Dossier: Blood How to feed 3000 flies? Antwerp top 10
“I survived Ebola” Jean Pé Kolie tells his story
Institute of Tropical Medicine, Antwerp | P³ | No. 1 - September 2015
responsible publisher Bruno Gryseels
editor in chief Roeland Scholtalbers editorial coordination Eline Van Meervenne editorial committee Ildikó Bokros Nathalie Brouwers Nadia Ehlinger Stefan De Pauw Alexandra Hörlberger Roeland Scholtalbers Mieke Stevens Nico Van Aerde Eline Van Meervenne Marc Vandenbruaene Luc Verhelst Daphné Vleeschouwer Maria Zolfo lay-out & photography Stefan De Pauw translations Kristien Wynants contact email@example.com +32 (0)3 247 07 29
Welcome to the first edition of the ITM magazine P³. As you can read in the footnote, its name captures our Institute’s scope of activity. Twice a year, P³ explores education, research and medical services through human stories. Each edition has a central theme. For the very first P³ it is a vital one: we chose blood as the point of departure. This lifeline plays a central role in each bodily function, but it is also under threat from bacteria, parasites and viruses. In the coming pages, you will discover that blood plays an important role in our daily business. P³ is meant for everyone who has an affinity with ITM. First and foremost, the magazine goes out to our staff and students of yesterday and today. P³ is also a magazine for those we work with worldwide, as well as for anybody who simply wishes to learn more about our activities. At ITM we passionately work for scientific advancement and a healthier world. We hope that this magazine will convey some of that passion. I wish the editorial committee the best of luck for this new initiative. Enjoy your reading! Kind regards, Prof. Dr. Bruno Gryseels Director
*P³ - ITM’s essence captured in one letter Our innovative and interdisciplinary research focuses on Pathogens (Department of Biomedical Sciences), Patients (Department of Clinical Sciences) and Populations (Department of Public Health). ITM researchers improve our understanding of tropical diseases, and develop better methods for their diagnosis, treatment and prevention. Others study the organisation and management of health care and disease control in regions where means are limited, but needs are huge. We also focus on the health of animals and the diseases they spread to humans.
5 6 Dossier: Blood
I survived Ebola
14 8 10 Doctors and vampires
How to feed 3000 flies?
Tick versus dipping tank
Do mosquitoes get drunk?
18 15 The ITM number
16 Researcher, midwife, mother
20 Antwerp top 10
1933 - Brussels to Antwerp
22 24 Portrait - Marco Rafael Coral Almeida
ITM and I - Science and romance
ÂŠ The contents of this publication may not be reproduced in whole or in part without the express consent of the publisher. Images in this report were taken with full understanding, participation and permission of the people portrayed. The images truthfully represent the depicted situation and are used to improve public understanding of our work.
Meet the world of tropical medicine and international health in Antwerp
Course overview 2016-2017 available at www.itg.be/education • Master of Science in Public Health • Master of Science in Tropical Animal Health • Postgraduate courses • Short courses
Blood The life-giving maroon liquid that courses through our veins delivering nutrients and oxygen in exchange for carbon dioxide and waste products. The world over, blood is laden with cultural and religious beliefs whilst flowing ubiquitously through language. Blood is thicker than water, but if things are done in cold blood leaving blood on the carpet, this may cause bad blood and result in a blood feud! Many religions believe blood to be the life force of living beings, whilst others view it as a profane substance that must be avoided. In Sub-Saharan Africa, disruptions of social order, weakness and disease are often attributed to a lack of blood. We dedicate the theme dossier of the first edition of PÂł to the all-encompassing topic of blood, which is at the heart of ITMâ€™s activities, exploring related stories, facts and upcoming events.
