Learning another culture through its food

By Karissa Magnuson
Student, Ohio State College of Veterinary Medicine

I happen to love bread and carbs in general.  At home, I love making homemade bread and even have my own bread machine in my apartment, so I was curious about the bread of Ethiopia. The staple bread, although it is not really like our bread, is injera. It is most comparable to flatbread or possibly a tortilla or crepe. The main differences are its spongy texture and that it is made from a completely different type of grain called teff.

Teff is a cereal grass and is only found in Ethiopia. It is ground into flour and then is mixed with water and baked to make injera.

Injera is included in almost every native dish in Ethiopia, and it is often used to hold the dish, acting as both a plate and utensils.  Ideally, you use the injera to wrap up whatever you ordered inside like a seasoned meat and then eat both the injera and meat. (If you are like me, you end up using a fork at some point, because without a fork, it is quite a messy undertaking.)

Not only is injera used as an edible plate and utensil, it is also often the main course. For instance, the other night, our partners asked if I wanted to try Firfir. To me this dish looked like some sort of meat with mashed up beans served on top of injera. Well, I was having a hard time understanding the ingredients they were listing off, and they kept shaking their heads when I repeated back what I thought were the ingredients until I realized that part of the dish which I thought was meat was not meat but shredded up injera served in a sauce with seasoning.

So there you have it — injera — the staple bread of Ethiopia. By the way, for those who are gluten intolerant, teff is gluten free.

How to Make Injera: https://www.youtube.com/watch?v=UDv15Wb0DE0

After our delicious meal

After our delicious meal

Learning Amharic in Ethiopia: It’s for veterinarians, too

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By Karissa Magnuson
Student, Ohio State College of Veterinary Medicine

I have always loved learning foreign languages, and when I was in junior high, I considered the possibility of majoring in linguistics in college. However, my passion for animals won out, and instead of being a linguist, I am half way to being a veterinarian. It is nice to know, though, that despite my career choice, I can still enjoy learning foreign languages and incorporate my career and other interests together.

Today at lunch, fellow Ohio State student Korbin Smith and I invited one of our Ethiopian team members, Atnaf, out to lunch at our hotel. I decided to ask her about how their sentence structure works here.

Side Note:  I took German in high school and college and knew that in German if you wanted to say ‘ I would like to play football’ it would be like saying in English ‘ I would like football to play’. Well I was curious how it worked here because I was hoping to actually form a sentence by the end of the six weeks. We will see if this actually happens or not.

Anyways, Atnaf pulled out a piece of paper and started writing down their alphabet. The alphabet in Amharic is like little drawings. Each drawing represents a different sound. For instance there is a character that looks like a ‘u’ and is pronounced ‘ha’. From my understanding the ‘u’ for ‘ha’ is the root for other variations with similar sound/characters… i.e. ‘hu, hi, ha, h, ho’ which will look like the ‘u’ but may have an extra tail, circle, or squiggly attached somewhere on the ‘u’. They then have other root shapes with variations for a total of over 30 characters.

There are a few characters in Ethiopia with sounds that I could not make. For example, in Amharic they have a character that sounds like ‘Kkah’ but with an extra, barely imperceptible sound when pronounced. Korbin and I kept trying to say it, and she just kept laughing and shaking her head and then pronouncing it again. It requires some muscle in your throat or something that we as English speakers never have to use.

Anyway, it was a very interesting lesson, and Atnaf really enjoyed teaching us and appreciated our efforts to learn their language. Perhaps, by the end of the summer I will be able to write a sentence in Amharic.

If generosity equaled power Ethiopia would control the world

korbin smith

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

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

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

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

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

Show and Tell: Our “First Kits” in Ethiopia’s Simien Mountains

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By: Tim Landers, RN, PhD
Ohio State College of Nursing

This past weekend, we had a chance to take a hiking tour of the Simien mountains in Ethiopia.  This has to be one of the most beautiful places on earth – the landscapes are gorgeous, the people are smiling and proud, and there is plenty of wildlife.

I have done quite a bit of hiking with my two sons and friends from Boy Scout Troop 33 in Columbus.  As we were hiking across the Simien mountain pass, our guide and I chatted about our experiences hiking and guiding groups.

