'Together We Can' Guides UPDF, U.S. One Health Efforts

U.S. Army Maj. Thamus J. Morgan, a veterinarian from the 411th Civil Affairs Battalion in support of Combined Joint Task Force-Horn of Africa, greets children from Kakute Primary School in Kakute, Uganda, April 23, 2013. Morgan inspected the village's livestock-sanitation procedures with Uganda People's Defense Force (UPDF) animal healthcare experts as part of One Health, a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to strengthen Uganda's healthcare capabilities. Overall, 61 percent of emerging infectious diseases are caused by transmission from animals. One Health's goal is to educate people how the health of humans, animals and ecosystems are interconnected. (Photo by U.S. Navy Petty Officer 1st Class Tom Ouellette) CJTF-HOA Photo U.S. Army Maj. Thamus J. Morgan, a veterinarian from the 411th Civil Affairs Battalion in support of Combined Joint Task Force-Horn of Africa, greets children from Kakute Primary School in Kakute, Uganda, April 23, 2013. Morgan inspected the village's livestock-sanitation procedures with Uganda People's Defense Force (UPDF) animal healthcare experts as part of One Health, a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to strengthen Uganda's healthcare capabilities. Overall, 61 percent of emerging infectious diseases are caused by transmission from animals. One Health's goal is to educate people how the health of humans, animals and ecosystems are interconnected. (Photo by U.S. Navy Petty Officer 1st Class Tom Ouellette)
Villagers from Kakute, Uganda, gather at the Kakute Church of Uganda, April 23, 2013, to see theatrical presentations of proper food, water and personal hygiene sanitation procedures performed by human and animal healthcare experts from Combined Joint Task Force-Horn of Africa (CJTF-HOA) Surgeon Cell; 411th Civil Affairs Battalion, Uganda People's Defense Force (UPDF), and their civilian counterparts. Because of high illiteracy rates in Kakute, the performers decided to share knowledge with the villagers by acting out information, sometimes called "live theater." The event was part of One Health, a 2-week series of events that recognizes the health of humans, animals and ecosystems, like their nations, are inter-connected. Overall, One Health is a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's healthcare capabilities. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette) CJTF-HOA Photo Villagers from Kakute, Uganda, gather at the Kakute Church of Uganda, April 23, 2013, to see theatrical presentations of proper food, water and personal hygiene sanitation procedures performed by human and animal healthcare experts from Combined Joint Task Force-Horn of Africa (CJTF-HOA) Surgeon Cell; 411th Civil Affairs Battalion, Uganda People's Defense Force (UPDF), and their civilian counterparts. Because of high illiteracy rates in Kakute, the performers decided to share knowledge with the villagers by acting out information, sometimes called "live theater." The event was part of One Health, a 2-week series of events that recognizes the health of humans, animals and ecosystems, like their nations, are inter-connected. Overall, One Health is a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's healthcare capabilities. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette)
Villagers from Kakute, Uganda, gather inside the Kakute Church of Uganda, April 23, 2013, to see live theater skits dramatizinh proper water and food sanitation procedures performed by human and animal healthcare experts from Combined Joint Task Force-Horn of Africa (CJTF-HOA) Surgeon Cell, 411th Civil Affairs Battalion, Uganda People's Defense Force (UPDF), and their civilian counterparts. Because of high illiteracy rates in Kakute, the performers shared knowledge with the villagers by acting out information. The goal of the presentations is to help prevent the spread of diseases, often viruses from wildlife found in water and food. The event was part of One Health, a 2-week whole-of-government program that recognizes the health of humans, animals and ecosystems, like their nations, are interconnected. Overall, the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA sponsored One Health to help strengthen Uganda's healthcare capabilities. (Photo by U.S. Navy Petty Officer 1st Class Tom Ouellette) CJTF-HOA Photo Villagers from Kakute, Uganda, gather