“I survived Ebola” Medical student Jean Pé Kolie contracted Ebola in March 2014, before health workers even realised they were dealing with an outbreak of the ferocious virus disease. Nursing an early Ebola patient at Kipé hospital in the Guinean capital of Conakry nearly cost him his life. But it also gave his life new meaning when he recovered after several months of solitary convalescence. Roeland Scholtalbers
“Nobody had ever seen a personne guéri, somebody who had recovered from Ebola. People avoided and stigmatised me. Only my mom and a friend from university stood by my side,” recalls Jean Pé, age 28. Jean Pé grew up in Nzekoré, in the inlands of his native Guinea. His dream to build a career in public health had led him to the coastal capital of Conakry, his port of departure to save lives. Jean Pé intended to do so either with his own skilled hands, or by influencing or drafting the policies which would transform his country’s ramshackle health system. P³ | 6
Early 2014, the student specialising in internal medicine was gaining work experience in the surgery unit at Kipé hospital, in the bustling neighbourhood of Conakry which goes by the same name. On the 22nd of March, Jean Pé was on a night shift. “A man was admitted after dusk. I took care of him throughout the night, as he had a fever and was vomiting at regular intervals. He was clearly suffering.” Jean Pé describes the night that changed his life, and what happened next, with a steady voice. The assumption that the man was suffering from malaria
or typhoid fever. The lack of protective gear to handle highly infectious diseases. But also the loss of his boss, colleagues and friends at the hospital who, just like him, had contracted Ebola. “I got depressed when I learned I had Ebola. This had to be the end, because the little I knew from the literature about this disease was its high mortality rate. My mom spent two days in a taxi to come and visit me, but none of my friends showed up. To them I was dead already.” Jean Pé spent three weeks in the recently opened Donka Ebola treatment centre run by
Médecins sans Frontières and needed another three months to fully cover. His thesis on non-traumatic abdominal surgical emergencies seemed a distant memory, and a career in public health an unattainable dream. Yet, less than a year later I find myself at Conakry’s Gamal Abdel Nasser University listening to a detailed disquisition on appendicitis, peritonitis, pancreatitis and other acute abdomen cases. Jean Pé’s pointed finger marks the rhythm of his presentation in front of the thesis committee. “When I regained my strength I was determined to pick up my studies again and to make myself useful in the fight against Ebola.”
“My mom spent two days in a taxi to come and visit me, but none of my friends would show up. To them I was dead already.” And so he did. Jean Pé first joined the health promotion team of Médecins Sans Frontières (MSF) and later got involved in a clinical trial on convalescent plasma led by the Institute of Tropical Medicine in Antwerp. This European Union-funded project, which evaluates whether antibodies in the blood of Ebola survivors can help symptomatic patients fight off the disease, could not
have been without the active involvement of Ebola survivors. Jean Pé became a focal point for the Ebola-Tx project, representing the Guinean association of Ebola survivors. Together with his colleague Achilles and a group of ten survivors, Jean Pé provides information to the population, showing that les personnes guéris are no longer a danger to their loved ones. “We have gone through this terrible disease. We know how it is acquired, what the symptoms are and what kind of care patients receive in the Ebola treatment centres. Poor information about the epidemic, especially in the early phase, has led to myths and misconceptions which are hard to overcome. But survivors
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Doctors and Vampires are best placed to set the facts straight.” They also mobilise donors to give plasma, which could be lifesaving, for the clinical trial. “Survivors are eager to help their compatriots by donating their plasma. Our role is to guide donors and their families through this process, especially since blood donation is quite a sensitive issue in Guinea. The donors also have plenty of practical questions about the donation and the use of their blood plasma.” Jean Pé, who carries around his draft thesis safely tucked away in his backpack every day, gives me a clear-cut answer when I ask him whether Ebola has changed his life or his plans for the future. “I am ever more certain about pursuing a career in public health. What I have experienced over the past year is precious baggage to make that happen.” Visit www.ebolatx.eu for more information about the Ebola-Tx project, including a short film featuring Jean Pé Kolie.
