There And Back Again (and There Again Soon)

At the end of May, I had the opportunity to visit Mekelle, Ethiopia, in advance of our move there in the near future. This visit was part of a USDA project hosted by Iowa State University, called the Foreign Agricultural Service Faculty Exchange Program. Each fall, several faculty members from veterinary colleges throughout Africa spend the semester in Ames, Iowa, working with colleagues in their respective areas of interest, with an emphasis on curriculum development and pedagogy. Then, the following spring, their counterparts at Iowa State visit corresponding veterinary colleges in Africa for about a week, to better understand the similarities and differences between Iowa State’s veterinary school and the particular African veterinary school, and to discuss/brainstorm potential collaboration between the two institutions.

Last fall, Iowa State hosted two faculty members from Mekelle University’s College of Veterinary Medicine. One of Iowa State’s faculty members was unfortunately able to make the trip, so I was asked to go in his place, as someone who will be working closely with Mekelle University and who will maintain close contact with Iowa State faculty members. I naturally jumped at the chance, at traveled to Mekelle with Dr. Matt Brewer, assistant professor of parasitology at Iowa State.

It’s a tough trip to make when you’re only staying for a few days. There are now direct flights via Ethiopia Airlines (a quality airline with a solid reputation) from Chicago and Washington, D.C., but for bureaucratic reasons we had fly from Des Moines to Chicago, with a six hour layover, United/Lufthansa to Frankfurt with an 11 hour layover, Frankfurt to Addis Ababa, where we went through customs, discovered and reported missing luggage, and shifted over to the domestic terminal for our flight to Mekelle. We left for the Des Moines airport at about noon on Saturday, and arrived at our hotel in Mekelle at about two pm on Monday.

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Waiting to board our last of four flights, from Addis Ababa to Mekelle.

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Arriving in Mekelle, “The City of Knowledge,” after nearly two days of travel.

 

Mekelle University College of Veterinary Medicine

Our welcome to Mekelle helped us overcome our exhaustion, however, thanks to our veterinary colleagues’ incredible attention and hospitality! We were invited to dinner at the home of Dr. Birhanu Hadush, one of the exchange program’s scholars, where we were treated to a number of delicious, homemade Ethiopian dishes, with lots of injera, and, of course, a coffee ceremony. This hospitality was especially noteworthy because the vet school was hosting a number of visiting veterinary faculty from schools across Ethiopia, as it was exam week for the veterinary students (in which both internal and external examiners gave oral exams) and the school was hosting a National PhD Curriculum Review Workshop to review the college’s new proposed PhD programs (something that I will be heavily involved in!). We are immensely grateful to the leadership at the college for their kind and detailed attention during our visit.

We spent most of the week visiting with colleagues at the vet school, including tours of the college and attendance at a number of students’ exams and the curriculum review workshop. We discussed ways in which Iowa State and Mekelle University might collaborate in the future, as well potential projects and responsibilities that I will take on when we settle in Mekelle. We were also invited to present some of our research at Iowa State in terms of potential future collaboration with Mekelle.

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Discussing the research program at Mekelle University and potential collaboration with ISU.

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Many of our discussions involved amazing Ethiopian cuisine.

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Presenting some of my research on bovine digital dermatitis.

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Dean Berihu Gebrekidan presenting me with welcome gifts from Mekelle University.

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We were able to become familiar with the veterinary college’s campus.

 

 

St. Frumentius Ethiopian Orthodox Seminary

I also made time to visit St. Frumentius Ethiopian Orthodox Seminary and to discuss our plans there, as well. I met with Dean Tesfay Hadera, the Academic Vice Dean Gebre Hawarya, and the Theology Department Head Kase Tafesse. We discussed some of the ways that I might help, especially with biblical languages and exegetical methodology (i.e., the ways and means in which we approach interpreting Scripture). I was extremely encouraged by their enthusiasm and welcoming demeanor, and I’m confident that we’ll find ways to work together when we get to Mekelle.

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With Dean Tesfay Hadera, dean of St. Frumentius Ethiopian Orthodox Seminary.

 

Mekelle and Axum

Our hosts made sure that we took time to see Mekelle and Axum, where the ancient kingdom of Ethiopia was situated, during our visit. It was a great time to visit with our guide, Baruk, a veterinary microbiologist with a strong interest in church history. Naturally, we hit it off. It was so great to see Axum and all of the history I’ve read so much about; I’m excited to share it with those who come to visit us once we’re settled!

 

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At Mekelle’s memorial and museum for those who fought against the communist regime (The Derg) in the ’70’s and ’80’s.

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Exploring the ancient ruins of Axum. These stellae are about 1,700 years old.

