Goodbye new friends, hello old ones!

As my time at the hospital comes to an end, the next step in this adventure begins.  Two of my best friends from home -- Sarah Lim, a fellow vet student who has spent her summer researching elephants in Nepal, and Lindsay Hoyle who is experiencing her last summer before she sells her soul to BC law-- are making their way to Udaipur to begin our travels across Northern India. Starting in Udaipur we will then head north to the small town of Mount Abu. From there, we will travel to the cities of Pushkar and Jaipur before leaving Rajasthan for Delhi and Agra. While I have grown to love the city of Udaipur, I am excited to see more of this fascinating country with two of my closest friends.

Reflections

Having never left the U.S. before, some say I dove head first into the deep end by traveling to India...Alone. I had no idea what to expect and admittedly had serious doubts as I sat on that plane, one month ago, traveling halfway around the world to a foreign country so dramatically different from anything I had ever known. 

I can honestly say I learned more  from this experience than I had planned. As I expected, I learned about the devastating animal situation in India.  I learned about injuries.  I learned how to treat wounds and splint legs. I learned how to be comfortable around large animals.  I learned a different kind of medicine and how to work with minimal resources.

But not only did I gain a new perspective on the world of veterinary medicine, I gained a new perspective on the world in general. I learned about a new culture, language, religion and way of life. I learned new recipes and how to eat with my hands. I learned about Gypsies and Rajputs. I  learned about the social and economic oppressions women face in rural India. I learned I take a lot for granted in my everyday life. I learned about patience.  I learned about suffering. I learned about compassion. 

Do I see myself moving to India? Probably not.  Do I see myself coming back? Absolutely. 

I'm glad I've been able to share my experiences with you all. To my parents who support me in so many ways, and to those who donated to help make this trip possible - I cannot thank you enough. 

Namaste.

Before and after

Just as I was beginning to get discouraged with the recent death and general lack of improvement among most of the animals, I was contented somewhat when we examined the donkey with the hobble wound. I think I wrote about the donkey a while back, on one of my first days in cattle, but for those of you wondering, a hobble is a piece of wire, rope or plastic that is tied to the donkey's front and back legs, or front leg and neck.  This is to prevent them from running away.  Many of the donkeys we see have had the hobble tied too tightly for too long and a deep wound persists, sometimes requiring amputation.

This one particular donkey had developed a serious, granulomatous mass of "proud flesh" around where the plastic hobble had been tied.  The wound had looked raw and painful and she didn't put any weight on it at all. I didn't see the animal when it had first come into the hospital, as it had arrived a few days prior, but I was able to snap a picture of it after a few days of treatment.  For several weeks we replaced splint after splint, cleaning the wound and applying wound powder and betadine routinely. Today I noticed that she is now able to stand on the leg.  The swelling and raw flesh has receded and only a small wound exists where the large mass had been. Success! Finally.

This situation reminds me of a story my friend recently sent me.

Once upon a time there was a wise man who used to go to the ocean to do his writing.   He had a habit of walking on the beach before he began his work.  One day he was walking along the shore.  As he looked down the beach, he saw a human figure moving like a dancer.  He smiled to himself to think of someone who would dance to the day.  So he began to walk faster to catch up.  As he got closer, he saw that it was a young man and the young man wasn't dancing, but instead he was reaching down to the shore, picking up something and very gently throwing it into the ocean.

As he got closer he called out, "Good morning! What are you doing?"  The young man paused, looked up and replied, "Throwing starfish in the ocean."
"I guess I should have asked, why are you throwing
starfish in the ocean?"
"The sun is up, and the tide is going out, and if I don't
throw them in they'll die."
"But, young man, don't you realize that there are miles and miles of beach, and starfish all along it.  You can't possibly make a difference!"

The young man listened politely.  Then bent down, picked  up another starfish and threw it into the sea, past the breaking waves and said, "It made a difference for that one."

:(

The small white dog with the horizontal ears died. The mange puppy is in bad shape. I sat for over an hour trying to syringe feed her today. I doubt she will be there when I go in tomorrow morning.

