Counting dogs, with Gondar’s children helping us

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

Our dog survey project takes us through various areas and communities in Gondar. Many of these areas are homes or rural communities that are heavily populated with families who have many children. As we walk around the areas, we quickly attract children. It is not common in many of these areas for individuals with white skin to pass through. When I was in Ethiopia the previous summer, in very, very rural communities children used to run and hide from us. This summer they run straight for us.

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Often times we know they are coming for the screams of “you, you, you” or ” foreingee, foreingee.” Once they arrive, they begin to ask us our names, how we are and where we are from. Many will try to speak some English with us and others will suddenly become shy and run and hide. If you pull out a camera to take a picture, they also all hide but when we bring out the iPad to record data they become super interested in what we are doing. The brave ones come up and want to shake hands with us. Such a simple gesture brings a wide smile to their faces.

They have been very helpful, helping us identify what sex the dogs are, where they are and even bring them up to the front of the yards to help us see them better. In the suburban areas we had as many as 30 children following us and in the rural side entire small villages of children.

Interestingly, the local veterinarians have told us that the main breeding season is in the Ethiopian Spring (September by U.S. calendars), although we have seen many pregnant dogs and puppies. Despite our initial thought that each dog would be hard to tell apart, we have seen a variety of shapes, sizes, breeds and coat patterns. So far we have been able to casually determine that dogs are mostly found in the peri-urban, or housing, areas. Although dogs tend to remain in a small area, or territory, there are many friendly dogs that roam in groups.

 

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We have seen many different medical conditions in the dogs, such as lameness, ticks, fleas, fighting wounds, and malnutrition, but none of this was outside of what we expected. We have completed our two rural paths, that are high up in the mountains where there are less than 15 houses per path. We have seen many dogs there, but more incredibly, the stunning panoramas of Gondar from up high. This season heralds strong winds and rain, and sometimes we had to brace ourselves from falling over as we navigated hilly terrain. In a few more days, we will wrap up our dog survey.

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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

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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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.