Veterinary Medicine | One Health

Think Globally: Experiences Abroad Provide Perspective on Life

December 30 2014

It is human nature to get used to the routines of life. Commuting to work, the morning coffee, walking the dog, and hundreds of other daily rituals create a level of comfort within our increasingly hectic lives. Being born in America provides an inherent level of comfort. While there is poverty in the United States, most Americans are born into a system of privilege that is not accessible in many areas of the world. Our daily rituals and comforts become second nature, while in other parts of the world these “minor” parts of our day are elaborate luxuries. For example, the United States has a health care system that provides a high level of care inside pristine facilities that contain the latest health technology available to treat and prevent diseases. We don’t think about this, we expect it. We get sick, we go to the doctor, and in most cases we get well. We have a growing culture of preventative health care that promotes healthy living and leads to early detection and a higher rate of successful treatment with many cancers and other diseases. While many countries also share a strong health care system, there are millions of people throughout the world that do not have this luxury. Again, we don’t think about that when we are taking advantage of the health care system, we take it for granted that the system is in place and it will always be there when we need it.

Working in higher education, I see students of all ages, ethnicities, and races expanding their knowledge each and every day. The facilities and resources available to faculty and students in the United States are the best in the world. If you can think it and dream it, you can probably get access to an expert that will help you learn to do it yourself. Similar to our American health system, students and faculty often take this infrastructure of knowledge for granted. There is amazing comfort in academia in the United States with freedom to study and be whatever you want to be, as long as you can financially afford the dream. While our college students are learning in the traditional sense within the confines of this comfortable system, many of them are not learning with a global perspective. The experience that comes from visiting a foreign country and getting outside the umbrella of comfort in the United States provides a valuable perspective that will make a person grown not only in knowledge, but humanity and compassion for others.

While visiting Ethiopia as part of the Global One Health initiative, I was surrounded by many opportunities to see, hear, smell, feel, and experience things that made me contemplate my own realities and expectations. While meeting with doctors I heard stories about the growing epidemic of pediatric cancer patients in Ethiopia, how many cases of cancers are not being detected until it is too late, how access to the needed treatment is not available when needed, and I saw medical facilities that were inadequate to meet the growing demand of the population. While meeting with veterinarians I heard and saw cases of animal diseases that aren’t being treated because of a lack of awareness & understanding and instances of diseases transferring from animals to humans because of contaminated contact.

At the same time I saw and heard a spirited population that is passionate about life, with a rich culture and heritage that is beautifully embraced and celebrated. I saw a level of appreciation for collaboration and the sharing of ideas that I don’t see on a daily basis in the United States. Ethiopia is a country of 96 million, with a median age of 16, who are living in an environment of rapid growth, where building and expansion is outpacing the capacity of the infrastructure, which in turn causes issues from traffic gridlock to water contamination from industrial runoff. In the past seven years, the number of colleges and universities in Ethiopia jumped from three to thirty-three! They live a reality that is vastly different than that of the average American.

As I climb back into my own daily routines in the USA and at OSU, I do so with a different perspective and a greater sense of love for my family, my job, my country, and my beloved alma mater, The Ohio State University. It is my wish for all OSU students to take the opportunity to study abroad and for OSU faculty and staff to engage in global projects. It will truly change your life and open pathways to be energized by collaborating with others in a way that will make a huge impact on the lives of others. Go Bucks, Be Global!

Ebola a stark reminder of link between health of humans, animals, environment

November 14 2014November 14, 2014

By Emily Caldwell
Ohio State Research Communications

COLUMBUS, Ohio – For many, global public health seems like an abstract and distant problem – until the Ebola virus is diagnosed among people in our midst.

Though no one would call the Ebola pandemic a good thing, it has presented an opportunity for scientists to alert the public about the dire need to halt the spread of infectious diseases, especially in developing and densely populated areas of the world.

“What often seems like an abstract notion becomes very concrete when a deadly virus previously contained in Western Africa infects people on American soil,” said Wondwossen Gebreyes, professor of veterinary preventive medicine at The Ohio State University. “It does create a certain sense of urgency and awareness that this world is much smaller than we think.”