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In front of the Church of Our Lady Mary of Zion, home of the ark of the covenant.

 

I’m extremely grateful to have been able to visit Mekelle and touch base with our future hosts and collaborators. We’re definitely working our way around the bases now; God willing, we’ll get to home plate soon!

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Camel Diseases and Human Health in the Horn of Africa

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Our translator very thoughtfully marked this camel for me.

In this post we want to discuss one aspect of the veterinary component of the work we hope to participate in when we move to Ethiopia. When we discuss our desire to help Ethiopians (and share the love of Christ) through veterinary medicine, many folks in the U.S. (understandably) haven’t considered the value that people in developing countries place on their livestock, and on the veterinary infrastructure (or lack thereof) that is necessary to enable their livestock to be productive. Even fewer have considered the role of livestock species that are uncommon in America or the West.

A couple of years ago, I (John) got to help my boss write a review article for CAB Reviews (part of the Centre for Agriculture and Biosciences International), which we titled “The impact of camel disease on human welfare in East Africa.” We’d like to share some of the more interesting (in our humble opinion) information from this article here, to show how significant veterinary medicine can be for people who have extremely limited access to veterinarians and veterinary technology.

Introduction

We begin by describing how half to two-thirds of the 27 million camels in the world are in East Africa (i.e., Djibouti, Eritrea, Ethiopia, Kenya, and Somalia), where their ability to adapt to extremely harsh environments is highly prized. In East Africa, (dromedary, or one-humped) camels are used for meat, milk, transportation, market/wealth reserve, prestige, hide, and labour. We discuss how 75% of the world’s camels are found in the world’s Least Developed Countries, and are thus often neglected in terms of research into improved production methods and veterinary diagnostics and treatments. When we conducted interviews with pastoralists to better understand their livestock priorities and concerns, camels were ranked the most important species more than 95% of the time.

Adaptation to Extreme Environments

As drought and water shortages increase in the Horn of Africa, the camel’s ability to withstand these challenges (especially as compared to other livestock species) increases the potential value of these animals in this region. Camels can lose up to 30% of their body’s water (~3x that of other domestic animals) and survive. They also have unique mechanisms (including their kidneys, the shape of their red blood cells, and the shape of their bodies in general) that decrease water loss and enable rapid rehydration. Whereas a cow will naturally lose 8-11 gallons of water per day, a camel will lose about 1/3 of one gallon of water per day. In addition, camels are able to withstand extreme heat due to the shape of their bodies and special blood vessels in their noses.

If you want an idea of how harsh the Ethiopian environment can be, check out these photos of the Danakil Depression (and the camels there!).

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The harsh landscape in the Horn of Africa.

Reproduction and Calf Viability

Camels take a relatively long time to reproduce. Fertility rates in the Horn of Africa are around 40%, and gestation is 13 months. If everything goes well, a healthy cow (female camel) will have a calf about once every 28 months. There are a huge number of diseases that cause infertility or loss of prenatal calves in camels, such as pasteurellosis and trypanosomiasis. Losses may be as high as 40%. Once born, camels, like cattle, need “first milk,” or colostrum, from their mothers to protect them from infection until their own immune systems are developed. Many who make a living by herding (i.e. pastoralists), however, told us that they prevent the calves from drinking colostrum, because they believe that the colostrum itself makes the calves sick. Thus calf deaths are extremely common; the number we often heard was 50%. Probably 3/4 of these are caused be calf diarrhea – E. coli, Salmonella, rotavirus, etc.

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Acacia thorns are often used as corrals, here keeping the calves from wandering and protecting them from predators, like hyenas.

Diseases Affecting Production in General

In addition to reproductive diseases, there are many diseases that “cause wasting, weakness, decreased milk production, and in some cases, death. They also decrease in value from an economic/market perspective. These animals thus fail to serve their intended purpose, which is ultimately to benefit the welfare of the people who care for them. Diseases that affect overall health include (but are not limited to) trypanosomiasis, infectious respiratory disease, paratuberculosis (Johne’s disease), Camel Sudden Death Syndrome, intestinal parasite infestations, and ectoparasite (i.e., tick) infestations.”

Uses for Camels in East Africa

Food

Studies have shown that camel milk often makes up 30-50% of the nutritional needs of pastoralists in East Africa. One year old children in this region can receive up to 2/3 of their required mean energy and 100% of their protein from camel milk. Camels in the Horn of Africa produce an average of 11 to 13 pounds of milk per day (higher than cattle in the same region). Lactation lasts between 9 and 18 months. The milk has unique antimicrobial properties, and has lower somatic cell counts than that found in cattle. Mastitis is therefore an extremely significant disease for these camels (and, unfortunately, extremely common). In addition, the fact that the milk is commonly consumed raw is a cause for concern, as there are a large number of food-borne illnesses caused by drinking raw milk (i.e., brucellosis, tuberculosis, salmonellosis, etc.).