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Blood and research in Sub-Saharan Africa
“Blood is full of symbolism,” said Flor Peeters, a teacher at the Interaction Academy in 2001, following a media-hype in Flanders surrounding the paintings Dave Schweitzer made with HIV-positive blood. “Blood is a binding element and holds a central place in human history. Think of sacrifices which often required blood offerings. When tensions ran high in a society, blood ‘ran in the streets’. Words such as ‘blood bonds’, ‘blood ties’ and ‘blood relatives’ are all age-old collocations that indicate solidarity. But blood is also sacred and has to do with the mystery of life and death. Blood is life, passion and death. In short, you don’t fool around with it.” This was similar in many cultures, and still holds true today in Sub-Saharan Africa, according to Prof. Koen Peeters Grietens, Charlotte
Gryseels and their Unit of Medical Anthropology, in an article in the American Journal of Tropical Medicine and Hygiene in 2014 and in The Lancet in 2015 in relation to Ebola. Prof. Koen Peeters Grietens: “It’s not a good idea to attribute these rumours and beliefs of blood being sold to the local population’s ignorance. People everywhere attempt not only to make sense of sickness and death but to bring order into a chaotic world. Even science does: it is founded upon a universal rational search for causality in reality as we perceive it.
In Gabon, where we worked, disruptions of social order are believed to be part of a phenomenon which locals call ‘evou’: a mystical agent of the invisible world, translated in French as ‘le vampire’. It is in no way related to vampirism and the living dead depicted in various TV series. According to local belief ‘le vampire’ is passively available in most people but is an active force in sorcerers who use it to inflict illness and in healers who use it to heal people. People who are successful in an ‘unnatural’ way, are suspected of having acquired these powers through buying and drinking blood, and through the consumption of the souls of mystically killed innocents.” Consequently, collecting blood in centres where clinical trials take place organised by Western agencies is considered highly
suspect. These rumours and beliefs are a reflection of social injustice and asymmetrical power relations between local communities and international bodies. “It is not easy for a researcher to anticipate these rumors and beliefs. Don’t think that writing a, in our view very clear, informed consent, can resolve this issue. We sometimes invite local community leaders to visit a laboratory or the site of a clinical study to show them what really happens with the blood samples and that there is absolutely no question of selling it to powerful people. Another remedy is for example, to avoid the colour red in symbols, products, fol-ders, or texts. But even so, there is no research on how to handle these rumours or beliefs and how to make them an intrinsic component of clinical trials.
Doctors and Vampires in SubSaharan Africa: Ethical Challenges in Clinical Trial Research Koen Peeters Grietens, Joan Muela Ribera, Annette Erhart, Sarah Hoibak, Raffaella M. Ravinetto, Charlotte Gryseels, Susan Dierckx, Sarah O’Neill, Susanna Hausmann Muela and Umberto D’Alessandro. Am. J. Trop. Med Hyg., 91(2),2014,pp.213-215
Blood as medicine: social meanings of blood and the success of Ebola trials Melanie Bannister-Tyrrell, Charlotte Gryseels, Alexandre Delamou, Umberto D’Alessandro, Johan van Griensven, Koen Peeters Grietens on behalf of the Ebola-TX platform The Lancet 01/2015; 385(9964). DOI:10.1016/S0140-6736(14)62392-8 · 39.21
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How to feed 3000 flies? Ildikó Bokros
Tsetse flies are indigenous to regions of Sub-Saharan Africa and often transmit a devastating disease: African trypanosomiasis, commonly called “sleeping sickness”. If left untreated, sleeping sickness can be fatal, and may affect humans and animals alike. According to the World Health Organisation, the human population at risk is about 70 million in 36 countries whilst the impact on livestock, agricultural development and food security is even greater. Researchers at ITM have been investigating this disease for decades. They study the interaction between the tsetse fly, the trypanosome parasite and the human or animal host and the resistance developed by the parasite against currently used drugs. To aid the scientists in their research, a small tsetse fly colony has been bred at the Institute since 1985.
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The colony The ITM tsetse fly colony consists of about 3000 uninfected producing females. They have a lifespan of 6 weeks and produce three to four offspring. There are about 30 flies in a cage. The room simulates their environment in the wild: a temperature of 26.5°C and 70% humidity.
The bloody feeding process Tsetse flies are blood-feeders. They are fed through membranes made of silicone rubber, overlying trays filled with pools of fresh cattle blood that has not been treated. Under the trays there is a heating mat, which is kept at 37-3°C to simulate a live animal’s body temperature.
every 2 weeks. These insects do not need to eat every day – they are only fed four days a week. Three trays fitting 42 cages are used simultaneously per session. Five minutes are allowed for feeding, taking altogether an hour and a half for the entire colony. The flies prefer to eat in the dark, so the cages are covered with a cloth.
