International Cultural Boma: a training and mentorship model for capacity development in one health

International Cultural Boma: a training and mentorship model for capacity development in one health

Samuel George Okech¹, Samuel Majalija¹, David Okello Owiny^1,2, Francis Ejobi¹, Gabriel Tumwine¹, Paul Ssajjakambwe¹, Stevens Kisaka¹, Margaret Loy Khaitsa^3,&, John Baligwamunsi Kaneene⁴, Florence Wakoko⁵, William Sischo⁶, Douglas Freeman⁷, Baljit Singh⁷, Claire Card⁷, Charles Mulei⁸, Kiama Gitahi⁸, Robinson Mdegela⁹, Berihu Gebrekidan¹⁰, Maurice Byuka¹¹, Gladys Kalema-Zikusoka¹², Bill Epperson³, Robert Wills³, Hart Bailey³, John David Kabasa¹

¹College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, PO Box 7062, Kampala, Uganda, ²Directorate of Research and Graduate Training, Makerere University, Kampala, Uganda, ³Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA, ⁴Center for Comparative Epidemiology, College of Veterinary Medicine, Michigan State University, 736 Wilson Road, Room A-109, East Lansing, Michigan, USA, ⁵Department of Criminal Justice and Sociology, Columbus State University, Columbus, Georgia, USA, ⁶College of Veterinary Medicine, Food and Waterborne Disease Research, Washington State University, Pullman, Washington, USA, ⁷Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive Saskatoon, Saskatchewan, Canada, ⁸College of Veterinary Medicine, University of Nairobi, Kenya, ⁹College of Veterinary Medicine, Sokoine University of Agriculture, Morogoro, Tanzania, ¹⁰College of Veterinary Medicine, Mekelle, University Ethiopia, ¹¹College of Veterinary Medicine, University of Rwanda, Rwanda, ¹²Conservation Through Public Health, Uganda

^&Corresponding author
Margaret Loy Khaitsa, Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi, 39762, USA

Introduction    

The development of a One Health Global Workforce is one of the ways of contributing to the realization of the Global Health Security agenda (GHSA) - a partnership of over 50 nations, international organizations, and non-governmental stakeholders launched in 2014 to help build countries´ capacity to create a world safe and secure from infectious disease threats and elevate global health security as a national and global priority [1]. GHSA pursues a multilateral and multi-sectoral approach to strengthen both the global capacity and nations´ capacity to prevent, detect, and respond to human and animal infectious diseases threats whether naturally occurring or accidentally or deliberately spread [1]. GHSA is facilitating collaborative, capacity-building efforts to achieve specific and measurable targets around biological threats, while accelerating achievement of the core capacities required by the World Health Organizations (WHO) International Health Regulations (IHR), the OIE Performance of Veterinary Services Pathway, and other relevant global health security frameworks [1]. Universities and university partnerships or consortia play a key role in contributing to the GHSA effort. The project “Capacity Building in Integrated Management of Transboundary Animal Diseases and Zoonoses (CIMTRADZ)” was one such collaborative effort between African and United States (US) universities and other partners that initiated “International Cultural Boma,” an innovative approach to One Health Global Workforce development. The concept of ‘Boma’ is derived from an African word with varied, but closely related, meanings and interpretations [2]. Its use in this context is based on one of the interpretations drawn from a practice in an African culture that involves transfer of wisdom and knowledge from the (wise, knowledgeable, and highly experienced) elders to the young that they are nurturing and mentoring into responsible members of the community [2]. This process happens in a relaxed peaceful, relatively secure, and conducive environment usually around a fireplace in the evening, (sometimes under a roof) but most times in open air with a bright sky lit by the moon and stars. Bites and drinks are shared; sometimes roasted or boiled using the same fire that also drives away cold and disease vectors (such as mosquitoes) [2]. Fire also scares away wild animals, thereby limiting them within safe distance so that they and humans can peacefully co-exist in the same environment. Such a setting would be called a ‘Boma´ in some African communities. Besides the wisdom and knowledge shared and transferred in a Boma, lots of new ideas are hatched during the discussions and several plans and strategies are crafted [2].Under the CIMTRADZ project, every summer, 2 to 3 days were dedicated to offering the International Cultural Boma. The purpose of the Boma was to provide opportunity for networking, sharing research output, mentoring students, and offering workshops and developing further research collaborations among partners with special emphasis on One Health principles and practices.

