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.

Kelsey and Giant Tortoise at Awash National Park

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!

 

Life-saving and life-sustaining: Maternal, newborn interventions at work

 

By Monica Terez, RN
Clinical Program Manager
The Ohio State University College of Medicine

The sixth floor of Black Lion Hospital in Addis Ababa is a bustling place.

One wing is dedicated to the care of laboring mothers, many of whom require complicated care provided by midwives and obstetrical residents.

Another wing houses approximately 45 infants, all requiring some degree of newborn intensive care. The infants are not arranged in rooms by chance, but rather by the level of care they require.

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One large room is dedicated to the most fragile infants, often born weeks or months before the mother’s due date. Due to a lack of sufficient equipment, infants often share a bed or isolette. Babies are kept warm by space heaters positioned throughout the unit.

At any one time, each nurse may be assigned to care for as many as 10 sick neonates over the course of a 14-hour nightshift.

Considering how busy the unit is at any given moment, it would be easy to miss the most important care providers – the mothers of those infants – who desire to give their baby the best chance for survival.

With the support of the physicians and nurses in the neonatal intensive care unit, mothers provide Kangaroo Care for their babies for many hours. Kangaroo Care allows the mother to hold her baby, skin to skin on her chest, thereby regulating the infant’s temperature, calming the baby, enhancing growth and promoting maternal/infant attachment.

Three rooms of the neonatal unit are dedicated solely to mothers to rest, breast-feed, care for their infants, and just do what mothers do best – love their babies.

Black Lion has long realized the importance of maternal involvement in the health and growth of infants.

The unit’s equipment may be sparse and malfunctioning, nurses may be few and far between, the workflow may be less efficient than desired, but one thing is for sure. At Black Lion Hospital, the mother has taken her rightful place as an important care provider for her infant.  THIS is newborn care at its best!

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Big audience for neonatal resuscitation training in Addis Ababa

 

By Diane Gorgas, MD
Associate Professor of Emergency Medicine
The Ohio State University

In four days at Addis Ababa University, we educated more than 50 health care providers on basic neonatal resuscitation. These individuals spanned the spectrum from new pediatric nurses and labor-and-delivery scrub nurses, to neonatal nurses with decades of experience, to midwives, to pediatric residents.

What we discovered was a commitment to excellence and a dedication to providing the best patient care possible, even in a resource-poor environment. The baseline fund of knowledge in addition to the intellectual curiosity of the group impressed us. There was a drive and a passion to learn that spoke for itself and was manifest in insightful questions, enthusiastic interaction, and a resistance to let us leave at the end of the day.

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Diane Gorgas demonstrates advanced resuscitation techniques at the Black Lion Hospital in Addis Ababa.

The refresher training began by framing the need for this knowledge and skill set.  The Black Lion Hospital in Addis Ababa is the premier teaching and patient care site in this country of 92 million people. About 3,000 deliveries a year take place at the hospital. Being a tertiary care referral center, these are disproportionately more complicated and higher risk pregnancies than the general population.

Within an average, healthy population, 10% of babies will require some sort of support at delivery.  In this high-risk population, estimates can be as high as 30-40% of newborns who will require resuscitation.

Our training started with a definition of the scope of the challenge, and nurse-midwife Sharon Ryan, CNM, DNP, discussed both maternal and labor and delivery risk factors which may compromise a newborn and necessitate resuscitation efforts.

Monica Terez, RN and life-time neonatal nurse took over and outlined the equipment needs and basic resuscitation algorithm for a newborn, including ventilator support through bag valve mask and chest compressions.

I finished the training with a discussion of more advanced resuscitation techniques including intubation and vascular access. The training received high praise for its interactive nature, and for the hands-on experience it afforded all the learners.

Ethiopia is a book-rich culture.  They are an exceedingly motivated, bright, and industrious people who are struggling with the challenge of every developing country: how to educate and train its best yet retain them in country and not lose out to the developed world’s insatiable appetite for experienced health care workers.

The “brain drain” of trained physicians and nurses from Ethiopia to the U.S. and Europe is real. We have heard estimates that there are currently more Ethiopian-born physicians practicing in Chicago than there are in the entire country of Ethiopia. This creates a practitioner experience vacuum. Practical, clinical training is difficult to sustain as senior clinicians are wooed away to greener pastures, leaving the young to train the young.

The One Health Initiative is an excellent start towards bridging this gap, and the possibility of the three of us traveling to Ethiopia as supported by the Greif Foundation is making strides at providing these valuable experiences.

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!

 

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.

The city of Addis

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 ally coffeemuseums 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.

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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.

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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.

Scenes from Ethiopia

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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.

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.

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

Photos by Rick Harrison, Ohio State University Communications

One Health Summer Institute: Class is in session

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Ohio State faculty arrive at Addis Ababa University’s Akaki campus. From left: Eric Sauvageau, MD, Andrew Shaw, MD, from the College of Medicine, Michael Bisesi, PhD, from the College of Public Health and Wondwossen Geybreyes, DVM, from the College of Veterinary Medicine.

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Dr. Bisesi lectures at the Akaki campus.

A student walks through Addis Ababa University Akaki campus on July 8, 2013.

A student walks through Addis Ababa University’s Akaki campus.

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Addis Ababa University students listen as Dr. Bisesi lectures.

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Dr. Gebreyes teaching class.

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Students listen during Dr. Gebreyes’ lecture on molecular epidemiology.

Photos by Rick Harrison, Ohio State University Communications

Images of Ohio State – Ethiopia hospital collaboration in neurosurgery

From left, Dr. Mersha, neurosurgery cheif, Dr. Ebenezer, Dr. Eric Sauvageau and Dr. Andrew Shaw enjoy coffee before making rounds at Tikur Anbessa (Black Lion) teaching medical center at Addis Ababa University.

From left, Tikur Anbessa’s Dr. Mersha, neurosurgery chief, and Dr. Ebenezer with Ohio State’s Dr. Eric Sauvageau and Dr. Andrew Shaw enjoy coffee before making rounds at Tikur Anbessa (Black Lion) teaching medical center at Addis Ababa University.

Eric Sauvageau, right, looks at a scan at Addis Ababa University hospital.

Eric Sauvageau, right, looks at a scan at Addis Ababa University hospital.

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Drs. Azarias Kassahun and Eric Sauvageau examine a patient with myelopathy, a spinal cord constriction.

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Signs reading “Good Luck” are posted all around the wards at the University of Gondar Hospital.

Photos by Rick Harrison, Ohio State University Communications

Second team of Ohio State faculty arrive in Ethiopia

Eric Sauvageau is all smiles at baggage services.

Eric Sauvageau is all smiles at baggage services.

By Wondwossen Gebreyes, DVM
Ohio State College of Veterinary Medicine

The second team of Ohio State faculty arrived in Addis Ababa yesterday after 18+ hours of flight and airport transfers. While our travel was overall smooth, some flight glitches occurred. One of our team members, Mike Bisesi, had his first and last name switched on his ticket, and TSA and United made it a big deal worth a thousand USD to correct his ticket. Two team members, Eric and I, did not get our luggage on arrival. Despite the long flight and the mishaps, there are still lots of smiling faces. This morning, we are at the Akaki satellite campus of Addis Ababa University, gearing up to begin the environmental health course module led by Bisesi. We will keep you all posted with more updates.