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A Student’s account of Experiences from the Frontlines of the Rift Valley Fever Outbreak Investigation in Kabale District, Uganda

On 4 March 2016 Uganda’s first case of Rift Valley Fever (RVF) was reported in the Kabale District, about 400 km southwest of Kampala. Although only one other case has been confirmed in Kabale, RVF is a viral disease that can be easily transmitted through infected mosquitoes or contact with infected animals. Since 4 March 2016, rapid response teams have been deployed by the Ministry of Health to respond to the outbreak. Six One Health Student Club members at Makerere University were chosen to join the rapid response team and have been at the frontlines of the outbreak since 21/03/2016 to 24/03/2016.The One Health students have been trained to prevent, detect, and respond to infectious disease outbreaks by the One Health Central and Eastern Africa network with the support of the U.S. Agency for International Development’s One Health Workforce project. Upon selection, the Ministry of Health provided additional training to the students as part of its operational response.

On March 18th, 14 days since the first outbreak, students were called to urgently convene at 2pm to leave for Kabale at 6pm. Tonny Tindyebwa a member of the One Health Students’ Club, based at Makerere University School of Public Health, is one of the students who were part of this investigation. In this post, he shares his experiences.

The morning after we arrived, we had an early morning meeting with the District Task Force, followed by identification of activities to be done. These included mainly social mobilization and surveillance. Multi-sectoral teams were then constituted and assigned duties. We also created a communication platform using WhatsApp.

The next day, Tuesday 22nd we identified new cases including a truck driver from Burundi. Tis case caused a lot of panic among residents at the border who mistook the symptoms for those of Marburg. 

The rest of our time as part of the investigation team, we mainly took part in case tracking, sample collection, social mobilization, report writing, case management and records review. Illegal structures like slaughter houses/places were also visited and closed, while abattoirs were also inspected.

In the course of executing this assignment, I realized that there are areas that could be improved in future, like the slow response on delivery of the supplies such as PPE which scared medical workers on attending to cases, delay of Laboratory results of the samples collected still put the DTF members in anxiety, slow response of the Alert desk team to requests.

There was also late dispatch of teams to the field, absence of key district political leaders and inadequate transportation facilities like cars, making it problematic for teams to get to the field in time

There were also challenges with some media houses misinforming communities on the progress of the outbreak investigation, treating suspected cases who had died as confirmed cases.

There are some good practices that I think can be used as lessons and strengthened for future outbreaks. For instance, the population exhibited eagerness to report any suspects basing on signs and symptoms of the disease they had, to the extent that some people just referred themselves to the health workers.

Social mobilization was done in creative ways, using currently popular technologies as well as reaching out to specific populations and communities like schools and training institutions.

Key populations we worked with like meat sellers were very responsive in providing information about their counterparts who had exhibited signs and symptoms of RVF.

Participants were taken through the different components of risk management and risk prioritization, risk-based inspection and surveillance and rapid assessments, risk communication and project management.

Kenya Trains In-service Trainers for Risk Analysis

In the recent past, Kenya has had outbreaks of emerging and re-emerging infectious diseases like Rift Valley Fever (RVF), Highly Pathogenic Avian Influenza (HPAI) and common endemic diseases like rabies and anthrax. This calls for a workforce that is able to identify, manage, prevent and communicate risk using the One Health approach. Risk analysis training for government officers responsible for disease control and prevention will build capacity for prevention, detection and response to public health threats. 

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Mekelle Faculty During Orientation

Mekelle University Faculty Orientated in One Health Curriculum Integration

The integration of One Health core competence into existing courses of both undergraduate and postgraduate programs was conducted in Year III of One Health Workforce project. During the integration, only a small number of staff participated while many others who deliver the same courses were not able to attend.  It was however considered worth bringing all faculty who deliver integrated courses to have the same understanding of One Health core competencies.  In Year 4, all faculty involved in the delivery of the courses were oriented to sustain OH and to reach a wide OH future generation. 

The objectives of the orientation were; 1) to build the capacity of the faculty to ensure the delivery of the integrated courses, 2) to have common understanding among faculty about delivery of OH integrated courses and sustain OH in the teaching and learning processes in the university, 3) to support the institutionalization and sustainability of OH training in the system.

All the 36 staff who attended the orientation briefly presented their own courses integrated with OH core competencies. Below is the list of courses integrated with OH core competencies:

  1. Advanced Ecology course beneficiaries a staff who delivers the course and PG environmental health students.
  2. Health System Management(Public Health Officers course syllabus) – beneficiary UG and faculties who delivers the courses
  3. Principles of Health Service Management- beneficiary PG students and faculties who delivers the courses
  4. Epidemiology I for public health students beneficiary UG students and faculties who delivers the courses
  5. Veterinary Public Health- beneficiary UG veterinary students and faculties who delivers the courses
  6. Zoonotic and emerging diseases- beneficiary PG veterinary students and faculties who delivers the courses
  7. Veterinary epidemiology and economics- beneficiary PG veterinary students and faculties who delivers the courses

The discussion was very lively and many questions was raised and addressed by focal persons. Each course with OH competencies integrated was presented by the course custodians and the mode of delivery briefly discussed. Participants raised a lot of concerns (what effort was being done at ministry level?, does the integration affect load/credit and time of the course?, How can we integrate OH with community based education, does OH core competency need specialization?

The Jimma University OHCEA Focal Persons agreed to continue orientating staff on the same page in integrated course delivery

  • Interest of the staff was highly rewarding to in accepting the integrated courses and in OH concept in making difference in our ecosystem.
  • It was agreed that each department head and the dean take responsibility to follow up the implementation of the integrated courses.

Common understanding was developed about those specific courses integrated by OH core competency and their mode of delivery was thoroughly discussed.

The Focal Persons promised faculty to share the OH modules to use for further reference.

Mekelle University conducted a one-day workshop to orient faculty of the College of Health Sciences and College of Veterinary Medicine in One Health curriculum integration. The orientation workshop conducted December 17th 2017, is the continuation of the training of trainers (ToT) training in One Health curriculum integration held at Wukro in August, 2017. Thirty two (32) faculty from veterinary medicine, environmental health, Public health, nursing, pharmacy, medicine and midwifery participated, working together on various One Health-related curricula to develop content that can enable them train students that can solve the challenges at the human-animal and environment interfaces. The workshop was facilitated by Dr. Getachew Redae from Environmental Health, Dr. Abreha Tesfay and Berihun Afera from College of Veterinary Medicine.

Workshop participants during the orientation of faculty in One Health Curriculum Integration

Photo Credit: Berihun Afera

 

 

Training on Risk Analysis conducted at Mekelle University

One health Central and Eastern Africa (OHCEA) Mekelle Office through the support of USAID Fund has provided Training on Risk Analysis from December 28/2017 to January 1/2018.

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Faculty Orientation on One Health Curriculum Integration Conducted at Mekelle University on December 17/2017

Mekelle University through the support of the Office of One Health Central and Eastern Africa (OHCEA) Office USAID Funded Project based at College of Veterinary Medicine has conducted a one day workshop aiming at Orientation faculty of college of health sciences and veterinary medicine on one health curriculum integration on December 17/2017.

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