The risks of raw milk comes to my mind frequently when I work with camels, because there is a tradition that those who are about to work a herd will come together and share a bowl of fresh milk before getting started. It is considered impolite to decline, but I have found that if I make sure I have a big milk mustache, even if I only sip a little, my hosts are satisfied.

Camels are also slaughtered for their meat, which has a much lower fat content (and is much tougher) than beef. The hump, which consists of fibrous fat, is considered a delicacy in many pastoral areas. As with any slaughtered animal, there are a number of  potential food-borne illnesses associated with camel meat, including salmonellosis, campylobacter infections, toxoplasmosis, and echinococcosis.

Conditions at slaughterhouses are vastly different, as well. A colleague and I visited a camel slaughterhouse at one point, accompanied by the slaughterhouse’s veterinary inspector. We didn’t know quite what to expect, and when men with machetes started hacking at the camels’ hamstrings so they would lay down before being slaughtered, our eyes widened and our jaws dropped. The inspector noticed, and asked, quite innocently, “Is this not how you do it in America?”

 

Camel milk and meat. Note the fat from the hump on the upper left side of the plate.

Transportation

Another use for camels is for hauling goods, milk, water, or, in the case of many pastoralists, for relocating one’s entire home when in search of better pasture. In northern Ethiopia, many people won’t drink camel milk or eat the meat for religious reasons, but have found the camel’s capacity for transportation to be immensely useful. Camels are well-known for hauling salt out of the Danakil Depression in north-eastern Ethiopia.

Economic and Cultural/Societal Resource

Camel herds function as the wealth reserve (and therefore as a measure of cultural prestige) for many in the Horn of Africa, especially pastoralists. The Horn of Africa exports enormous numbers of animals (~$600 million per year) to the Arabian Peninsula, especially around Ramadan. Diseases in the Horn of Africa will occasionally lead to an export ban, which has enormous consequences for those who depend on this trade to make a living.

Zoonoses

We wrap up the article with a discussion of diseases that are shared between humans and camels, including brucellosis, Rift Valley Fever, Q Fever, rabies, and Middle East Respiratory Syndrome (MERS). All of these present serious health risks for the people that care for and come into contact with camels.

Conclusion

Hopefully this post has shown that “the camel is of immense value to many in East Africa, and especially to the pastoralist peoples who live there. This animal, which gets so little notice in most of the world, gives food, provides transportation, income and a sense of self-worth to these people.” Hopefully it also shows the role that a veterinarian can potentially play in East Africa, and how one can love others using their veterinary training and skills.

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Me and a friend.

Why Ethiopia?

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The highlands of northern Ethiopia.

Thanks to everyone who has contacted us with words of encouragement and contact information, as we work to get our name out there! We’re very grateful for all of you!

The train has left the station, and we’re in full swing now in terms of being functioning candidates with Christian Veterinary Mission. We’re compiling our mailing list for our monthly newsletters (contact us if you’re interested in being added to that list!), and we’re determining out topics for our weekly blog post over the next few months, based on questions we’re getting from our supporters.

There are three main ways that folks can help us with this process. The first, and most important, is prayer. Our prayer requests can be found here. The second is through financial contributions. We’ll write more about this topic in the next few weeks, but the gist is that CVM requires that its field staff be receiving monthly contributions equivalent to our monthly budget before allowing us to move to Ethiopia and start working. That is to say, we need enough people giving on-going monthly gifts to meet our monthly expenses. On-going gifts that have started before we move over will go towards our one-time expenses, like plane tickets, visas, furniture, a vehicle, etc.

The third way to help out is to connect with us via social media (this blog, Facebook, Twitter, and Instagram), and to encourage others who might be interested in our work to check us out!

For the rest of this post, I’m going to talk about why and how Ethiopia has become our intended destination.

Hearing About Ethiopia

When I came back from Iraq in 2009, Kristen and I decided to look into the possibility of working long term in developing countries. I had worked in a number of developing countries as part of the Army Veterinary Corps, and Kristen traveled to Haiti in 2010 and 2011, where she worked short-term with a couple of ministries.

