One Health Team Combats Animal-to-Human Disease Transmission

U.S. Army Capt. Danielle Diamond, a veterinarian with Combined Joint Task Force-Horn of Africa (CJTF-HOA) Surgeon Cell and Maj. Thamus Morgan, a veterinarian with the 411th Civil Affairs Battalion, in support of CJTF-HOA, explain to civilian and Uganda People's Defense Force (UPDF) soldiers at a farm in Luwero, Uganda, why preventative diagnoses of infectious diseases in cattle can prevent the worldwide outbreak of viruses. The group is part of a whole-of-government program  named One Health that strengthens Uganda's healthcare capabilities and recognizes the health of humans, animals and ecosystems, like nations, are interconnected. Overall, One Health was 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. Air Force Capt. Jay Ostrich) CJTF-HOA Photo U.S. Army Capt. Danielle Diamond, a veterinarian with Combined Joint Task Force-Horn of Africa (CJTF-HOA) Surgeon Cell and Maj. Thamus Morgan, a veterinarian with the 411th Civil Affairs Battalion, in support of CJTF-HOA, explain to civilian and Uganda People's Defense Force (UPDF) soldiers at a farm in Luwero, Uganda, why preventative diagnoses of infectious diseases in cattle can prevent the worldwide outbreak of viruses. The group is part of a whole-of-government program named One Health that strengthens Uganda's healthcare capabilities and recognizes the health of humans, animals and ecosystems, like nations, are interconnected. Overall, One Health was 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. Air Force Capt. Jay Ostrich)
U.S. Army Maj. Thamus Morgan, a veterinarian with the 411th Civil Affairs Battalion, in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), demonstrates how to administer a taping device that determines the weight of cattle to a Ugandan veterinary care specialist working with the Uganda People's Defense Force (UPDF) at a farm in Luwero, Uganda, which is the epicenter of two of the world's most recent Ebola outbreaks. Ebola is a severe, contagious and often-fatal virus that affects humans and nonhuman primates and is believed to be caused by animal-to-human interaction. The group is part of a whole-of-government program named One Health that strengthens Uganda's healthcare capabilities and recognizes the health of humans, animals and ecosystems, like nations, are interconnected. Overall, One Health was 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. Air Force Capt. Jay Ostrich) CJTF-HOA Photo U.S. Army Maj. Thamus Morgan, a veterinarian with the 411th Civil Affairs Battalion, in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), demonstrates how to administer a taping device that determines the weight of cattle to a Ugandan veterinary care specialist working with the Uganda People's Defense Force (UPDF) at a farm in Luwero, Uganda, which is the epicenter of two of the world's most recent Ebola outbreaks. Ebola is a severe, contagious and often-fatal virus that affects humans and nonhuman primates and is believed to be caused by animal-to-human interaction. The group is part of a whole-of-government program named One Health that strengthens Uganda's healthcare capabilities and recognizes the health of humans, animals and ecosystems, like nations, are interconnected. Overall, One Health was 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. Air Force Capt. Jay Ostrich)
Maj. (Dr.) Godwin Bagyenzi, director of medical research for Uganda People's Defense Force (UPDF) Health Services, and U.S. Army Maj. Thamus Morgan, a veterinarian with the 411th Civil Affairs Battalion, in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), discuss best practices about preventing infectious diseases in cattle with civilian and UPDF animal healthcare specialists at a farm in Luwero, Uganda, April 19, 2013. The group is part of a whole-of-government program named One Health that recognizes the health of humans, animals and ecosystems, like nations, are interconnected. Overall, One Health was 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 Maj. (Dr.) Godwin Bagyenzi, director of medical research for Uganda People's Defense Force (UPDF) Health Services, and U.S. Army Maj. Thamus Morgan, a veterinarian with the 411th Civil Affairs Battalion, in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), discuss best practices about preventing infectious diseases in cattle with civilian and UPDF animal healthcare specialists at a farm in Luwero, Uganda, April 19, 2013. The group is part of a whole-of-government program named One Health that recognizes the health of humans, animals and ecosystems, like nations, are interconnected. Overall, One Health was 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)
