Fall 2005 Issue
Perspectives: On-the-Job Training for Disease Detectives in Kenya
The Joint Field Epidemiology and Laboratory Training Program in Kenya is a CDC Foundation program that trains local scientists to respond to disease outbreaks and improve the region’s overall public health system.
- CDC Foundation Program Officer: Expanding CDC’s Reach
- The Resident: Preparing for a Public Health Career in Kenya
CDC Foundation Program Officer: Expanding CDC’s Reach
As a health volunteer in the Peace Corps, I witnessed firsthand some of the devastating health threats facing Africa – HIV/AIDS, malaria, tuberculosis, diarrheal diseases, respiratory infections, meningitis and polio. One of the primary ways I helped address these diseases was by teaching basic computer skills and spreadsheet applications to local health professionals and volunteers. Now, as a program officer with the CDC Foundation, I help CDC set up programs in Africa and other developing regions to help detect and control health threats with the potential to affect both local communities and communities around the world.
One of the reasons developing countries often have higher rates of disease is that they don’t have enough public health scientists or clinical facilities. No one is watching for the first faint signs of a potential disease outbreak, so diseases are able to affect entire communities before they can be identified and stopped. For 25 years, CDC experts have worked with developing countries to increase public health training opportunities through field epidemiology training programs. Students receive “disease detective” training in their own countries that is tailored to address the regions specific health needs. They participate in disease outbreak investigations and help design programs to improve health that immediately benefit local communities. Currently, CDC has field epidemiology training programs in 31 countries. The CDC Foundation and its partners have provided support for programs in Brazil, India and Kenya.
The training program in Kenya is unique. In 2002, the CDC Foundation received a grant from The Ellison Medical Foundation to establish a field epidemiology program in Kenya that included a laboratory training component. In addition to teaching field investigation skills, the program trains participants to use lab techniques to quickly identify the source of an illness or potential outbreak. Once they complete the two-year program, participants receive a master’s degree in public health and graduate to work with the Kenya Ministry of Health, where they help the country respond to emerging threats and prepare for future public health needs.
In my role as Foundation program officer, I work with CDC staff in Kenya and Atlanta to ensure that program goals are met, resources are used appropriately and strategies are designed for the programs future success. I am proud to be a part of this program because as a Peace Corps volunteer, I saw the need for public health training, and as a Foundation program officer, I believe we are meeting that need by providing top quality training opportunities that otherwise would not be available. With the skills they acquire in our program, health scientists are prepared to protect hundreds or even thousands of individuals from disease, injury and death. Working with the Kenya field epidemiology training program is a great opportunity to apply my passion for improving health in Africa and to work with many other dedicated individuals who share this passion.
I look forward to working with these individuals to continue to improve and expand the Kenya program. Diseases do not stop at Kenya’s borders. We believe the Kenya field epidemiology training program shouldnt either. We are beginning to expand the program to help train scientists in neighboring countries, including Tanzania, Uganda and war-torn Sudan. The challenges are immense, but so are the opportunities. I salute all of the residents who commit to completing this challenging program and to protecting the health of their fellow citizens in Kenya and around the world.
– Matt Coles, CDC Foundation Program Officer
The Resident: Preparing for a Public Health Career in Kenya
On May 14, 2004, I was mid-way through a biostatistics lecture when our resident advisor, Dr. Chris Tetteh, asked the lecturer if he could make an urgent announcement. A mysterious disease had been reported. A number of patients had been admitted with acute jaundice and many had died. The Ministry of Health requested that CDC’s Kenya Field Epidemiology Laboratory Training Program assist in investigating the cause of this mysterious illness.
Suddenly, it occurred to me that, despite the fact that I had been in training for just three weeks, my colleagues and I were about to begin our first outbreak investigation. We put our training into action, designing a questionnaire, arranging for all the logistics, setting up laboratory equipment and procedures and beginning the investigation.
Our investigation revealed an aflatoxicosis outbreak caused by molded homegrown maize. It was, in fact, the second largest aflatoxicosis outbreak ever reported! The Government of Kenya responded with a massive maize replacement and public health education program that contained the outbreak. This was my induction into the Kenya Field Epidemiology and Laboratory Training Program.
Two months before, I had come across a newspaper advertisement for the program and applied because, though I had an interest in public health, I lacked postgraduate training. After a rigorous interview, I was among the seven pioneer trainees selected. The four-week introductory course was very demanding. For eight hours a day, we were bombarded with biostatistics and the principles of epidemiology. Those lessons also instilled in us the self-discipline an epidemiologist needs to meet tight schedules and deadlines.
Acquiring computer skills was especially challenging...and a little bit comical. Imagine a clinician who has never used a computer before trying to learn statistical software! On being issued a state-of-the-art laptop, I had not only to learn data management for epidemiology, but also basic typing skills. Looking back, I don’t know how I managed.
In the 16 months that I have been in the program, I have participated in four outbreak investigations – aflatoxicosis, cholera, meningitis and methanol poisoning. I served as the principal investigator in two of these investigations. My colleagues and I also participated in a survey to assess compliance to a new seat belt law in Kenya. It was interesting to learn that people need more than legislation to adhere to new laws; they need education! I presented the findings at an international scientific conference in Beijing where I was honored to represent Kenya.
In order to acquire necessary competencies, all residents in the training program are attached to various Ministry of Health departments where they not only learn, but also provide skilled services in epidemiology. My first 12-month attachment to the Ministry of Health gave me an opportunity to evaluate Kenya’s communicable disease surveillance system. I made recommendations to help improve the system’s accuracy, completeness, timeliness and capacity to disseminate information. I also helped analyze road traffic and cholera surveillance data.
The most challenging part of this program is balancing acquiring competencies and skills, offering quality epidemiological services to the Ministry of Health, and meeting the rigorous academic needs for a master’s degree in applied epidemiology ... all in two years. I hope to complete the program by March 2006 and then work with the Ministry of Health, either at the national or provincial level in disease control programs.
The most urgent public health needs in Kenya, in my own assessment, are strengthening disease surveillance at the district and provincial levels as well as improving the timely detection and response to outbreaks. I am glad to be a part of CDC’s Field Epidemiology and Laboratory Training Program, which really addresses these gaps. The competency-based training program is tailored-made for Kenyan public health needs.
– Dr. Patrick Mboya Nguku, Kenya Field Epidemiology and Laboratory Training Program Resident