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

Building knowledge in Ethiopia as Gondar builds buildings

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

Gondar, Ethiopia, Day 3

We changed venue today to fit some late arriving participants, which is great to know that you are gaining people as you go instead of the other way around.  Because we changed venue, we started a little bit later than planned, just merely an hour. And as I mentioned before, you become a good jazz player in improvising and adjusting the timing and rhythm to be able to still produce a good melody.

The group is also starting to get more involved in the material, especially in the afternoon when we started the first group activities. They became really enthusiastic, and strong discussions and conversations occurred throughout the afternoon.

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Interestingly, I wanted to film such heated interactions in Amharic (the official language), but as soon as I pointed the camera, silence. Got it, no filming.

In any case, I believe they are enjoying the course, especially because at the end of the day I received several requests for pictures.

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I am not sure about you, but I do not have a lot of pictures requests from my students when I finish a class!

And of course, no matter what, do not forget the coffee break. During one of them we had the opportunity to enjoy Ethiopian donuts and learn more about our families and jobs (pay attention to the order of topics discussed).

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Finally, it is impossible not to be amazed by the amount of construction around. Hundreds and hundreds of buildings and houses all over the place.

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The city is rising around you as I type this. The interesting part is that they are using beautiful basaltic rock.

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The mountains surrounding the city are mainly composed of basalt volcanic rock, which are several millions of years old. Rocks that are incorporated in one way or another in their building and houses.

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As one of my hosts indicated to me, “When you see such rocks in a building, you know you are in Gondar!” In short the rock is a symbol of the Gondar region.

From the Home of Lucy, the world’s oldest!

In Ethiopia, expect the unexpected – and coffee!

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

If Personal Space is big for you, then Gondar is not your place to be. Here it is customary to salute you with at least an extended handshake and a soft touch of shoulder to shoulder (you incline forward and gently touch your peer’s shoulder and stay there for a few seconds sharing pleasantries).

If the person greeting you already knows you, then you will get a full hug, which again last several seconds. And finally, if they have great respect for you, then the hug will be accompanied by three touches of the cheek , first right, then left and then right again. It is a big honor to receive such greetings, and I had several of those today. In conclusion, I received more hugs today that my wife has given me in a year. This heartfelt salutation definitively makes you feel welcome!!

Today we started the training, and the phrase “play by ear” perfectly describes the morning. I planned to start at 8:30, which in Ethiopian Time according to my hosts is around 9ish… Perfect, 9:00 it is. Then, the conference room was double-booked, not a problem.

The key in this type of extension and outreach training programs is to expect the unexpected and take it easy.

Finally, they gave us the Conference Room at the Dean’s suite reserved only for special occasions (which my courses always fit that description!!).

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The dean’s conference room.

 

Then after some housekeeping and preparation of the video, we were ready to go at 10:00 a.m.

A former dean and a chair are among the faculty attending the training program, which is a very different crowd from two years ago, as all of the people attending today are faculty.

Also very important to know is that no matter what happens to the schedule, never, never, never, never, ever skip the coffee break.

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Never, ever skip the coffee! Note the traditional coffee ceremony elements.

 

Ethiopia is claimed to be the birth place of coffee, so the coffee tradition is millenarian, and the “ceremony of coffee” is very important and a great opportunity to socialize. The process is very social and very beautiful because of the protocol that is followed: grass spread around for the green color that mean peace and calm, to the placement of flowers, to the accommodation of all the utensils in the short table, to the hot coals (see in the background) where the coffee is carefully reheat before serve, etc.

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Pouring the coffee during the traditional coffee ceremony.

 

However, even though it is very traditional, my infectious disease brain did not let me enjoy it to the fullest, if you do not understand what I mean you are not paying attention to this picture:

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This is it for today.

From the birthplace of humanity…!!

In Gondar, ‘dinner to go’ has a different meaning

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

Day 1

After a 36 hours total time of traveling, I am safe and sound in Gondar. This is a small town in the northwest corner of Ethiopia. It is in the mountains, 2,133 meters above sea level (almost 7,000 feet), a location that produces beautiful views of the city and surrounding areas as you travel through town.

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The lovely hills around Gondar

How do you move around? Well, the majority of the people walk from point A to point B. Those that have some income, can pay 2 to 3 Birr (the Ethiopian currency) for public transportation (basically small minivans similar to those in the 1960’s modified for public transportation), which is around 10 cents.

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The minivan taxis are in the background behind the Bajaj.

 

If you are ready to throw your money around, you can take a taxi for 80 Birr ($4).

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Inside a Bajaj taxi.

I tried to use the public transportation to go downtown, but every van was full with people and animals (mainly goats tied and place carefully under the seats), which more likely were the dinner for tonight.