One Health is defined as “the collaborative efforts of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals, and the environment [3]. To better integrate One Health principles into CIMTRADZ training, CIMTRADZ partners from East and Central Africa (ECA), and from the US, and Canada, actively engaged in activities of the Boma. ECA institutions included: Makerere University in Uganda (Lead Africa institution), University of Nairobi, (Kenya), Sokoine University of Agriculture (Tanzania), Mekelle University (Ethiopia), University of Rwanda (Rwanda), Sheik Technical Veterinary School (Somali land), Africa Field Epidemiology Network-AFENET, a Non- Governmental Organization (NGO), Terra Nova - Eastern Africa (NGO), and Conservation Through Public Health-CTPH (NGO). The US partners included: North Dakota State University (NDSU) (Lead US Institution 2010-2013), Mississippi State University (MSSTATE) (Lead US Institution 2014-2015), Michigan State University (MSU), Columbus State University (CSU), Washington State University (WSU), University of Minnesota (UM), and Kansas State University (KSU), as well as the University of Saskatchewan (USASK), Canada. The activities conducted during the Boma included: workshops, scientific presentations, and mentoring students who were from multiple disciplines (such as, veterinary medicine, public health, wild life biologists, medical laboratory technology, microbiology, animal production and food safety). This paper summarizes the proceedings of the Boma activities completed during CIMTRADZ, lessons learned, and the way forward.

Methods     

International Cultural Boma

To better integrate One Health principles into CIMTRADZ training, partners from ECA, the US, and Canada, actively engaged in the Boma activities (workshops, scientific presentations, mentoring students and developing research collaborations). The International Cultural Boma enabled interaction of students and faculty from ECA, the US, and Canada, and other stakeholders, such as university administrators, funding agencies (including US Agency for International Development (USAID)), government and non-governmental organizations (e.g. Veterinarians Without Borders, US), intergovernmental organizations (e.g. Food & Agricultural Organization (FAO), International Livestock Research Institute (ILRI)), and field practitioners. The purpose of the Boma was: 1) To showcase achievements and innovations from academia, industry, community and public sector, 2) To disseminate research findings, 3) To provide mentorship opportunities, 4) To broaden and strengthen training, research and community outreach networks, and 5) To demonstrate impact of international partnerships on community livelihoods and health.

Workshops and Short Term Training

In order to ensure efficient resources utilization, specialized workshops were organized and held during the International Cultural Boma when faculty from all CIMTRADZ partners were available to offer the training in various areas of expertise. The International Cultural Boma continued in 2016 after CIMTRADZ ended in 2015.

How the Boma evolved

Makerere University and her regional partners (University of Nairobi, Kenya, Sokoine University of Agriculture, Tanzania, University of Rwanda, Rwanda, Mekelle University, Ethiopia, Sheik Technical College, Horn of Africa, Somaliland) and international partners, such as MSSTATE, MSU, CSU, WSU, University of Sakatchewan, Canada, University of Edinburgh, Scotland, have been over the last 10 years repositioning higher education in Africa to realise development impact where its most needed, particularly in the area of health, livelihood, and human capital development. The International Cultural Boma was an innovation that allowed partners to continue meeting under the CIMTRADZ project with limited resources.

Why Hold a Boma?

The Boma provided a forum for partners to discuss the sustainability strategy proposal “Regional Universities Mediated Partnerships for Enhancing Livelihoods and Health in Africa (RUMPELHA),” developed by regional collaborating institutions and endorsed by African Union and Inter-Africa Bureau for Animal Resources (AU-IBAR).

What instructional design approaches were considered in the Boma?

