Getting a Feel for Beef Cattle

Coveralls? Check. Rectal sleeves? Check. Paraffin lubricant? Check.

With these necessary tools, Allie and I set out on another trip with Erik. This time, to perform pregnancy diagnoses on 1,500 beef cattle in Ghanzi, a town in the western part of Botswana, very close to the Namibian border.

The drive from Gaborone to Ghanzi (that should have taken about 8 hours) ended up taking closer to 11. We watched the sun disappear below the horizon (probably the most beautiful sunset I have seen so far). Driving proceed much more slowly after that, as we had to constantly slow down for cows, goats, donkeys, or wildlife by the side of the road. Driving in the dark, we watched the Kalahari come alive, as many of its inhabitants are nocturnal. We spotted two different types of antelope (duiker and steenbok), porcupines, spring hares, and an occasional kudu. Late in the evening, we reached the farm manager's house, our home for the next few days. After introducing ourselves to the farm manager, his wife, and three adorable children, we called it a night and prepared ourselves for the first day of work.

We woke up much earlier than 6:30am alarm to the sound of roosters crowing right outside our window. Following this slightly rude awakening, we quickly changed into our coveralls and headed to the kitchen to eat breakfast. We filled our stomachs with coffee and rusks (like a hard cookie similar to biscotti) before finding out that there was also pap (a traditional south african maize-based dish similar to oatmeal or grits) and meatballs for us. 

Pap

Rusks

Then we headed out to the cattle posts to begin the pregnancy checks. On day 1, Allie and I followed behind Erik and tried to identify the things that he described: an enlarged uterine horn (2 months pregnant), caruncles and a mouse-sized fetus (3 months pregnant), a cat-sized fetus descending in the pelvis and fremitus in the middle uterine artery (4 months pregnant), a small dog-sized fetus at the bottom of the pelvis (5 months pregnant), etc. At later stages of gestation, you can even reach your hand into the pelvis and put your fingers into the mouth of the calf or palpate a well-defined hoof beginning to extend into the birth canal. In the case of a non-pregnant cow, we identified the cervix, two similarly sized uterine horns and both the left and right ovaries.

Our PD "prof" Erik

He made it look and sound so easy, averaging 1 rectal exam per minute (500+ pregnancy diagnoses each day). So by day 2 we decided to test ourselves by guessing the stage of pregnancy and then double checking with Erik's diagnosis. Unfortunately, doing so was not nearly as Erik made it seem. Many times it was hard to differentiate a caruncle from an ovary, fremitus from a normal pulse, or to distinguish between a fetus that was descending into the pelvis from one that was ascending. Feeling frustrated and extremely sore in my left arm, I decided to take a short break. Only then did I notice that I was beginning to get sunburnt...on my ears and un-gloved right arm. Realizing that we had left the sunscreen back at the house, I did what any Bushman would do and turned to nature, slathering cow dung all over my right arm. I rubbed this "Botswana sunscreen" on the reddened areas. Though I nearly gagged from the smell at first, it quickly solidified in the heat and worked like a charm, despite all the strange looks I got for it :) 

Botswana sunscreen 

By day 3, we finally started to get the hang of PDs. Our accuracy had improved drastically from the day before, and we were able to determine the stage of gestation (give or take a month) most of the time. Though we still have a long way to go before we match Erik's skill level, it is incredible how much exposure we gained within 3 days. We finished the 1,500 cows earlier than expected, so Erik took us on a short field trip to Namibia. I had mentioned how much my dad wants me to go there, so we drove about 20 km from the farm and arrived at the Botswana/Namibia border. Although I still can't say I've been to Namibia, at least I've seen it. On the way back to the farm, we saw zebra, a red wildebeest, kudu and eland. 

Namibia

At the end of each day of palpating cattle, we had a hot bath and home-cooked meal to look forward to. We were treated to more traditional South African food (poike, steak and even warthog sausage) and enjoyed good food and company around a blazing fire and underneath a full sky of stars. Overall, we had a great time in Ghanzi, not only because we were able to see so much, but also because the trip allowed us to see a completely different part of the country (and a little bit of Namibia) as well as some incredible wildlife. 

Camping in the Kalahari

This past week was probably the busiest yet (hence the lack of blogging). Allie and I got to see and do so many things that it would be impossible to list them all in a single post. Instead, I will briefly mention some of the highlights from the past few days.

Monday - I performed my first cat spay! The clinic obtained three female cats from the BSPCA and allowed me and another veterinary student from the University of Glasgow to sterilize them. Dr Mbatshi guided us through the procedure and offered help and tips when necessary. I was able to locate  and ligate both ovaries and the cervix before removing them and closing up the incision. Mbatshi is an excellent and patient teacher, and the surgery went smoothly. Hopefully I will have the opportunity to practice my spay technique over the next few weeks so I can become more comfortable with the procedure.

