One Health

Power Up!

July 24 2013

By Karla Zadnik, OD, PhD; DeanVannasdale, OD, PhD; and Andrew Emch, OD, MS
College of Optometry

Dr. Dean inspiring Optometry faculty at the University of Gondar

Dr. Andrew and Dr. Dean spent their second full day at the Department of Optometry, University of Gondar. At the Gondar faculty’s request, they taught a crash course on keratoconus, irregular corneas, and specialty contact lens fitting. The faculty was clearly eager to learn and are well-educated. They asked complex questions, almost stumping Ohio State’s favorite sons with evidence-based questions that required detailed knowledge of disease epidemiology.

Glasses donated for hands-on student learning at the Department of Optometry

After a jet-lag antidote lunch that included Coke and strong coffee, they went back to tour the Department’s clinic. The facility is adequately sized to educate the enrolled students.

Unfortunately, frequent, rolling power outages regularly limit patient care, on average two days a week. Equipment is a limitation as well. The clinical equipment, shared between Optometry and Ophthalmology, is a rate-limiting step for both education and eye care delivery.

Power outage = keratoconus story time with Dr. Andrew!

In spite of these challenges, the young faculty (average age 27 years old), all products of the initial years of the program, are dedicated to building educational capacity, departmental independence, and high standards for the provision of comprehensive eye examinations.

Research ethics in Ethiopia

July 24 2013

By Karla Zadnik, OD, PhD
College of Optometry

I was hosted by Dr. Seleshe Nigatu of the University of Gondar as I opened the research ethics class in the Summer Institute with a discussion of the Tuskegee Study. The study is the U.S.’s 1978 Belmont Report with its basic principles of respect for persons, beneficence/nonmaleficence, and justice. The class of almost 60 people from the University of Gondar and Addis Ababa University, along with other Ethiopian institutions of higher learning, had expertise ranging across medicine, veterinary medicine, economics, and pharmacy. The photographs depict the engaged students. In the late afternoon, the participants tackled their first two case studies, one on

reporting of results to an industry sponsor and the other an accurate analysis of a case of subtle plagiarism but plagiarism nonetheless. Tomorrow, the class tackles animal care and use in research and biorepositories (thanks to Donna McCarthy and Mark Merrick and their lecture materials).

The transition from Addis Ababa to Gondar was ably assisted by advice from Dr. Jodi Ford from the College of Nursing, who taught research methods at the University of Gondar earlier in July.

Optometry Pride, Worldwide

July 24 2013

By Karla Zadnik, OD, PhD
College of Optometry

Office of the Director of the Department of Optometry, Destaye Shiferaw

Yesterday, Ohio State College of Optometry faculty members, Dr. Dean VanNasdale and Dr. Andrew Emch made their way to the Department of Optometry housed in the International Fistula Training Center at the University of Gondar. The Department’s mission statement reads, “The profession of optometry offers comprehensive eye care services to all mankind. The training program has the philosophy of producing skilled manpower equipped with adequate knowledge, skills and attitude to deliver such eye care services in the most ethical manner, both on the national and international level.” What institution wouldn’t aspire to that?

Optics lesson/ray tracing white board

Hosted by Department Director, Destaya Shiferaw, and several of the faculty, Dr. Andrew and Dr. Dean were struck by many things that surprised them. Dr. Dean found that the optometry bond ran deep, declaring the faculty at UoG “more similar than different to us,” and he was struck by the faculty’s honesty and candor and that they truly held nothing back. Dr. Andrew declared the faculty, “Enthusiastic and proud, yet self-aware.” Unusual characteristics for faculty members, don’t you think?

UoG and OSU optometry academicians

Destaya and colleagues are clearly altruistic, focused on the larger community and the optometric profession. They had a clear “vision” of the future of optometry in the country and all of Africa, and envision themselves as leaders in public health as it relates to eye care in east Africa. The two teams spent several hours in completely open, engaged communication. They return tomorrow to tour the clinical facilities and discuss strategies for advanced contact lens fitting instruction and practice in the UoG clinic. Stay tuned.