> The topics of the Boma were selected deliberately to cover a broad spectrum of areas of professional practice and entrepreneurship. The speakers and facilitators were subject matter specialists and practitioners in the areas of food safety and risk assessment; disease outbreak investigation and reporting; business management and entrepreneurship; leadership and life coaching; community assessment and outreach interventions; writing skills (grants, scientific and policy briefs); patents and patenting; communication to various audiences; and research design and data analysis. Invited speakers applied appropriate delivery approaches that would ensure successful attainment of the identified key learning outcomes for their respective sessions. Emphasis was placed on interactive discussions, case studies, demonstrations, and hands-on practice. This design was informed by Aristotle´s guidance: “For the things you have to learn before you can do them you learn them by doing” [4]. These approaches eased the learning environment thus creating conducive conditions for learning (attainment of learning outcomes).

Results     

International Cultural Boma

The Boma was held every year during the time when the CIMTRADZ project was active (2012-2015), and also in summer 2016, an indication that capacity had been developed at Makerere University to continue offering Boma activities. Participants included representatives from CIMTRADZ partner institutions from ECA, US and Canada, and other institutions from Australia and Europe. Others included Uganda government, USAID Uganda mission, Higher Education for Development (HED) in Washington, DC, Inter Governmental Organizations, such as the Africa Union Inter Africa Bureau for Animal Resources (AU-IBAR), non-governmental organizations, and other development partners and stakeholders. Each Boma had a specific theme to which research presentations were tailored utilizing expertise from multiple institutions with local, regional and global perspectives. The Boma attracted global keynote speakers that interacted and shared their experiences with the students, professionals, and practitioners of veterinary and public health nationally and regionally. Important topics like: A World in Change; The Rising Threat of ‘Zoonotic’ Diseases by Dr. Thomas Easley (Emerging Pandemic Threats Program Country Director); Cultural Context in Disease Management by Prof. Wotsuna Khamalwa, were presented and discussed. At the Boma, students were given an opportunity to share their experiential learning while highlighting One Health principles learnt. The participants of the Boma for 2014 and 2015 were multidisciplinary and composed of mainly funders, policy makers, university administrators, academicians, researchers, field practitioners, graduate and undergraduate students drawn from public and private institutions from North America and Eastern Africa represented by the following: 1) North America Universities: Mississippi State University, Michigan State University, Columbus State University, and University of Saskatchewan, 2) Eastern Africa Universities: Makerere University, University of Nairobi, Sokoine University of Agriculture, Mekelle University, Umutara Polytechnic, Sheik Technical Veterinary School, and 3) Regional and Local Institutions: African Field Epidemiology Network (AFENET), Conservation Through Public Health (CTPH), Regional Universities Forum (RUFORUM), College of Veterinary Medicine, Animal Resources and Biosecurity (COVAB) at Makerere University, College of Health Sciences, Uganda Wildlife Authority, NADDEC, Uganda Veterinary Association, and Uganda Wildlife Veterinary Network. The Boma also offered specialized workshops to participants in addition to the presentations where the students from the summer school had the opportunity to present their experiences (Table 1).

Workshops and short-term training

In order to ensure efficient resources utilization, specialized workshops were organized and held during the International Cultural Boma and throughout the year for the years 2014 & 2015. The workshops and short-term training included:

> Musk Training: this workshop was designed to equip COVAB faculty and staff course developers with skills for utilizing the Makerere University Sciences Knowledgebase (MUSK) Learning Management System for designing online courses, uploading and sharing learning materials across schools, colleges, and universities. The training used a ‘Diary Hygiene’ online course in MUSK as a case study. This course was drawn on research and open resources sourced and created by four students involved in research in the area of diary hygiene.

E-Learning Workshop: this workshop was designed to provide COVAB students the opportunity to develop skills to access and utilize online courses. The materials that were used were drawn from research and open resources sourced and created by the Master of Science International Infectious Disease Management (MSc IDM) students involved in research in the area of infectious diseases. Consequently, attempts were made to identify potential multimedia assets aligned with individual student research proposals that could be used in both the online course and in later feedback interactions with the farming community.

