We are pleased to announce the winners of EMPHNET’s 2016 writing contest Voices from the Field. After the review of all submissions, we now have the three winners. In the words of our committee members, these winners “spoke of achievements in the field in a personal tone and an eloquent style.” We thank them for their creative contributions, and we also thank the other contestants for taking part in our contest. And the winners are: First place: Dr. Yasser Mohammed Hasan Al-Eryani Title of Article:  Epidemiology and War Time Yemen Country Program: Yemen Prize: An all-expense paid opportunity to attend EMPHNET’s fifth regional conference and a chance to talk about the entry in an informal session. [su_expand height="150"]It was the end of the Islamic month of Ramadan 1435 (the beginning of July 2015). In the late evening, I  got a call from Mr. Mohammed Mahdi a director of a health facility center in the remote, mountainous, and difficult to access village of Go’ar, in the Raymah governorate in Yemen. He was asking for urgent assistance with emerging cases of unusual skin lesions among internally displaced persons (IDPs) in two  small villages: Al-Jabal and Al-Maraweh, for both of which the Go'ar health center offers health services. Those IDPs fled from the big cities of Yemen to their original cities and villages because of the war that has been taking place in Yemen. I advised him to contact the district surveillance coordinator through the official disease notification system. Speaking anxiously, he confirmed that he had already contacted the district health system  surveillance, but he got no response. We were facing a difficult time of war. This was exacerbated by the absence of essential living services: electricity, water supply, and cooking gas; and medical supplies. This led to stress, fear and overloaded tasks; and we knew from the World Health Organization reports how war was disrupting the surveillance    system. I sent an urgent SMS message to the director general of disease surveillance, who actually was so busy with the emergency committee for both the country’s primary health and curative health services. He texted me soon afterwards saying, "Tell him [the district surveillance coordinator] to go through the governorate’s official surveillance channels." Back to our case, there was no time to blame anyone and criticize this unusual delayed response by the official district and governorate coordinator. I was occupied by wordslike, outbreak, threats, complications, pandemic, and rapid response! At the same time, it was not my duty to help. It was a dilemma, wasn't it? I just followed my epidemiological sense of commitment as a member of the directorate, and my obligation to my honorable community. So, I immediately contacted my Friend Dr. Mohammed Abdul Jabbar Noman, Assistant Professor of Dermatology at Sana'a University. I discussed with him the increased number of people who manifested those skin lesions (more than ten at the time- aged between 2-15 years old). I sent him the photos of the cases and connected him with the health facility. He subsequently developed a case sheet covering the clinical and environmental aspects of the camp. After collecting and interpreting data, he made a differential diagnosis. The lesions were symptomatic of scabies, and so he recommended prophylactic measures and prescribed curative medications. Finally, few days later, I was informed that most cases have been cured and the outbreak stopped. Actually, two cases were left in the city of Al-Hodaidah which is the capital of the nearby governorate and has better health facilities and services than Raymah governorate. Unfortunately, our communication was through WhatsApp which –as we all know- undergoes continuous updates at interval times. So, all communication was deleted for a reason or another: we did not follow the instructions of keeping old conversations due to the overloaded memory. However, we still have two photos of the cases and the health facility registrations. At that time, I was not interested in considering the scientific validity for this ad-hoc rapid response by good documentation because the war, the bloodshed, the damage to the infrastructure, and the innocent victims made us only try to do something about it, as soon as we could. We could not document everything, especially when we saw people in the field doing their work at high risk for their safety. Fortunately, I read an announcement on EMPHNET’s website titled "Voices from the Field" which encouraged me to write about that unique and fruitful experience. I wrote this article as an answer to the EMPHNET’s question: "Are you proud of your achievements?"   [/su_expand] Second Place: Dr. Zakia Abadane Title of Article:  From the Clinic to the Field Country Program: Morocco Prize: An opportunity to choose between a one-year subscription to a medical journal of the winner's choice or a chance to attend an online course. [su_expand height="130"]My life changed overnight. From a family doctor dealing with mountaineers and nomads in the High Atlas Mountains to an epidemiologist monitoring databases in search of alert signs was not an easy transition. On September 24th, 2012, I flew from Warzazate, the door of the Moroccan desert to the mythical Casablanca, my hometown. The next day I moved to Rabat and a few hours later, I started my first day as an FETP participant at the National School of Public Health, and there was the start. My family was thrilled. After five years working in one of the most remote areas of the country, I would finally return to civilization to resume a normal life. But my father kept asking me embarrassing questions: “What is epidemiology? Does it offer you clear perspectives for your career plan?” I felt disappointed. My family had trouble understanding why I came to the decision to put aside my white coat and leave behind my hectic years of clinical training to manage numbers or improbable epidemics. I had my own doubts and even questioned my decision. Despite my keen desire to explore the different aspects of medicine, I was wondering if I had made the right choice by shifting my goals from treating patients to managing abstract concepts of morbidity and mortality in a population. On the one hand, in epidemiology we deal with epidemics, so stress is a key component of our work. On the other hand, the least appealing side was financially related. Being in a public health discipline, epidemiologists do not live high on the hog. So, was it worth the sacrifice? The medical profession offers much more comfortable and fulfilling alternatives both on personal and financial levels. This was the issue I was facing and I could not wait to explore its different aspects. In fact, after two years of training, I was