Gebreyes is the lead author of an article published in the Nov. 13, 2014, issue of PLOS Neglected Tropical Diseases that makes the case for accelerating efforts to put “One Health” into action. One Health refers to a strategy to more fully understand and address the links between animal health, human health and the environment.

One Health Ethiopia featured in news article

October 20 2014October 20, 2014

Our One Health program was mentioned yesterday by The Columbus Dispatch in an article on Ohio State’s College of Veterinary Medicine.

Here’s an excerpt:

“About 75 percent of emerging diseases originate from animals,” said Dr. Wondwossen Gebreyes, the director of the infectious-diseases molecular epidemiology laboratory. “That’s why our work in veterinary medicine is crucial, not just to save animal life but also to save human lives.”

With growing interest in that link, Ohio State now offers a degree that can be completed in four years by combining a two-year master’s in public health with a four-year doctorate in veterinary medicine. Graduates can fill the demand for veterinary experts at agriculture companies and government health departments.

“They will be detectives of diseases, from the animal side,” said Dr. Armando Hoet, the coordinator of OSU’s veterinary public-health program.

Students learn how to wear protective gear to deal with Ebola, anthrax or other infectious diseases that can pass between humans and animals. They learn about bioterrorism and that 80 percent of agents that can be used as infectious weapons spread from animals.

“We train professionals to deal with those diseases both in the animal side and human side, and to prevent transmission from one population to the other,” Hoet said.

A summer program has started sending students to Ethiopia to look for ways to help prevent the spread of rabies. Other projects study whether salmonella bacteria strains from around the globe act differently and how influenza jumps from pigs to people at Ohio county fairs.

Read the full article on the Dispatch website >>

One health summer, in review

September 22 2014

By Wondwossen Gebreyes
Professor, Ohio State College of Veterinary Medicine
Chair, Ohio State One Health Task Force

This summer we had another highly successful One Health Institute. There are a number of elements that made the 2014 Summer Institute unique and satisfying.

First, I would like to thank all the Ohio State, Ethiopian as well as East African (including Kenya and Tanzania) students, staff, faculty, researchers and administrators who took part on this wonderful and productive time. I highlight below the key events and activities.

1. The 2014 One Health Summer Institute engaged more partners than in any of the previous years. We had an unprecedented 26 faculty and 32 students from more than 10 Ohio State units. We delivered numerous courses, and several key networks have been established in several areas of clinical, research and service learning aspects.

2. We conducted clinical training mainly with spay-neuter as part of our rabies pilot project.

3. We launched the rabies elimination pilot project with the participation of 40 key officials from various Ethiopian institutes, including academic, research, legislative and regulatory. We conducted a thorough assessment of the plan prior to launch. Other collaborating U.S. institutes, mainly CDC, played a key role in this.

4. We hosted trainees from Kenya and Tanzania in addition to the Ethiopian trainees. As part of our NIH-Fogarty program, we also hosted 12 trainees from the three nations for 45 days of intensive training in molecular epidemiology of food borne pathogens including laboratory sessions.

5. In addition, we also witnessed memorable learning moments for everyone:

The University of Gondar Diamond Jubilee is the key positive moment we all witnessed.

The flooding of the surgical suite in the middle of spaying of dogs was a great challenge for our team.

The mass pooling of all vehicles by the UOG administration and scooter travel to dairy farms around the Gondar city areas were unforgettable.
Flexibility in action- the breakdown of our rental van with five people from Ohio State and CDC on board that had a domino effect of triggering so many phone calls and cancellation of a Skype call on cancer partnership.

Thank you all for all the hard work by our OSU-Ethiopia One Health Task Force on both sides as well as our NIH East Africa partners from Kenya and Tanzania. Look forward for continued and sustained partnership.

Collecting samples from camels in the Awash Rift Valley

August 8 2014August 8, 2014

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.

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.

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.

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!

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.

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!

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!

Flooding in the surgical suite during spay-neuter program in Gondar

August 6 2014

By Maria Belu
Ohio State Veterinary Public Health student

Is that water coming in?

It was the first thought that popped into my head when I looked up after taking the heart rate of my recently extubated dog in recovery. It was the last of an amazing six days that I had spent taking part in a sterilization and rabies clinic in Gondar, Ethiopia.

