Friday, September 20, 2013

Sitting in the shade with the pigs

Here is a short story about one of my favorite experiences while in Haiti:

Sitting in the shade with the pigs.  

The journey up the mountain was serene: blue sky and green hills.  The closer we got to the market the more people walked alongside the dirt road, the more donkeys with overstuffed straw saddle bags, the larger the baskets on the women's head became. 

It was already warm and humid and the road was a steady climb.  Motorcycles zipped by carrying FOUR people with bags strapped on the front, back and side.  Huge trucks carrying large bags of rice were piled even higher with people bringing their items to sell at the market. In the shadow of the mountains, sprawled across the land were at least a thousand tin-roofed lean-tos.  They were filled with everything from clothes to electronics to cooking pots and food.  

We were there to purchase goats.  Sellers would dismount the truck or motorcycle with their chickens, pigs, or goats and walk to the area where those animals were being sold.  We had arrived early and only a couple of goats were there.  Each goat was inspected by looking at their gums, to ensure a healthy pink color and the sides of their spine felt to see how much fat they had.  Acky did the buying while Ben and I sat in the shade holding the ropes.  On the other end of these ropes were young, healthy female goats, about 6-8 months old.  

We shared the shade with some rather rambunctious pigs; anytime one would get startled it would jump causing a chain reaction.  Each pig was also attached to a rope that was tied to a stick pushed deeply into the soft mud.  If one pig got out of line a brawl was bound to happen, hopefully not ending in the uprooting of their sticks.  Especially since the pigs outweighed me by an easy 200 pounds, I decided to keep my eye on them in case they wrestled in my direction.  

We slowly began accumulating goats, 2, then 4, then 6, 7, 8!  They were easier to handle if they were tied in the back of the truck.  That's when I looked in the field across the road and saw the donkeys, mules, and horses grazing and seeking out the shade.  Looking at their tense muscles and heaving ribs, they definitely deserved a break.  Even in the serenity of the mountains an unending supply of motorcycles, trucks and tap taps drove by, dropping people off, picking new people up.  Those who arrived early and sold their goods then turned around, bought what they needed from the market and headed home.  I watched as everyone came and went, struggling with their newly bought squealing pigs.  Which were then hog tied and placed in their lap on a motorcycle for the trip home.  

When all seventeen sought after goats had been purchased it was our time to descend back down the mountain.  These goats had a long journey ahead, not just down the road but to their new owners: the children of Merger.  

These goats are generally already bred and pregnant and are then given to a child that is then responsible for their care.  The children go to class to learn about types of forage, how to care for the goat, and more importantly how to make money by making sure the goat is healthy.  For a lot of these children, the goats and their offspring are their families' main source of income.  The better care the goats receive the more kids it can produce, the more money can be made.  These goats don't cost that much money, maybe $30-35 US dollars.  But what these goats represent is priceless: hope, the chance at a better life, self-respect, and a sense of responsibility are things you can never put a price tag on.  The excitement in the air is electrifying, each child runs to their goat, and tightly gripping their rope walks home with their head held high.

And to think this day all started by sitting in the shade with the pigs.


Sunday, September 15, 2013

Time flies!!

So 5th Semester down, 6th Semester is up next!  Things got crazy last semester and I wasn't able to update.

We took the PAVE (Program for the Assessment of Veterinary Education Equivalence) http://www.aavsb.org/PAVE/-  the test that used to be required of foreign graduates, but is no longer.  However, for some Federal jobs the exam is required.  The school paid for our registration and wanted to see how well we performed on the test (they say it correlates with how well you do on the NAVLE which we DO have to take).  It's divided into 5 sections:
Anatomy (22%) 
Physiology (23%) 
Pharmacology (14%)
Microbiology (20%)
Pathology (21%)

I PASSED!!!  I performed above average for all sections, I'm still in shock!

