Falling in Love with Africa

Another long holiday weekend here in Botswana gave me and the other IIP interns the opportunity to escape Gaborone to visit two of Africa's most popular tourist attractions: Chobe National Park and Victoria Falls.

After a short 1.5 hour flight from Gaborone to Kasane on Sunday morning, we were picked up by a van at the airport and driven to the Water Lily Lodge. We ate a light lunch and lounged by the pool before setting out on a boat cruise down the Chobe River.

Chobe National Park was established in 1967, making it Botswana's first national park. It is also the second largest park in the country (12,000 square km), and is thought to be the most ecologically diverse. Aside from its age and size, one animal species in particular makes Chobe stand out amongst the rest: the elephant. Home to 60,000 Kalahari elephants, Chobe National Park has the highest elephant concentration in Africa.

We were certainly not disappointed with the number of elephant sightings on our river cruise. Within minutes of leaving the dock, we saw many of these massive and majestic animals lining the shore. We watched quietly as they grazed on long strands of green grass after swinging it back and forth with their powerful trunks to remove any dirt and debris. Our guide told us that these animals can live to the age of 60 or 70 and can weigh up to 7 tons.

Later on, we were able to watch one of the elephants wade into the water. He stepped back onto the land, but then suddenly veered off course. We soon noticed why. He had been trying to avoid a close encounter with a well-camouflaged crocodile. 

Other animals we saw included: buffalo, kudu, olive baboons, hippos, sable antelope, and fish eagles. As the boat headed back to the lodge, we watched yet another stunning African sunset, its beauty enhanced by casting a reflection on the water.  The wide array of wildlife set against an amazing blue and green background makes it hard to imagine there being a more beautiful place in the world than Chobe... 

...Until we went to Victoria Falls the next day. The falls were discovered by David Livingstone, a Scottish Missionary, in 1855 and named in honor of British Queen Victoria. Located on the Zambezi River at the border of Zambia and Zimbabwe, Victoria Falls is the largest waterfall in the world: 5,600 ft wide and 350 ft tall (more than twice the height of Niagra Falls). 

We woke up early and ate breakfast before driving to the Botswana-Zimbabwe border. After going through the lengthy procedure of getting visas and going through customs, we signed up for activities at the Falls. While some of the more daring girls chose to do the bungee jump or the gorge swing, Allie and I opted for the "slide" -- zip lining from one side of the falls to the bridge. Although considered the least adventurous of the activities, I'll be the first to admit that I was still terrified as they hooked my harness to the line and pushed me off of the edge. I only managed to take one picture of the view below me because my hands were shaking so much. As we waited for the other girls to do the bungee or the swing, Allie and I walked around the bridge and were constantly haggled by people trying to sell us over-priced crafts (my only complaint from the trip).  

After a short stop to eat lunch and do some shopping, we headed back to walk around the actual falls. We began walking the trail and stopped periodically at look-out points. The view that awaited us at each look-out point somehow managed to be even more breathtaking than the previous one. As we continued deeper into the falls,we became engulfed in clouds of mist and were surrounded by a series of rainbows. At danger point, visitors can wander off the path and risk climbing a few slippery rocks to get a completely unobstructed view of the falls. The experience of being so close to one of the 7 natural wonders of the world is one that I cannot even begin to describe.

We drove back to our camp, ate dinner, and chatted around a campfire. As we sat there,  we noticed a herd of elephants approaching the watering hole. Later, a few giraffes joined them. We spent an hour or so observing the animals until they had their fill of water and left the watering hole to settle down for the night. It was amazing to be able to watch the group dynamics and behavior. At one point, one of the female elephants kicked her misbehaving calf in the head (I''m glad my mother never used the same child-rearing tactics on me).

The next morning we went on a game drive through Chobe National Park. Within 5 minutes of entering the park, our vehicle got a flat tire. We got out of the car and waited as they replaced the tire with a spare. Suddenly we noticed a large male elephant heading in our direction. Fortunately, he passed by without paying us much attention and got back in the car shortly thereafter. 

In addition to many more elephants, we saw hundreds of giraffe and witnessed a fight between two males.We also spotted impala, zebras, buffalo, kudu, vervet monkeys, sable and roan antelope. Overall, it was an excellent game drive. Rarely more than 5 minutes would go by without seeing some sort of wildlife.However, there were two situations in which our driver placed our vehicle between two elephants (usually not a good idea). In the second instance, she placed the car between a mother and one of her babies (an even worse idea). The elephant began shaking her trunk and head and flapping her ears angrily...the first warning sign that she is going to charge. Fortunately, she did not do so, and started walking in the opposite direction. We drove back to the Water Lily Lodge, checked out, and headed to the airport for our flight back to Gaborone. 

Our trip to Chobe National Park and Victoria Falls was unforgettable. It gave me an even greater appreciation of Africa's natural beauty. I highly recommend that you visit both of these places if you have the opportunity. I can almost guarantee that you will fall in love with Africa too. 

A Taste of the US in Gabs

1 week. 2 holidays.

July 1st, a holiday here it Botswana, allowed us to have a 3-day weekend. The day was spent catching up on some much-needed sleep and baking cupcakes for a friend's birthday. In the evening, Allie and I went to a nearby restaurant called Linga Longa for "rib night." It was here that we had our first taste of St. Louis, a locally made beer. I thought it was pretty good, especially considering the price of 14 pula (less than 2 US dollars).