inside the Kakute Church of Uganda, April 23, 2013, to see live theater skits dramatizinh proper water and food sanitation procedures performed by human and animal healthcare experts from Combined Joint Task Force-Horn of Africa (CJTF-HOA) Surgeon Cell, 411th Civil Affairs Battalion, Uganda People's Defense Force (UPDF), and their civilian counterparts. Because of high illiteracy rates in Kakute, the performers shared knowledge with the villagers by acting out information. The goal of the presentations is to help prevent the spread of diseases, often viruses from wildlife found in water and food. The event was part of One Health, a 2-week whole-of-government program that recognizes the health of humans, animals and ecosystems, like their nations, are interconnected. Overall, the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA sponsored One Health to help strengthen Uganda's healthcare capabilities. (Photo by U.S. Navy Petty Officer 1st Class Tom Ouellette)
U.S. Army Capt. Danielle Diamond, a veterinarian from the Combined Joint Task Force-Horn of Africa (CJTF-HOA) Surgeon Cell, sits with villagers inside the Kakute Church of Uganda, Kakute, Uganda, April 23, 2013. The group is watching live presentations of effective water, food and personal sanitation procedures designed to avoid the spread of disease. Overall, 61 percent of emerging infectious diseases are caused by the transmission from animals to humans, often through poorly sanitized food or water. Human and animal healthcare experts from CJTF-HOA Surgeon Cell, 411th Civil Affairs Battalion, Uganda People's Defense Force (UPDF), and their civilian counterparts gave the performances as part of One Health, a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's healthcare capabilities. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette) CJTF-HOA Photo U.S. Army Capt. Danielle Diamond, a veterinarian from the Combined Joint Task Force-Horn of Africa (CJTF-HOA) Surgeon Cell, sits with villagers inside the Kakute Church of Uganda, Kakute, Uganda, April 23, 2013. The group is watching live presentations of effective water, food and personal sanitation procedures designed to avoid the spread of disease. Overall, 61 percent of emerging infectious diseases are caused by the transmission from animals to humans, often through poorly sanitized food or water. Human and animal healthcare experts from CJTF-HOA Surgeon Cell, 411th Civil Affairs Battalion, Uganda People's Defense Force (UPDF), and their civilian counterparts gave the performances as part of One Health, a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's healthcare capabilities. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette)
A village boy and U.S. Army Capt. Danielle Diamond, a veterinarian from the Combined Joint Task Force-Horn of Africa (CJTF-HOA) Surgeon Cell, sit inside the Kakute Church of Uganda, Kakute, Uganda, to watch live theatrical performances of effective water, food and personal sanitation procedures designed to avoid the spread of disease, April 23, 2013. Human and animal healthcare experts from CJTF-HOA Surgeon Cell, 411th Civil Affairs Battalion, Uganda People's Defense Force (UPDF), and their civilian counterparts gave the presentations as a means to share knowledge of how the health of humans, animals and ecosystems, like their nations, are interconnected. Overall, the performances are part of One Health, a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's capabilities. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette) CJTF-HOA Photo A village boy and U.S. Army Capt. Danielle Diamond, a veterinarian from the Combined Joint Task Force-Horn of Africa (CJTF-HOA) Surgeon Cell, sit inside the Kakute Church of Uganda, Kakute, Uganda, to watch live theatrical performances of effective water, food and personal sanitation procedures designed to avoid the spread of disease, April 23, 2013. Human and animal healthcare experts from CJTF-HOA Surgeon Cell, 411th Civil Affairs Battalion, Uganda People's Defense Force (UPDF), and their civilian counterparts gave the presentations as a means to share knowledge of how the health of humans, animals and ecosystems, like their nations, are interconnected. Overall, the performances are part of One Health, a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's capabilities. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette)