The blood is defibrinated to prevent clogging, then exposed to gamma radiation to kill possible viruses and sterilise it, and afterwards it is frozen. New batches of blood always undergo a “test run”: flies are fed with it through two cycles of reproduction. Their offspring are tested, and if they are sound, the blood can be used. The flies in the ITM colony consume about 140-150 litres of blood per year. This means roughly 600 mL a day or 5 litres 11 | P³
The past Due to increased ethical awareness in the scientific world regarding the use of mammals in laboratories, ITM has searched for alternative feeding methods and has discontinued the use of rabbits for such purposes. As a result, the Institute has switched to using silicone membranes and bovine blood, which has the additional benefit of halving the feeding time. The former lab bunnies have been adopted and are very happy in their new homes!
Lord of the Flies Jos van Hees, a third generation Antwerpian, started working at ITM almost 30 years ago. Having just completed his Bachelor’s degree in Law, he realised he preferred working “with his hands” instead. In 1985 he was given the task by the late Professor Mortelmans to set up a relatively low-budget fly breeding unit for experiments at ITM. Over the years the colony has grown, but Jos never tires of ‘his flies’. He single-handedly does everything the rearing involves, even building the fly-cages himself. Whereas others might find the lab a tad lonely, he truly enjoys the solitude and independence the job entails, not to mention listening to his own music!
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Tick versus dipping tank Eline Van Meervenne
Just about everyone knows that ticks are harmful. This tiny bug is found all over the world and feeds on the blood of its host. A variety of tick-borne diseases affects not only public health but has a considerable economic impact on the production of livestock in the South. ITM scientists collaborate with partners in the South to monitor tick-borne diseases in cattle. Their research is supported by the Belgian Development Cooperation. “If livestock dies, so does the village”, is a well-known African saying that underlines the significant economic value of livestock, which often guarantee the livelihood of poor families. Cows, sheep and goats provide food, are used to cultivate the land and bring in money through the sale of their milk, meat, etc. ITM and the University of Pretoria, South Africa, are working together to ensure the health of both humans and animals. They are focusing their efforts on two regions where farmers and their cattle come into contact with wildlife, i.e. the area near the Kruger National Park, South Africa, and Limpopo National
Park, Mozambique. Certain diseases can spread from wild animals in game parks to cattle and vice versa.
to assess the risks of East Coast fever re-emerging at a later stage in South Africa,” says ITM Prof. Maxime Madder.
Corridor disease is caused by the Rhipicephalus appendiculatus tick that transmits the Theileria parva parasite from buffalo to cattle. The outcome can be fatal within a few weeks. The disease resembles East Coast fever, found in East Africa, which is transmitted from cattle to cattle by the same tick. Even if cattle are treated in time and survive, they subsequently become parasite carriers who in turn spread the disease.
Cattle are completely immersed in a dipping tank that is filled with a liquid that contains acaricide to protect them against ticks. “It is a truly impressive sight,” Prof. Madder continues. “Several farmers bring their cattle to tanks located near game parks. Hundreds or even thousands of cows line up and are immersed one after another. Once they are in, the anti-tick product kills the ticks or makes them release their hold. After the dip, the cattle are screened for other diseases transmitted by wild animals, such as foot-andmouth.”
East Coast fever has been eradicated in South Africa but treatment of corridor disease is prohibited in the country. Infected animals may still be vector carriers after treatment and become a threat to livestock. “Mapping and monitoring corridor disease is essential
ITM scientists are also investigating the growing resistance of ticks and are developing tests to detect the disease and resistance mechanisms. 13 | P³
Do mosquitoes get drunk? Who better than Prof. Marc Coosemans, our expert entomologist, to shed some light on this question. Marc Vandenbruaene
Mosquitoes carry an enzyme known as alcohol dehydrogenase, which breaks down alcohol. This means that mosquitoes regularly come into contact with alcohol, otherwise the enzyme gene would have long since been eliminated in the course of evolution. Mosquitoes dine on fruit juices and flower nectar which have a tendency to ferment and may eventually produce alcohol. Someone
who has had 10 drinks might have a blood alcohol content of 0.2%. To a mosquito a blood meal that contains 0.2% alcohol is like drinking a beer diluted 25-fold. Too little to speak of a drunken mosquito.
host on the basis of this body odour. Sweaty, drunk people are therefore real mosquito magnets.
