Latman, Niraj Patel and Carla Garver. Not pictured: Javed Cheema.

The Ohio State / Ethiopia One Health Partnership asked us to harness our business skills to help operationalize the partnership’s rabies elimination project, adding a layer of practical implementation to the research and training that veterinarians and scientists have already developed. We have split up into teams focusing on the finance, marketing, operations, logistics and data collection functions of the rabies elimination project. Our goal is to develop a proposed roadmap that will allow the U.S. And Ethiopian partners to implement the rabies elimination One Health model project on a targeted region in Ethiopia.

We will travel to Ethiopia from May 1-25 to work with officials in Addis Ababa and Gondar. For the past seven weeks, we have met with the CDC, Drs. Gebreyes and O’Quinn, cultural anthropologists and social service agencies to prepare for our trip. We have also eaten at the lovely Lalibela restaurant here in Columbus, received our travel visas, and gotten a lot of shots — and were dismayed to find a shortage of the yellow fever vaccine in the U.S.!

For all of us, this will be our first time visiting Ethiopia and sub-Saharan Africa in general, and we are excited for what are sure to be many new and rich experiences! We are looking forward to exploring the natural environment of the Blue Nile Falls and Simien Mountains, driving overland from Addis Ababa to Gondar, seeing the history of ancient castles and churches, visiting marketplaces and drinking delicious coffee with each other and our new colleagues and neighbors. We are thrilled for the opportunity to contribute our business skills and passion to build on the One Health Partnership’s success and help eliminate rabies in Ethiopia.