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Southeast Asia Blog: Vaccinating the Horses

This is the last in a series of travelogues that jockey-veterinarian Ferrin Peterson has written for the TDN about her charitable mission to Southeast Asia to bring much-needed veterinary care to the population's animals. To read the prior installments, click here, here or here.

The trials of the jungle are ever-changing. We had started vaccinating the horses one evening when suddenly the sky opened and a downpour came. We returned the vaccines to the refrigerator and ran for shelter. In the evenings, I always read my book, “Where There Is No Animal Doctor,” to look for answers from my cases that day. I used my headlamp to read, but that night the rain brought swarms of small moths which were attracted to the light. I tried to wrap myself in a tarp so they could not fly in my face, but they managed to find an opening and fly right into my eye. I finally gave up and went to sleep early. The villagers said those moths come out during storms, and the next morning everything was covered in dead moths. Usually the bugs are not that bad this time of year with it being the dry season. Next trip, I am bringing a mosquito net! Bathing in a cold river used to be tough for me, but between the humidity, long hikes with the herd, and looking at parasites, I was always grateful to jump in that river at the end of the day. Lacking the vet supplies I need happen on a case-by-case basis, and I will never be able to pack enough to cover all my bases. It makes me appreciate the convenience of working in a fully-equipped hospital and having pharmacies readily available.

The vaccines stayed properly temperature-regulated this time. Other than the rain storm delaying our vaccine clinic and working with half-feral mules and ponies, the mule men successfully vaccinated the entire herd. I told the men the amount of vaccine to draw up according the animal's size and the area on the neck to administer the vaccine, but I left the hands-on work up to them. One of the men was missing most of his fingers; but despite his birth defect, he was able to figure out how to connect a syringe and needle, which requires a fair amount of dexterity.

I conducted a fecal test to get an idea of the types of parasites infecting the herd. I went to the human medical clinic to use their microscope and met some of the medics and students working there. They were very interested in what I was doing with horse stool, so it was easy to strike up a conversation in broken English. I learned one of the medics, named Naytaw, had recently graduated with a Masters in Public Health. He spoke English well, and he told me there are university programs for refugees, and that he had interacted with Harvard Medical School through the program. After graduating, he chose to return to his village to help his own people.

After finishing my parasitology observation at the clinic, I headed back to meet with the mule handlers. The tubes of horse dewormer had taken up a lot of space in my pack, but it was a high priority, especially in a tropical environment. The ponies and mules demonstrated again that they are only half broke, but the men did a great job of working together. It was humorous to see such a small pony take advantage of four of us trying to hold them down, but we did succeed in the end.

I had a friend donate dog and cat dewormer for my trip, which had not been on my radar until she reached out about the idea. There had only been one dog in that village the last time I visited. His name was Freddy, and Freddy has since passed but left behind a bunch of Freddy juniors. I watched the village kids running around carrying puppies, and I envisioned the canine parasites that can be passed to humans. I observed the dogs scratching often, and I wondered which external parasites they could be passing on, too.

Deworming the dogs one time would not make much of an impact, so I packed in a surplus of dewormers but needed to find someone who would maintain a regular deworming schedule. I remembered Naytaw with his MPH, which focuses on the interaction of animals and humans. I hoped he might see the importance in what I wanted to implement.

I found Naytaw at his house, and he happily accepted the assignment. He went into his house and grabbed a list of the homes in the village that had dogs or cats and how many. I was surprised and asked him why he had this list. He said they had told him a veterinarian was coming to visit, and he hoped he might be able to work with her. He had been too reserved to ask to me when we had met before. That was an encouraging coincidence. Naytaw's list guided our house visits, and he dewormed all the pets in his village. I wrote out instructions so he could remember the dosages, and he thanked me for teaching him a new skill.

