Gondar

Things I have not missed

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

I was on Skype with my Mom during our last week in Gondar. Back in Columbus, she was telling me about the new washer and dryer that arrived while I was in Ethiopia. The two were installed six inches apart. They are finding that this is just enough space for things to fall down and get lodged perfectly. It sounds like a hassle.

Then, they asked me what I thought it would feel like to go back home to Columbus.

I said I didn’t think I could go completely back home.

Of course, I have missed my wife and my sons Joey and Brian. I am looking forward to seeing my friends and sleeping in my own bed. I have missed our cat and dog.

But there are plenty of other things I have not missed. I have not missed how I let my day get off to a bad start because it took three extra minutes to park. I am not looking forward to returning home and obsessing about the invasive thistle plant messing up our lawn. I have not missed the conversations about washers and dryers in our air-conditioned homes that are six inches too far apart.

These things seem important to us – but I can see now, they are not.

I have no right to complain about a three minute parking spot hunt to the woman I saw in the asthma clinic who had wheezed and walked for three hours to get to her 9 a.m. appointment.

I promise not to complain about the thistle growing in my back yard. I’ve learned that because it grows so well in almost any condition, it is an ideal forage food for work animals in the Ethiopian mountains.

Finally, I pledge to think of my new friend and colleague, Charles Turner, who told me about mango fly larvae burrowing under the skin when clothes are hung out to dry.  I will think about his stories from his adventures teaching nurses all over Africa the next time I agonize over whether to pick “Whites – hot” or “permanent press – cold” on the washing machine. 

And if that fails, I’ve asked my friends to give me a good smack upside the head.

Or, I’ll think of my friends in Ethiopia.

Endemenachu?

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

One of the things that has been most impressive in my visit to Gondar is the respect for people and for relationships that is present in every interaction.  Every conversation begins with a greeting, ሰላም, “Selam!”  Followed by some greeting such as “how are you”, “how is your day going”, or “how are you feeling?”  Or more often, all three.

In a typical conversation, each person in the group is acknowledged and receives a handshake.  The president of the university greets the department chair, the student, and the housekeeper.

There is a nonverbal conversation among Ethiopian men – what we’ve come to call the “ah-ha.”  It is a brief gasp taken with force which is usually uttered when another is speaking.  It says, “I am listening, I am interested, I am here.”

When I arrive at my office in the morning, I make it a point to say hello to the co-workers I meet – something I picked up from an airline pilot who told me he ALWAYS greets his flight attendants and co-pilot first thing.

However, it’s not the same kind of recognition and appreciation for the other person that I have seen in our visit to Ethiopia.

In the past two weeks in Ethiopia with each “Selam,” “good morning,”  “how are you feeling?” and “how was your day?,” I’ve learned more about my co-workers than I could have in six months in Columbus.

But, I’d like to change.

When I leave Gondar, I am going to be more aware of how I greet those around me – everyone.  It’s worth the time to let them know that I am interested in how they are doing.  I am hoping to let them know that I value them and am interested in them.

How are you doing today?  How are you feeling?  Did you have a good night?

After that, I will unlock my door and get to work.

And there is lots of work to do.

Risk perceptions

By Kristina Slagle

Student, Ohio State College of Food, Agricultural, and Environmental Sciences; School of Environmental and Natural Resources 

Soon after arriving in Addis Ababa, I had the opportunity to give a lecture on risk perceptions to students attending the summer institute. As my driver took me from my hotel to the university, I realized that traffic laws are merely a suggestion here, and pedestrians cross anywhere they can find a break in the traffic. My driver explained that the road we were on went from Addis to Djibouti, so it was constantly busy. Trucks full of construction materials, minibuses used for public transport, and small passenger cars jostled for position, while rickshaws led by mules stayed largely to the side and out of the fray. Needless to say, I was thankful for a driver who knew the unwritten rules of the road!

Once I arrived at the university, I had a bit of lunch, and then I was off to lecture. Throughout the lecture, I asked the students for examples of risk perceptions from Ethiopia, and one student mentioned traffic deaths. At the end of the lecture, we spent some time discussing strategies that had failed and what future efforts to reduce traffic deaths might look like. It was a very rewarding experience having engaged students interested in applying knowledge, and learning about applications within their culture. It’s always wonderful when the learning goes both ways in a classroom!

Now I’m off to Gondar to meet up with our team working on rabies!

University of Gondar graduation

By Ally Sterman
Student, Ohio State College of Veterinary Medicine

Yesterday was a day of celebration here in Gondar. The university graduated over 45,00 students today. Students graduating were from a variety of fields and disciplines including undergraduate, masters, and professional students. The University of Gondar also graduated three PhD students in the field of public health from the College of Medicine and Health Sciences, which was a first for the university. Most of the students were undergraduate students with close to 1,000 students from the Faculty of Social Sciences and Humanities. Next was Faculty of Natural and Computational Science with 850 students. The Faculty of the Veterinary Medicine will graduate their first class next year though there were students who graduated today with a degree in the field of veterinary public health.

Though a majority of the graduation process was similar there were a few subtle differences between graduation here and at Ohio State. In the states it is typical for graduates to enter to the song Pomp and Circumstance. Today they entered to a different song that seemed to be much shorter and strictly keyboard-based.  Another big difference, here in Gondar they announced and gave awards to students with the highest grades in their respective fields as they graduate. Though we acknowledge them in our programs, with cords or other visual means, we do not announce their names.

There were also a lot of similarities. They had speeches including one from their president and then a special guest speaker. Very similar to Ohio State, they awarded the speaker an honorary degree from the university. They also dressed very similar. Students and faculty were in the black graduation robes with hoods if they were from a degree program that we would hood for, but the undergraduates had sashes where we would have nothing to distinguish the different undergraduate majors.

