Veterinary Public Health in Khwisero

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Public health is dependent on animal health in rural areas because poor animal health directly affects the human food supply. Veterinary public health entails the diagnosis, surveillance, …

Public health is dependent on animal health in rural areas because poor animal health directly affects the human food supply. Veterinary public health entails the diagnosis, surveillance, epidemiology, control, prevention and elimination of Zoonoses. Unsatisfactory implementation of stringent disease control, meat inspectorate and drug dispensation legislations prevents the efficient production of food of animal origin; creating obstacles to international trade in animals and animal products and hence an impediment to overall socioeconomic development

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  • zoonosis to describe this commonality of disease that can pass between animals and man. Becoming a strong advocate for the improvement of meat inspection, sewage systems and housing conditions, Virchow recognized the interconnectivity between human health, safe food and a clean environment. American veterinary epidemiologist Calvin Schwabe developed his view of one medicine in the 1960s. Inspired by his work with Dinka pastoralist healers in Sudan who cared for humans and animals alike, Schwabe recognized the pool of knowledge in anatomy, physiology and pathobiology that is common among animals and humans. His concept of one medicine applied these principles to food safety and nutrition, zoonotic disease, epidemiology and population medicine, environmental health and social wellness. In 1999, WHO veterinary public health . (This holistic notion has gained international acceptance ); In 1999 WHO convened  a conference of invited experts from 18 industrialized, countries in transition, and developing countries in Teramo, Italy in collaboration with FAO and OIE(1) Human and animal health problems are inextricably linked
  • Veterinary Public Health (VPH) was defined by the WHO consultation on "future trends in veterinary public health" held in Teramo, Italy in 1999 Human health is inextricably linked to animal health and production. This link between human and animal populations, and with the surrounding environment, is particularly close in developing regions where animals provide transportation, draught power, fuel and clothing as well as proteins (meat, eggs and milk) preventable animal diseases that can be transmitted to humans (i.e. zoonoses) such as rabies, brucellosis, leishmaniasis and echinococcosis continue to occur in many countries especially in the developing world where they mostly affect the poorest segment of the human population.
  • GEOLOCATION: Western province, Bordered by Kakamega south [E], Butere[N], Vihiga[S], Siaya[West], Annexed from Butere District in July 2009, Received DVO in August 2009, Inaugurated in September 2009.
  • in rural setups,
  • To develop recommendations for delivering VPH services at the community level that are consistent with community involvement in health promotion, and take into account the increasing privatization of veterinary services
  • Butchers, who are to operate new slaughter facilities and butcheries, must also be trained in slaughter techniques and in meat cutting and hygiene. Mkombozi: comparison of goodmeat and condemned.
  • KENYAN VS USA SITUATION An alarming report from the Government Accountability Office warns of a growing shortage of veterinarians nationwide, “particularly of veterinarians who care for animals raised for food, serve in rural communities, and have training in public health.” veterinarians have played a vital role in the identification, diagnosis, control and surveillance of all  EID With 50 percent of U.S. Public Health Service veterinary medical officers now eligible for retirement , The Bureau of Labor Statistics has projected a need for an additional 22,000 veterinarians by 2016, yet colleges of veterinary medicine have not received direct federal infrastructure support in more than 30 years . This must change, and it must change soon . Dr. Marguerite Pappaioanou is executive director of the Association of American Veterinary Medical Colleges.
  • In summary, information management skills must replace memorization and intuition in VPH decision making. epidemiology must be used as the primary guide for veterinary public health policies based on prevention. exchanging information on surveillance of diseases is to ensure that similar criteria are used to collect and count the data. This harmonization is best achieved by adherence to standards developed by international organizations such as OIE and WHO
  • Communities should be regularly informed on the progress and achievements of VPH programs using the local media information sources. If they know they are part of the action and contributing to it the controls are much more likely to succeed

