From Dr. Jay Merriam
We arrived late at the hotel in Las Galeras, a small town east of Samana to find the SA team just finishing dinner after a very long first day. We were pretty tired as well after our all day clinical skills lab and lectures and an unexpectedly long drive. But we were all ready to go this morning and the project didn't disappoint. We had to load our inventory into the two trucks, trade supplies with Small Animal (2 bottles of LA Xylazine to us for a large pack of catheters and drapes to them).
El Valle, a small cluster of rural houses and fincas is served by a road the went from wide and paved to slick, steep red clay and a 12% grade that ended, literally in a river, as the bridge was still not finished (I have pictures from 15 years ago). The communities are mainly clustered along the road which ultimately, if you are intrepid enough, leads to a spectacular, secluded beach on the North side of the peninsula. Ending there was the incentive to work hard and wade through the 15 or so castrations and the 40 more desparasitantes.
It's always a bit of a struggle getting the team into a rhythm , but with Harry and Steve on board we were able to get going pretty quickly.
A makeshift anesthesia pole was constructed in front of our area by a machete wielding campesino who cut a 8 inch diameter tree, sharpened it and then drove it into the ground himself as we unpacked! We will have pictures. Then O'Grady and our Dominican vet, Carla Nova, examined, weighed, and sedated our first patient. Our newest vet, Julia Bentley, a just graduated intern from Woodford in Kentucky, got set to assist me in the opening event! We use the Henderson instrument, so the procedure is quick, almost bloodless and the animals recover amazingly fast. Our conundrum this year (as usual) was not finding all the supplies and not having tetanus antitoxin (TAT) for every patient. We saved it for the youngsters, and vaccinated the adults. We try to source as much medication as we can locally and sometimes it works, sometimes it doesn't.
Our other student, Christina Carballo, was the next surgeon and since she's helped us before, I gave her a mule! They are always harder to anesthetize, prep and dissect! And many require extra Ketamine/valium. The tissues are always tightly adhered and sine we do them closed, it's a workout. But all went beautifully and we began to get our pace! We never rush the surgery itself, but we like to get as much done before the heat of the day is too intense for safety.
So by 1 o'clock we try to be packing up. At one point we did run out of shady places to drop them and had to wait till some got up to use their bit of the "OR". One horse was presented with a swollen,maggot covered penis, that needed some help. We had gelded him 2 years ago and he'd already had a damaged Glans that we had resected. But this year he needed another surgery and a partial amputation. The other problem in the community is the tick burden. The grass is lush this year and so are the garapatas (ticks)! It's amazing to see the difference in the individual loads, mules have very few anywhere, grey horses are loaded! We treat topically, systemically and encourage the owners to pay attention and use frequent application of the various topicals available. After the last patient, we re-forded the 4 rivers we'd crossed coming in and headed to the beach.
Day 3
Usually, Wednesday is a free day for the teams, but since we’d missed Monday we elected to work half day to catch up. Only 5 castrations. Kim promised ... O and maybe a couple of serious “look ats”, horses with special problems. Sounded easy and we said sure! Our first stop was nearby, at a house on a steep hillside next to the worst excuse for a road I’d seen since Haiti! But there were 3 mules there, all of them “ours”, mules born to Kim’s mares, imprinted by her at birth and then handled softly till they were two or 3.
Caramello and Milan are beautiful, young and strong. They pack coconuts full time for their owners, and work steadily enough to have early saddle soreness which we discussed with the ‘dueño” (owner). They are small, typey and strong, we are very proud to call them ours. They were sold to the carefully chosen owners for a very large sum in Dominican markets, and can also make it all back for the owners in the first year. We operated one and while he was sleeping, Dr. Julia introduced him to the Power Float, because he needed some dental work. It’s pretty awkward to do while the patient is recumbent but lots of willing hands made it easy. Over the years we have limited our dental work to specific problem cases, not done routine floating both because of the time constraints of a high caseload, and the limitations of working in the heat with hand floats.
This year, PowerFloat via Dr. Dennis Rach sent us a loaner for the trip and we have been using it every day. The other factor is of course, showing the owners and local coordinators the need and the results. Kim presented us with a 25 year old mare who couldn’t chew and was loosing weight. After a thorough exam and float she tucked right into her “alimento” (grain mix) and will resume her life of retirement in better health.
Another aspect of the project has been to introduce the owners to the “chop and carry” feeding practice. Under Kim's guidance, some owners with access to plantable land have started growing King Grass, which, in the growing season will go to 7 feet in 21 days. You can almost see it grow! Then it’s chopped with a machete and carried to the paddocks where the horses eat it like lollipops! It’s rather stemmy by our standards but they love it, it’s fresh and green.
Hoof care is pretty rudimentary, with only the tourist horses getting shoes. Otherwise, the hard, coral based soil seems to keep most of the feet in adequate condition, but there are the usual crop of club feet, sheared heels and cracks, but survival of the fittest is the rule. Mules and donkeys have the best feet, with few major problems.
We finished the work day with a “drive by castration” of a 6 year old Criollo whose owner had died and the family wanted him donated to a “sanctuary”. the operation, from induction to finish took 7 minutes, and the Team didn’t even know I was timing them, or they would have “hurried!” Then back into the truck and off to a lovely beach with a restaurant and showers. Harry practiced his Spanish ( “Dos mas Cervezas, por favor) to the amazement of the waitress and the table in general, then we splashed, snorkeled and relaxed till the sun went away.
