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
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
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.
Dr. Bisesi lectures at the Akaki campus.
A student walks through Addis Ababa University’s Akaki campus.
Addis Ababa University students listen as Dr. Bisesi lectures.
Dr. Gebreyes teaching class.
Students listen during Dr. Gebreyes’ lecture on molecular epidemiology.
Photos by Rick Harrison, Ohio State University Communications
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.
Drs. Azarias Kassahun and Eric Sauvageau examine a patient with myelopathy, a spinal cord constriction.
Signs reading “Good Luck” are posted all around the wards at the University of Gondar Hospital.
Photos by Rick Harrison, Ohio State University Communications
From left, Tikur Anbessa’s Dr. Mersha, neurosurgery chief, and Dr. Ebenezer with Ohio State’s Dr. Eric Sauvageau and Dr. Andrew Shaw as they enjoy coffee before making rounds at Tikur Anbessa (Black Lion) teaching medical center at Addis Ababa University. (Photo by Rick Harrison, Ohio State University Communications)
By Andrew Shaw
Clinical House Instructor at Wexner Medical Center, Ohio State
Since returning from Ethiopia I am filled with excitement. The people there are incredibly welcoming, warm, and giving. They invited us to see their patients, wards, and hospitals. The doctors there exhibit such passion for medicine, learning, and are always wanting a lecture.
Establishing a long term relationship with the Neurosurgery Department at Black Lion hospital will be mutually beneficial.
Upon our arrival, I believed we would be the teachers, but I often found myself on the learning end. The pathology they see is often advanced and requires much skill to treat.
You might recall the show MacGyver. As Wikipedia says, “Resourceful and possessed of an encyclopedic knowledge of the physical sciences, [MacGyver] solves complex problems with everyday materials he finds at hand, along with his ever-present duct tape and Swiss Army knife.”
Our Ethiopian partners are the “MacGyvers” of medicine doing amazing things with limited resources.
By Karissa Magnuson
Student, Ohio State College of Veterinary Medicine
During our time here in Ethiopia, we have been surprised to find out how often people, especially in rural settings, believe and prefer a traditional healer instead of modern medical doctor. My curiosity on this subject led to me to do a little research online into the prevalence of traditional healers in Ethiopia as well as traditional treatments for rabies proposed by these healers.
Traditional medicine dates as far back as the 15th century in Ethiopia and consists not only of herbal remedies but also of animal and mineral-based concoctions as well as spiritualistic rituals and aromatherapy. Most traditional healers have learned their trade from a family member, and like doctors, these healers go through both a physical exam and history when they examine their patient.
Not surprisingly, many modern health care workers do not support traditional medicine; however, there are some that feel collaboration between traditional and modern healers could provide the best treatment for patients.
In my research I was shocked to discover that up to 80% of Ethiopians use traditional medicine as their primary source of health care. (A historical overview of traditional medicine practices and policy in Ethiopia.) Being from a country where modern medicine is viewed as infallible, with Chinese and other traditional medicine slowly gaining some credence in the U.S., an 80% preference rate is surprising.
So is there any stock in traditional medicine in the treatment of rabies? In my search, I found remedies which have included the use of skullcap on wounds (This herb tends to have astringent effects, antiseptic effects on wounds, and anti-anxiety effects.) Garlic was also frequently mentioned for treatment. I was shocked to discover that garlic has been found to have some effects on paralytic disorders. The bark of Alangium salviforium, a flowering plant, has also been indicated as a possible treatment and has been proven to have anti-epileptic effects. The main question that I am left with is: Are these treatments and herbs effective or is traditional medicine hindering rabies eradication in Ethiopia? Or perhaps, it warrants further research and possibly future collaborative efforts in the cure and eradication of rabies within this amazing country. Only more research will tell.
By Korbin Smith
Student, Ohio State College of Medicine
School of Health and Rehabilitation Sciences
The initial data collection for the project has been finished. Our group was unable to blog or access the internet over the last week due to traveling in small towns throughout Ethiopia that don’t have internet. To catch up, we traveled from Gondar to Woreta where we conducted interviews before moving to Debre Tabor. It is crazy how different the climate can change 
here with a 40 minute drive. Woreta has a warm climate with temperatures probably averaging around 80 degrees. A 40 minute drive to the highland in the mountains and Debre Tabor was probably around 55-60 degrees.
Luckily for me, this means I now have a cold. I am beginning to think I have a weak immune system, as I am always the only one to get sick. From Debre Tabor we met with Dr. Gebreyes, who brought a photographer and Dr. Sauvageau, a neurosurgeon from Ohio State. It was good to see others from Ohio. We drove to Bahir Dar which is the city that borders Lake Tana, the biggest lake in Ethiopia. Being a fishing connoisseur, it was very neat to see the traditional fishing methods.
We celebrated finishing the data by going to a traditional Ethiopian club in which we saw many styles of “shoulder dancing.” I think I can dance better in Ethiopia than in the U.S. As long as you can move your shoulders to the music you can be accepted as a dancer here. People are less inclined to judge me on my overall lack of rhythm (or if they are judging me it is in Amharic and I can’t tell).
Once we returned to Gondar I was happy to pick up the suit that I had ordered in the city aweek ago. Since I am a rather tall, skinny, and lengthy individual, the suits already made did not fit me. Dr. Tamiru, a partner we have been working with, took me to his tailor who agreed to make me a suit from the cloth of my choosing for 1,900 birr. While that might seem like a lot in the U.S. that is equivalent to 100 USD. This is extremely inexpensive for a customized tailored suit. The suit fits excellently.
In addition to completing the data collection, I have appreciated experiencing different aspects of the culture here in Ethiopia.
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.
By Timothy Landers, RN, PhD
Ohio State College of Nursing
and Gennit*, 9th grader from Atlanta, Ga.
*Gennit is not her real name but the story is true. Her mom gave us permission (from the row behind us) to use this story and photo. Hopefully, this counts as her “What I did over summer vacation” essay when school starts.
I’m sitting on the plane with Gennit, a 13-year old girl who was born in Ethiopia, but now lives in Atlanta with her brother and parents. Gennit is a nice and articulate 13-year girl, and we chatted during the 13-hour flight about our experiences in Ethiopia.
She had a lot of things to say, and I noticed that she was somewhat soft-spoken making it difficult to hear her at times. I asked her about my observation that many Ethiopian girls and women speak softly and what she thought about that.
Gennit told me she thought is was more “ladylike” to speak softly and, in Ethiopia, children are taught that it is wrong for a girl to talk loudly.
She spoke in her own dialect – the American southern teenager — and said, “Like, it’s like wrong for a girl to speak like that. Ok, like, it’s just like, everyone has, like, their own traditions and, like, it’s just how a girl is raised.”
At the same time, she had some very interesting and important opinions to share. It’s, like, totally cool that a 13-year-old gets this linguistics lesson.
I started thinking about what this means for nurses and for nursing. It is often difficult for us to articulate our contribution to health and health care. We are trained to be reserved and deferent. It’s considered respectful, but it means that our voices are not heard. This can be especially true at the table of health care decision-making.
As we work with our colleagues from the University of Gondar, we need to encourage them to represent nurses in a way that is culturally acceptable and to advocate for nursing’s contribution to patient outcomes — to speak up for what nurses mean to patient care.
This is true for us in Ohio, too. We should learn to make our voices heard.
REPRESENT!
What nurses do is, like, totally awesome!
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.