In the spring of 2012, I contacted Christian Veterinary Mission (I’ll explain more on why we chose to work with CVM in a future post), and started a months-long conversation with Fred Van Gorkom, CVM’s Africa Regional Director. When Fred heard about our background, he began to urge us to consider Mekelle, Ethiopia, as a potential destination. For one thing, my time in the Army had taught me that one of my greatest strengths and joys is in training others, and encouraging them to develop their understanding and skills. This led us to talk about the possibility of teaching at a veterinary school in a developing country. Fred, who had served in Ethiopia for nearly three decades, had a number of connections at the veterinary school in Mekelle, and knew that this school had expressed a need and desire for improvements in both pedagogy and its research programs.

In addition, the fact that I was well-versed in both evangelical and Orthodox expressions of Christianity led Fred to urge us to consider Ethiopia; more on this below.

With Fred urging us to consider Ethiopia, we began to learn more about the country, and in particular, about its livestock and veterinary infrastructure, and about the history and status of Christianity and other religions in the country. I plan on writing in greater detail in future posts on both of these topics, but here’s an overview:

Veterinary Medicine in Ethiopia

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Goats in the pastoral Afar Region of eastern Ethiopia.

Ethiopia is a landlocked country located in the Horn of Africa. It has over 100 million inhabitants, and occupies 420,000 square miles (about 1.5 times the size of Texas). The terrain varies from mountain to savanna to desert; and livestock are abundant throughout all areas of the country.

Ethiopia is said to have the highest population of livestock in Africa, with over 150 million animals, made up primarily of cattle, sheep, goats, and camels. This number omits the livestock population in the Afar and Somali regions, where most people are pastoralists (that is, herders), because it is extremely difficult to get accurate counts. Suffice it to say that the numbers are very high. Many of these animals are ultimately exported, often to the Arabian Peninsula via Djibouti, Somalia, or Kenya. Livestock plays a significant economic role in the country.

Unfortunately, due to a lack of veterinary infrastructure, debilitating diseases are common in many herds. This adversely affects Ethiopians in at least two ways; first, it decreases the number of animals born, the number that are brought to slaughter and/or milked, and it drastically decreases the amount of milk and/or meat produced. This is the economic and nutritional impact. It also predisposes people to zoonotic disease – diseases spread from animals to humans, often when animal products are consumed.

A key step toward improving veterinary infrastructure is improving both veterinary medical education and improving the research capacity of those institutions. As research capacity improves, veterinarians and livestock owners will have better information about animal disease in the Ethiopian context, and will be able to make informed decisions regarding animal health.

Christianity in Ethiopia

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The roof of Kidus Giorgis (St. George’s Church), an 11th century stone-carved church in Lalibela.

Ethiopia embraced Christianity by the early fourth century, at the latest, when the Ethiopian Orthodox Tewahedo Church received her first bishop, St. Frumentius, from Alexandria, Egypt. Today, the EOTC has between 40 and 46 million members. In addition, over the last 200 years, various Protestant churches have appeared and grown throughout the country, so that there are approximately 14 million Protestant Christians of various denominations in Ethiopia.

The relationship between the Orthodox Church and the Protestant Churches has been tense at times, for a number of often complicated reasons. Recently, members of the EOTC and a number of Protestant churches gathered in Addis Ababa, at the first ever regional consultation of the Lausanne-Orthodox Initiative, to discuss the relationship between Orthodox and Protestant churches and Christians.

Ultimately, for there to be peace between Orthodox and Protestant Christians, there must be increased understanding in where the true and important differences lie, as well as what is genuinely shared in common (indeed, 20 years of communism went a long way in teaching Ethiopia that in many cases the commonalities far outweigh the differences). People who are able to understand both the Orthodox and Protestant perspective could be very helpful in this regard.

In addition, there is currently a need at the local Orthodox seminary for teachers of biblical languages, biblical studies, and patristics.

Why Ethiopia?

We are going to Ethiopia (God willing) because we believe that’s where we can best share Christ’s love in terms of the gifts, skills, and experiences that he has given us. We remain unspeakably grateful for your support as we pursue this goal.

Why “Hands Outstretched”?

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“…let Ethiopia hasten to stretch out her hands to God.” (Psalm 68:31)

What an adventure this has been!

In July 2017, a few days before our second child Judah was born, we received an email from the Africa Regional Director at Christian Veterinary Mission, informing us that we had been formally approved as Candidates with CVM. A new and significant step has been made in what has already been a long and prayerful journey! After working through some of the necessary logistics, not to mention having baby #2 and John starting the last semester of coursework for his PhD, we are ready to introduce you to “Hands Outstretched,” our vision for where we hope to go, and how we hope to share Christ’s love along the way.