The city of Addis

July 22 2013

By Ally Sterman
Student, Ohio State College of Veterinary Medicine

Addis is quite the interesting city full of vibrant city life, u-turns (that aren’t quite legal), coffee shops on every corner, and all the history and museums you could wish for. Upon our arrival to Addis from Gondar there were a few food items that we were greatly missing. The majority of our previous stay in Gondar was during the fasting season which means no animal products. At a local coffee shop where we stopped for lunch we also stopped for ice cream. This local coffee shop had a very recognizable logo. Upon first glance, we all did a double take to check the name. The sign here is very reminiscent of a similar coffee shop that is also located on every street corner in the U.S.– Starbucks. We felt quite at home here, both the coffee and ice cream were delicious.

ally icecream

After our conference we had two days to explore the city. We all supported the Ethiopian economy during our shopping trip down the busy streets of the market. Street vendors were selling everything you could want including both more traditional and less traditional items. That night we went to a local traditional dance club again with some of the OSU professors here for the conference. We were all able to indulge in a local favorite, tej. It is a honey mead made here in Ethiopia. It is served in a special flask called berele. If you didn’t know, you would think you were being served some form of science experiment because the flask looks like something out of a chemistry lab and the tej is an off orange color.

But Addis wasn’t all eating, dancing and shopping. We took the time to visit both Addis Ababa University Museum and the National Museum. At the AAU museum we had the opportunity to see and learn quite a bit about the history of Ethiopia including various traditional medicines used, various tribes and lifestyles present in Ethiopia. There was also a section dedicated to the discovery of coffee and traditional coffee ceremony here in Ethiopia. Another room that particularly caught my eye was the room on musical instruments and their collection of them. We traveled to the National Museum second. The highlight exhibit here was Lucy.

Lucy was discovered in Ethiopia, in Awash valley in 1974. She is thought to be around 3.2 million years old and one of the first bipedal hominid. Seeing her ( both in the standing statue pieces and separate pieces kept apart from the standing statue) was a once in a lifetime chance. Lucy had been in the US for about 6 years but having the chance to see her while in Ethiopia where it is said that humans first lived was a wonderful opportunity.

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

July 21 2013

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.

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).

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.

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

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.

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

Rabies In Ethiopia And The Way Forward – Stakeholders Workshop

July 21 2013

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

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.

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!

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!

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.

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!

Scenes from Ethiopia

July 21 2013

A soccer match is played adjacent to a neighborhood near Addis Ababa University’s Akaki campus.

Friends walk hand-in-hand on the Addis Ababa University Akaki campus.

A young boy rides a horse-drawn cart in the city of Woreta, South Gondar.

Photos by Rick Harrison, Ohio State University Communications

Gondar hospital, present and future

July 20 2013

Gondar will soon have a new hospital. This photo shows the construction in progress. Below are some scenes from the current facility.

Women walk into the Dean’s Office at the University of Gondar Hospital.

The hospital’s emergency room entrance.

A ward at the University of Gondar Hospital.

Photos by Rick Harrison, Ohio State University Communications

Interviews and data collection

July 19 2013

Ohio State student Korbin Smith helps interview a farmer in the South Gondar region of Ethiopia.

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

Environmental health is a priority for Ethiopia partnership

July 18 2013

By Michael Bisesi, PhD
Ohio State College of Public Health

Since my arrival on July 7, we have accomplished several activities. As an environmental health scientist, I was able to teach applicable modules to a wonderful group of grad students, clinicians (veterinarians, physicians, nurses) and scientists.

Addis Ababa University students listen as Dr. Bisesi lectures.

The modules included lectures and discussions regarding the properties of various environmental matrices (air, water, soil) and the fate of microbial and chemical contaminants that can adversely affect plants, animals, and humans.

An extension from the classroom included a field trip and qualitative assessment of the waste water treatment facility for the city of Addis Ababa. This was very enlightening since it demonstrated a system that has insufficient capacity for the volume of polluted waste water originating from municipal, industrial, hospital and runoff sources. The surrounding adjacent areas had fields growing crops, animals drinking and feeding, and humans using this area as a resource.

This river runs through the Kera region of Addis Ababa. People use the river to irrigate crops.

Field hands work near a large amount of foam caused by water pollution in the Kera region of Addis Ababa.

I also visited the slaughterhouse and tannery which have some pollution control technologies and practices in place. Observation of the river and surrounding land confirms suspicions that multiple sources are contributing to environmental pollution that impacts animal and human health. Our integrated approach to address this will bring results, but much work lies ahead. Our Ethiopian partners are wise to have included this work as a priority for our partnership.

Hides are stored before processing at the tannery in Addis Ababa.

Photos by Rick Harrison, Ohio State University Communications