December 2, 2010

Sterile conditions despite drawbacks

Today as well as on our first day in Iquitos, Barbara and I walked the local streets and poor areas with either Molly or Gustavo (the kennel manager) as translator. We offered free parasite control for the common infestations seen here in dogs: sarcoptic mange, fleas, ticks and roundworms. The mange responds to ivermectin injections, the fleas and tick to fiprinil spray. These dogs need a repeat treatment of ivermectin in a month, but most don't know this and they don't seem to be proactive in getting the treatment. The cats are less visible than the thousands of owned and street dogs, but they do exist and occupy a place in the household.

Judith in surgery
The low cost spay and neuter clinics are offered in various venues around Iquitos and in nearbly villages and up the Amazon river. We have spent three days in the Punchana district. We are met at the Amazon Cares clinic by Bruno, the pr man, Molly, vets Luis and Esther, techs Behtjane and Harry, and the local Punchana officers in their official truck, which is loaded with plastic kitchen tables, sand bags, vet supplies, about a million sterile surgical packs, educational literature, clean drinking water, dog catching nets, and people inside and on the back of the truck. The site is a cement amphitheater in a small square....angled steps lead up to the stage on both sides. A portable awning/tent is set up for the treatments given by the resident vet, Esther or Luis. People are lined up with their pets: in baskets, bags, arms, motos, afoot. Few if any are on leashes. Chaos begins. While the line is organized, up top on the stage we are unpacking everything.

Lisa, our Vet Nurse from Wales
Thank goodness we have three excellent techs in Lisa, Harry, and Bethany. One table holds the needles, syringes, drugs, and a chart. Each surgery animal has a number taped on it's head on day one; but since masking tape (what is available) doesn't stick well to hair, we came up with the idea of paper stapled on collars. The chart lists numbers, sex and species, procedure (OHE or castrate), premed doses, induction doses, physical exam notes, weight, tattoo, parasite treatment, and a box to check when each is completed. (With all the chaos of 5 vets, 3 techs, up to 4 surgeries going at one time, multiple animals preanesthetized and waiting for induction, multiple animals being preped and recovering, multiple owners sitting or standing with their animals as they wait, the local Punchana health official dispensing human parasite medicine, AND the many hangers-on: volunteers, gawkers, many school children on their way home from school, little girls wanting to know when we were coming again. Wading thru throngs of people to get to the surgeries, the scrub station, and simply to ask them to move out of the light and not to touch the surgery tables and supplies added more challenges.
Onlookers with Vet Gaby

Surgeries were done with sterile technique, donated drugs and gloves and suture material. All animals were given pain meds and antibiotics. Surgical recovery was in a cage or on the floor beside the surgeon. Most procedures were done sitting in plastic chairs since the tables were low. Plastic bags filled with sand served a positioning props. On some days, a surgeon worked nonstop while animals were prepped and brought to her. Drinking was essential due to the heat, and some scrub tops especially mine were wet halfway to the waist. We arrived around 9 and worked nonstop until the animals were done...then clean up, load up, repack, climb in the truck or a moto and back to the clinic for washing instruments, sterilizing, cleaning up. Then a very late lunch, very much needed, very much enjoyed. Some shopping, sight-seeing, or just sitting preceeded a moto trip back to Cabo Lopez.

Captured street dog
Some of our most frequent patients are the street dogs. Harry is the ultimate the meat markets, on the streets. He will spot a mangy dog, and then the chase is on: the dogs sense our scent and are very wary and wily. The net is large and once a dog is caught the net is twisted until the dog is secure, two people either carry the dog to the surgery site or to a truck that brings them in. Most of these dogs are watchful and quiet until restrained. We learned the hard way to simply muzzle them for the exam and preanesthetic. Weighing has been another challenge; the use of a luggage scale and a lamb sling has helped, but the captured dogs were dangerous so we managed to weigh them while still in the net.

This article is written by Dr. Judith Bechtum and refers to activities during a recent Veterinary volunteer campaign in October, 2010.

If you liked this blog, you might also like:

Iquitos by way of Minnesota
Team Awesome…
New Beginnings at Mobile Clinic
The Operating Theater
Walking Dirt Paths for Animals (with short video)

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