On Monday night, Allie returned from Thailand. I'm very happy to have her back and have enjoyed hearing stories from her trip. 

Tuesday and Wednesday - Allie and I went into the clinic in the morning and left for Jwaneng in the early afternoon to continue working with the baboons. However, first we had to make a stop at Erik's house to pick up camping supplies and got to hold lion cubs that he and Marlize are rehabilitating. After arriving in Jwaneng, we drove around the mine and adjacent game park trying to get a better sense of the number and size of the troops. At sunset, deterred the baboons from sleeping in the office areas by shooting a shotgun (loaded with blanks) at them. It seemed to work temporarily, but the baboons returned the next evening. We chased them off again before heading back to Gaborone. 

Thursday - We started off with a cat castration in the morning (unlike the first time, all of the tools functioned properly). After we finished, we went into one of the consultation rooms to help with the morning appointments, but we were quickly called out to help in the other consult room. A client had brought in 3 cats and 1 dog to be euthanized. He was moving to Canada and not able to take them with him. The vets reassured him that euthanasia was the best option in the situation. I found it difficult assist in putting these animals to sleep, especially the cats, which were young and healthy. Therefore, Allie suggested that we use the animals to practice spaying. That way, at least their deaths would serve an academic purpose. It turned out that the cats had already been spayed, so instead we pretended as if we doing a splenectomy. Although it was still a sad and an unfortunate situation, we were grateful that the animals gave us an opportunity to learn. In the afternoon, we helped debride and stitch up a couple of bite wound injuries, and Allie did a dental (I don't do well with teeth-related things and decided to observe). 

Friday - Friday brought in a few more bite and hit-by-car injuries. By this point, we've seen more gruesome injuries than we can count. We both agreed that some of them made us feel a little queasy. 

Saturday - At 8am, Penn's International Internship Program students met at the front gate for a weekend camping trip in the Khutse Game Reserve in the Kalahari Desert. We were picked up by a massive Land Rover that seats 11 people and is designed for game viewing. Our guides, Chris and Kenny, drove us from Gaborone to the Kalahari. The drive lasted 4 hours. Seeing as there were no windows on the vehicles, and half of the drive was on unpaved, we arrived at the camp site with a thick layer of dust and sand on our faces and hair. We ate a quick lunch, set up our tents, and headed out for an afternoon game drive. On the drive, we spotted yellow billed horn bills, lilac breasted rollers, ostriches, a jackal, and an african wildcat and headed back to camp just before sunset. Kenny cooked a delicious dinner and we drank some very fine boxed wine before ending the night talking around the campfire. Upon our request, Chris gave us a brief synopsis of the history of Botswana. Unlike other African countries, Botswana was never colony, but rather a protectorate. The country is also fortunate to have had some very strong leaders, such as Khama the Great, and a wealth of minerals (including diamonds). Today, Botswana is one of the wealthiest and most politically stable African countries. However, Chris also mentioned problems that desperately need to be addressed, such as gender inequality. Due to the lack of women's rights, Chris said that being a woman in Africa is like hell on earth. In fact, Chris's own mother was an extremely vocal advocate of women's rights, and she was killed because of it. He also discussed the practice of witchcraft and black magic, particularly among politicians in election years. In extreme cases, black magic can involve abducting a child (usually male) and sacrificing him for his blood, which is believed to be an extremely powerful substance. It is common knowledge that people here believe in and practice black magic, yet it a subject that is rarely acknowledged. I hope to read more about some of these issues and others that Chris described to us and discuss them more in future blog posts. 

Sunday - We woke up early to watch sunrise before eating breakfast and packing up camp. We returned to UB this afternoon, only to pack for a week-long trip to Hansi starting tomorrow that will involve performing pregnancy diagnoses on beef cattle and darting giraffe. 

The Orphans

Orphaned animals come into the clinic on a pretty regular basis. They include dogs and cats that have been abandoned by their owners or puppies and kittens that have gotten lost or been rejected by their mother. In the wild, rejection of offspring is thought to be a mechanism of natural selection. The mother invests her time and energy into the babies that are most likely to survive and go on to have offspring of their own. 

However, as a person and a vet-in-training, my primary instinct is to want to help the orphaned animals, and I couldn't help but become emotionally attached to one of this week's patients. 