Researchers have found that mosquitoes find drunk people highly attractive. People who have had a glass or two tend to sweat more, and as a result release a stronger body odour. Female mosquitoes select their
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the itm number
Last year, our Central Laboratory for Clinical Biology received 10,350 blood samples for testing. The laboratory carried out 595,373 analyses for 33,260 patients. Blood, urine and other samples were tested for tropical diseases such as dengue and chikungunya. As national reference centre for the diagnosis of infectious and tropical diseases we performed 30,497 analyses. 15 | P続
Researcher, midwife, mother Three women on the challenges of maternal and neonatal health Every day about 800 mothers die from preventable causes related to pregnancy and childbirth. Most could have been prevented through skilled care and efficient monitoring. Although maternal and infant mortality has dropped by almost 50% since 1990, the Millennium Development Goals (MDGs) on child mortality (MDG 4) and maternal health (MDG 5), have not been reached. ITM and its Moroccan partner École Nationale de Santé Publique (ENSP) will draw attention to these issues during the 57th ITM Colloquium in November 2015 (see box). Three women - a researcher, a midwife and a mother share their story on motherhood Alexandra Hörlberger & Eline Van Meervenne
A social death Bouchra Assarag –Researcher ITM-ENSP
Physician Bouchra Assarag from Morocco obtained her degree in medicine in 2002 followed by a Master in Public Health (MPH) in 2008. Later that year she took up an assignment in a health centre in a remote mountainous region. There she was confronted with the problems faced by expectant mothers who have little or no follow-up after their pregnancy, and no chance of a Caesarean section. They were often affected by social stigmatisation following long-term health problems.
Following this experience Bouchra was convinced that more research was needed on maternal and child health. She decided to undertake a PhD in maternal morbidity at ITM. If complications during or after pregnancy are not properly monitored, severe (permanent) damage can ensue. “For many women, these conditions mean a social death,” says Bouchra. “The women are at risk of being rejected by their husbands and families-in-law. In addition, the unequal relationship between men and women complicates matters and does not allow for an open dialogue concerning sexual health.” Bouchra stresses that doctors, midwives and nurses need better training in the human aspect of deliveries. Clear and open communication is essential. Thanks to Bouchra’s doctoral research, a thorough investigation on the social consequences of maternal complications is being carried out in Morocco for the very first time.
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The missing link Marie Chesnay MPH-Disease Control 2014-2015 ITM alumna
Midwife Marie Chesnay was exposed to the harsh realities of maternal health when posted in Chad. Women too young to be mothers often suffered irreparable damage from while giving birth, whilst others living in very remote areas sought medical help too late, with fatal consequences. However, it was also in Chad that Marie experienced her most powerful experience as a midwife, one day when a troubled young woman was rushed in by her family. The heavily pregnant
adolescent was in labour with a dilated cervix, but would not cooperate with the midwife and nurses owing to a psychological condition that afflicted her. The medical team was forcefully restraining her, afraid that her erratic behaviour was being caused by evil spirits that had possessed her. The situation threatened to end badly because of the lack of communication between staff and patient, when Marie took charge and removed the suffering young woman from the controlling grip of those present. The family was made to wait outside, whilst Marie created an environment in which the young woman felt safe. Refusing to remain on the delivery table, the patient writhed in pain and chose the ground as her sanctuary. The local nurses watched in disbelief as Marie crouched beside her and safely delivered a healthy baby. Marie stresses that a midwife is the bridge between the medical and the social, offering non-judgemental support and removing all other stressors so
that the woman’s focus can be the carefree birth of her child.