U.S. Army Maj. Thamus Morgan, a veterinarian with the 411th Civil Affairs Battalion, in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA); Maj. (Dr.) Godwin Bagyenzi, director of medical research for Uganda People's Defense Force (UPDF) Health Services; and Dr. Kawule Leonard, a ranch veterinarian and production manager for GLS Ranchers, discuss the importance of detecting infectious diseases in cattle at a ranch in Kitende, Uganda, April 19, 2013. Undetected disease in cattle, when used for human consumption, can threaten the health of people.  The group is part of a whole-of-government program named One Health that recognizes the health of humans, animals and ecosystems, like nations, are interconnected. Overall, One Health was 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 Morgan, a veterinarian with the 411th Civil Affairs Battalion, in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA); Maj. (Dr.) Godwin Bagyenzi, director of medical research for Uganda People's Defense Force (UPDF) Health Services; and Dr. Kawule Leonard, a ranch veterinarian and production manager for GLS Ranchers, discuss the importance of detecting infectious diseases in cattle at a ranch in Kitende, Uganda, April 19, 2013. Undetected disease in cattle, when used for human consumption, can threaten the health of people. The group is part of a whole-of-government program named One Health that recognizes the health of humans, animals and ecosystems, like nations, are interconnected. Overall, One Health was 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)
A spout is used to collect rain at a homestead in Kakute, Uganda, April 20, 2013. Many Ugandans collect rainwater for cooking and washing, often unsafe for consumption and possibly contributing to the spread of infectious diseases. In an effort to improve healthcare in Uganda, medical experts from Uganda People's Defense Force (UPDF), Combined Joint Task Force-Horn of Africa Surgeon Cell and the 411th Civil Affairs Battalion visited residents throughout Uganda's Luwero District to teach them water sanitation procedures. The visits were part of One Health, a whole-of-government program that recognizes the health of humans, animals and ecosystems, like nations, are interconnected. Overall, One Health was 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 A spout is used to collect rain at a homestead in Kakute, Uganda, April 20, 2013. Many Ugandans collect rainwater for cooking and washing, often unsafe for consumption and possibly contributing to the spread of infectious diseases. In an effort to improve healthcare in Uganda, medical experts from Uganda People's Defense Force (UPDF), Combined Joint Task Force-Horn of Africa Surgeon Cell and the 411th Civil Affairs Battalion visited residents throughout Uganda's Luwero District to teach them water sanitation procedures. The visits were part of One Health, a whole-of-government program that recognizes the health of humans, animals and ecosystems, like nations, are interconnected. Overall, One Health was 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)
U.S. Army Maj. Daisy Wilson, a public-health nurse from the 411th Civil Affairs Battalion (411th CA BN), in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), gives multivitamins to villagers in Kakute, Uganda, April 23, 2013. Together with healthcare experts from the Uganda People's Defense Force (UPDF), the CJTF-HOA Surgeon Cell and 411th CA BN soldiers dispensed the vitamins and taught villagers how to improve water, food and personal hygiene sanitation procedures to help prevent the spread of disease -- a goal of One Health. 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. Daisy Wilson, a public-health nurse from the 411th Civil Affairs Battalion (411th CA BN), in support of Combined Joint Task Force-Horn of Africa (CJTF-HOA), gives multivitamins to villagers in Kakute, Uganda, April 23, 2013. Together with healthcare experts from the Uganda People's Defense Force (UPDF), the CJTF-HOA Surgeon Cell and 411th CA BN soldiers dispensed the vitamins and taught villagers how to improve water, food and personal hygiene sanitation procedures to help prevent the spread of disease -- a goal of One Health. 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)

