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