Melese Beza (of www.outstandingsimienmountainstours.com) grew up tending livestock as a shepherd and works as a professional tour guide through the mountains as he completes his bachelor’s degree in tourism management.  He speaks English quite well and we began to talk about the types of health problems he encounters as a professional hiking guide.

We took a break as it began to rain and started a “show and tell” of our first aid kits.  He had a basic kit ready for the main emergencies from African trekking – including what he adoringly called “potions” such as acetaminophen, wound disinfectant, and diarrheal medications.

Simien Mountain tour guide Melese Beza of Outstanding Simien Mountains Tours and Tim Landers, RN, PhD do a show and tell of their first aid kits during a rain break while trekking through the Simien Mountains north of Gondar, Ethiopia.

Ohio State’s Tim Landers and Simien Mountain tour guide Melese Beza do a “show and tell” of their first aid kits during a rain break while trekking through the Simien Mountains north of Gondar, Ethiopia.

The two take turns with their "show and tell" on first aid.

The two take turns with their “show and tell” on first aid.

He used somewhat different terms, but described several conditions which would be expected – ankle “dislocations” (strains/sprains), altitude sickness, injuries from rock falls (abrasions and cuts), and blood sugar emergencies.  He also described unfortunate drowning victims he recalled from last summer and that they had attempted “breath blowing” with success in one victim.

In my training back home, we’ve prepared for emergency evacuation of wounded hikers by helicopter transport, extricating from deep woods by foot and by vehicle, and most of our Scouts have completed training in first aid and CPR.

In this region of Ethiopia, there is no such option.  There are no helicopter evacuations from the Simien Mountains.  Guides call for help and it will come as soon as word can reach the village by foot and a jeep, configured as an ambulance, can make it to the wounded person.

As we discussed how injured hikers are treated and our own experiences, I was impressed with his solid grasp on these conditions.  He has been working with several other guides trying to organize a more formal training in first aid and CPR for Simien Mountain guides.

Because our group is exploring the possibility of working with nurses and health extension workers to do health education, I was able to direct him to some excellent training resources developed by my friends at Columbia University School of Nursing. They have developed a fine first aid training curriculum in first aid for health extension workers.

I left him with some supplies from my kit and he reciprocated by sharing knowledge of local plants and remedies.

He left me with an appreciation for the training and preparation it takes to safely enjoy the outdoors – whether it is in Ohio or in Ethiopia.

Hand-in-hand on hygiene in a hospital setting

Tim Landers, RN, PhD, from Ohio State’s College of Nursing and Nora Mohammed, MSc, from University of Gondar -- an infection prevention hero!

Tim Landers, RN, PhD, from Ohio State’s College of Nursing and Nora Mohammed, MSc, from University of Gondar — an infection prevention hero!

By Tim Landers, RN, PhD
Ohio State College of Nursing

“Are you from Ohio? Will you talk to me?”

Nura stopped me in the courtyard of the University of Gondar hospital. She was waving my business card that had been given to her from a School of Nursing instructor who knew that my work centers on infection prevention.

She had just defended her Master’s thesis on hand hygiene at the University of Gondar in which she completed an audit of hand hygiene practices by nurses and other health care workers at a local hospital. When she told me about her project, I was very excited to learn more, so we met the next day to review her findings.

Improving hand hygiene saves lives. Reducing transmission of germs on the hands of health care workers is the most important means of preventing infections.  A recent article of mine on patient-centered hand hygiene is here. Another important article on the subject is here.

Effective hand hygiene programs use a multimodal approach, including strong administrative support, education, training, monitoring of hand-washing and feedback. A critical element of hand hygiene programs is providing products and supplies in the health care setting, and I’ve worked on the best approach for years.

But I had forgotten how critical the provision of products is in our hand hygiene efforts. Without a sink, running water, soap, or alcohol-based hand rubs, hand hygiene is simply not possible.

Quite frankly, I had come to take this for granted.

Until I met Nora.

In her study, Ms. Mohammed showed that in more than half of the “hand hygiene opportunities” – times when workers should perform hand hygiene – no soap, running water, or alcohol-based hand-rubs were available at this hospital. As a former nursing matron, or director of nursing, she saw the impact this had on patient outcomes.