The following day, I hiked with a few of the mule men, Poh, and a mule to a village who had questions regarding their water buffalo. I brought along a tube to teach them how to relieve bloat and a wound insecticide to prevent screw worms. When we arrived at the village after our long hike, I did not see any water buffalo. Apparently the message had not been relayed that a water buffalo needed to be present for the clinic. It was another good reminder of patience and flexibility when working in a foreign culture. We waited over an hour in a bamboo hut while they said they had someone trying to find a buffalo. A sack of rice on a bamboo floor was comfortable enough, and I took a nap while I waited for the buffalo round-up.

Poh woke me up, telling me there were two very sick teenage boys that would be passing by from another village who were trying to reach the medical clinic. I offered them the mule we had brought in with us and wondered if he was broke to ride. They nearly took me up on the offer, but instead the people from the village appeared with a hammock strung on bamboo and carried the boys themselves through the mountainous terrain to the clinic. I watched them head out–working together to carry the boys and was once again blown away by the way they care for each other.
After they left with the boys, we returned our focus to the water buffalo clinic. It was another reminder to me of the importance of being patient and flexible with my planning. If we had not had to wait so long, I would have missed out on an amazing demonstration of selflessness.

The villagers were unable to find where the buffalo had gone, so I decided we could just have a sit-down meeting where I would do my best to answer their questions. Sitting on a hard bamboo floor for hours is another jungle challenge I am learning to appreciate.

I had been refreshing my knowledge of common cattle pathologies in preparation for the trip, and I was able to answer more questions than I expected. The most peculiar question was that some buffalo had eaten their clothes which were hanging to dry, and the clothes became trapped in their stomach. Even Poh laughed while translating that one. They wanted to know if there was something they could give to break down the fabric. When I worked as a small animal vet, I was shocked by the items we scoped out of dogs' stomachs; things which they had spontaneously decided looked appetizing. I never knew water buffalo had some much in common with golden retrievers.

My time in the jungle ran out, but I believe that important nutritional changes had been made which, in time, would do a lot to improve the herd's overall health. Several days after my departure, one of the volunteers still at the village reached out to assure me that the mule handlers were still turning the herd out to pasture and still cutting down banana leaves for them to eat with their increased portion of grain.

When I made it back into town, I returned to the vet shop with a translator to find medications that I had promised to send back to the village for their water buffalo. One of those items was dewormer. After witnessing how little the buffalo from that village are handled, I realized it was important to find a topical solution rather than an injection, as it is far easier to pour liquid on their back than inject them with a needle. It took a lot of translating and charades to identify what I was looking for, but we found the medications and the buffalo will be receiving their first dewormer treatment any day now.

My last stop in town was to visit ECHO, a nonprofit farm that carried a copy of the book, “Where There Is No Animal Doctor.” I wanted another copy to send back to the mule handlers in a second language (theirs is in English). Most of the mule handlers are illiterate, but they told me if they have the book in two languages they can show it to other villagers who can read it to them. Thankfully there are illustrations on every page, too.

When I went to ECHO and told the staff that I was a veterinarian, they asked me to come look at three of their sick calves. I assessed the young calves and gave their intern, Christina, a basic treatment plan. Christina and I discovered we were from the same hometown, Sacramento, CA, and now here we were both using our unique interests to serve on the other side of the globe. It really is a small world.

Christina gave me a tour of the rest of the farm, which had livestock that they were using for nutritional assessment. She taught me which plants are hardy and easy to propagate in the jungle and which ones have higher protein content. I took a special interest in that, as I want to continue building the herd's nutritional plan even as I return to the U.S.

That concludes this journey. It was a special time to foster new and old relationships, teach and learn from the local villagers, and do my part to make a small difference in the lives of animals and the people connected to them.

The post Southeast Asia Blog: Vaccinating the Horses appeared first on TDN | Thoroughbred Daily News | Horse Racing News, Results and Video | Thoroughbred Breeding and Auctions.

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Southeast Asia Blog: Treating Colic in the Jungle

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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Travelogue: Southeast Asia, Day 2

Editor's note: Jockey and veterinarian Ferrin Peterson is traveling in Southeast Asia to help refugee groups with the veterinary care their animals need, helping humans to survive the refugee crisis in a war-torn area. Click here to read yesterday's blog post.