Manuscript writing: manuscript writing is a process that every scientist goes through before publishing. It has been noted that many scientists carry out research and most of the time the work remains unpublished. Universities emphasize and encourage students and researchers to publish. Faculty promotion policy considers the number of papers published in a peer-reviewed journals. The session was included among the activities because it was noted that many of the faculty in Africa do supervise graduate students who end up not publishing their work. This has been a great draw back in regard to mentorship in scientific writing, contributing to the body of knowledge, disseminating knowledge that is useful for policy development, and increasing the number of publications (especially joint) for participating institutions (Table 2, Table 3).

Model African Union

Although it is now believed that the global community is under constant threat of emerging pandemics, and that the ill researched and culturally insensitive policies undermine solutions to disease control and prevention, food safety and food security, social justice, and economic growth, and these realities are less explored and often misunderstood in many African settings. Misconceptions about Africa as a country and not a continent comprising of 54 independent states are abound. They blur our appreciation of the complex nature of the challenges and prospects facing the continent, especially as the global community becomes more integrated economically, socially, politically, culturally, and scientifically. CIMTRADZ, a United States Agency for International Development (USAID)-supported project decided to simulate the role, organization, and policies of the African Union as a means of promoting One Health education and cultural competencies in learning about the formulation and implementation of food security and public health policies and overall human development. The Model African Union (MAU) Summer Seminar was conducted on June 15th, 2015 to provide CIMTRADZ partner institutions with guidance on how best to integrate the MAU in teaching about One Health in the International Infectious Disease Management program and international summer course program.

Study design and data management skills

The participants (31) utilized an existing animal health data set on a respiratory disease outbreak to learn the following specific skills: 1) How to enter/arrange data in an Excel spread sheet in preparation for data analysis using various software, 2) How to check for accuracy of the data, and 3) How to run descriptive statistics using pivot tables and simple inferential statistics. This was a hands on activity with participants working individually & in groups of 3. After successfully completing the course students were expected to: 1) Acquire skills in study designs, 2) Gain knowledge in data management skills, 3) Gain knowledge in selecting appropriate quantitative methods for the research questions, 4) Develop an understanding of how to integrate the methodological and analytical tools gained in applied public health research, 5) Develop skills in data interpretation, and 6) Develop an appreciation of the contribution of Epidemiology to public health policy. At the end of the data analysis, each group shared their work with the instructor who provided feedback onsite on how they had analyzed their data based on correctness of method of analysis and completeness of the analysis.

Networking & Partnerships Development

The Boma drew participants (students and practitioners) from various institutions and organizations, and from diverse cultures, professional disciplines, and levels of experience into a semi-formal environment prepared for free interactions. This was a good recipe for networking and partnerships development. These interactions continued variously within and between students, faculty, and practitioners. For example, after the course, students continued to interact with peers by use of emails and social media, such as WhatsApp and Facebook. From the resultant networks, collaborative activities were started and old ones were rejuvenated or transformed. RUMPELHA was one example of such developments. Additionally, faculty and student exchange, joint research and joint publications occurred due to collaborative research that resulted from networks developed at the Boma. For instance, one student from Makerere University spent two months research experience at University of Saskatchewan; several faculty from Makerere University visited MSSTATE and MSU and advanced their research career due to increased access to the research literature published in the US; and faculty from Makerere University received Adjunct Faculty status at MSSTATE. Also, local and regional journal publications, such as Africa Journal of Animal and Biomedical Sciences (AJABS) hosted by Makerere University were strengthened.

Understanding the African cultural diversity

While the first evening of the Boma was dedicated to networking within the university, the last one was reserved for exposure to the Ugandan culture. This was achieved through visitation of the renowned Ndere Cultural Centre in Kampala. The performance given in this center told stories largely about the diverse Ugandan culture and a little about the Rwandan and Burundian cultures. The stories were told through poetry, music, and dance. International participants took part in the dance and played local musical instruments as part of their cultural immersion.