By demonstrating the need to improve access, her study provides an important first step in improving hand hygiene practices.

I was really excited to meet someone who shares a passion for infection prevention and hand hygiene. She really is making a difference at her hospital and helping to save lives in Gondar. In the U.S., we call them “heroes!”

Yes, I am from Ohio, and I would love to talk to you!

O – H – I – O ! Ohio State students arrive in Ethiopia

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We were very excited to welcome four Ohio State students to Gondar yesterday.  They are beginning their work on the needs assessment for a rabies prevention/elimination project.

Last night over a traditional Ethiopian dinner, the group met with University of Gondar Veterinary Medicine Dean Dr. Mersha Chanie, Chair of Sociology Molalign Belay, guest Dr. Judd Walson from the University of Washington’s Department of Global Health, and Ohio Staters including Veterinary Medicine Professor Baye Molla, College of Nursing Vice Dean Usha Menon and other College of Nursing faculty.

One thing that struck me was the diversity and intensity of the group.  These four students represent the breadth of programs at Ohio State and how interdisciplinary work can bring creative and innovative perspectives to important problems.

Third-year veterinary student Karissa Magnuson is interested in wildlife veterinary medicine.  Ally Sterman is a third-year veterinary student with an interest in shelter medicine and public health approaches to veterinary problems.  Korbin Smith, BS ’13, was inspired by Dr. Randall Harris in the College of Public Health to consider opportunities in public health.  Heading up the team is graduate student Laura Binkley, who is working on a Master’s degrees in public health and wildlife ecology.

Absolutely striking was the passion that each student brought to their particular interests and the lively discussion about where interests overlap and intersect.  This is the kind of collaboration that we can build only at a major academic institution like Ohio State.

Go Bucks!

Ohio State and Ethiopia: Building Collaborations

Here I am reviewing some class materials with students in the “Food Safety and Food Borne Diseases” course, as part of the Summer One Health Institute.

Here I am reviewing some class materials with students in the “Food Safety and Food Borne Diseases” course, as part of the Summer One Health Institute.

by Bayleyegn Molla, DVM, PhD
Clinical Assistant Professor and International Programs Coordinator
Ohio State College of Veterinary Medicine

Our hope is to establish ongoing collaborative relationships–not just during the One Health Summer Institute, but well in to the future.  We hope to be able to build a mutually beneficial partnership between faculty and students at Ohio State and University of Gondar, which will help leverage expertise and open opportunities for all.

For participants from Ethiopia, this experience can bring the world-class knowledge and expertise of Ohio State to address important public health problems, though training and ongoing working relationships.  Partners at the University of Gondar bring a wealth of knowledge about local priorities and infrastructure.

Research and practice priorities are well organized in thematic areas with an emphasis on team-based research.

For faculty from Ohio State, this partnership offers the opportunity to explore and help develop solutions to tropical diseases, wildlife and environmental issues, and to apply new approaches in a different culture and region.  This opportunity helps expand the capabilities for students trained through the University of Gondar and faculty to use this knowledge to address important issues in Ohio, in our country, and throughout the world.

It is very rewarding to see this partnership in action in the One Health Summer Institute.  Students and faculty from nursing, public health, veterinary medicine, basic sciences, and human medicine have been discussing important problems such:

  • Food-borne illnesses
  • MRSA prevention
  • Cervical cancer
  • Zoonotic diseases

More importantly, these workshops explore potential ways to work together in the coming months and years.

The “One Health” framework is an excellent foundation on which to build this partnership, because it relies on contributions from a range of scientific experts and the active engagement of students in workshop sessions.

Being from Ethiopia originally, and now as a faculty member at Ohio State, it is tremendously rewarding to see the engagement of both universities in an effort to improve health.

Making Animal Inquiries in Addis Ababa

I took this picture outside of the Jupiter Hotel in Addis Ababa. This is kind of how I felt trying to navigate a busy street with an unfamiliar language.

I took this picture of a stray dog outside the Jupiter Hotel in Addis Ababa. This is kind of how I felt trying to navigate a busy street with unfamiliar language and surroundings.

By Tim Landers
Ohio State College of Nursing

One of the first people we met when we arrived in Addis Ababa was Daniel, our driver who took us around some of the sights.

