Jockey and veterinarian Ferrin Peterson has been writing a blog for the TDN on a charitable veterinary trip to Southeast Asia to help refugees care for their animals. To read the prior installments, click here or here.
I had my first meeting with my new team: the five men who are given the job title in their village as the “mule handlers.” They were all new acquaintances to me, as the mule handlers I worked with in the past became human medics and others moved to new villages. The translator that was going to work with me was an old acquaintance who felt like an uncle to many of us. His name is Poh and he is a human medic, which is helpful when he translates medical concepts for me. One of the mule men pulled out the book, “Where There Is No Animal Doctor,” that I had left with the past mule team. It was a miracle after the disappointment of my failed attempt to bring them their own copy when I had to rearrange my schedule after missing my connection. I suppose my missed flight connection was not as detrimental as I had originally thought.
The mule handlers, Poh, and I sat together, and they told me about the problems they had been witnessing with the herd. Listening to the mule men's questions gave me a sense of their compassion for their herd and attention to detail, and knew I would enjoy working with them. The herd's problems mostly originated from their digestive tracts, so I would be looking for a common denominator there.
I got up early the next morning and walked into the village, when one of the mule men alerted me that one of the mules had a stomach ache. I was planning to teach them how to do a colic workup by the end of the week. Here was a real life example instead, so we sprung into action.
Grabbing my stethoscope, I showed them how to take a heart rate, which took a few tries for the first man to come up with the same number as I did. With a horse's heart beat having a distinct “lub-dub,” they had a tendency to double count. I observed them correcting each other as each man took his turn with the stethoscope while I gathered supplies.
I fetched my nasogastric tube and showed them how to pass it through mule's nose and into her stomach. Poh was there beside me as I described the signs to check to be sure they passed the tube down the esophagus and into the stomach and not down the trachea and into the lungs, an easy and lethal mistake.
After emptying the mule's stomach, I pulled the tube and had the mule men pass it themselves. We all worked together as one person would hold the tube in place, another would funnel in water, and another would hold the bucket for the siphoned stomach contents. The men continued checking vitals, but our mule quickly went downhill. It became apparent to me that this colic would require surgery, which is not an option in the jungle where we do not have an anesthetic machine nor a sterile environment. The mule did not make it, but she provided a valuable teaching opportunity that will help the mule men to treat future sick members of her herd.
I spent the next day in data collection and observation. I believe a lot can be learned from simply studying and getting to know your patient. I stayed around the herd all day, sometimes watching from afar and other times sitting on a rock near them. It was fun to see different members of the herd come up to check me out. I usually won them over with scratches.
On my past trips, the herd would wander far off and forage all day. I noticed this herd was staying in the center of the village waiting for their breakfast and dinner. The mule men were feeding pellets for breakfast, and dinner was rice hulls which had been ground into a powder. I realized the herd was consuming all concentrates and no fiber, which is not conducive to the function of the equine gut.
At breakfast the next morning, I brought this up with the other volunteers. None of them had a horse background, but everyone was concerned about the herd and asked for updates at every meal we shared. I told the coordinator that we needed to increase their pellets for calories, but most importantly the herd needed plant fiber that they can eat throughout the day. He said they could send in more pellets and they would hire porters to carry them in. Unfortunately, to bring in enough hay would be too impractical long-term. One volunteer at the breakfast table had worked in another region of Asia and said he had seen horses eating banana leaves. Fortunately, there were plenty of banana plants surrounding the village here.
Banana leaves and bamboo adds necessary fiber to the mules' diet | Ferrin Peterson photo
When the mule men came to feed the herd their breakfast, I had them add salt and water to the grain and asked them increase the quantity. They told me they would run out of grain by the end of the week if they fed more, but I assured them that more grain was on the way. Then I asked if they could help me get a few banana leaves to see if the herd would eat them. They grabbed their machetes and chopped off a few branches and the herd loved it! The mule men were excited by this finding too and went back to chop down more banana leaves.
I started taking the mules hiking. They needed to build their fitness in order to be useful for packing, and I wanted to see what plants they chose to eat along the route. It also helped me get to know their personalities, and I certainly discovered which mules were the most stubborn of the group. I learned they enjoyed dry banana leaves as well as the fresh ones, and they loved bamboo, both the leaves and the young shoots. That was another exciting discovery, as there is a surplus of bamboo in the jungle.
On one of my mule treks, I came across a fenced-in rice field. I mentioned it to the volunteer coordinator, and he said they had seen the herd out in that field in the past after the rice was harvested. He brought it up to the owner of the rice field, and they gave permission to turn the herd out on it. It was a 45-minute hike from where the herd was staying. I asked the mule handlers to help me turn them out overnight and bring them back in the morning. I did not want to make a sudden feed change and cause one of them to founder. The mule men happily obliged. I left them to work on some things for an hour then returned to move the herd to their pasture, but the herd was gone. I went on my own out to the rice field and found the herd grazing in the rice paddies. One of the mule men was still there, and he showed me the buckets he had filled for their water source. I was extremely impressed with their initiative.
Tomorrow: horses and water buffalo.
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