The human touch Kévine Nkaghere Mbuembue –MPHHealth Systems Management and Policy 2014-2015 ITM alumna
Kévine Nkaghere from Cameroon is a physician, studied at ITM, and is a mother of two – the most recent of which was born during her year in Antwerp. Looking back, her first child was born in a very different context. In Cameroon, families must save up for a birth, as health care requires out-of-pocket spending and tipping, if extra services are
The Colloquium will make recommendations on how maternal health can be improved in an integrated post-2015 development framework. It will explore how we can work towards a vision of a healthy life for all, beyond reductions in mortality, in line with the UN Global Strategy for Women’s, Children’s and Adolescents’ Health. The conference will focus on three areas: • respectful childbirth; • maternal morbidity and its consequences on newborn’s and women’s health; • maternal mortality surveillance
required. Those who can afford to, opt for an obstetrician to accompany their pregnancy, whilst the less affluent seek the assistance of a midwife. The care received is very hands-on with little distance between the medical professional and patient, which reassures the mother-to-be. In Belgium, Kévine received excellent preand post-natal care, yet felt that she was held at arm’s length. She would have preferred a more human approach amidst the well-planned schedule of appointments and hi-tech equipment. Kévine gave birth to her healthy second child in a Belgian birthing suite, accompanied by her mother and 3-year-old daughter. Had she been in Cameroon, this would have taken place alongside many other women, away from her family. She stresses that both countries have their pros and cons and has learned a lot from both experiences.
MATERNAL & NEONATAL HEALTH BEYOND 2015 ITM-ENSP Colloquium 2015 Rabat, 24-27 November 2015
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the list Henryk Bonte
ITM alumnus Henryk Bonte reveals his 10 favourite activities in Antwerp.
10 things to do in Antwerp
1. Antwerp’s agenda
After I finished my medical studies in Ghent, I did the Postgraduate Certificate in Tropical Medicine and International Health at ITM in 2014. Even though I’m from Belgium, it was quite exciting to move to Antwerp on my own. I have always lived and studied in Ghent and wasn’t too familiar with Antwerp. Luckily Antwerp is a vibrant city, where you don’t get bored easily. I’ve listed my Antwerp top 10 check them out! But don’t let this keep you from exploring the city yourself with your newly-made friends from the Institute!
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Are you bored and don’t know what to do? Visit www.weekup. be, an online weekly agenda and see what’s going on in Antwerp.
the Izzy Maze, where rastamen and lawyers alike mingle on the dance floor.
3. Let’s play ball
2. Mechelseplein The Mechelseplein is the perfect place to start or end an evening near ITM. A charming square packed with vibrant bars and terraces. Have a drink at Antwerp’s oldest bar - De Boer van Tienen - start a party at De Pallieter or get some free tapas at Korsakov on Sunday afternoon. Around the corner you’ll find
My classmates and I used to play football every week. In winter we reserved a hall at the Middelheimcampus of the University of Antwerp to play indoors or when the weather allowed it, we played in Antwerp’s many parks. In the city centre you find many squares where you can play basketball outdoors with the local kids.
4. Antwerp = culture Buy a booklet of culture cheques at ITM’s student service and enjoy the many cultural activities on offer in Antwerp. Discover new music at concert halls such as Trix or Roma. Visit the many museums or just take a stroll around the city.
5. Drink! Are you looking for cosiness, “pintjes” for € 1.80, free nibbles and good music? Check out Cabron near the city hall, play pool at Boogaloo at the Troonplaats or go to Zeezicht at the Dageraadplaats where you can have a drink before eating at Overvloed.
6. Eat! Choose your pick from the wide range of diverse restaurants in Antwerp. Eat falafel at Falafeltof or Benny Falafel. Go vegetarian at Overvloed or Broers van Julienne. Sample Chinese food in Antwerp’s Chinatown. If you’re dining out in a large group, enjoy the Indian buffet at “Aahaar”
(only € 10 per person) near the central station.
7. International Antwerp One of the best things about Antwerp is the international vibe throughout the city. Explore and expand your culinary horizon and go to the many Indian, Moroccan, Polish, etc. shops in Antwerp. An important plus: they are cheap! Visit Chinatown, which is mainly one street, with all kinds of shops and restaurants. Find Sun Wa, a huge Chinese supermarket for food, fireworks or kung fu shoes.