We were there to serve the local community by offering spay/neuter surgeries at no cost to them as well as rabies vaccines. The second (and equally important) aspect of our mission was to educate recent veterinary graduates on how to perform spay/neuter surgeries through ventral approach from sedation to recovery.

Maria Belu, center

I was overwhelmed every morning by the patience of people who brought their animals to us, waiting from early in the morning to late in the afternoon for when we could fit them in. Often the need of the community overwhelmed us, and at times we had to turn dogs away.

Despite this, I’m so proud of the small effort I played alongside my fellow students: Alexandra Medley, Kelsey Gerbig, Mal Kanwal, and Ally Sterman. It was an amazing clinical experience, being able to take care of a dog from the moment they were intubated and catheterized to when they recovered.

Most of the dogs we worked with were often scared of us; thus, they could be a little more difficult to handle. This observation is what made our last day so unbelievable.

As I said, I was recovering one of the last dogs we spayed that day, and when I looked up, water was coming in through the front door.

The rain for the past 15 minutes had been deafening, but I was used to rain, so we paid it little attention. In a heartbeat’s moment, more and more water kept coming in. People around me began scrambling, taking any supplies that were resting on the ground to place high on tables.

We were laying the dogs on a mat in the corner, and the few of us recovering dogs pulled up that mat to form a kind of comical island. One of the surgeons we worked with, Dr.Terefe, looked outside the window and called out that water was rising quickly.

Our other surgeon and head director of the project, Dr.O’Quin, quickly made the decision to evacuate the surgery suite since we were at the bottom of a hill.

I wrapped up my dog in a surgery gown and lifted her off the ground. She was one of the less aggressive dogs, so I was thankful that I was carrying her.

Alexandra, sadly, was helping recover one of the more aggressive dogs. Miraculously, as if she knew we were helping her, she let Alexandra lift her up and carry her without any fuss. That was the first miracle of the day.

The second miracle was that we had no dogs in surgery as the water rose. If we had to be flooded, it was a pretty good time for it happen.

We picked up our dogs and moved toward the door. Some of the veterinary students helping us opened up the doors. The moment I stepped out, suddenly water was all the way up to my hip.

We walked out unable to see the ground under our feet, with water moving past us at a rapid pace. I gingerly stepped forward. We made it up the steps and joined some of the other university staff.

We placed the dogs on a nearby table and wrapped them up in window curtains that people brought us to keep the animals warm.

As we stood around looking like cats after an unwanted bath, with our patients wrapped in beautiful curtain, we began to laugh. It was not the end I had expected to our amazing week, but it was certainly a fitting one.

Q&A on animal care and vet students in Gondar, Ethiopia

July 18 2014

Dr. Sintayehu on the far left, Christine second from right, during Christine’s visit to Ethiopia earlier this year.

Introduction: Christine O’Malley and Dr. Sintayehu Mulugeta are friends who work on collaboration between Ohio State and the University of Gondar (UOG), Ethiopia. This summer, Ohio State sent a team of students and faculty to partner with UOG on a spay/neuter program and dog inventory as part of a rabies elimination pilot project. Below is a transcript of a Skype conversation between the two friends. Sintayehu, a veterinary medicine faculty member, describes the field training UOG provides its vet students.

Christine: Now that the Diamond Jubilee is over, what’s going on at the University of Gondar? Is it summer break?

Sintayehu: Well, I am out of office for field work with students on their clinical field experience. Most of the schools are on summer vacation now, but students in Medicine and Health College, Vet Faculty and freshmen in various departments are still in campus.

Christine: What kind of field work do the vet students do?

Sintayehu: To support clinical medicine course and help them develop confidence and get acquainted with the real picture at clinics out there in working place, students take a course called off-campus training. The students will have about two weeks’ time exposure to different districts’ government vet clinics where they work as clinical vet students with close supervision by one faculty staff from UoG, and the district’s vet.

Sintayehu: They also engage in community services and help the clinics in every capacity they are capable of, like cleaning the clinic compound, providing recommendations on potential shortcomings, etc. After completion of off-campus training, they are supposed to present a field practice report about their stay and will be evaluated based on that.

Christine: Do they provide direct care to animal patients?