Villagers of Kakute, Uganda, watch a dramatized, live performance of effective water, food and personal sanitation procedures inside the Kakute Church of Uganda, April 23, 2013. Human and animal healthcare experts from Combined Joint Task Force-Horn of Africa (CJTF-HOA) Surgeon Cell and 411th Civil Affairs Battalion (411th CA BN), Uganda People's Defense Force, and their civilian counterparts sang, danced and acted out skits to remind villagers that diseases, often viruses from wildlife transmitted into water or food, can be prevented by safe handling procedures. Overall, the performances were part of One Health, a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's capabilities. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette)
CJTF-HOA Photo Villagers of Kakute, Uganda, watch a dramatized, live performance of effective water, food and personal sanitation procedures inside the Kakute Church of Uganda, April 23, 2013. Human and animal healthcare experts from Combined Joint Task Force-Horn of Africa (CJTF-HOA) Surgeon Cell and 411th Civil Affairs Battalion (411th CA BN), Uganda People's Defense Force, and their civilian counterparts sang, danced and acted out skits to remind villagers that diseases, often viruses from wildlife transmitted into water or food, can be prevented by safe handling procedures. Overall, the performances were part of One Health, a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's capabilities. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette)
U.S. Army Maj. Thamus J. Morgan, a veterinarian from the 411th Civil Affairs Battalion (411th CA BN) in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), and U.S. Army Col. (Dr.) Richard Birdsong, a physician with the 411th CA BN, use song and dance with their civilian human and animal healthcare counterparts to teach villagers in Kakute, Uganda, effective water, food and personal sanitation procedures to help prevent the spread of disease at the Kakute Church of Uganda, April 23, 2013. Kakute suffered an outbreak of Ebola in November 2012, claiming 20 lives. To help educate residents about disease-prevention methods, U.S. military members from CJTF-HOA, Uganda People's Defense Force (UPDF) and their civilian counterparts gave the performances. The event was part of One Health, a 2-week series of events identifying how the health of humans, animals and ecosystems, like their nations, are interconnected. Overall, One Health is a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette) CJTF-HOA Photo U.S. Army Maj. Thamus J. Morgan, a veterinarian from the 411th Civil Affairs Battalion (411th CA BN) in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), and U.S. Army Col. (Dr.) Richard Birdsong, a physician with the 411th CA BN, use song and dance with their civilian human and animal healthcare counterparts to teach villagers in Kakute, Uganda, effective water, food and personal sanitation procedures to help prevent the spread of disease at the Kakute Church of Uganda, April 23, 2013. Kakute suffered an outbreak of Ebola in November 2012, claiming 20 lives. To help educate residents about disease-prevention methods, U.S. military members from CJTF-HOA, Uganda People's Defense Force (UPDF) and their civilian counterparts gave the performances. The event was part of One Health, a 2-week series of events identifying how the health of humans, animals and ecosystems, like their nations, are interconnected. Overall, One Health is a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette)
Luwero District community-based animal health specialist Gladys Namale; U.S. Army Maj. Courtney Legendre a physician assistant with the 411th Civil Affairs Battalion (411th CA BN) in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA); and Luwero District (Namaliga-Bombo town council) village health team member Muhamed Kasena perform a skit on the importance of using sanitary water in Kakute, Uganda, April 23, 2013. Sixty-one percent of emerging infectious diseases are caused by the transmission from animals to humans, often through poorly sanitized water. The demonstration, performed inside the Kakute Church of Uganda, was part of One Health, a 2-week series of events that recognizes the health of humans, animals and ecosystems are interconnected. Overall, One Health is a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's capabilities. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette) CJTF-HOA Photo Luwero District community-based animal health specialist Gladys Namale; U.S. Army Maj. Courtney Legendre a physician assistant with the 411th Civil Affairs Battalion (411th CA BN) in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA); and Luwero District (Namaliga-Bombo town council) village health team member Muhamed Kasena perform a skit on the importance of using sanitary water in Kakute, Uganda, April 23, 2013. Sixty-one percent of emerging infectious diseases are caused by the transmission from animals to humans, often through poorly sanitized water. The demonstration, performed inside the Kakute Church of Uganda, was part of One Health, a 2-week series of events that recognizes the health of humans, animals and ecosystems are interconnected. Overall, One Health is a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's capabilities. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette)