Discussion     

Platforms for scientific research and information dissemination remain unlimited in the developing country settings. Developing nations face many major problems, including: widespread poverty, high illiteracy rates, overpopulation, and a heavy disease burden [5]. A common link underlying these problems is that science and technology could play a key role in their alleviation. At the same time, access to knowledge, primarily in agriculture, medicine, and technology, can help to create stronger social, economic, and technical infrastructures that are essential in the development process [5]. It has long been recognized by international agencies, such as The United Nations Educational, Scientific and Cultural Organization (UNESCO), that “assimilation of scientific and technological information is an essential precondition for progress in developing countries” [6]. However, the research infrastructure and the capacity to absorb scientific and technical knowledge are also weak in developing countries, leading to low levels of scientific output and further under-development. New knowledge is largely created in richer countries, where spending on research and development are highest. In a study of the comparative performance of the world´s major science producing countries, [7] it is reported that researchers in eight countries (led by the US, the United Kingdom (UK), Germany, and Japan) produced almost 85% of the world´s most cited publications, while another 163 countries (mostly developing countries) account for less than 2.5%. Another example of this highly uneven output was reported by the Global Forum for Health Research, that only 10% of the global health research was undertaken in the developing world [8], and only 2% of the 3,000 journals indexed on Medline are from developing countries [9]. In addition, institutions and researchers in developing countries often had little or no access to the research literature published in the North due to the high cost of journal subscription and inadequate and expensive distribution mechanisms [10]. Under these circumstances it is clear that progress in science and development in low-income countries will be made only with very great difficulty. As long as this asymmetry in research output and access to up-to-date information remains, research scientists in the developing world will remain isolated and their research will continue to have little impact. Therefore, the International Cultural Boma, established under the CIMTRADZ project, provided a much needed opportunity for scientists and students from participating institutions, particularly from ECA, to engage in a scientific forum. Students had an opportunity to present their research in a scientific forum that was friendly and not intimidating. Additionally, faculty and student exchange, from particularly Makerere University to Universities in the US and Canada, led to career advancement due to increased access to the research literature published in the North. The CIMTRADZ project was implemented by The Africa US Integrated Disease Management (AFRUS-IDM) consortium of over twelve higher education institutions and NGOs [11]. The International Cultural Boma events of CIMTRADZ highlighted the strength of AFRUS-IDM consortium. The large number of institutions in AFRUS-IDM allowed the CIMTRADZ project partners to draw upon the strength of each institution to contribute expertise to the training in different disciplines. The Boma provided unparalleled opportunities for sharing best practices and experiences, research findings, and advances in technology in management of transboundry animal diseases and zoonoses. Local and regional journal publications were strengthened.

Conclusion     

The International Cultural Boma is a useful model for capacity development in One Health considering its multidisciplinary, transcultural, multi-sectoral, and multi-institutional nature. The environment in the Boma fosters interactions, thereby enabling learning, networking, and partnership development. It is, therefore, an approach that is useful to apply in the efforts to contribute to the building of a One Health Workforce that will in turn contribute to the Global Health Security agenda.

Competing interests     

The authors declare no competing interest.

Authors´ contributions     

All authors contributed to writing drafts of the article, reviewed several drafts, provided important intellectual content, and approved the version to be published. Additionally, all authors participated in The International Cultural Boma. All authors have read and agreed to the final version of this manuscript and have equally contributed to its content and to the management of the manuscript.

Acknowledgments     

The authors wish to acknowledge financial support provided by the USAID under The Africa-US Higher Education Initiative of APLU and HED through the CIMTRADZ project.

Tables     

Table 1: International Cultural Boma: sample schedule, June 16-17, 2015

Table 2: workshops conducted by faculty from US, Canada and East and Central Africa Makerere University, 2012 to 2015

Table 3: examples of topics covered during workshops and short term trainings held targeting professional development of faculty and staff at partner institutions

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