Sintayehu: Yes, with supervision. That is why I am currently with them here in field.

Christine: I bet they learn a lot from that.

Sintayehu: Sure. That is the best way of learning from practical courses. And this is witnessed by them. However, because of small amount of budget they sometimes come back to campus earlier than planned. This is really a continuous challenge to the faculty and to them.

Christine: What are the most common illnesses or conditions that you see at the district clinics?

Sintayehu: Well, I can say we have all sorts of diseases. For instance, in the place we are now working are Infectious (Pasteurellosis, Black leg, Anthrax, Lumpy Skin Disease, Sheep pox, Rabies, Newcastle Disease), Parasitic (helminthes, arthropods: ticks, lice, mange mites; protozoans: Trypanosomes, Coccidia), Metabolic and nutritional, and reproductive disorders in cattle, sheep, goats, donkeys and chicken. I was surprised to see dogs as well in the clinic.

Sintayehu: However, to be honest with you, there are no laboratory facilities for confirmation of cases, so the diagnosis is almost always relied on history and clinical findings. No single laboratory diagnostic aid and there are only few drugs available.

Sintayehu: I saw a new building for the clinic and I was told that it has been built from the World Bank fund. Mr Nigussie, the vet technician working here, told me that it is now completed and will be furnished with basic clinic facilities from the same fund. Then it can have better veterinary service.

Christine: Why were you surprised to see dogs?

Sintayehu: I mean not to see them, but the awareness of the community, most of which are poor farmers, to get medical care for their dogs.

Christine: That seems like a good thing.

Sintayehu: Definitely! I was told by Mr Nigussie that the community has good awareness about the importance of bringing their animals to clinics whenever there is ill-health to their animals. That shows there is a big demand for vet service.

Christine: Also a good thing for the rabies project, perhaps? Showing awareness of needing to take care of their dogs?

Sintayehu: Yes. You know, I also asked about the status of rabies in the area. It is terrible to hear that there is high prevalence of rabies in the countryside. This is worsening by strongly rooted perception of the community that traditional healers can cure the disease. It is challenging human/animal health care. There is no rabies vaccination at the clinics. The only thing the vets in such districts doing are advise farmers to be careful of suspected dogs.

Christine O’Malley: Yikes! What areas will you visit next?

Sintayehu: This is the last field work for this academic year. Koladdiba, the place we are now working in, is not that much far from Gondar, about 35kms, but the road is rugged and may take you about an hour or so. I love having seen the countryside. I wish I could visit such places more often.

Group of students with Dr. Sintayehu, their mentor, in the middle wearing the blue jacket.

Counting dogs, with Gondar’s children helping us

June 20 2014June 19, 2014

By Ally Sterman, 2015 DVM and
Alexandra Medley, 2017 DVM and 2018 MPH/VPH
The Ohio State University

Our dog survey project takes us through various areas and communities in Gondar. Many of these areas are homes or rural communities that are heavily populated with families who have many children. As we walk around the areas, we quickly attract children. It is not common in many of these areas for individuals with white skin to pass through. When I was in Ethiopia the previous summer, in very, very rural communities children used to run and hide from us. This summer they run straight for us.

Often times we know they are coming for the screams of “you, you, you” or ” foreingee, foreingee.” Once they arrive, they begin to ask us our names, how we are and where we are from. Many will try to speak some English with us and others will suddenly become shy and run and hide. If you pull out a camera to take a picture, they also all hide but when we bring out the iPad to record data they become super interested in what we are doing. The brave ones come up and want to shake hands with us. Such a simple gesture brings a wide smile to their faces.

They have been very helpful, helping us identify what sex the dogs are, where they are and even bring them up to the front of the yards to help us see them better. In the suburban areas we had as many as 30 children following us and in the rural side entire small villages of children.

Interestingly, the local veterinarians have told us that the main breeding season is in the Ethiopian Spring (September by U.S. calendars), although we have seen many pregnant dogs and puppies. Despite our initial thought that each dog would be hard to tell apart, we have seen a variety of shapes, sizes, breeds and coat patterns. So far we have been able to casually determine that dogs are mostly found in the peri-urban, or housing, areas. Although dogs tend to remain in a small area, or territory, there are many friendly dogs that roam in groups.