Traffic is very bad, with pedestrians, loaded mules, stray animals and vehicles trying to share the same road.

Most of the dogs we saw were roaming the street, but as we wove through traffic, I asked Daniel if he had a dog.  He was happy to show us photos of “Jack.” We know that dogs are important parts of many peoples’ families, and this was true for Daniel as well.

We asked more about Jack – where did he find him, when did he go to the doctor, and what type of dog he was.  Expecting that he would tell us about Jack’s pedigree, Daniel seemed very puzzled by the this question.  “He’s a small dog, a nice dog.”

Daniel was concerned because Jack had some sort of infestation, and he did not know how to treat it.  Unfortunately, we had two nurses in the car and no veterinarians.  We did stop at a local pharmacy to see what treatments they might have.

While we were able to buy fairly high-end human antibiotics, but they did not carry veterinary medications.

During our tour of Gondar, we encountered this donkey, which in Ethiopia are seen as work animals.

I asked one of the veterinarians with our group about an ulcer on the back of this donkey.  He actually pointed me to a paper he had written about these “pack ulcers” –erosions caused by loading of the animal for transport of goods to the market.  They are generally non-infectious, but they look uncomfortable!

 

Ohio State Arrives in Gondar–Let One Health Begin!

By Tim Landers
Ohio State College of Nursing

We’ve arrived in Gondar!

Our traveling group from the College of Nursing arrived this morning and were greeted by officials from the University of Gondar and Baye Molla, PhD, clinical assistant professor in Ohio State’s College of Veterinary Medicine.

Dr. Molla is a native of Gondar and has been a wonderful guide and adviser as we have planned our trip to Ethiopia for the One Health Summer Institute.

Over the summer, we will be joined by 20 faculty and students from Ohio State, representing the colleges of Nursing, Veterinary Medicine, Medicine, Public Health, Optometry, and Food, Agricultural and Environmental Sciences, as well as faculty from Addis Ababa University and University of Gondar.

In addition, Robert Agunga, director of Ohio State’s Center for African Studies, will join us in presenting a series of short courses using the One Health framework.

The College of Nursing’s faculty contingent will begin the institute by offering a week-long course in research methods to students and faculty from the University of Gondar.

Meeting Our Partners

We have already met some amazing people as we get acclimated to Ethiopia. Here are some of our recent experiences:

We were welcomed to the University of Gondar by President Mengesha Admassu. With incence wafting through the room, we were served coffee and talked with senior leadership of the University. President Admassau expressed the great value that the University of Gondar placed on its collaboration with Ohio State.
We were welcomed to the University of Gondar by President Mengesha Admassu. With incense wafting through the room, we were served coffee and talked with senior leadership of the University. President Admassau expressed the great value that the University of Gondar placed on its collaboration with Ohio State.
Dr. Sisay Yifru, Dean of University of Gondar College of Medicine and Health Sciences demonstrates to me the use of a hand sanitizer dispenser on an inpatient unit at the University of Gondar Hospital. These dispensers are manufactured at a local plastics factory. The dispenser location and design demonstrate local adaptation of international “best practices” for hand hygiene in health care facilities, including placing hand sanitizer at the “point of care.” This technology was developed and deployed in cooperation with the Patient Safety Initiative, World Health Organization, but has been sustained by administrative support and leadership of the University of Gondar.
Dr. Sisay Yifru, Dean of University of Gondar College of Medicine and Health Sciences demonstrates to me the use of a hand sanitizer dispenser on an inpatient unit at the University of Gondar Hospital. These dispensers are manufactured at a local plastics factory. The dispenser location and design demonstrate local adaptation of international “best practices” for hand hygiene in health care facilities, including placing hand sanitizer at the “point of care.” This technology was developed and deployed in cooperation with the Patient Safety Initiative, World Health Organization, and has been sustained by administrative support and leadership of the University of Gondar.
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Drs. Jodi Ford and Usha Menon, College of Nursing, walk with the director of International Relations at the University of Gondar on a tour of the university’s new hospital under construction though a partnership with United States Centers for Disease Control and Prevention (CDC-Ethiopia), the Ministry of Health, and a private donor.