A client brought in a small pitbull puppy whose mother had picked it up by the head and shaken it around violently, causing trauma to the skull and brain. When we first saw the puppy, it was crying continuously, its head and face were extremely swollen, and its nervous function was so impaired that it could hardly walk. By the next day, however, the puppy's condition had improved tremendously. The swelling had gone down, pain had diminished, and mobility had improved (despite the fact that it was circling to the right). The veterinarian's were very pleased with the progress, and I spent the morning monitoring (but mostly cuddling) the puppy. When the owners came in later, they decided that they did not have the time or the money necessary for the dog to make a full recovery, and they chose to euthanize the dog. 

Unfortunately, this type of situation occurs in veterinary practices all over the world, not just Africa, and is one of the most frustrating parts of a veterinary career. The animal had a good chance at a full recovery, but wasn't given the opportunity. All I could do was gently pet the animal as the vet administered a lethal dose of phenobarbitone. 

Fortunately, later in the week, I had the opportunity to meet two more orphans and on a much happier note. Erik (the wildlife vet) and his wife Marlize (another one of the vets in the practice) have been given the honor (and challenge) of raising two orphaned wild animals: Kali the leopard and Kelele the lion. The two originally lived in Marlize and Erik's house (along with 6 dogs and 8 cats), and then moved to large cage. Recently, they built an extensive outdoor confinement area including trees to climb and a jungle gym to allow more freedom of movement. They will likely spend the rest of their lives in the backyard because they would not be able to survive in the wild.  

It was incredible to be able to see (and touch) such beautiful animals so close up. They have become so used to human contact that they let Marlize and her daughter play with, pet, and kiss them, just like any other pet. However, Kelele and Kali's natural instincts are still there, and we were warned not to make sudden movements around the leopard and told that the lion likes to "play rough." Overall, I was happy to see that the leopard and the lion will have the happy ending that the little pitbull puppy unfortunately did not. 

Monkey Business

On Monday and Tuesday, I accompanied Erik, one of Botswana's four wildlife veterinarians, to Jwaneng for a consultation.

Though the town of Jwaneng itself is unremarkable, it is home to the world's largest diamond reservoir. The mine is renowned for the quantity and the quality of the precious stones found there. In fact, one of the diamonds from Jwaneng recently sold to a US buyer for $27 million US.

Unfortunately, the mine is also home to a large quantity of baboons. The reason for the consultation was the number of complaints about the animals being made by mine workers. The incidents reported include baboons breaking and entering, raiding kitchens and offices, stealing lunches, and even attacking some individuals.

We departed Gaborone early Monday morning and arrived at Jwaneng a few hours later. Immediately we had to go through "induction," a nearly 3-hour-long orientation program to familiarize visitors and workers with the mine's security, health and safety procedures. The mine is divided into so-called green, blue, pink, and red areas, with the red being the heart of the mine. Security measures increase the closer you get to the red area. Even leaving merely the blue area requires randomly conducted strip searches. During the sessions we also learned about the reward (up to 30,000 pula) given to individuals that identify diamonds and report it to the proper officials. Unfortunately, I did not notice a single glimmer amongst the gravel, and left empty-handed.

We spent the rest of the day observing the baboons both in the mine and in the surrounding game park. The goal was to establish baseline, to figure out the number, size, and location of the baboon troops. After a private night game drive, we settled into our accommodation: an observation tower that we converted to our camp site for the night. Though I wasn't necessarily expecting to camp out in the Kalahari desert in near freezing weather, I fell asleep with an unbelievable view of the stars and slept extremely well.

We woke up early the next morning to check on the baboons and figure out where they moved to during the daytime. The afternoon was spent interviewing workers about their personal experiences with baboons. Though many people expressed concerns or frustrations over the problems caused by the baboons, many admitted that they enjoy seeing and having the animals around.

I enjoyed getting a taste of wildlife management and camping in the bush. I can also say that I have been inside the world's largest diamond mine. More importantly, I learned the many ways in which the diamond mines benefit the people and the country of Botswana as a whole (for ex. by subsidizing the education of Botswana's citizens).

Now I'm back in the clinic for the rest of the week.

Our ride

Entrance to the game park - where we want the baboons to be

Large baboon 

The morning migration 

Practice Makes Perfect

"It's easy. Just like riding a bike."

This is how Mbatshi, one of the veterinarians in the clinic, described placing a catheter. Once you've done it, you never forget how. It becomes second nature.

I didn't find this piece of advice even remotely helpful earlier in the week as I tried time after time to stick a needle in the cephalic vein of numerus patients and failed every single time. The real thing is not at all like the styrofoam covered tubing that they have us practice on in vet school, and I found myself becoming increasingly frustrated and disappointed.

By Wednesday I had gotten to the point where I almost wanted to stop trying. I didn't want to go through the embarrassment of missing the vein (yet again) or make an animal suffer due to my incompetence. However, Mbatshi and Lawrence, another vet, gave me a lot of great tips and really challenged me to keep trying. They would not take no for an answer.

