In many wildlife-protected areas in Uganda, communities and wildlife are sharing habitats, living closer and interdependent lives than ever before. Dr. Gladys Kalema-Zikusoka is linking Uganda's wildlife management and rural public health programs to create common resources that benefit both people and animals.
The New Idea
In Uganda, public health programs are managed separately from conservation programs in wildlife-protected areas, using different resources and institutions. This traditional approach has overlooked their interconnection, specifically the problem of zoonotic transmission of diseases between human beings and wildlife that threaten the success of conservation programs. Gladys facilitates institutional change and the creation of new resources dedicated to the control of zoonotic transmission of diseases through linkages between the Ministry of Health and Uganda Wildlife Authority (UWA).
She has developed a set of interventions that help communities living in and around the national parks to manage their health and to change their attitudes, seeing themselves as active participants in protecting wildlife. The result is a new early warning system for disease outbreaks in both animal and human populations that facilitates timely interventions from both public health and wildlife conservation programs. A wildlife health monitoring program constantly monitors and treats diseases in the animal population. A public health program improves human health and prevents transmission of disease among humans, wildlife and livestock by engaging the community as monitors of treatments and hygiene. Lastly, an information and education campaign constantly keeps the community knowledgeable about the link between public health, sustainable environments, tourism, and livelihoods.
Similar to other communities living in and around protected wildlife areas, the people of southwestern Uganda are amongst the poorest with very limited access to information, services, and resources to cover health, education, housing and other basic needs. Originally, these communities were subsistence agriculturalists and herders, growing food mainly for home consumption and living off their cattle with very little saved for sale. The booming tourism in these areas, especially from the mountain gorilla trekking, diversified the economic base from agriculture and herding to services for tourists. Those continuing to practice agriculture present a conflict of interest with those dependent on the presence of wildlife. The close proximity between communities and wildlife, including mountain gorillas, creates conflict, as wildlife frequently ventures into human settlements and destroys crops and livestock. The lack of a compensation policy fueled human hostility towards wildlife and frustrated numerous wildlife conservation programs.
However, this close interaction between humans and wildlife presented an even bigger threat—the possibility of transmission of diseases between animals and people referred to as ‘zoonoses’ in veterinary terms. In a bid to protect wildlife and boost tourism, the government declared areas inhabited by wildlife as ‘protected areas,’ limiting human access to land and other resources. This policy left many people without land, contributing to land conflicts. However, Gladys believes that cross-contamination between human, livestock, and wildlife population—a trend hidden from current approaches to conservation and public health—is the leading threat to the success of conservation programs and the centre of the human/wildlife conflict. Communicable diseases such as tuberculosis and scabies are easily transmitted between people and wildlife. These mostly affect the gorillas, which are closely genetically related to humans—scientists show a 98 percent genetic resemblance.
In 1996 and 2000 there were two outbreaks of mountain gorilla scabies in the Bwindi Impenetrable National Park, resulting in the death of an infant and severe symptoms of hair loss, scratching, scaly skin and illness in the rest of the gorilla group. In both instances, the scabies outbreaks were traced back to people living in and around the national park. Scabies is a disease that thrives among low income groups of people who live in crowded conditions with very limited health services and poor hygiene information. In 2004 an outbreak of anthrax in the Queen Elizabeth National Park—which receives the highest number of visitors in Uganda at over 46,000 tourists per year—killed over 300 hippos (8 percent of the hippo population). Besides the negative impact on the tourism industry, the disease outbreak was a great health risk to the human and livestock population in the area. The problem of zoonotic disease transmission is not restricted to people living in and around protected areas. The recent Bird Flu pandemic has the potential to affect people in all parts of Uganda where wild birds nest. Government and private initiatives have overlooked the issues of cross-contamination between humans, livestock, and wildlife. Although operating in the same communities these initiatives address conservation and public health as independent fields. Human health authorities (Ministry of Health) and wildlife authorities (Uganda Wildlife Authority) have injected large amounts of resources to address public health and wildlife health/conservation independently, yet the problem of zoonotic disease transmission still presents a major threat to both human and wildlife populations.
Conservation programs are facing uphill challenges, mainly because there are no measures to compensate herders for culling sick livestock or farmers for lost produce accruing from disease transmission. In the case of public health programs, local people have few incentives to participate in seeing through the interventions. The declining health status of human beings affects the health of animals and is a threat to the success of conservation programs.
