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Researcher reaches out to ‘forgotten continent’

The following article describes one of many poster presentations set for this year’s faculty convocation Aug. 22. The Catalyst will highlight some of the presentations on MUSC’s international clinical, educational and research opportunities and outreach. Photo provided.

by Heather Woolwine
Public Relations
It’s hard to watch television, surf the Internet, or read the newspaper without becoming aware of the dire circumstances that haunt the daily lives of people who live on the African continent. They have civil war and unrest, famine, drought, and their populations are rampant with disease. Some have called Africa the forgotten continent, left to wallow in so many problems with too few solutions.
 
One of Ethiopia’s eight neurologists points out the Addis Ababa University’s dire need for textbooks and other educational materials. The photo shows the neurology department’s entire library. Neurology residents must sign up in advance for specified periods of study time in order to access the books.

For all its woes, Anbesaw Selassie, Dr.PH., Biostatistics, Bioinformatics & Epidemiology associate professor, hasn’t forgotten his homeland in Africa. With inspiration taken from the actions of some colleagues at the Storm Eye Institute (SEI), he has a plan to address the plight of Ethiopians in dire need of neurological services.
 
“There is this feeling that the world has abandoned Africa, with complete disregard to the plight of disease that is entirely preventable and able to be controlled,” Selassie said. “About two-thirds of the world’s HIV burden is in Africa and there’s little that’s really being done to alleviate all the problems associated with widespread disease. It behooves us to get involved.”
 
Selassie has been involved with several outreach efforts involving AIDS and HIV in Ethiopia throughout his career. Through his efforts Selassie was also able to acquire and donate duplicate textbooks and journals to the Addis Ababa University in Ethiopia. “Dr. [Barbara] Tilley approved the payment of the freight cost from here to Baltimore where they would be shipped out via a non-profit organization, and I’m very grateful to her for allowing us to help,” Selassie said. 
 
But now, Selassie is ready to expand efforts to help AAU to further aid the millions of Ethiopians that need neurological health care. For many patients, including those who suffer from HIV/AIDS, neurological disorders are devastating, misunderstood and under-treated conditions. The country has eight practicing neurologists for approximately 72 million people, making each physician responsible for roughly 9 million people. “That’s like saying we have one neurologist for North and South Carolina combined,” Selassie said. “All eight of them practice through AAU, so unless you’re in the same area with them, you don’t even have access to that kind of care. The total per capita expenditure on health care is $14 [or 3.6 percent of the gross domestic product] per annum, among the lowest in Africa. It is even worse when it comes to specialized services and training, the worst among the health services being access to a neurologist.”   
 
While it is incomprehensible for those privileged with health care access, what the Ethiopian population faces seems even beyond preconceived notions of what Third World conditions are like.
 
“When you add the burden of disease on top of the obvious deficit in available physicians to treat neurological disorders and disease, it’s easy to recognize that an incredible amount of work remains to be done,” Selassie said.
 
So, he proposes to begin a twinning program between AAU’s neurology residency program and MUSC to train  Ethiopian neurology fellows at MUSC and provide experience with American physicians on their own turf. Selassie, an adjunct neurology faculty member, sees the concept as a way to begin to alleviate the gap in neurological services, and has offered the SEI’s program as a model. “The template for what we ultimately want to do is in Dr. Wilson’s work with ORBIS International. They are an incredibly dedicated group who exemplify American generosity and what makes this country great in terms of its outreach efforts that actually make a difference in the lives of Africans,” Selassie said. “These people are my heroes.”
 
Go to http://www.musc.edu/catalyst/archive/2006/co7-21orbis.html to read the full text of the article detailing the SEI’s efforts.
 
Before a twinning program can begin, the neurology residency program at AAU must gain accreditation by the presiding regulatory body in Ethiopia. Selassie discussed some of the challenges associated with getting a project of that scale up and running. Residents must share textbooks and a small library more akin to someone’s home health care book selection than one found at a major university. Their political position is precarious, at best, as one of the oldest, predominately Christian nations surrounded by Islamic nations and governments opposed to democracy. “It’s risky to be radical about anything in that area of the world, even suggesting radical changes in the health care system,” Selassie said.
 
Little-to-no money exists for technology to train physicians of all kinds, and neurologists face a particular challenge working with only five EEG machines, two EMG machines, and six CT scan machines in both private and public institutions across the entire country.
 
While Selassie serves as a sort of liaison for information-sharing between neurologists and neurology residents at AAU and neurologists at MUSC, he is one of several Ethiopian physicians and researchers stateside who are working to alleviate the plight of their homeland in this format.
 
“The physicians at AAU send me their challenging brain images and I pass those on to neurologists here for them to evaluate and provide their professional opinions. I also send some of the images to contacts I have in New York, Louisville, and Atlanta. Here, Dr. (David) Griesemer in particular has been very eager to help us,” Selassie said. Selassie works closely with Mehila Zebenegus, M.D., an Ethiopian chief neurology resident and Enawgaw Mehari, M.D., a Kentucky neurologist, who are determined to set up a network of Ethiopian-born health care professionals who practice in more advanced Western countries to establish a lifeline of valuable information and skills desperately needed in Ethiopia.
 
Selassie’s involvement doesn’t end with his liaison role. By Christmas, he plans to visit his homeland and provide much needed research design training for the neurology fellows at AAU. While the neurology program is currently focused primarily on the training, education, and hands-on experience components of the program and requirements for accreditation, AAU does recognize the need for community-based research training.
 
“Of all the places that I’ve been, MUSC is the most receptive when it comes to assisting foreign nations and universities wherever it can. It’s not a huge university, but even with the resources it has, MUSC still manages to do so much. In Ethiopia, in large part because of the ORBIS and Storm Eye program, MUSC is as, or more popular as any well-known institution in the world,” Selassie said.
 
In the mean time, Selassie encourages all neurologists in the Charleston area to do one of several things: “Go there and teach, bring your extra text books and supplies, and donate your over-inventory items or things that you might consider surplus. Something that you might consider out-of-date or old would be cutting edge technology over there,” he explained.
 
Selassie’s wife Lily, a nurse, also will participate in outreach in Ethiopia this year assisting a cardiac surgery team with open heart surgeries. “Although we are American citizens, our hearts and minds belong to where we came from, and we want to do whatever we can to help stability and progress in our home country,” Selassie said.    He continued to herald the efforts at MUSC and expressed his gratitude for the opportunity to not only work at MUSC, but to be a part of an institution that he described as a model of American generosity.
 
“Cost-effective and important contributions could be made through networking, web-based consultation, and provision of over-the-inventory devices and educational materials to alleviate disease and improve health in poor, developing countries like Ethiopia,” Selassie said.  “The fledgling neurology residency program in AAU seeks the support and assistance of MUSC faculty and administration.
 
“The outreach efforts that take place at MUSC show what makes this country great. I was educated by the Peace Corps, and am a recipient of that spirit of outreach,” he said. “This country serves as a beacon of hope for developing countries and you have to work to stay that symbol. MUSC is a part of those efforts to keep American generosity flowing to those who need it badly.”
   

Friday, Aug. 4, 2006
Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.