Teamwork tackles troubling, complex health issue in rural Kenya

“When you go into a community to do a large-scale project like this, it’s really important to understand the discipline that you bring to the table.”

-Dr. Dewey, Director of the One Health Institute and Associate Vice President (Academic), University of Guelph

The One Health concept is often best understood through examples…like that of Dr. Cate Dewey, Professor at the Ontario Veterinary College (OVC) and the Director of the One Health Institute at the University of Guelph, who pursued answers to a difficult, multi-faceted health problem in rural Kenya. There, she assembled a team to manage a mysterious tapeworm, Taenia solium, that was causing epilepsy in the countryside. The parasite was transmitted through pigs, and mostly unheard of, even to local health officials.

The communities Dewey and her team visited were wrought with food insecurity. Pigs, raised primarily by female farmers, were important sources of income: they paid for food, medicine, and school fees. So, they couldn’t simply be banished.

Dewey, a specialist in swine health management and population medicine, recognized this as a complex issue at the interface of human, animal and environmental health. Such multi-dimensional issues require a wide-sweeping One Health approach, calling on many perspectives to find a holistic, impactful, and sustainable solution.

From 2006-2016, Dewey’s research project included a diverse team of specialists; epidemiologists, gender anthropologists, economists, and nutritionists. It became the graduate work of three PhD students, and more than 100 undergraduate volunteers travelled to Kenya to help facilitate the research.

The community helped to find answers. Dewey’s Kenyan PhD student, Dr. Florence Mutua, from the University of Nairobi, met with community members – the women who raise the pigs, the elders, and the local veterinarians – to understand what the community considered to be its needs for pig health management education and research.

The community members had a lot of ideas. The farmers wanted to get a better profit from their pigs – they wanted to improve how they fed and raised their pigs, and they wanted to be able to weigh pigs before selling them to the butcher. The butchers wanted to learn how to make budgeting plans for their businesses, so they could pay for business licences and inspection fees. In order to limit the spread of Taenia solium, the community members were going to have to make significant changes to their usual practices. Dewey believed that the best way to get them engaged was to give them tools to improve their livelihood of adapting the protective practices.

As a first step, Dewey and her team, taught Kenyan extension officers about optimal pig health management practises – such as tying their pigs up instead of letting them run loose and feeding them a mixed diet – and about Taenia solium. Equipped with this knowledge, these local public health officers, social workers, and animal specialists put on workshops for the pig farmers to help them implement research-based approaches to the problem.

Because many farmers didn’t have access to scales, they had to estimate their pigs’ weight before selling them to butchers. Usually, the estimates were much too low, and the farmers weren’t getting the true value for their pigs. So, Dewey’s team developed a way to estimate pig weight, by using length and girth measurements. Then they worked with local butchers to teach them the importance of meat inspection to prevent Taenia solium transmission, and to develop budgeting plans so they could pay to get their pork inspected.

Meanwhile, another team member developed a recipe for nutritious pig rations, using weeds and readily available food like cassava and banana leaves, and facilitated workshops to teach farmers how to make the rations. Later studies had aimed to understand the implications and complications of gender and familial dynamics in pig health and pig raising. They showed that female farmers were more likely to put in the extra work of making rations if they were able to keep the money – whereas if their husbands kept the money, they weren’t likely to do so.

To help with malnourishment, Dewey started a lunch program to increase school attendance of children orphaned due to AIDS. Farmers in the community were taught permaculture, organic farming, composting, and crop rotation by growing food on school properties. This enabled the children to eat lunch at school, and the farmers were able to develop skills that enhanced the productivity on their own farms.

The community fed and educated 2,800 orphans, and increased overall food security, over the twelve years that this project took place.

Dewey brings the many lessons from this Kenya project to the One Health Institute at the University of Guelph.

“My hope is that my story inspires students and researchers to develop creative, holistic, and collaborative approaches to research and learning,” she says.

This article, written by Marilyn Sheen, was adapted from the One Health Institute’s, University of Guelph webpage for use on the OVC’s website. The original article can be found here: Cate Dewey | Faculty Focus One Health Institute (uoguelph.ca)