I talked with Dr. Smriti for a while today about veterinary school in India. She told me that all students who want to go into a medical field take a standard exam. Those that get the highest grades are accepted into medical school and those who get lower grades are put into dental and veterinary school. She said that virtually no one goes into the exam wanting to be a veterinarian and that even she had a hard time coming to terms with the fact that her exam grade wasn't good enough for medical school and that she was going to be a "dog doctor." She said that even though it wasn't her first choice, she has come to love being a vet and working at Animal Aid. We discussed how the work here isn't like the medicine we learn in school. An animal has a wound, you clean and dress it. An animal has a fever, you give it antibiotics. If it seems dehydrated and painful you give it fluids and pain meds. She is working with such limited resources, virtually no diagnostics, so in a way she is only able to do half her job. Regardless, she does it well.

Field trip.

As soon as I arrived to the hospital yesterday I could tell it was a special day.   That night, 12 of us were heading into the jungle to sleep over in a Shiva Hindu temple. Everyone was in a good mood as we started on treatments.  My spirits were brought down when I realized the hypocalcemic cow from the other day had passed away over night.  I talked to the doctor about it and she explained how hard it is to properly treat the large animals, as they require such large volumes of fluids and drugs. She can't give them as much as they need because then the dogs wouldn't have enough.  I began to realize the fine balance in allocating precious drugs among the animals at the hospital. We carried on and I helped plaster the leg of the cow with the broken metacarpals. It took almost an hour, and every once in a while she would struggle violently, sending me flying.  After the cast was finally dry, it was time to head to the temple.

The trip length: 2 and a half hours. Our mode of transportation: the animal ambulance. 10 of us piled into the back of the truck.  Packed in like sardines with only two small windows I felt like a bunch of illegal immigrants trying to sneak across the border. After about an hour we felt the truck stop as we had pulled up to a small road side stand.  It was clear we were already in a more rural setting.  All eyes were on us as one by one we climbed out of the back of the ambulance.  It must have been quite the sight.  After drinking some tea and picking up snacks we were back on the road.  The rest of the trip was spent singing - both American and Hindi songs- and before I knew it we were almost there.  Jim was on his motorcycle and Erika insisted that I get out of the truck and ride on the bike the rest of the way.  I was so glad she did because the view was incredible.  We were in the mountains, surrounded by nothing but lush, green vegetation- a refreshing sensation after having lived in the city for over three weeks now.

We followed the truck up to the temple.  We walked up a narrow path, removed our shoes, and had a look around.  The entire compound was made up several structures, the main one honoring the god Shiva and the others dedicated to other Hindu gods.  In the main area a small fire was light and water constantly trickled out of a small spout, both symbols to honor Shiva. While Melanie, Claire, Erika and I explored and gazed at the monkeys and birds in the trees, the rest of the staff was already hard at work preparing food.  The dinner they prepared was amazing- spicy daal and fried chapati- a true Rajasthani dish.

Our beds consisted of small cushions with sheets and we lined them all up on the floor of the main building.  One of the staff members brought out an Indian drum called a dholak (http://en.wikipedia.org/wiki/Dholak) and another pulled out a wooden harmonium.  The guys sang for over an hour while the rest of us clapped along.   What I noticed during that time was the relationship between the people in the group.  There was such a sense of brotherhood between these unrelated young men.  I looked around the room at each of the staff members.  I saw Lackshman, the manager, who is usually rather stern, wearing a bright smile (to match his pink checkered pajama pants.)  I saw Mangi Lal, the vet assistant from "A" ward with whom I had worked with the most. I saw Fatji, the polio survivor with legs of different lengths, who always has the biggest brightest smile. I looked at all eight of them enjoying themselves, entirely content with just the music and each other.  It reminded me of another quote from Shantaram: "That's how we keep this crazy place together - with the heart...India is the heart. It's the heart that keeps us together.  There's no place with people like my people, Lin. Theres no heart like the Indian heart."

The cute canine, the calcium deficient cow, and the cooking class.