U.S. Army Col. (Dr.) Richard Birdsong, a physician with the 411th Civil Affairs Battalion in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), consults with a patient, Christine Nakiying, in Kakute, Uganda, April 23, 2013. To deal with the language barrier, Luwero District (Nyimbwa Subcounty) Village Health Team member Iwanga Fred assists as an interpreter. Birdsong met with Kakute villagers to answer their medical questions as part of One Health, a 2-week series of events that recognizes the health of humans, animals and ecosystems, like their nations, are interconnected. Overall, One Health is a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's healthcare capabilities. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette) CJTF-HOA Photo U.S. Army Col. (Dr.) Richard Birdsong, a physician with the 411th Civil Affairs Battalion in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), consults with a patient, Christine Nakiying, in Kakute, Uganda, April 23, 2013. To deal with the language barrier, Luwero District (Nyimbwa Subcounty) Village Health Team member Iwanga Fred assists as an interpreter. Birdsong met with Kakute villagers to answer their medical questions as part of One Health, a 2-week series of events that recognizes the health of humans, animals and ecosystems, like their nations, are interconnected. Overall, One Health is a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's healthcare capabilities. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette)
U.S. Army Capt. Courtney Legendre, a physician assistant with the 411th Civil Affairs Battalion in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), examines a child with the help of U.S. Air Force Maj. Andrew A. Herman, a medical planner in the CJTF-HOA Surgeon Cell, in Kakute, Uganda, April 23, 2013. Legendre conducted examinations as part of One Health, a 2-week series of events that unites health professionals from human, animal and environmental fields to eradicate the spread of disease. Overall, One Health is a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's healthcare capabilities.  (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette) CJTF-HOA Photo U.S. Army Capt. Courtney Legendre, a physician assistant with the 411th Civil Affairs Battalion in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), examines a child with the help of U.S. Air Force Maj. Andrew A. Herman, a medical planner in the CJTF-HOA Surgeon Cell, in Kakute, Uganda, April 23, 2013. Legendre conducted examinations as part of One Health, a 2-week series of events that unites health professionals from human, animal and environmental fields to eradicate the spread of disease. Overall, One Health is a whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA to help strengthen Uganda's healthcare capabilities. (Photo by U.S Navy Petty Officer 1st Class Tom Ouellette)
U.S. Army Maj. Daisy Wilson, a public-health nurse with the 411th Civil Affairs Battalion, in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), pulls key health assessment information from community leader Nalubwma Vincent and family as Ugandan veterinarian Dr. Douglas Kibuuka records findings during a site survey of dozens of homes in the remote village of Kakute, site of the world's last Ebola breakout in November 2012.  The human and animal healthcare team is part of One Health, a 2-week whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA that strengthens Uganda's healthcare capabilities by recognizing the health of humans, animals and ecosystems, like partner-nation militaries, are interconnected. (Photo by U.S Air Force Capt. Jay Ostrich) CJTF-HOA Photo U.S. Army Maj. Daisy Wilson, a public-health nurse with the 411th Civil Affairs Battalion, in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), pulls key health assessment information from community leader Nalubwma Vincent and family as Ugandan veterinarian Dr. Douglas Kibuuka records findings during a site survey of dozens of homes in the remote village of Kakute, site of the world's last Ebola breakout in November 2012. The human and animal healthcare team is part of One Health, a 2-week whole-of-government program coordinated by the Ugandan government, UPDF, U.S. Agency for International Development, U.S. State Department, U.S. Embassy in Uganda and CJTF-HOA that strengthens Uganda's healthcare capabilities by recognizing the health of humans, animals and ecosystems, like partner-nation militaries, are interconnected. (Photo by U.S Air Force Capt. Jay Ostrich)