You can conveniently buy your goat next to the bus stop for dinner to go, so you can process them as soon as you get home. Fresher and more organic is impossible!

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Dinner to go: Goats for sale next to a bus stop.

So, I got my taxi, and I went to the main square to have a short (touristic) walk after lunch. I will share those pictures down the road. Then, I got another taxi to go back to the hotel.

I will have 25 to 30 faculty tomorrow to teach about International Trade and Public Health, which is just a fancy name for Introduction to Risk Analysis, so I need to get ready. Let’s see how the week progresses.

From Gondar (Ethiopa), The Camelot of Africa.

Patient patients in Gondar’s Vision Clinic

By Jeff Walline, Associate Professor
Ohio State College of Optometry

In Ethiopia, optometry is a bachelor’s degree, but I am here to teach six motivated students obtaining Master’s degrees in optometry. One purpose of their education is to expose them to optometry procedures that are practiced in the United States that are typically not practiced by optometrists in other parts of the world. Therefore, I teach them things that they cannot practice due to economic, social, and/or technologic constraints. However, the students are very interested in learning. Hopefully, they will also be able to practice these procedures in Ethiopia and teach future optometrists to practice them as well.

Below is a picture of patients waiting to have their eyes examined in the Vision Clinic. They wait in the courtyard of a three story building that appears old and decrepit in some areas and never completely finished in other areas.

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Patients waiting to have their eyes examined.

 

Ethiopian people are very patient, and waiting seems to be a natural part of their lives. They wait for eye examinations, they wait for cabs, they wait for something that never seems to appear. However, they never complain about waiting. It just seems to be a part of their lives.

What I teach optometry students in two semesters, I have squeezed into one week. I don’t know how much of it actually “sunk in,” but I know that the students will certainly have more information than when I arrived. They are anxious for a final, but I didn’t know that I was to give one. I will prepare a final when I return and send it to them, but first I will prepare them for the final on my last day here.

I want them to have a positive feeling about their experience, and I think a strong performance on the final would help to solidify that feeling.

I have one more day to lecture. On Monday, I thought this day would never arrive. Now that it has, I look forward to going home but not with as much fervor as before. The people of Ethiopia are very kind and I will miss them.

What I see when teaching optometry in Gondar

 

By Jeff Walline, Associate Professor
Ohio State College of Optometry

I am in Ethiopia to teach two courses at University of Gondar: advanced contact lenses; and children’s vision.

The students have a strong basis in pediatric care, and they ask very intelligent questions. They are very patient with me when I ask them to repeat their questions.

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My University of Gondar students

 

Traveling from the Gondar airport to my hotel, I went through an entire evolutionary cycle. Near the rural airport, several men tended their sheep and cattle grazing on the lush, green grass. No fences or borders exist, except those extended by men with canes and ever-watchful eyes. Soon, grass huts appeared, with little to adorn them or signify life nearby. I imagined that the same people tending the herds lived in these small, round huts, but I have no confirmation.

Shortly, the rural life began to intertwine with modern life, as the livestock grazed along the roads infrequently traversed by fueled automobiles. Although vehicles existed, it seemed as though most people of Gondar walk from place to place as they generally carried walking sticks to seemingly help them traverse the hills and sometimes rugged roadside.

As automobiles increased in frequency, so too did people. More people waited, as opposed to actively walked, alongside the road. They waited for one of the minivans or the three-wheeled motorized carts that would transport them to their location. Our bus continued to pass slower vehicles and be passed by faster ones on the hills, seemingly never concerned about the side of the road on which one drives.

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A woman preparing grain on the roadside.

 

I was dropped off at my hotel, located across the street from the Vision Care Training Center and Fistula Clinic, where I lecture to six Master’s students about pediatrics and specialty contact lenses. The electricity only went out for 5 minutes during the morning lecture, so we were able to use technology to project PowerPoint slides on the wall. However, the projector was very touchy.

So, I have witnessed everything from farmers to exceedingly bright, enthusiastic students, and every bit of the evolution connecting the two, and all of this within the small boundaries of Gondar, Ethiopia.

 

 

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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Rabies project: MBA students meet faith healers, health workers in Gondar

 

By Danielle Latman
Ohio State MBA student

Wednesday, 5:30pm: Rain pelted the windows as I sat in the back of the van with seven men, interviewing a young woman about administering health information in the Gondar region.

We were pulled over on the side of the road on the outskirts of Gondar city, asking the woman about her role as a Health Extension Worker (HEW). This 8-year-old program trains and employs women to provide basic health education, information and supplies to each kebele (small municipality) throughout Ethiopia. The HEW program responds to the limited formal health care in the country, with very few doctors and nurses to meet the population’s needs.