Once we reach the village, we set up camp which means successfully tying up your hammock between two sturdy trees to sleep in overnight. We bathe and wash our clothes in the river, and the pack animal team roams freely like a herd of wild horses. They always return at feed time, of course. The villagers cook for us, which consists of a rice dish with meat from one of their village animals and a vegetable. My past two trips were during my Christmas breaks from school, and on Christmas Day the villagers offered us their delicacy: cooked chicken feet. Thankfully there were always enough people around that I could nonchalantly pass that dish on to the next person.

I have an exciting, yet testing journey ahead of me. Veterinary medicine is challenging enough, working with patients who do not speak and amongst species that are so different from one another. A sedative that can relax one species can cause euphoria in another species. Each species has their unique Achilles heel: it is not always their feet and gut.

The pack team currently consists of seven mules and nine Mongolian ponies. I plan to vaccinate the pack animal team against rabies and Japanese encephalitis. I attempted this on my last trip, but when we reached our destination and I retrieved the vaccines from the transport cooler, I saw they had frozen, which ruined their efficacy. That was disheartening after packing them all that way and wondering when the next opportunity would arise for someone to vaccinate the herd. Hopefully I improve with temperature regulation this go-around.

Some of the training sessions I have planned for the pack animal handlers include: basic observations of a healthy versus a sick animal, checking vital parameters, body condition scoring, hoof care, wound care and bandaging, medication routes, nasogastric intubation for choke, and fecal flotation to detect parasites (the medical facility is equipped with a microscope).

Another important aspect I wish to address is selecting for their pack team. One or two of the village leaders travel to the city to select the Mongolian ponies and mules. In the past, they had introduced a gray mare with very poor conformation who could not stand up to the demands of her new job, and as a result she slowed down the entire team. They told me that in the city there is a Monkhood ceremony where the young monk rides in on a “white” horse. When the village leader saw this gray mare for sale, he assumed she must be a good deal. I just spent weeks looking at top Thoroughbreds going through the sales ring in Kentucky. I will have to readjust my lens for the type of horses best equipped to trek through mountains and thrive in jungles.

I also plan to teach the villagers to pass an orogastric tube down a water buffalo's esophagus and into its stomach to relieve bloat. I taught a village this technique on a past trip despite only learning it from a YouTube video. The entire village came to watch me do this crazy “magic trick.” To my relief, I successfully passed it into the rumen and then watched several villagers do it, too!

I have learned to go in with a plan but to be adaptable and always ready to rise to the occasion. I believe it is important to give back and share the knowledge a person has acquired, but to never underestimate the importance of local understanding about someone's culture and environment. Most importantly, I am going in with an open mind to see how the villagers and I can learn from and help each other.

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Travelogue: Southeast Asia

Editor's note: Jockey Ferrin Peterson, DVM, has embarked on a charitable mission to Southeast Asia to help refugees care for their animals in war-torn areas, bringing veterinary knowledge and supplies to villagers with no other access to care. She will be contributing a blog to the TDN when conditions permit.

Helping the under-served groups of the world was modeled to me from a young age. My parents had worked in Mexico before raising our family, and I have had relatives who served in China, Turkey, India, and Spain as engineers, teachers, and musicians. This was foundational in my upbringing, and it instilled in me a passion to use my individual interests and skillsets to help those in need.

While pursuing my Bachelor's in Animal Science at Cal Poly San Luis Obispo, I had colleagues who were part of organizations such as Engineers Without Borders and Doctors Without Borders. I saw a breach in the care for the animals that support the livelihood of people living in under-served parts of the world. I reached out to several of my professors, and one connected me with a humanitarian organization called The Free Burma Rangers (FBR). This group helps refugees in the jungles of Southeast Asia and uses a pack animal team comprised of mules and Mongolian ponies to carry supplies to remote villages, where they have no veterinary care.

On my initial trip, the refugees had lost several of their pack animals due to an unknown illness, and diagnosing the lethal disease became the focus of my first trip to Southeast Asia. I had little veterinary training at the time but connected with my future professor, Dr. Eric Davis, at UC Davis who guided me in sample collection and provided the lab upon my return. We diagnosed the disease as trypanosomiasis, which is carried by a tsetse fly vector and is endemic in Asia and Africa.