9. Visit Doel Twenty-five kilometers from Antwerp, you’ll find the abandoned village of Doel. After the inhabitants had to leave their houses because of expansion of the industrial area nearby, several artists took over in Doel. Organise a cycling trip and admire the impressive graffiti artwork.
8. Midget golf If you’re looking for the ideal activity for a lazy Sunday, play midget golf in Wilrijk (only 3.5 kilometres from Antwerp). For only € 4 you can try out “minigolf ” where you have to combine strength, intelligence and cunningness. Beware of “hole 10” - it’s a pain in the ass!
Cinema Cartoon’s has a wooden ticket booth, red velvet seats and pictures of directors such as Woody Allen, Ken Loach, etc. Don’t forget to use a culture cheque for a discount. The place also has a nice bar to chat afterwards and allows you to take your drinks into the theatre. Please find links to the addresses of the places in the online version of the magazine.
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1933 – Brussels to Antwerp Eline Van Meervenne
1933 is a key moment in ITM’s rich history. It is the year the Institute moved from Brussels to Antwerp and changed its name from School for Tropical Diseases to Prince Leopold Institute of Tropical Medicine.
More than 100 years ago, in 1906, the School of Tropical Diseases opened its doors to train doctors and nurses in tropical medicine. Not a moment too late it seems, as malaria, yellow fever and sleeping sickness were wreaking havoc in the Congo Free State and private property of King Leopold II between 1885 and 1908. The Prince Leopold Institute of Tropical Medicine refers to Leopold III, not Leopold II. The colony had alarmingly high
death rates among Congolese and European expats alike. The school, located in the buildings of the Brussels École Coloniale, started with only a handful of teachers and three classrooms. The school slowly expanded over the years and with Alfons Broden as its director, it moved to Villa Duden, also in Brussels. In the 20s some fierce lobbying took place between the government and the province of Antwerp to set up an Institute of A Congo boat!
Tropical Medicine in Antwerp. The Institute was to be integrated into the buildings of the Provincial Institute of Hygiene, which was then under construction. The site was a stone’s throw from the Congo docks and allowed sick colonials and missionaries to get medical treatment in the Institute’s hospital as soon as they got off the boat. Ecole de médecine tropicale, Park Duden, 1920
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<< rewind On 11 February 1931 the School of Tropical Diseases was renamed the Prince Leopold Institute of Tropical Medicine. The Institute trained doctors and health officers going to the colonies, to promote research in tropical diseases and to set up laboratories and hospitals. For the first time, research was a key task of the Institute. The director at the time, JĂŠrĂ´me Rhodain, was deeply involved in the move from Brussels to Antwerp. According to him, the Institute had three main tasks: to provide quality education, supported by active research and advise and coordinate laboratories in the Congo.
The laying of the foundation stone, 7 august 1925
On 4 November 1933, the Prince Leopold Institute of Tropical Medicine was officially opened in the Nationalestraat in Antwerp. The brand new building was the result of an architectural competition organised in 1925. Architects were asked to design a plan for the Pro-
vincial Institute for Hygiene. The jury, of which the famous Belgian architect Victor Horta was a member, selected the design by two young architects, Paul Lebon and Marcel Spitael. Eight years later, the result was an impressive Art Deco building in which no detail had
been overlooked. Especially the magnificent staircase, the modern laboratories and the ingenious air conditioning system were praised during the opening ceremony.
Library (Broden Hall), Antwerp -/+ 1933
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Marco Rafael Coral Almeida PhD student Alexandra Hörlberger & Ildikó Bokros
What made you decide to study at ITM? ITM is well known worldwide for its work on HIV, tuberculosis , and malaria, for example, and caught my attention due to my background as a veterinarian. Also, ITM had some projects running in my home country Ecuador and some of my colleagues and even my former boss are ITM alumni. What course did you do at ITM? I did the Master’s in Tropical Animal Health in 2010-2011. What are you doing at ITM at the moment? I’m a PhD student, working on Taenia solium (Pork tapeworm) human cysticercosis, mostly on how the transmission occurs at a population level and its impact in different scenarios. Pork tapeworm can be P³ | 22
very dangerous to human and animal health. While the 2-3-metre-long adults often leave you symptomless, the larvae can get stuck in human muscles and the brain, causing all kinds of trouble: chronic headache, acquired epilepsy, memory loss. Prevalence in Ecuador is between 1-5%, in some parts of Africa even up to 20%.