The hotel was quiet tonight as the SA Team decided to finish off their free day by eating at a real restaurant in Samana, avoiding the hotel's “dorm food” buffet. And once again the internet was down for no particular reason so only a whisp of wi fi and no way to respond.
Day 4 Thursday
Rainy start, heavy air made my morning run more like a swim without the flippers. But it’s a necessary start to every day, especially in the heat when brain activity seems to be slogging along too slowly. We packed the trucks during intermittent showers, worrying , unnecessarily it turned out, about working wet. By the time we got to our site we’d picked up and dropped off a cat owner on her way to the SA clinic, and were surprised to see her walking out of the underbrush as we began our first of the 15 ops we had planned.
“Caroline”, she said, shaking my hand and continuing her conversation in a heavily accented French to English mode. She wanted to see this procedure as her Dominican boyfriend had just lost a horse to a local vet's castration. “Blood all over the place, she continued, “a butcher”.
So as we started, she stood back and watched as we did our dance with a little 400 lb. mule. In less than 10 minutes he was a gelding and, as promised, there was no blood! Sometimes things do go as planned.
We worked today in a small community on the end of the peninsula, Las Galeras. It looks directly toward the Mona passage to Puerto Rico, ninety miles away. We were looking out on a forested point across a deep blue bay. It was possible that, with the exception of the few boats seen today, it must look somewhat similar to what Columbus saw in the 1490’s. The high coral cliffs and limestone underlay what had been upthrust so many eons ago and could not have changed so recently. Our OR was a grove of palms spaced widely across a flat, open pasture that led immediately to a small beach and out into crystal clear waters toward a reef.
As we worked in the building heat, the proximity to the water seemed to keep us all cool and refreshed. We encountered one very clearly cryptorchid animal and decided to take the plunge down a seemingly impenetrable canal to remove a small, completely retained testicle. Having several experienced hands, it was an easy choice, for Julia and Steve to go in and remove. We never like to “go abdominal” here, but these cases need to be done, or their lives are miserable since they are reviled for their “studishness”.
We finished up around 2 and then followed Kim up a steep, unpaved coral road to a cliff-side restaurant that certainly wasn’t there in Columbus’s time. Got back in time to clean up, shower and follow Dra. Karla Nova, one of our Dominican hosts to her family home in Las Galeras. There, in one of the most fascinating homes I’ve ever seen, we got a glimpse into a seaside world we never see in the US. Dra. Karla has just returned from 6 months in an elephant sanctuary in Laos and is currently living in San Diego, studying for the NAVLE and volunteering at the zoo.
Day 5 - From Dr. Jay Merriam:
Our other efforts at equine care seem to be bearing fruit. In the entire week we saw only 2 saddle sores and they required only discussion, not treatment and only 2 horses with a body score of less than 2/5 that couldn’t be allowed to work til better.
We castrated almost 50 animals and treated many others, so many that we ran out of wormers. That prompted a discussion with a major tourist operator that in effect said that from now on they must provide their own de-wormers, insect sprays and other preventive care. We would provide for medical and surgical care and continue to train local vets and techs.
It is important that we maintain a watchful presence through our visits and local contacts so that things don’t get neglected as the businesses prosper. Generally, Samana is growing in a healthier manner and the government seems more stable and responsive. The roads are expanding and immensely better than ever. The whales are back stronger this year and the cruise ships are being controlled. There are many initiatives that are protecting local business and generally a higher level of prosperity. There are also no signs that we will be out of a job any time soon.
Our team brought back 8 puppies this time and will probably continue to bring more. We finished the last day at my favorite “Starbucks” Parada La Familia, where we have been stopping for the last 15 years, drinking their amazing home grown coffee and chocolate while buying their carvings and local jewels. This year, the dueña, and her husband , now great grandparents, are both failing in health as the years advance. I talked to him awhile and sent her my abrazos (hugs). At the end of our coffee the daughter asked me to come in and see her mother, who was resting on a large bed. The house, like her impeccable kitchen was spares but spotless. Her husband and son sat quietly by her bed and watched as she and I spoke briefly, shared a short “dios bendiga’ (God bless) and she squeezed my hand. It was truly the end of an era for me as I was always welcomed warmly there and it is sad to see the leaves falling from that tree.
We drove back to Kims and the still chaotic SA group, where health papers were being assembled for the departing puppies, inventory was being taken and supplies packed for the next group. Lele was there, having just come from Santa Domingo where she got a clean bill of health from her doctors and was in a clearly celebratory mood. Augusto was there and Ileana and cousins.
The day sparkled as only a Caribbean summer day can, all diamonds and blue waves and water. In the distance, kids were jumping exuberantly off the docks, tourists disembarking from boats, dogs weaving through the people and cars that milled about the malecon (pier). We chatted for quite awhile then said our goodbyes, making many promises to return in the whale season, which this winter we will do for sure. That night we had a lobster fest at the hotel with the Italian owner trying to salvage the rumpled feelings of several group members, who thought it not appropriate that they had come to the 3rd world and met non-functioning AC, insects, enteritis and some rather bland side dishes in an otherwise clean and lovely place. All part of the deal in most cases but not satisfactory in others.
Oh well, the animals benefited greatly from the effort and that’s what counted. We are all changing and growing, and as long as our animals remain the target of our efforts, the rest will come along.