Below is a video taken while graduates are walking in. Many are seated while quite a few are still walking past. In the background you can hear the music they are entering to, cheers from graduates/families/friends. You can also see some of the professors and external examiners that came to help give exams or determine if candidates were eligible to graduate.

[youtube=http://youtu.be/K1hiRAxU0J4]

Data collection in Debark

By Karissa Magnuson
Student, Ohio State College of Veterinary Medicine

For the past two days we have been in Debark, a town about 100 kilometers north of Gondar. Debark was our second data collection site for our rabies research project.

It is a common resting place for tourists who wish to visit the Simien Mountains. On our two-hour drive up to the city, we passed stunning scenery. The countryside is full of lush, rolling hills and looks like a patchwork quilt of rich coffee brown fields and vibrant green countryside.

We passed many farmers out plowing their fields with oxen and an old-fashioned plow. It was idyllic, and I felt like I had stepped back into a different time.  It was hard to go five minutes without seeing a shepherd out with his flock of goats or sheep, and there were always cows, goats, and sheep grazing in the distance. Our van had to stop or slow down a few times as wandering goats, sheep, and cattle crossed the road.

The people of Debark were very friendly and accommodating. For the project, my team was in charge of urban adults and children. It was truly a privilege to be able to walk their streets and be invited into their houses, especially since they knew nothing about me. Every house we went to, I was offered a chair or a place to sit, and a few times, they roasted a snack for me over their fire for me to eat. The hospitality here was truly amazing.

Our last day of data collection, we went up to a small neighborhood on a hill. Immediately we were surrounded by a huge group of children, all probably under the age of 10. They were all extremely friendly and asked me my name.

As my Ethiopian team members told them about the study and asked if they would like to participate, one of the little girls grabbed my hand.

All the children were eager to participate in the study. As we followed them back to their houses, my other hand was grabbed by a little boy, and I was led off down the dirt road to their homes.  Walking from one house to another, my hand was never empty. At one point, two of the children had a little disagreement about who actually got to hold my hand.

When we finished our data collection and were saying goodbye, all the children who had followed us around came over to me and shook my hand, and we touched shoulders. In Ethiopia, when you greet someone you shake hands and touch shoulders with the person. There must have been six or seven kids in line to say goodbye to me. It was truly a heartwarming and memorable experience that I will carry with me forever.

Winner Winner, no more cheeseburger for dinner

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

If there was a competition for the first Ohio State student to get sick during the summer research project, I came out victorious.

I have tried many different types of dishes without getting sick. However, I figured I would give their American equivalent to a cheeseburger a try, and it was a bad decision. Unlike when I feel ill in the U.S., getting ill here is more serious. The majority of our Ethiopian collaborators have reached out to me in one way or another to make sure I am OK. They are all truly compassionate and caring.

Since the rest of our research team changed cities, I am the only one left in Gondar until tomorrow. I immediately noticed people are more willing to practice their English on an individual rather than a group. My waitress for dinner tonight was practicing with me and I could tell she was very excited when I understood and responded.

I understand what it feels like to try to have a conversation in a language you aren’t familiar with. Anytime I can say “Hello” or “Thank you” in Amharic, I do so.

I have also noticed that most conversation stops briefly when I walk into a room.  There aren’t a lot of 6’3” blonde, blue-eyed males walking around in athletic shorts and an Ohio State T-shirt.

All-in-all, as we continue our stay here in Gondar, I am constantly impressed with the class and generosity of the people of Ethiopia.

A lesson in the art of craftsmanship

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

I’ve noticed some really excellent craftsmanship in Gondar.

Craftsmanship is evident in the way a napkin is carefully folded that turns an evening meal in to a “dinner.”  And craftsmanship is the patience of our waitress giving me a lesson in napkin folding.

Craftsmanship is the way that the pharmacist carefully wrapped up a packet of medication she prescribed for me because of the cold I’ve acquired in my last days in Gondar. It says, “I hope you feel better” before you open it.

folded_medicine_packet

Craftsmanship is the certain way a bundle of straw is tied to the back of a donkey on the way to market or the way a cup of coffee is poured when the person actually cares. It’s the expert skill and flair a microbiologist uses to streak an agar plate or a nurse uses to comfort an ailing patient.

One of the great craftsmen I have met is Mr. Abebe Demise. Abebe has a small shoe-shine bench outside our hotel. What makes him a craftsman is not that he does a good job cleaning and shining shoes; he does a great job on shoes from the dusty streets of Gondar. abebe_working

What makes him a craftsman is that when Mr. Abebe is at work shining shoes, he is in the zone. His full attention is on the task at hand. He uses the tools of his trade – he uses all of his attention – to shine shoes. To watch him in action is to see a master craftsman at work.

Craftsmanship is a difficult concept to teach to students in our “Research Methods Course.” There is just a way that a carefully constructed title of a scientific paper can grab your attention. A well-written set of specific aims can explain the purpose of a research project in a way that extends beyond the words printed on the page.  A well-organized literature review can make reviewers beg you to do your experiments.

This skill of craftsmanship in writing grants takes years to develop — and I am no pro.  But I know good grants craftsmanship when I read it—and when I see it.

On my last day in Gondar, Abebe Demise called to me from his shoe-shine bench across the street.  He had a small envelope for me with “For: Tim Landers, From: Abebe” written on the outside.  Inside were two picture postcards of Gondar.

I’d like to think that maybe – just maybe – this was one craftsman’s way of acknowledging a fellow craftsman.

tim_and_abebe

Professor Tim Landers and Mr. Abebe Demise, one of the great craftsman of Ethiopia.

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

tim landers 3

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.

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

Image

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!