Features
Vet Fights Parasite, Poverty in Kenya
Population Medicine chair says veterinarian's goal to improve public health is global
BY BARRY GUNN
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| Thanks to friends and supporters in the Guelph area, Prof. Cate Dewey, above, has raised $20,000 to date to provide school supplies and uniforms for orphans in Kenya. Her efforts were rewarded with lots of smiling faces when she handed out pencils to the children on her last visit to Africa in November. Photos by John Dewey |
Prof. Cate Dewey has had a lot on her plate in the past year. In addition to starting a new appointment in September as chair of the Department of Population Medicine, she made three trips to Africa to establish and monitor a research project. She also “adopted” a primary school in rural Kenya on a quest to improve the lives of children living in one of the poorest regions on Earth.
It was a year full of challenges and opportunities, both professional and personal. The way things are shaping up, 2007 promises to be more of the same. And Dewey couldn't be happier.
“It's a very exciting time for our department, for the Ontario Veterinary College and for the profession,” says Dewey, an epidemiologist who specializes in swine health management.
“It's very important that we continue to update our research and teaching programs to address problems that are relevant to animal owners, the agriculture industry and society as a whole.”
Dewey heads a department trying to fill the void left by the departure of key faculty due to retirement and the startup of a new veterinary school in Calgary, all the while contributing to plans for OVC's expanded role in public health research, education and service.
“We're on the cusp of a phenomenal opportunity with establishment of the Centre for Public Health and Zoonoses,” says Dewey. “Many of our faculty are already doing a significant amount of work in the public health realm, and the centre will open up research opportunities that wouldn't have been available in the past. That's exciting for me.”
Although her career path is taking a decidedly administrative turn, Dewey can still indulge a passion for research and a soft spot for critters of the porcine variety. Last year, she launched a research project to investigate the links among pigs, the Taenia solium tapeworm and epilepsy in the Busia district of western Kenya.
The people of Busia are primarily subsistence farmers. With half the population struggling to survive on less than 50 cents a day, they are among the poorest of the poor. It's a society reeling from HIV/AIDS infection rates that are among the highest in Africa.
Busia also provides a tragic illustration of how lending a helping hand can sometimes have unintended and even tragic consequences. In one development project, Busia farmers, many of whom have taken in AIDS orphans and live in households with eight to 14 children, were given pigs as a way to lift them out of poverty. But many had little or no experience raising swine and couldn't afford to buy feed for their animals, so they let them roam free to forage for food.
Dewey says that poor husbandry practices, combined with nearly non-existent sanitation and rudimentary meat inspection have created a situation where the T. solium parasite is being passed from pigs to people, people to pigs and people to people. It's a vicious cycle that is destroying lives and livelihoods, she says.
Pigs and people become infected through ingestion of food or water contaminated by T. solium eggs shed in the feces of a human tapeworm carrier. People get the tapeworm eating undercooked infected pork, then shed thousands of eggs in their feces each day. People can ingest a tapeworm egg by hand-to-hand-to-mouth contact. This leads to neurocysticercosis, a disease in which the egg migrates to the central nervous system, causing epilepsy.
The disease is difficult to diagnose — often it can be detected only with a CT scan or MRI — and problematic to treat, says Dewey. Drugs can kill the parasite, but that triggers an adverse immune response, which in turn must be controlled by anti- inflammatory medication. In a desperately poor country where medical resources are scarce, it makes more sense to stop the transmission cycle of the tapeworm infection in the first place, she says.
From a western perspective, the tapeworm problem might seem fairly straightforward. But it's not, says Dewey, who was inspired to go to Africa by OVC professor John McDermott, who delivered the Schofield Memorial Lecture in 2003 and urged veterinarians to put their skills to work in developing countries.
“In reality, controlling the tapeworm is enormously complex because it touches on livelihoods, it touches on health care and poverty issues, and it touches on cultural practices,” she says.
Many Busia farmers who have outhouses may not all use them, for a variety of reasons. For example, in a country where it's common for extended families to live in one compound, it's a cultural taboo for a man to use the same toilet as his daughter-in-law.
“The challenge is to understand it well enough to ask yourself how you can help without imposing your culture and your beliefs,” says Dewey.
Her project focuses on working directly with farmers, holding workshops to help them understand the connection between the tapeworm and epilepsy, teaching them how to accurately weigh and measure their pigs, and encouraging them to adopt better husbandry practices so they can raise healthier animals that will fetch higher prices.
A Kenyan veterinarian working on her PhD in epidemiology is managing much of the legwork for the project. Global Vets students from OVC also did hands-on work for the project last summer. Dewey hopes to secure enough funding to support two graduate students from Kenya and a graduate student from OVC.
She returned to Kenya for three weeks in November to follow up on work begun last summer. Two research teams visited 176 farms, taking blood samples, checking on the farmers' record keeping and conducting surveys to gather critical information about how the animals are being fed and housed.
Dewey is encouraged by what they've found so far and plans to expand the project to include urban and peri-urban areas.
“It's enormously challenging, but it's been such a gift for me to do this,” she says.
So much so that she's also taken a personal interest in the well-being of children at the Bukati Primary School, a bone-rattling nine-hour drive from Nairobi.
With no electricity and meagre resources, the school serves some 1,500 families. About 250 of its 700 students have been orphaned by HIV/AIDS, and many more orphans don't go to school because their adoptive families can't afford school uniforms or even basic supplies like pencils.
Dewey returned home from her first visit to Kenya last March determined to do something to make a difference in their lives.
Thanks to friends and supporters in the Guelph area, she has raised $20,000 to date. The project has delivered pens and pencils for the orphans, as well as 300 pounds of donated books to start a library. In November, a tailor was hired in Kenya to produce some 200 school uniforms; the tailor, in turn, hired four people to help do the work.
Students at Guelph's Sir Isaac Brock School, where Dewey's husband is a teacher, held a fundraiser and have exchanged letters with their counterparts at Bukati School. And OVC students are selling bracelets made by the AIDS orphans using beads that Dewey took to Kenya from Guelph.
The goal is to raise $150,000 over five years to establish a sustainable lunch program at the school. One idea is to generate income by setting up a mill at the school, where locals would pay to grind corn into flour. The leftovers could also be used to feed poultry and pigs, which would be cared for by the students.
“There are many schools in the region that could benefit from a project like this,” says Dewey, who admits to feeling angry after her first trip to Kenya last year. Like so many westerners who travel to the developing world, the culture shock didn't hit her until she was back home safe and sound and surrounded by consumer excesses.
“The need there is so great, but all the wealth is here. This was one way I could turn my feelings of frustration into something positive.”