going to start working at the Public Health and Epidemiological Surveillance Service in Casablanca. In September 2014, our FETP cohort joined the field. We were witnessing a historic epidemiological event: the epidemic Ebola virus was spreading at high speed in West Africa, and the world held its breath fearing the spectrum of a pandemic. The times were very serious, but we knew- as novices in the field- it was a rare opportunity from which we can learn how to apply theory in the field. Due to its geographical situation and proximity to affected areas, Morocco implemented preventive health measures to raise awareness by monitoring passengers, at entry points, three weeks after their return from countries affected by the epidemic. This was done particularly at the Casablanca Airport, a key transportation hub between the world and West Africa. It was a dangerous situation where the stakes were high and the involvement of all partners at different levels was required. The high commitment and effective coordination made it possible to deal with the outbreak and fight the disease. The Ebola experience for a budding epidemiologist, like myself, made me aware of the fact that Morocco was not immune to the growing risk of global epidemic threats. Hence, there was a need to strengthen internal collaboration between public and private institutions. They needed to pool their human resources and technical skills in order to anticipate and promptly respond to threats of epidemics. In fact, I had previously the great privilege during my FETP training to participate in a leadership training workshop of the Network Alert and Action Epidemic (GOARN), a network established by WHO in April 2000 to help countries manage epidemiological or pandemic crises. During my participation, I realized the importance of leadership in global health and epidemiological surveillance, and our role as FETP graduates to help countries in the region strengthen their position in the global network and create new partnerships in the field. During those 16 months of work in Casablanca, I had the opportunity to dig into the reality and face field challenges as part of epidemiological investigations. Interventional epidemiology is a race against the clock, and it requires the use of evidence- based medicine, common sense, and many times diplomacy. In this time of domination of social media, information travels fast. We must constantly be vigilant and be ready to respond to real emergencies amid the plethora of false rumors that can easily lead to panic in the population. Epidemiology has taught me to broaden my horizons by adopting a new paradigm: my target is now supporting whole communities and not specific individuals. This is how things changed for me: generalization has taken over therapeutic decision, and statistical significance became my primary focus. In epidemiology, we learn to temporize, taking into account individual variability, as well as interaction with environmental factors. The clinician in me must constantly initiate dialogue with the epidemiologist. The challenge is big, and I am proud to be part of the epidemiologist’s community, helping to strengthen global health security. [/su_expand] Third Place: Dr. Samar Jazzazi Title of Article: Challenging the Myths of Immunization Country Program: Jordan Prize: A Dell Latitude E5450 laptop [su_expand height="125"] One of the most important achievements which I am proud of in my field work is helping people who did not think that they needed help. From my experience in the field, which focuses on outbreak investigations, health research, immunization, and others programs; I met different kinds of people with different visions of health care. Some of them thought that because they ate organic foods -as they claimed-they did not need medical care. Others hesitated to talk about their illnesses or to seek medical help from doctors because they believed in alternative medicine. Others believed that their children did not need routine immunization. In Ajloon, back in 2004, there was an outbreak of tinea capitis in Sachneh village because hairdressers were giving special offers on haircuts: for your children, get two haircuts and the third is for free. Parents did not know that this would cause illness for their kids if hygiene standards were not met. We spent a lot of time explaining this to them through health education. Similarly, in Deralla, during a typhoid fever outbreak, we reached a lot of houses where people kept their animals inside the house. We advised them to separate the animals from their children, and we gave all women of childbearing age a tetanus vaccine and all children the needed routine immunization. We also educated this community on how to look after their health and how to get good health care in nearby health centers. We explained to them the importance of family planning. They were satisfied with our visit, especially because they were able to speak freely to a female doctor, as they stated. While working with the mobile national immunization team in my governorate, I visited a lot of people in their homes and tents in areas where the risk was high for vaccine preventable diseases. These areas were far away from cities or villages, and it was hard to reach these people. There, an old woman refused to vaccinate her newborn grandson because she believed that he was born in a natural setting. His mother ate organic food, and she breastfed him. I remember we spent a lot of time explaining to the mother the importance of this vaccination. At the end of this visit, she agreed to vaccinate the child and all female family members of childbearing age. She also asked me to give her my telephone number and my work address. On another occasion, we met a very nice woman. She had four married sons who all lived in tents. When we came to her tent and explained the aim of our visit, she welcomed us and she called all her daughters-in-law, along with their children, and she explained to them the importance of these vaccines. We vaccinated them one by one. I admired the fact that she took all the immunization cards so she can keep them a small box where she kept all important documents for her family. I am happy that I had this opportunity to meet all kinds of people in different places with different beliefs. I was happy to talk to them about their knowledge of vaccines and other health topics. Finally, I believe that in the field we can see every unsuspected thing. I like my job, especially when women talk to me about their private health problems. I feel that I have their trust and I thank God for that. [/su_expand] Note: For the other contestants, stay tuned for the announcement of the contest’s social media prize (the fourth). You might still have a chance to win!