Transcript

  • 1. Veterinary Public Health in Khwisero District, Kenya - Success, challenges, and possibilities. Mark O Nanyingi 1, § , Alfred O Koballa 1 , Christopher M Okello 1 , Humphrey O Ongili 1 , Tindi Bushuru 2 Kelly A Nelima 3 1 Ministry of Livestock and Development, District Veterinary Office, PO BOX 60 -50135, Khwisero, Kenya 2Ministry of Livestock and Development, District Veterinary Office, PO BOX 1160, Butere, Kenya 3 Ministry of Livestock and Development, Provincial Veterinary Office, PO BOX 871, Kakamega, Kenya § Corresponding author and Presenter : [email_address] , +254 721 117 845 44 TH KVA ANNUAL SCIENTIFIC CONFERENCE , APRIL 2010 ALMOND RESORT, GARISSA KENYA THEMATIC SESSION : ZOONOSES
  • 2. VPH HISTORICAL ROOTS: 1850 – 1960 - 1999 WHO(1999) VETERINARY PUBLIC HEALTH: “ the sum of all contributions to the physical, mental and social wellbeing of humans through an understanding of veterinary science ”. Dr. R.L.K. Virchow (1850) COMPARATIVE PATHOLOGY Meat inspection Interconnectivity (Human health, safe food & clean environment ZOONOSES ONE MEDICINE Dr. Calvin Schwabe (1960 ) DINKA IN SUDAN Food safety & nutrition, Zoonotic dse. Epidemiology, Population medicine, env. Health & social wellness. Safety
  • 3.
    • Veterinary Public Health (VPH) - a component of public health activities devoted to the application of veterinary skills, knowledge and resources to the protection and improvement of human health [ WHO,2002 ].
    • The core domains : Diagnosis, Surveillance, Epidemiology, Control, prevention and elimination of Zoonoses; food protection; Biomedical research; Health education and Extension.
    • The role of VPH within the global health agenda is to promote activities that contribute to the achievement of “ health for all" and help realize its objectives.
    • Zoonoses still represent significant public health threats, but many of them are neglected.
    • All major zoonotic diseases prevent the efficient production of food of animal origin, proteins, and create obstacles to international trade in animals and animal products.
    Background :
  • 4. Geographical position: Epidemio-Surveillance MAJOR DISEASES: Helminthiasis, Nutritional deficiencies and Tick borne diseases SERVICE PROVIDERS: 19 Agrovets, 9 Practitoners, 2AI,
  • 5. Justification and Research Questions
    • Inconsistent enforcement of VPH laws is a major challenge to the surveillance and containment of zoonoses and foodborne zoonotic diseases.
    • Defective meat inspection regulations and imprudent dispensing of veterinary pharmaceuticals
    • Economic & public health importance and resistance, ADR to antimicrobial agents in animals
  • 6.
    • Can implementation of veterinary legislations in meat hygiene, drug use and disease surveillance/control significantly improve the overall service delivery in poor resourced regions?
    • Does paucity of personnel and diagnostic facilities coupled with inadequate financial provisions and conflict with private service providers greatly hamper successful service delivery?
    RESEARCH QUESTIONS
  • 7.
    • GOAL: To review the contribution of veterinary science to public health and to assess the needs of Khwisero district concerning the organization and management of VPH programmes and activities.
    • AIM: To strategically plan the development or revival of VPH services to improve both human and animal health. This will assist DVS, collaborators, NGOs, and the food and animal health industry with guidance on how to respond better to these needs.
    • SPECIFIC OBJECTIVE :
    • To develop recommendations for model interdisciplinary, cost-effective delivering of VPH programmes at the community level that are consistent with community involvement.
    OBJECTIVES
  • 8. APPROACHES AND SITUATIONAL ANALYSIS
    • Assessment of hygienic standards of slaughter slabs ,flayers and butcheries.
    • Inspection and advice on veterinary pharmaceutical outlets.(Agrovets & Clinics).
    • Determination and Trend Analysis of slaughter figures; Revenue stabilization and adjustment programs.
    • Departmental Collaboration ; PHO in licensing of flayers and Butchery attendants.
    • Enforcement of relevant laws by staff training and public education.
    • Establishment of Research collaboration.
    • Mobilization of Private service providers in official programmes.
    • Staff retraining on Meat Inspection and Public health code.(Reorganization)
  • 9.
    • Inadequate knowledge and technology transfer for VPH programs and support their adaptation to meet local and regional needs.
    • Lack of strong public support and an efficient administrative infrastructure: Inadequate private investment to assure meat safety.
    • Staff has little or no idea how surveillance data are used, as they are not provided with feedback.
    • Inadequate meat inspectorate and aging veterinary staff
    • Local knowledge and attitudes which might present major barriers for implementation of participatory field research
    • Transboundary deficiencies in I disease mitigation and VPH policies; Stock theft.
    • Budgetary constraints : VSDF & Recurrent, Donors and partners.
