Sunday, April 3, 2016

Dr. Tony Aliro: the heart of the matter


A week ago I listened as Okello Francis, wearing his signature wide, knowing grin, lowered his cell phone and said to me "We have been granted our radio time by Dr Tony...and the doctor..." Francis chuckled, "the doctor wants to meet you."  I've long known that the four Big Fix team members I live with are the visible part of the iceberg that rises above the waves, and that a solid expanse of effort rides underneath. Dr. Aliro is the Gulu District Veterinary Officer (DVO) and he is a key part of this support. But let's face it, in the States it's rare that someone with intense work demands and an important job title wants to meet you, just to know who you are-- not to talk to you about 'crafting the message', inquire about your motivation, or check up on your work.
For my first visit with Dr Aliro, Dr. Wilfred drove me over to his office. As we waited for him to arrive after a field call I had time to desperately wish I'd brought my camera to document the recurring theme I've experienced at school district headquarters, medical laboratories, recording studios, and now the department of agriculture: that much can be done with what Americans call "nothing", and that large parts of the world still function with only a paper log book and a precious pen. When there IS something that runs off electricity it requires blanketing to keep the red dust from fingering its way into the working mechanisms.
Notice the yellow jerry cans of water at the base of the bookshelf :)

Dr Aliro greeted us with easy humor and said I could come back and take pictures at any time. One thing I've learned, however, is that people stare at me wherever I go and official-looking armed guards often ask my business. (Armed guards are in many places--supermarkets, universities, churches...)
Two days later, I was lucky to catch up with him again. Dr Aliro's position with the government is analogous to the position of a state veterinarian in America, only imagine one state veterinarian for 20 or 30 states. And imagine those states lacking the infrastructure of plumbing. Or road access as Americans know it. Or electricity. Or Amazon.com.  A sense of humor, proportion, and great faith develop in place of many of those things.

There are some stories that are shared through narration and other stories shared through a feeling. When I asked what lead Dr Tony to the veterinary field his demeanor became centered. He began to gently rock back-and-forth in his  chair. "Some things you know in your heart" was the phrase he lead with. A darkness scurried across the desk between us as he carefully chose words to describe his childhood. But he lightened when he spoke of working with livestock, especially all their cattle, every day. I sensed the daily connection with the animals provided something available no where else in this childhood. He then described how, when there was need to call for a veterinarian for their animals, that person was rarely a source of help and he was left to wonder if the creature's suffering could have been averted, and if so, how? While listening I scribbled in my book "the spirit of inquiry". 

What's struck me while harvesting stories from veterinarians here about their career choices is how close each of them came to engaging in a career in education instead of medicine. In these men I can clearly see the skills shared between two fields viewed as disparate where I come from: communicating and mobilizing, working to problem-solve in a wide variety of circumstances with pressures and limitations coming from all directions.

We agreed that the phrase "Got your back!" describes the relationship between Aliro and The Big Fix team, but I asked him to describe why it was important to support TBF in his own words. His response bolstered my understanding with numbers. Prior to having these guys around he might receive 2000 rabies vaccines to inoculate 15-20,000 dogs where the disease is endemic. The lack of resources and support infiltrates Ugandan veterinary medicine at every level. He sites the magnitude of dealing with these challenges as one of the most important things dissuading young people from committing to veterinary medicine even if they feel the calling. Makerere University in Kampsla has a challenging veterinary program that's been running for many years ( I toured the facility in 2005 and was impressed!) but not surprisingly earning potential for young vets is higher outside of Uganda and certainly outside of Gulu.

It's a character prerequisite to enter the veterinary field here knowing every challenge is  an opportunity. When I asked Dr Aliro if he had any final thoughts he wanted Americsns to know he gave an open invitation to anyone looking for thesis work, clinical trials, further study and just plain hard work and satisfaction. Wanna study tick- born diseases? Newcastle disease? Have an interest in zoonotic epidemiology? Swine disease transmission? I'll be damned if I wasn't inspired to dream up PhD work! So, my American friends and veterinary allies...when are we going to make it back here to start? We really are all in this together.