We have seen many different medical conditions in the dogs, such as lameness, ticks, fleas, fighting wounds, and malnutrition, but none of this was outside of what we expected. We have completed our two rural paths, that are high up in the mountains where there are less than 15 houses per path. We have seen many dogs there, but more incredibly, the stunning panoramas of Gondar from up high. This season heralds strong winds and rain, and sometimes we had to brace ourselves from falling over as we navigated hilly terrain. In a few more days, we will wrap up our dog survey.

Public health course ends with a conference lecture in Gondar

June 19 2014June 19, 2014

By Armando Hoet
Associate Professor and Director of Ohio State’s Veterinary Public Health Program

Gondar Ethiopia, day 6

I am still not sure what happen, but I blinked, and there I was in the front row of the largest conference center in Gondar at the Medical School, seated between the president and vice-president of Gondar University , as one of the main keynote speaker for the 24^th Annual Research Conference of Gondar University.

This year the conference was even more special, which explain the large number of journalists and cameras, as it was the 60^th anniversary of the university (Diamond Jubilee).

Before the conference started the President shared with me his career path, starting as a sanitarian doing pre- and post-slaughter inspections, later becoming a Public Health official, studying part-time to become a physician and in the last 8 years he has been the president of the University of Gondar; leading a 30,000-student institution of higher education. He is in his own words “one of the strongest advocates of One Health.”

I believe the presentation went well based on the amount of interesting questions and post-conference trading of business cards.

As I am leaving tomorrow, I would like to thank my guide in Gondar, Professor Tamiru, who showed me the best of the city in this and my previous visit in 2012. And who took me today to the best view in town: The Goha Hotel.

Everything ended well, except for the Spanish team (5-1 to the Netherlands in the world cup) …

Finally, one of the best ideas I am taking back this trip is the unisex open bathrooms. I am sure they will pick up really fast at OSU.

Why misuse valuable space in duplicating men and women bathrooms, when we can share one? I am sure that we can use the extra space for additional offices. Right?

From the city of the Emperors of Africa

Thesis defenses and counting dogs in Gondar, the student perspective

June 16 2014June 16, 2014

By Ally Sterman, 2015 DVM and
Alexandra Medley, 2017 DVM and 2018 MPH/VPH
The Ohio State University

After a 13-hour flight, we arrived in Addis Ababa, Ethiopia. A thought that kept crossing through both of our minds was whether or not our 140 pounds of veterinary medical supplies would make it to Ethiopia, through customs, and with us to Gondar. After locating the correct baggage claim lanes (this airport has 4), we waited patiently for our oversized and heavy baggage. Thankfully we made it with no difficulty through customs and to our airport.

Flights to Gondar leave early morning and we stayed overnight at the Jupiter hotel near the airport in Addis. The view from our room was of a large abandoned field. By day this field was a grazing zone for various sheep and goats, but by night it was a parking lot for local vehicles. After exploring around the area, we ended up calling it an early night.

We arrived to the airport early and upon arrival in Gondar were greeted by our partners from University of Gondar and taken to our hotel. Soon after settling in we headed to the vet school. We had the opportunity to listen to senior veterinary students defending their theses, which is the final project necessary to graduate. There are some striking differences between Ethiopia and U.S. vet school training. In Ethiopia the students defend a final thesis project instead of a cumulative boards exam (USA NAVLE), they attend school for 6 years (USA, 4), and primarily focus on large animal medicine because that is the primary need in the country.

After listening to the defenses we had a meeting with the faculty who helped us organize our dog survey. For the next week we are walking 15 different paths we have plotted through the city to count the roaming dog population and do a brief visual physical exam on each dog. Data we want to collect are the number of dogs seen along the path, sex, age, reproductive status, and any other clues to their health status.

Something we have learned already is how mountainous Gondar is, so although the paths are short, they take a while and we get a great workout. To get to destinations we take buses or taxis which are far more crowded than the average taxi in the US.

Taxis and busy city streets

We have seen many types of dogs so far, from a small Papillon cross to a large Mastiff. Our favorite dog is the mixed breed brown dog who resides directly outside our hotel, affectionately named Kino.

Kino, the dog