“The effective control of any disease has to be done in both animal and human populations and the environment.”
What are your plans after ITM? I have already received some job offers from universities in Ecuador. However, international work (WHO, FAO, etc.) is also very appealing because of the big impact you can have on improving the living conditions of regional and global populations. What are some fond memories you have as a student? I have so many! I remember one class with the late Prof. Peter Van Den Bossche. He just wrote two words on the blackboard and then gave a brilliant lecture. The support from staff was enormous when I lost my grandmother (who basically raised me) just few days before defending my master’s thesis. I received a beautiful card signed by everybody in the Department of Biomedical Sciences.
What sparked your interest in science? I have always been curious about life and its processes. Since I was a kid I have been into science books and exploring nature. My family has always been involved in the sciences, so it is a field I am comfortable in. How do you maintain a healthy work-life balance? I try to eat as healthily as I can, buy organic products and cook my own food. I do sports regularly which helps me to relax, and I actually get the best ideas while playing music or exercising. My passion is music (bass guitar), which I think is complementary to science; I cannot think of one without the other.
What do you think about the One Health concept? How do animal and human health affect each other? One Health should be the first concept people learn when studying anything healthrelated. Human and animal populations are linked. We share the susceptibility to many diseases, we belong to the life cycle of many pathogens and we humans are dependent on animal products. If we effectively want to control any disease, it has to be done in both animal and human populations and environments.
What challenges do students face now that they did not, say, 50 years ago? 50 years ago information was scarce and access to it limited. Today young researchers have to deal with information overload: some of the information published is considered to be “noise” (publishing for the sake of publishing), so finding good-quality information and publishing something “new” has become very difficult. What achievement are you most proud of? Working with communities and seeing change!
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itm and i
Science and romance October 1982. Shortly after I graduated as a physician, I registered for the five-month post-graduate training course at the Institute of Tropical Medicine (ITM) in Antwerp. It was as if the door of the tropics opened and I entered a magical world. Jan PhilippĂŠ (Ghent University, member of the ITM Board of Governors)
Although our course took place during the winter months, I will always remember this period as one long hot summer. We found our way, through the magnificent entrance hall, to all kinds of classrooms and dusky laboratories where the most diverse insects were studied in the entomology course. We examined flat and round worms in our helminthology class and we discovered the life cycle of protozoa. Memorable teachers such as professors Gigase and Piot shared their knowledge with us. I never ever got so much insight into laboratory
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work, not even when I was training as a physician. I suddenly found myself in this strange, but at the same time, very real world. Thanks to the Institute, I thoroughly enjoyed some extraordinary tropical experiences in Zaire. It certainly mapped out my professional career as a clinical laboratory biologist. For years, ITM remained a sweet memory, a place that checked the occasional blood sample I sent them. It took almost 30 years before I returned to that magnificent institute. Ghent University asked me to represent them on the ITM
Board of Directors. I went early for my first session and reread the papers sitting on a bench in the lovely gardens that surround the main building. It was and still is an oasis in the city. Meanwhile, ITM has acquired the St. Rochus convent. An aesthetic pleasure thanks to the successful combination of modern architecture with an old convent. Although the building on the Nationalestraat now houses hi-tech laboratories, the former grandeur remains and is perhaps best preserved in the Broden Hall, the former library. Every time I visit the Institute, I feel like I am coming home.
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Calendar 23-25 23-27 27-30 27 1 2-5
OCT NOV NOV NOV DEC DEC
Alumni meeting Ethiopia Colloquium 2015 Alumni meeting Indonesia National HIV symposium (organised by BREACH) World Aids Day Alumni meeting Colombia
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Institute of Tropical Medicine in Antwerp Foundation of Public Utility RPR 0410.057.701 | IBAN BE 38 2200 5311 1172 Nationalestraat 155 | 2000 Antwerp | Belgium Tel: +32 (0)3 247 66 66 Fax: +32 (0)3 216 14 31