Living on a planet with more than seven billion people and countless more animals, viruses have many options to invade - and they're not picky. Viruses often jump from animals to humans, causing many diseases ranging from avian flu to Lyme disease, West Nile virus to severe acute respiratory syndrome (SARS).

The U.S. Agency for International Development (USAID) estimates that more than 60 percent of emerging infectious diseases in humans are transmitted from animals in a process called zoonoses. Though some diseases transmit from livestock, many more - at least 74 percent - come from wildlife, which is most likely a result of human encroachment into animals' habitats. Making matters worse, some diseases, such as anthrax, can be harvested for bio-terrorism.

With the opportunity to make a difference in this fight, human and animal healthcare experts from Combined Joint Task Force-Horn of Africa (CJTF-HOA) Surgeon Cell, 411th Civil Affairs Battalion (CA Bn), the Uganda People's Defense Force (UPDF), and their civilian counterparts recently launched a program called One Health in Luwero District, Uganda.

Traditionally, One Health recognizes the impact of zoonoses and how the health of humans, animals and ecosystems, like nations, are interconnected. Overall, One Health is a whole-of-government program coordinated by the Ugandan government, the UPDF and USAID.

"One Health is a good concept we need to advance," said Maj. (Dr.) Godwin B. Bagyenzi, director of medical research for the UPDF. Previously, medical professionals, veterinarians, environmental specialists and wildlife scientists worked separately, he said, "but because the high percent of diseases challenging mankind are emitting from animals, we need to work together."

U.S. Army Maj. Thamus J. Morgan, a veterinarian with the 411th CA Bn., which is supporting CJTF-HOA, said everyone should be concerned about preventing disease in Uganda, including Americans.

"I can leave here, get on a plane, and be back in the United States within 19 hours," said Morgan. "That's a very long time to pass on a virus. If we can stop an outbreak here, then we are going to prevent a whole lot of other people from dying."

To combat such threats, One Health uses a mix of classroom instruction and practical field exercises to prepare others in the fight against infectious diseases. Dozens of Luwero District animal and human healthcare experts, handpicked by local health officials, joined the UPDF and U.S. soldiers every morning to review basic diagnosis of various diseases, treatment plans, and preventive measures. Participants then fanned out across the district to test their newly acquired skills.

"This training has boosted our knowledge about zoonotic diseases," said Serunkuuma Daniel, a Luwero District vector control officer. "I'm more than happy because the community now has people who are technically aware of diseases, how to prevent them and can do a lot to make sure epidemics are combated before they spread."

Since inadequate sanitation contributes to the spread of disease, One Health also included a review of human hygiene and water and food sanitation procedures at ranches, farms, households, and medical facilities.

"Probably the greatest success story is the linkage of all diseases to sanitation," said U.S. Army Col. (Dr.) Richard Birdsong, a physician with the 411th CA Bn. "Safe water, safe food are key to preventing disease."

Program coordinators chose the Luwero District for One Health because the area has experienced two Ebola outbreaks within the past year. Ebola is a highly contagious, often-fatal virus which is believed to be transmitted to people from animals, although the exact origin, locations, and natural habitat of Ebola remain unknown. The virus can be transmitted from person-to-person in several ways, including direct contact with the blood or secretions of an infected person or through contact with objects, such as needles, that have been contaminated with infected secretions. .

"This is the epicenter or 'tip of the spear' of where an outbreak took place last year," said Morgan, who is from Clinton, Connecticut. She said the information will be collected, analyzed, and shared with citizens to prevent another outbreak.

"It's a new culture. Under One Health, we learned we can't leave out the vets," said Col. Dr. Samuel Kasule, the UPDF director for public health. "We realize diseases come from the life circle of man, animal and environment."

Protecting humans often starts by protecting animals, prompting One Health participants to visit several ranches and farms to learn how to identify disease in livestock. For example, one ranch located in the remote Kitendeli area measures six square miles and raises cattle, pigs and poultry.

"Not treating livestock for disease would be disastrous," said Dr. Kawule Leonard, the Kitendeli ranch veterinarian and production manager. "What we produce on the farms will target humans. Not putting this in to consideration is a very big risk to the market and ultimately humans, who are consuming the products."

Humphrey Kabugo, a monitoring and evaluation officer for USAID's Emerging Pandemic Threats Program, said he was pleased with One Health's accomplishments in addressing the interconnectedness of human and animal life.

"Individuals are much more prepared to work together from different disciplines to respond to outbreaks so that the impact on human life, animal life and the environment is reduced," said Kabugo.

The partnership is working, said Kabugo, "and the best is yet to come."

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