Since Allie left for Thailand on Tuesday, I've become the only student in the clinic. Whereas last week I could always turn to Allie for help or pass off a job that I didn't feel comfortable with, this week there was no one to turn to or hind behind.

Finally, I stopped getting preoccupied with the details: At what angle do I hold it? How do I know how deep to go? Instead, I made an attempt based on feel alone and was rewarded with a flash of blood inside the catheter, a sign that I was in the vessel. Two days later, I still may not get it every time, but I feel much more comfortable with the skill.

First success!

This is only one example of how much I have learned this week and how much confidence I have gained. I was also able to perform my first solo cat castration, scrub into a reconstructive eyelid surgery and a pyometra surgery, and assist when a dog crashed during surgery rather than moving away and letting someone else take over.

Reconstructive eye surgery

Solo castration 

Fractured radius and ulna

Mbatshi was right in the end. Like any other skill, placing a catheter is like riding a bike. I just had to take off my training wheels (and fall a few times) before learning how.

Presidential Pups

Two black cats ran in front of us on the the walk to the kombi station.

Allie and I joked about our bad luck with public transportation in Africa so far, but otherwise ignored the bad omen. After having missed our stop a few times, we learned from our mistakes and were convinced that we finally knew what we were doing and where we were going.

But our bad luck continued.

For some reason, still unbeknownst to us, the kombi took a completely different route than it had the last time. Before we knew it, we had passed the clinic. We quickly shouted "emma mo stopo," signaling the driver to pull over at the next stop, but still ended up having to walk quite a ways to get to work.

Frustrated with the kombi system (there is no map...the routes are "common knowledge" to everyone except foreigners) we decided to take a detour (an intentional one this time) to indulge in fat cakes, balls of fried dough typically eaten for breakfast.

In the morning, we observed a number of spays and neuters. However, we quickly got distracted by a patient out in the waiting room. From a distance, it appeared to be a kitten. However, upon closer inspection, we realized that it was a monkey. A very tiny marmoset ironically named King Kong. The client (who owned 42 other pets!) noticed how interested Allie and I were in the little creature with strikingly human features and allowed us to hold and photograph King Kong.

Around lunch time, Allie set out for her two-week trip to Thailand. I was sad to see her go and it felt strange being at work for the rest of the day without her, but I know that she will have an amazing experience not only performing surgeries, but also sightseeing.

In the afternoon, I was told we would be making a home visit to vaccinate the minister's dogs. For some reason I had assumed that the veterinarians meant religious minister. I was surprised to learn that we would actually be going to the home of Botswana's Minister of Education and a Presidential candidate in next year's election, Hon. Pelonomi Venson-Moitoi.

We drove to the "posh" part of Gaborone and waited outside of a large house surrounded by a high wall and electric wires until a security guard allowed us entry into the driveway. The Minister had four very beautiful but slightly skittish Great Danes. Administering rabies vaccines took some time as it involved chasing them around the large backyard.

As we were packing up our supplies and getting ready to leave, one of the housekeepers brought out a large tray of food. She had cooked a traditional lunch for us, consisting of goat, rice, butternut squash and cabbage. I was extremely surprised and touched by the gesture and found it hard to imagine such hospitality being shown to a vet back in the States.

With any luck, maybe next year I will be able to say I vaccinated the dogs of the President of Botswana.

Fat cakes

Climbing Kgale

An easy hike. A slight incline. This is how our student guide, Anesu, described the climb up Kgale Hill (one of Gaborone's most famous landmarks) when he generously offered to lead our group of Penn students to its summit to watch sunrise.

By 5am this morning, we were awake and ready to go. We excitedly squished ourselves into 3 cars, drove to the base of Kgale Hill, and began our climb. Still quite dark outside, we had an amazing view of Gaborone illuminated by buildings and street lights and a crystal clear view of the stars above.

As Anesu effortlessly maneuvered up the hill, the rest of us struggled to keep up. The terrain become increasingly rocky, and we had to strain our eyes to find solid footing as no one had thought to bring a flashlight. The incline became extremely steep toward the end of our hour-long hike, during which we reached an elevation of 4,222 ft above sea level. Though everyone was slightly out of breath, the view that greeted us at the top of Kgale Hill was even more breathtaking as we watched the sun creep up over the horizon.

After sitting and enjoying the view for over an hour and letting our tired legs rest, we headed back down (much more quickly than we had come up as we were able to see where we were going).

Climbing Kgale Hill to watch sunrise was an amazing experience (not to mention a great workout). The pictures below really don't do it justice, and many of us are hoping to go again before we head back home.

Entrance to the hill 

Sun just beginning to come up 

View from the top