    • Transport , office space and support staff unavailability.
    • Lack of internet connectivity
    Challenges
  • 10. MEAT INSPECTORATE: Status
  • 11.
    • Epidemio-surveillance system (ESS) : GPS, SMS, e-mail= Relational database which analysis of local surveillance data gives valuable insights into the epidemiology of the disease.(Archive, Acess,retrieve)
    • Improved Meat inspectorate services : Facility phytosanitary and 50% Revenue increment
    • Personnel training on basic hygiene principles, quarantine and isolation, biosecurity, surveillance systems, diagnostic capability, treatment options and depopulation capability.
    • Rejuvenation of Khwisero Dairy Cooperative Society via Technical advisory services
    Improvements- Successes
  • 12.
    • Vector and pest control: Public awareness and involvement in integrated zoonoses control programmes for additional benefits at marginal cost.(CDF dip committee)
    • Training of staff and paraprofesssionals on Drug dispensation(Agrovets), AI; Facilitation and assistance in premises registration and regulation.(ADR, Resistance)
    • Support the establishment of Private Artificial insemination Schemes (60%) ; 3 schemes.
    • Training local NGO members and community health workers on relevant activities and practices needed by local populations at risk.
  • 13. MEAT INSPECTORATE: Improvements
  • 14. Khwisero Hypothetical Economic Model
  • 15. DISEASE CONTROL : Vector and Pests
  • 16. Pharmaceuticals, AI and Paraprofessionals
  • 17. VPH global legislative perspective
  • 18. Lack of adequate Technical Staff
  • 19. Applicable Future trends
    • Looking to the future, it is certain that the challenges of public health for veterinarians are prepared and willing to work with colleagues from other disciplines to respond to these challenges and to develop effective programs to continue to improve the public’ health
    • Developing policies, guidelines, operational research and strategies for the control of zoonotic and foodborne diseases.
    • Developing project proposals on control/eradication programs to be submitted to donors and international organizations.
    • Strengthening access to information by electronic access, networking and training; disseminating relevant information to experts in public health, veterinary science and other scientific disciplines.(ProMED mail).
    • Establishment of joint interregional scientific programs including both medical and veterinary professionals from countries with similar epidemiological problems.
  • 20.
    • Capacity development for coordinated surveillance such as staff recruitment, training, equipment, networks
    • Adaptation of computer open source software programs such as Epi-Info and Epi Map, linkage of local, national and regional surveillance.
    • Decision-makers, stakeholders, and the population at risk must always be made aware of the actual losses caused by zoonotic diseases for long term cooperation.
    • Establishment of Veterinary Research Systems and intersectoral collaboration in VPH, zoonoses and legislative enforcement .
    • National Zoonosis Center ; Regular seminars and workshops focussing on epidemiological findings and control measures in both rural and urban situations .
    • Technical Cooperation Project linking with Pan- networks such as the Khwisero Animal /PublicHealth Surveillance Network (KAHSN) to share information across districts and provinces.for coordinated human/animal health databases for zoonotic infections
  • 21.
    • Veterinarians must be involved in aspects of agent/host/environment causation triad so as to identify and develop logical evaluations, design sound intervention systems and ultimately effective zoonotic prevention strategies
    • Policy development on veterinary involvement in the restructuring of public health services in food safety and control of transboundary diseases. Guiding Principles for Planning, Organization, and Management of VPH Programmes
    • VPH initiatives should focus at the community levels and also choose programmes   prioritized on the basis of disease burdens, are epidemiologically defensible, risk based and have a reasonable probability of success and sustainability
    CONCLUSIONS
  • 22.
    • ‘ Future Trends in Veterinary Public Health’ Teramo, Italy, (1999).   WHO – in press.
    • The Veterinary Contribution to Public Health Practice’.  FAO/WHO Technical Report Series #573.  WHO. Geneva 
    • Electronic Conference on Veterinary Public Health and Control of Zoonoses in Developing Countries. Nov. 1- Dec. 15, 2001      www.fao.org/ag/aga/agah/VPHeconf/home.htm
    • Emerging Infections of International Public Health Importance. University of Washington, Seattle, Washington.  USA  http://cer.hs.washington.edu/em_inf/index.html
    • ProMED – Mail. Global electronic reporting system for outbreaks of emerging infectious diseases. International Society for Infectious Disease.   www.promedmail.org
    • Community participation and the delivery of Veterinary services in Africa (2001) A. Catley and T. Leyland. Preventive Veterinary Medicine. 49.95-113. 
    SELECTED BIBILOGRAPHY
  • 23. Asanteni Sana