Starting in the Bwindi Impenetrable National Park in southwestern Uganda, Gladys is linking national conservation, public health institutions, as well as communities to create fresh institutions and resources that improve both animal and human health.Gladys has set up a wildlife health monitoring infrastructure that monitors disease trends among the gorilla population and links animal health with human health. A human public health system compares disease trends in humans to those in the gorilla population and rallies the community as observers of disease treatments. Finally, an information and education campaign keeps the momentum of the human and animal health program by constantly raising awareness on the link between public health, conservation, ecotourism, livelihoods and the economic value of wildlife.Because the mountain gorilla is endangered and any disease outbreak will have catastrophic consequences on the remaining population, Gladys begins by keeping track of the disease trends in the gorilla population to capture patterns and act swiftly on diseases before an outbreak.
She has partnered with the UWA which has the national mandate to run conservation programs and manage the national park, to run the program. Park rangers and gorilla trackers from the UWA collect mountain gorilla fecal samples from the interior of the forest and pass them onto Gladys’ staff for analysis. The analysis is carried out at a field clinic. The clinic is equipped with microscopes, test tubes, and other equipment to acquire accurate study results. She has recruited a locally based laboratory technician who carries out the analyses and runs the facility. Since July 2005, Conservation Through Public Health (CTPH) has analyzed over 2000 fecal samples. The results of the laboratory tests provide information that directs action programs and shapes policy on conservation in the short and long term respectively. The results are also shared with public health officials to guide interventions in human health. The wildlife health monitoring program involves health checks and treatments on sick wildlife and postmortems on dead wildlife. To effectively address zoonotic disease transmission, an equally intensive analysis of health trends among humans is required. Gladys has brought together public health officials, private health practitioners, UWA officials and the community to monitor and treat diseases.
By comparing disease trends from the animal health program to human health trends, the human public health program ensures that no diseases are transmitted between humans, mountain gorillas, and other wildlife. Using data from the animal health program, CTPH collaborates with public health officials to closely monitor disease trends in human populations and treat them swiftly before they spread. Disease trends in human populations provide an early warning system for possible outbreaks in the animal populations. This information is shared with UWA to plan interventions for the animal health program. First concentrating on tuberculosis, a big threat to the mountain gorilla, Gladys has adopted the Community Based Direct Observation of Treatments (CBDOTS) program. CBDOTS was invented by a community-based doctor to improve effectiveness of tuberculosis treatments in communities. The program searches for TB patients and puts them on TB treatment. It also involves volunteer community members—usually an immediate neighbor—rather than doctors, following up on patients to ensure that treatments are followed correctly and fully. Since CTPH’s expertise is in conservation, Gladys engages community health centers in the area to execute the program. So far CTPH has put 36 people on the CBDOTS program. Gladys’ information and education program raises awareness about the link between human health and wildlife health and the economic value of wildlife. CTPH targets local volunteer drama groups working to promote either conservation or public health.
The groups create drama shows with messages that show the link between human health and gorilla health, modeled around brochures Gladys produced as a UWA veterinary officer. The shows, performed at public gatherings, attract a cross section of the population— children and adults alike—sending out the message in an entertaining manner. Gladys invites public health officers, veterinary officers, and UWA officials to utilize the forum to educate the public about the interrelated nature of animal and public health. To reach a national and regional audience, CTPH films the drama shows and adds subtitles in various languages. Since the beginning of the program in February 2005, CTPH’s message has reached over 5,000 people. CTPH also puts up health message signposts around Bwindi sending the same message—the link between human and gorilla health. Since October 2005, CTPH has erected five signposts and plans another 56 signposts requested by the community.
Dr. Gladys Kalema-Zikusoka developed a strong connection to animals as a child. She grew up with pets at home, and by the age of 12 had decided to become a veterinarian. While in high school, Gladys gained an interest in wildlife, biodiversity and environmental issues, and started her career in conservation at the age of 18, when she revived a wildlife club in her secondary school that had not been functioning for five years.During veterinary school at the University of London, she conducted research on intestinal parasites in wild chimpanzees (Budongo Forest, northwestern, Uganda) and parasites and bacteria in tourist-habituated and non-tourist-habituated mountain gorillas (Bwindi Impenetrable National Park, Uganda).
She found that gorillas visited by tourists had a higher parasite burden than those not visited by tourists, implying that tourism can have a negative impact on mountain gorillas’ health. This experience opened up her eyes to the need for veterinary services in conservation programs. Because conservation programs are run mainly by citizen sector organizations, Gladys taught herself about managing such programs and obtained a Duke University certificate in Non-profit Management during recess in her master’s academic program at North Carolina State University and Zoological Park.Between 1996 and 2000 Gladys set up the first Veterinary Unit in Uganda Wildlife Authority and has continued to make strides to improve the health of wildlife through her organization, Conservation Through Public Health.