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

1Ministry 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

3Ministry of Livestock and Development, Provincial Veterinary Office, PO BOX 871, Kakamega, Kenya

§Corresponding author and Presenter : mnanyingi@gmail.com, +254 721 117 845

44TH KVA ANNUAL SCIENTIFIC CONFERENCE , APRIL 2010

ALMOND RESORT, GARISSA KENYA

THEMATIC SESSION : ZOONOSES

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 PATHOLOGYMeat inspectionInterconnectivity (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

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 :

Geographical position: Epidemio-Surveillance

MAJOR DISEASES: Helminthiasis, Nutritional deficiencies and Tick borne diseases

SERVICE PROVIDERS: 19 Agrovets, 9 Practitoners, 2AI,

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

1. Can implementation of veterinary legislations in meat hygiene, drug use and disease surveillance/control significantly improve the overall service delivery in poor resourced regions?

2. 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

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

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)

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

MEAT INSPECTORATE: Status

• 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

• 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.

MEAT INSPECTORATE: Improvements

Khwisero Hypothetical Economic Model

DISEASE CONTROL : Vector and Pests

Pharmaceuticals, AI and Paraprofessionals

VPH global legislative perspective

Lack of adequate Technical Staff

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.

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

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

‘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

Asanteni Sana