Anesthesia was by far the favorite class for me that semester because of all of the hands on experience we were able to have.  We got to anesthetize both a dog and a sheep!  Both were HUGE learning experiences.  They say you learn from your mistakes and boy is that true!  There weren't any major mistakes but we were supervised the entire procedure and that helped to avert disaster.  We were divided into groups of 4 and we assigned the tasks amongst the group.  We knew our dog and her weight a week before the procedure and performed our initial calculations for drug dosages.  The day of we started off by doing a physical exam including weight then calculated the drug dosages and obtained the drugs from the pharmacy.  After administering the pre-meds we placed an IV catheter and gave the induction drugs then started the fluids.  It sounds simple and it is but there's so much pressure to do everything correctly and you feel like the life of the dog is in your hands.  We then intubated and started the inhalant anesthetic and began monitoring the patient.  We had many tools to monitor our patient:  Pulse oximeter, Oscillometric blood pressure cuff, Doppler monitor, Esophageal Stethoscope, Capnographer, EKG and a temperature probe.  Almost everything during the canine anesthesia went according to plan, except our Doppler monitor (which monitors the systolic blood pressure with a sphygmomanometer) didn't want to work, neither did our blood pressure cuff and our monitoring sheet was filled in wrong. 

The sheep anesthesia on the other hand did not go according to plan.  For sheep you have to place a jugular catheter which we got in but became dislodge soon after.  After 2 more attempts and the use of the other jugular we finally had a patent vein.  We administered the induction agent but he had pretty severe laryngospasms (we just thought we were bad and intubating).  Well intubation took too long and while we though the inhalant anesthetic would maintain our patient he was awake enough to chew through the tube to the inflated cuff.  We were unable to get another endotracheal tube in before he started regurgitating.  We followed procedure and made sure he wasn't in position to aspirate the regurgitated contents and put him in sternal recumbency.  The remainder of the procedure was then cancelled.  I still wanted to gain the experience of monitoring the sheep under anesthesia so I ended up joining another group a week later.  It was a good thing because I learned so much!  That sheep bloated during the procedure so I got to help reduce the bloat.  Both sheep recovered without any further complications.

Our other major practical exam was the OSCHE which is where we have to demonstrate how to do portions of the physical exam for Canine, Sheep, and Equine.  This was a pass/fail grade.  You NEVER want to fail!  The exam only lasted for 30 minutes, you had 5 minutes to perform 5 tasks.  Professors just stand there while you explain and demonstrate the tasks.  It wasn't difficult but just that feeling that you forgot to say something in your explanation terrifies you.  The stressful part dealt more with a communications module where you simulate a client/doctor interaction.  Ugh, such a tough scenario and you are supposed to use the Calgary-Cambridge Model.  Again, just the thought that you've forgotten to say something basic that could cause you to fail is overwhelming!  Then we had to wait until 5p the next day to find out if we passed.  So nerve wracking!!!

Diagnostic Imaging was another one of my favorites.  We learned so much about radiographs, Ultrasound, CT, and MRIs.  There were even practical portions of the labs where we got to perform ultrasounds and echocardiograms on dogs.  Makes ya feel like a REAL doctor!

Toxicology was interesting but it all kind of ran together in my head, it seemed that every animal for every toxin just had convulsions.  The really cool thing is that our professor maintains a Toxic Garden on the school's property and we get to see all of the plants.  You don't want to touch them because some of them are toxic to humans as well.  There's one tree, the Manchaneel tree, that if you walk under it when it's raining it can cause blindness!

Small Animal Medicine was interesting and for the first time we started discussing specific treatments as we discuss the diseases.  It was extremely challenging, especially the cardiology section.

CVF kept me busy, we gave talks about Stress and Anxiety throughout the semester as well as a food and clothing donation drive; so as the 7th semester students leave the island, inevitably there are things they can't sell.  So I thought it would be great to donate them to people in St Kitts that are in need rather than people throwing it away.  I think its safe to say that we have around 5 car loads of clothes, shoes, and housewares.  The leadership of CVF spent one whole afternoon just sorting through everything (separating women's from men's, shirts from shorts, etc.).  I'm so excited about this adventure because we paired up with the neighboring medical school (UMHS)  who will be doing a health fair at the same time!  Hopefully plenty of people come out from the community in Middle Island :-)

I took my final exams, sorted through the donations and then it was Saturday and the day to leave for Haiti!!!  I was beyond ecstatic but a little anxious too.  Especially when LIAT cancelled my flight from St Kitts to St Maarten.  Talk about going into a tail spin!!!  I called one of my professors to see if they knew of any other way I could get off the island.  Lo and behold I got the name and number of a pilot that does charter flights.  Divine Intervention!!!  I ended up making my flight from St. Maarten to Haiti.  Next update I will tell you about my amazing experience while in Haiti :-D