I returned two years later while I was a veterinary student at UC Davis. The pack animal team had stayed relatively healthy, so the focus of my second trip was to branch out to help other species. The villages we visit are far off the grid and we backpacked 10 hours into the jungle through steep mountains to reach our first village. Those villagers had never met a veterinarian, and although I was not officially a Doctor of Veterinary Medicine (DVM) yet, I provided training in basic animal husbandry. I experienced the gratitude they shared by improving the health of their animals who were essential to their livelihood. It was apparent that the villagers appreciated their animals and were providing the best care they knew under limited conditions and no training. I helped them with their water buffalo, pigs, chickens, dogs, cats, and even a monkey.

I am sitting in the airport about to embark on my third trip, my first as an official DVM. Just weeks after breezing some of the top Thoroughbreds in the world in preparation for the Breeders' Cup, I now have the opportunity to work with some of the most underrated equids I know: tough, selfless, and also life-changing to their owners. I think that is one of the beautiful things about horses worldwide: to witness the important role they play in a wide variety of uses.

The Free Burma Rangers reached out to me this past spring, as they had lost four members of their pack animal team this year, three of which I had worked with on previous trips. The symptoms sound like a combination of parasites, colic, and malnutrition. Their base camp lost their entire flock of chickens and herd of swine this year, so there have been some devastating losses. The base camp provides essential medical care, as it is the only medical facility of its kind within days of travel. FBR has trained local medics and built a basic facility to care for people. In previous trips, I witnessed a woman who had walked all night in labor to reach the medical facility. I also met a man who had traveled for several days with a snake bite that needed treatment. To realize that the medics serving at the base camp lost two important food sources in their pigs and chickens is very concerning.

When my plane lands in Southeast Asia, I will connect with a mentor of mine, Dr Peter Quesenberry, who is also a UC Davis Veterinary School alumni and has dedicated his career to the underserved animals and their owners in Asia. He wrote the book “Where There Is No Animal Doctor,” inspired by “Where There Is No Doctor,” the most widely used health care manual in the world. I use Dr. Quesenberry's book in my training sessions with the villagers. We can turn to the same page and while I read in English they follow along from their copies written in their own language and accompanied with simple illustrations. It has been instrumental in the language barrier hurdle.

Dr. Quesenberry will take me to local shops in town to purchase the rest of the supplies I need: vaccines, dewormers and ointments to name a few. While I am bringing a large pack with me from home, it is important to source as much as possible from local stores. This supports their economy and familiarizes the local people with the brands of vaccines and medications so that they can purchase more on their own for long-term care. Through the generosity of my supporters, I will be stocking up on essential supplies before I head off the grid.

I will backpack in everything needed to live off the grid for two weeks. Anyone who has backpacked understands the delicate balance of bringing the necessities while keeping your pack as light as possible. On my first trip, I started handing off the snacks I had packed out of desperation to lighten my load as we ascended yet another mountain. The 10 hours of backpacking is up and down steep mountains. Upon reaching the summit of one mountain, you have to go back down the other side, only to do it all over again on the next mountain. FBR makes these trips during the dry season, which is our winter and early spring, as they say it is too difficult to travel during the rainy season. I have been training for the mountainous terrain as best I can by running hills and stairs in Kentucky, but I know it cannot compare. It is always humbling as I agonize up a mountain, despite fitness and proper hiking gear, and then look over to see a villager easily traversing the same terrain in plastic flip flops. I am always impressed by how tough these people are who have never known the comforts I take for granted.

The first leg of the trip ends with a bit of trouble, as my flight to London arrives late and I miss my connection by 15 minutes. But all in all, it's a small price to pay, and I appreciate the encouragement and support of others who helped make this happen- my connections in racing who support my absence from the circuit for a few weeks, Back on Track USA who helped with outfitting me for the trip, and every one who donated through www.freeburmarangers.com.

Tomorrow: Day 1-What's On Tap

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