This blog is intended to serve as an invitation to our readers to come alongside us as we continue this journey, one that will lead us, shortly, to Mekelle, Ethiopia. It is our intention to post here regularly as we begin to prepare for our long-term relocation to Mekelle. In doing so, we hope 1) to keep everyone informed as to our status and our progress as we pursue this goal; 2) to share what we’re learning about the history and status of Christianity, as well as of veterinary medicine and public health, in Ethiopia; and 3) to ask for your support as we pursue this goal.

There are three ways that you can help us: through prayer, through financial contributions, and through interacting with us via social media (including this blog, Facebook, Twitter, Instagram, etc.), as well as sharing our updates with anyone and everyone you think might be interested. We welcome any questions about what we’re doing; please feel free to contact us!

So here we are. We plan on sharing more over the next few weeks about who we are, where we’re coming from, how we got here, and how (and why) we intend to get where we’re going. But first, I want to talk about the name we’ve chosen for this ministry, “Hands Outstretched,” and what that means to us.

In Ethiopia, there is one half-verse of Scripture that is more widely quoted, written, and scrawled across walls and billboards than probably any other text: Psalm 68:31 – “…let Ethiopia hasten to stretch out her hands to God.” If you look this up in an English version of the Bible, there’s a fair chance that “Cush” will be mentioned rather than Ethiopia; this is simply a translational issue.

For at least the last 1,700 years, and probably for much longer, Ethiopia has been stretching out her hands to God. It is our joy and privilege to join her in doing so as we seek to share our gifts and blessings with the people of Mekelle, of Tigray, and with the rest of Ethiopia. This is first and foremost what we mean by “Hands Outstretched”: that we long to seek God alongside those with whom we’ve chosen to live.

However, there are other nuances involved with “Hands Outstretched” that have led us to choose this image for our ministry. In the Orthodox Church, Psalm 141 has been considered the psalm of evening prayer since at least the third century (and almost certainly earlier than that). In 141:2, the psalmist prays: “Let my prayer arise as incense before you, and the lifting up of my hands as the evening sacrifice.” Thus, “Hands Outstretched” also represents the orans, a common posture for prayer in the early Church:

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In addition, John Cassian, in commenting on Psalm 141, makes a powerful observation:

Here the true evening sacrifice can be understood in a more spiritual way as . . . that evening sacrifice that he offered to the Father on the last day – namely, at the end of the ages – by the raising of his hands for the salvation of the world” (Institutes, 3.3.8-10).

Thus, as Cassian points out, the “Hands Outstretched” are the hands of Christ, allowing himself to serve as the true and final evening sacrifice. And we who are called to take up our crosses and follow him are called to stretch out our hands alongside him, thereby participating in his sacrifice.

“Hands Outstretched” also refers to our love for one another, in that we stretch out our hands as a sign of peace (in a handshake), of love and acceptance (in a hug), and in giving and receiving in community (via the exchange of goods). We hope to be peacemakers, sharers in Christ’s love, and to give what we have to those who may need it, as well as to receive what is offered in return (i.e., knowledge and understanding about other cultures, faiths, and worldviews).

Finally, as we wrap up this introduction, I’d like to talk a little more about the Psalm from which we take our name, Psalm 68. Psalms are numbered differently in certain versions of the  Bible and in certain translations, because when the Psalms were translated from Hebrew to Greek in the centuries before Christ, the numbering was changed, and so Orthodox Bibles and liturgical texts will number this Psalm 67. This psalm is an extremely significant one in the Orthodox tradition; Fr. Patrick Henry Reardon describes its use well in his excellent book, Christ in the Psalms:

The Christian sense of this psalm is abundantly clear in its traditional liturgical use, the best example being the rush procession of Holy Saturday night. In front of the church doors, after we have thrice marched around the building, we stand and listen to St. Mark’s account of the myrrhbearing women coming to the empty tomb of the Risen Christ. Then, after that Gospel, we repeatedly chant the triumphant troparion of Pascha: ‘Christ is risen from the dead, trampling down death by death, and upon those in the tombs bestowing life.’ Between chantings of that great troparion we sing lines from Psalm 67: ‘Let God arise, let His enemies be scattered; let those also who hate Him flee before Him. As smoke is driven away, so drive them away; as wax melts before the fire, so let the wicked perish at the presence of God.’

Here we have the deeper, more authentic sense of the psalm: Jesus, the author and perfecter of our faith, arising from the dead (‘Let God arise’), triumphant over sin and death (‘Let His enemies be scattered’), bringing His saints from the demonic depths of Hades (‘I will bring back from Bashan, I will bring them back from the depths of the sea’), leading the Church in her journey through history (‘O God, when You went out before Your people’).

Thus, with Hands Outstretched, we proclaim his death, we confess his resurrection. We thank you for joining with us on this journey. Please consider helping, in one or more of the ways described above. Welcome!