There is this one small dog at the hospital that Melanie and I are particularly worried about.  She is so small and lives in the mange ward because she is covered with the skin disease.  Many days she is too weak to walk, other days she seems to have a bit more energy. Whatever her state is, however, she is always growling at the other,  much bigger, dogs who get too close.  She is definitely a street puppy.  A few days ago when she was in the worst shape I had seen her yet, it was clear she needed help. The doctor was in surgery and the vet nurses were busy with other treatments. I got the approval to give her some I.V. fluids and Meloxicam.  As flies swarmed around me, sweat dripping from my face, the smell of the mange ward making me nauseous, I tried every effort to get the small needle into the tiny puppy's veins.  It was impossible.  I went and got help from the assistant but even he couldn't place the catheter. We ended up giving the animal sub q fluids, as it was better than nothing at all.  Every day we check on the puppy, and every day her condition seems to be different.  Today, thankfully, she was brighter and more alert than she has been in the past week.  Hopefully this means she's finally improving.

The other day on my day off I met a group of Americans and ended up tagging along for a cooking class. We got to pick 12(!) different Indian dishes to learn how to make. The cook was amazing and the food was delicious. (No promises on whether or not I can recreate any of the dishes, though.) Also, I was pleasantly surprised to discover most of the dishes were vegan. While they used a LOT of oil, there wasn't any butter at all and only one dish called for milk. :)

I returned to the hospital to discover the cow with the papillomas was in bad shape.  She laid recumbent on the paddock floor, her respiration  labored and eyes bulging. Her temperature was a low 97 degrees.  The doctor came down and assessed her condition and determined she was most likely hypocalcemic. (Again, diagnostics here are a shot in the dark and the doctor was simply concluding this based on prior experience.) The diagnosis made sense - these animals eat trash, a far cry from a proper, balanced diet. We set the cow up with fluids and a calcium injection. Hopefully I will see her in a better state tomorrow.

I hateeee maggotssssss (and dog bites)

Note: if you are eating, you might want to read this later.

I woke up feeling a bit off; it might have been the heat I'm not really sure. I started the day in large animal as it seems to be a bit calmer. Melanie and I fed the calves and I was happy to notice that Dennis is now back to normal.  Thank goodness, I love that little calf. We saw the ambulance bring in a new animal: a cow with a large, open, bleeding mass on it's ear.  The thing was about the size of a tennis ball.  Other, smaller warty-looking lumps covered the rest of the body. The vet assistant couldn't tell me what it was. (After further research I conclude that it is Bovine Papilloma Virus.) They got the animal down after some struggle and we inspected the mass.  It was dripping blood and then I saw one of my most dreaded creatures: a squirming maggot.  I looked closer and saw that there were dozens of them living off of the growth. If that wasn't disgusting enough, the smell of the infected, maggot-filled tumor was enough to make anyone want to vomit.  The assistant used scissors to pull of parts of the growth along with individual maggots. He cleaned the wound and dressed it.  It was an awkward bandaging job and the poor cow looked like it was wearing some sort of headdress when it was all done.

I think I mentioned that when we were trying to save Mama that she got a bit of my finger in the process. When I got home I realized she had, in fact, broken the skin.  "Oh god, I thought" as statistics of rabies cases in India filled my mind.  I cleaned it well and brought it to Jim's attention the next day.  He wasn't concerned at all as Mama had been there for several years, was well-vaccinated, and comes into contact with only a few dogs.  The vet on the other hand, recommended I get a rabies booster vaccine.  I went to the (human) hospital today and got the vaccine. I simply went in, told them what I needed, and they gave it to me for just under 500 rupees (about $10.)

This afternoon I spent some time at Claire, Jim and Erika's house.  We had a fantastic lunch and sat talking in their wonderfully air-conditioned room for a while.  Before we were about to leave, Claire asked me to help her treat one of their dogs.  The dog had the biggest under bite I had ever seen - the bottom jaw sticking out about two inches past the top. When the animal had first come to Animal Aid a few weeks ago it had a large laceration under it's tongue, where the teeth meet the floor of the mouth. A flap of skin lifts up to expose some of the bone and deep parts of the teeth.  Claire told me it had been infested with maggots, but she THOUGHT they were all gone. Awesome.  I cleaned the flap of skin, flushing it with salt water.  Thankfully, there were no maggots. Phew.