With no convenience, grocery or big box stores in sight, let alone transportation to get there, residents of Kakute, an electricity-free village in Uganda with no running water, live off the grid and on what nature and their own resilience allow their weather-beaten hands to reap.

While food within the lush jungles is seemingly abundant, good health and hygiene is a daily challenge as villagers within the 200 palm-thatched and corrugated tin-roofed homes that dot this quiet community compete against wildlife and biology for survival.

Standing outside a two-room, windowless broken-brick schoolhouse stained rusted red like the clay which surrounds the village square, U.S. Army Maj. Thamus J. Morgan, a veterinarian with the 411th Civil Affairs Battalion, in support of Combined Joint Task Force-Horn of Africa, reflected upon the importance of this area.

"We are standing within the very bull's-eye of the world's last Ebola outbreak," said Major Morgan, explaining that Ebola is an often-fatal virus with a short incubation period that if left unchecked could cause a deadly worldwide epidemic.

Clearly, this is of no small importance to the more than 50 animal and human healthcare experts who joined their military counterparts from the Uganda People's Defense Force (UPDF) and CJTF-HOA to participate in One Health April 9-26, a whole-of-government program that shares best medical practices by recognizing health of humans, animals and ecosystems, like their nations, are interconnected. Overall, the program was coordinated by the Ugandan government and U.S. Agency for International Development, an arm of the Department of State.

While the exact cause of Ebola is still unknown, Morgan said One Health teammates and researchers worldwide suspect inadequate food preparation, poor hygiene and interaction with wildlife are closely linked. Because of this connection, they are visiting Kakute, not only to learn from each other, but to help teach villagers here more healthy ways to harvest, store and prepare food and water.

People here mean well, said Charles Ssemugabo, a Ugandan environmental health official who works with area villages, but they just aren't aware of modern techniques that can help stave off disease and parasites. With education and more outreach from groups like One Health, villagers will stand a better chance avoiding sickness.

With the opportunity to make a difference, One Health members fanned out across the rain-soaked village to survey sanitation and food preparation problems, individual health issues and other environmental risks.

"This is very important inside and outside the village because communicable diseases affect the (world) population," Ssemugabo said, noting that international travel poses a grave risk should viruses such as Ebola go uncontained. "We have common problems and if we come together we can come up with a common solution."

With that in mind, One Health attendees took survey findings to a classroom outside Kakute, where they spent a day comparing notes and preparing results for villagers. Among their structural findings were many unkempt compounds where sharing sleeping quarters with animals, pools of stagnant water, rodent infestations, lack of hand-washing stations, dilapidated shelters, uncontained poisons and unsanitary food storage was the norm. Common maladies discovered, especially among children, included HIV/AIDS, malaria, measles, mumps, parasitic illnesses, flu and various mental-health issues.

"The only way we get public health done in the United States is to team up," said U.S. Army Maj. Daisy Wilson, a public-health nurse with the 411th CA Bn. "That's what we need to do here, too."

Wilson, a 19-year Army veteran who grew up without running water in Wagram, N.C., said teaming up on this unique mission requires unorthodox methods in delivering the message. With high illiteracy rates among villagers, no television or computers and many cultural barriers, One Health members decided to develop theatrical skits, or living theater, to get their findings across.

"You can't do a PowerPoint in the villages so you have to deliver something they will understand," said Major Wilson. "It's a teaching technique we used successfully in Afghanistan."

Just 48 hours later on a makeshift stage in the standing-room only parish church, 7 to70-year-old villagers attended the only show in town, where UPDF, U.S. service members and civilian One Health members performed song-and-dance routines with their civilian human and animal healthcare counterparts to teach effective water, food and personal procedures to help prevent the spread of disease.

Garnering belly laughs and raucous applause from a crowd culturally used to passing on knowledge through oral tradition, soldiers never lost perspective on why they were there.

"The time is now that we should all come together to address problems affecting our communities," said Maj. (Dr.) Godwin Bagashe Bagyenzi, a research scientist and the only military veterinarian in the UPDF. "We can have a better place to live in - together we can."

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Uganda, the Pearl of Africa, is a lush, green, mountainous country home to 34.1 million people. The people who live there share the land with mountain gorillas, zebras, rhinos, and other wildlife and domesticated animals.

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