We were meeting with the woman, whose name translates to “Love,” to learn more about the role of HEW and if/how they could be helpful to the rabies plan.

We (Danny, Javed, Niraj and myself, plus our three guides/translators from the University of Gondar, and our driver Amhara) were sitting in the van because of the rain outside, and because the HEW’s post was far away.

Surprisingly, this wasn’t our first van interview of the day. We started the afternoon by visiting the health station near Gondar city. The Ethiopian health system has a set structure operating from the kebele to the regional level.

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The Ethiopian health system has a structure operating from the kebele to the regional level.

The HEW operate from a local kebele post and visit families door-to-door. Above them is a health station, with nurses. Above that is a health center. And the highest level of care is provided at the hospital level, but only two main hospitals (in Addis and Gondar) can provide a wide range of health services.

At the health station we could meet with a HEW coordinator. Our van idled for a few minutes in front of the short cement building while the team members discussed with our hosts what we wanted to ask. A young woman approached our van to ask what we wanted. Our hosts spoke with her in Amharic, and then the young woman left and shortly returned carrying an umbrella over the head of another woman, wearing a white coat.

Sister Abanesh entered the van, sat in front and answered some of our questions about Ethiopia’s 17 health priorities which the HEW workers focus on. She was the coordinator and managed six HEW. But we didn’t get to talk to her long, since the director of this health center preferred that we speak with him formally in his office.

So we got out and walked to his office in the health station compound. On the walk we saw some cool posters promoting different positive health behaviors, which Danny and I (the marketing team) were very interested in for our part of the project.

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A health poster at a local clinic

We filed into the director’s office, sitting in chairs around his desk. He answered our questions about the training and reporting processes for HEW, and Sister Abanesh gave us some pamphlets that they use for family health education.

One important thing we have learned is that, while there is an overall 40 percent literacy rate in Ethiopia, almost all households have at least one child who can read, and so the child will read information for the whole family, leading to an almost 100% literacy rate at the household level. Then they showed us the storage area where they keep the vaccines cold.

We left with smiles, thank you’s and handshakes all around, then drove to our second van meeting of the day.

It is worth noting that the health station is located in a Jewish area just outside Gondar. We saw a house with a wooden Jewish star outside painted blue and white.

Our first meeting of the day had been no less surprising. We met with a group of faith healers who were having their association meeting at 9am. We all gathered behind their shack in downtown Gondar, which had posters for remedies like aloe vera curing HIV.

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Meeting with faith healers in downtown Gondar.

We had heard that a lot of people in Ethiopia use traditional or faith healing (bahawali hakeem in Amharic) instead of or in addition to modern medicine, especially the rural population. About 90 percent of Ethiopians live in rural areas. Thankfully, our university guides Akilew and Debasu had contacts with them and were able to set up a meeting.

Though we directed our questions to the group of about seven men and one woman faith healers, for the most part only the chairman responded. We asked about their motivation for becoming faith healers. For some it was a change from their strict religious backgrounds. For others it was passed down in their family. We also asked if they had or would ever collaborate with doctors or other medical scientists in their treatment. We were pleasantly surprised to learn that they are open to collaborations, especially with treating dogs that have rabies.

We then visited a vaccine storage facility, a health clinic, and a vet clinic (with a very sad-looking chicken outside). Rabies vaccines have to be kept cold – one of the challenges in warm climates like those in Africa. The veterinarian told us they had administered 500 rabies vaccines since March and showed us their cold storage and even a sample vaccine, which came from India.

After our morning meetings, our host Tamiru suggested we go to Hotel Taye for traditional Ethiopian coffee. In the second floor lounge area, a woman was roasting coffee beans and cooking ground coffee in a traditional pot over hot coals. Rose petals were strewn in front of her cooking area.

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Traditional coffee ceremony at the end of a long but productive day.

It was a very long, insightful and rich work day which lasted about 12 hours, and some of us retired early to be well-rested for what will surely be another full, surprising and enriching day.

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.

One Health web feature — inspirational Buckeyes

By Christine O’Malley
Executive Director of Health Sciences

Our university communications team just posted this great web feature on our One Health initiative in Ethiopia:

Here’s the link to the full story:

http://www.osu.edu/features/2014/destination-ethiopia.html

Things that struck me from the video:

Cervical cancer is the second-highest cause of death in Ethiopia, yet it’s very treatable if caught early. Our cervical cancer project is working to address that.

The student interviewed, Korbin Smith, went to Ethiopia as part of the rabies project. This was a fantastic student learning experience for him and our other students. This initiative benefits both our partners in Ethiopia by improving people’s lives and our community here at Ohio State by providing international learning opportunities.

I hope you are inspired as much as I am by our faculty, students, and One Health partners.