Tim Landers of Ohio State’s College of Nursing shares this clip of what 5 a.m. sounds like in Gondar, Ethiopia, as he prepares for another day with the One Health Summer Institute.
Ohio State University
Microbiology lab at the University of Gondar hospital
From left to right: Ohio State’s Baye Molla and Tim Landers along with University of Gondar’s Wubet Birhan, head, School of Biomedical and Laboratory Sciences; Kassie Molla, head, microbiology laboratory; and Tigist Feleke, lab technologist
By Bayleyegn Molla, DVM, PhD
College of Veterinary Medicine, The Ohio State University
This week, I had a chance to tour the microbiology at the University of Gondar Hospital.
The lab processes hundreds of samples from patients every month. Patient samples are accepted, labeled and sent on to the microbiology lab where they are placed in different agars and broths to check for the growth of bacteria in patient samples.
I was surprised when the staff showed us a large book where the date, source, and patient information are recorded. This can be a time consuming task and makes it difficult to transmit results efficiently to clinicians. Papers can be torn, lost, or burned.
It is a less than ideal system.
When I asked to see the computer, they happily showed us the new electronic system to track individual results including results, name of the organism recovered, and information about antibiotic resistance for each organism. Having this system allows more rapid feedback to clinic staff and can be used to research problems in microbiology.
I was relieved and encouraged that they were using this technology.
This made me reflect on how I still rely on older systems in my old work. They are comfortable for us to use. In order to really harness technology to address important health and food safety problems, I also need to help develop effective technology, trust it to perform, and use it to its maximum.
That is what I learned in the microbiology lab.
Ohio State in Ethiopia: Now the students’ work begins
By Ally Sterman
Student, Ohio State College of Veterinary Medicine
With the start of the both the new week and new month our Ethiopia summer project really begins. Though we four students from various colleges at Ohio State arrived near the end of last week in Ethiopia, we did not begin our field work until July 1.
Our project takes us into both the rural and urban communities interviewing local adults, children, policy makers, community and faith leaders, as well as health care workers about rabies and dogs. We are set to travel around to three different areas before a workshop is held in Addis Ababa to discuss rabies further in mid-July.
However we do not go out alone. Each Ohio State student has two wonderful Ethiopian University of Gondar partners. These individuals are primarily faculty and staff at the university from a variety of fields/disciplines. They not only serve as interpreters for our project but tour guides of the city and historians for Ethiopia’s culture/traditions/history. They are quickly becoming lifelong and treasured friends. I know I can speak for all of the students about how grateful and appreciative we are for their help and how much fun/enjoyable they are making this experience.
The picture below was taken before one of the interviews conducted by my group. My group’s main focus is community leaders which include teachers, faith leaders, elders, and other various leaders in both the rural and urban settings. This picture was taken of one of the churches we travelled to in the city of Gondar where we had the opportunity to meet and talk to the priests about rabies and the dog population here in the city.
Learning Amharic in Ethiopia: It’s for veterinarians, too
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
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
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.
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.
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!
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!
Making Animal Inquiries in Addis Ababa
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.
Welcome!
The Ohio State University Health Science Colleges established the One Health Ethiopia Task Force in August 2012. Our goal is to develop a sustainable and mutually beneficial partnership with Ethiopian academic and affiliate partners, especially the University of Gondar and Addis Ababa University.
Because Ohio State has seven health science colleges on one campus, unlike any other American university, we are able to offer our Ethiopian partners unprecedented interdisciplinary collaboration that results in healthier, happier, more productive lives for Ethiopia’s citizens. The work we do is also intended to be replicated elsewhere, amplifying the impact of our collaboration.
This blog features the activities of our faculty and students involved in:
- One Health Summer Institute courses taught by faculty from Ohio State’s Colleges of Veterinary Medicine, Nursing, Public Health, Optometry, and Medicine;
- Ongoing research initiatives on rabies, cervical cancer and food security, including the Ohio State health sciences colleges above and the School of Environment and Natural Resources; and
- Workshops on rabies eradication, One Health partnerships, molecular epidemiology, and neurosurgery.
Our faculty and students are in Ethiopia to collaborate, educate, and inspire.
We hope you enjoy our offerings!