We celebrated July 4th by getting off work early (after being forced to recite the pledge of allegiance in front of our co-workers) and attending a party hosted by the US Embassy. We called a cab and asked the driver to take us to Embassy. Once we arrived, tickets in hand, we asked one of the uniformed and heavily-armed guards where we should go for the party. He wore a confused look on his face; he didn't know of any 4th of July party. Turned out that the celebration was not at the Embassy itself, but rather at the recreation center further down the street (I hadn't read the invitation closely enough in the rush to leave). Despite the mistake and the fact that we didn't get to go inside, it was still fun to see Botswana's US Embassy.

When we arrived, the recreation center was decorated with red, white and blue and American flags. Feeling a little bit awkward about being some of the first people there (apparently even American events run according to Africa time), Allie and I headed to the bar and very un-patriotically ordered 2 bottles of St. Louis. We ate hamburgers, hotdogs, corn, cupcakes and much much more at dinner. It was nice to have American food for a change since we couldn't be home to celebrate.

Between the holiday festivities, we also got to see a few really interested cases in the clinic this week. I was allowed to scrub in on a surgery to repair a vaginal prolapse (apparently very common in a breed found in Africa called the Boerboel). The procedure required us to pull the part of the vagina that had been externalized back into the pelvic cavity and fix it there with sutures. 

The same day, a dog came in with extensive soft tissue damage to the palmar aspect of one of its forelimbs. The owners were not home when the injury occurred, and the vet recommended amputation. It was a very interesting surgery to watch (we had only seen a partial amputation in the past). It is remarkable how quickly animals recover from this type of procedure and how well they cope with only three legs. 

Later in the week, a dog came in with a basketball sized mass on its chest. The vet suspected that it was a seroma and proceeded by opening and draining the lump. At first a large amount of serum-like fluid and blood poured out. Upon further exploration however, the vet discovered cancerous tissue that appeared to be a hemangiosarcoma. Based on this finding, the owner elected to put the dog down. 

Looking forward to spending a nice, relaxing weekend in Gabs (one of our last, since the rest will be spent traveling). 

Getting a Feel for Beef Cattle

Coveralls? Check. Rectal sleeves? Check. Paraffin lubricant? Check.

With these necessary tools, Allie and I set out on another trip with Erik. This time, to perform pregnancy diagnoses on 1,500 beef cattle in Ghanzi, a town in the western part of Botswana, very close to the Namibian border.

The drive from Gaborone to Ghanzi (that should have taken about 8 hours) ended up taking closer to 11. We watched the sun disappear below the horizon (probably the most beautiful sunset I have seen so far). Driving proceed much more slowly after that, as we had to constantly slow down for cows, goats, donkeys, or wildlife by the side of the road. Driving in the dark, we watched the Kalahari come alive, as many of its inhabitants are nocturnal. We spotted two different types of antelope (duiker and steenbok), porcupines, spring hares, and an occasional kudu. Late in the evening, we reached the farm manager's house, our home for the next few days. After introducing ourselves to the farm manager, his wife, and three adorable children, we called it a night and prepared ourselves for the first day of work.

We woke up much earlier than 6:30am alarm to the sound of roosters crowing right outside our window. Following this slightly rude awakening, we quickly changed into our coveralls and headed to the kitchen to eat breakfast. We filled our stomachs with coffee and rusks (like a hard cookie similar to biscotti) before finding out that there was also pap (a traditional south african maize-based dish similar to oatmeal or grits) and meatballs for us. 

Pap

Rusks

Then we headed out to the cattle posts to begin the pregnancy checks. On day 1, Allie and I followed behind Erik and tried to identify the things that he described: an enlarged uterine horn (2 months pregnant), caruncles and a mouse-sized fetus (3 months pregnant), a cat-sized fetus descending in the pelvis and fremitus in the middle uterine artery (4 months pregnant), a small dog-sized fetus at the bottom of the pelvis (5 months pregnant), etc. At later stages of gestation, you can even reach your hand into the pelvis and put your fingers into the mouth of the calf or palpate a well-defined hoof beginning to extend into the birth canal. In the case of a non-pregnant cow, we identified the cervix, two similarly sized uterine horns and both the left and right ovaries.

Our PD "prof" Erik

He made it look and sound so easy, averaging 1 rectal exam per minute (500+ pregnancy diagnoses each day). So by day 2 we decided to test ourselves by guessing the stage of pregnancy and then double checking with Erik's diagnosis. Unfortunately, doing so was not nearly as Erik made it seem. Many times it was hard to differentiate a caruncle from an ovary, fremitus from a normal pulse, or to distinguish between a fetus that was descending into the pelvis from one that was ascending. Feeling frustrated and extremely sore in my left arm, I decided to take a short break. Only then did I notice that I was beginning to get sunburnt...on my ears and un-gloved right arm. Realizing that we had left the sunscreen back at the house, I did what any Bushman would do and turned to nature, slathering cow dung all over my right arm. I rubbed this "Botswana sunscreen" on the reddened areas. Though I nearly gagged from the smell at first, it quickly solidified in the heat and worked like a charm, despite all the strange looks I got for it :) 

Botswana sunscreen 

By day 3, we finally started to get the hang of PDs. Our accuracy had improved drastically from the day before, and we were able to determine the stage of gestation (give or take a month) most of the time. Though we still have a long way to go before we match Erik's skill level, it is incredible how much exposure we gained within 3 days. We finished the 1,500 cows earlier than expected, so Erik took us on a short field trip to Namibia. I had mentioned how much my dad wants me to go there, so we drove about 20 km from the farm and arrived at the Botswana/Namibia border. Although I still can't say I've been to Namibia, at least I've seen it. On the way back to the farm, we saw zebra, a red wildebeest, kudu and eland. 

Namibia

At the end of each day of palpating cattle, we had a hot bath and home-cooked meal to look forward to. We were treated to more traditional South African food (poike, steak and even warthog sausage) and enjoyed good food and company around a blazing fire and underneath a full sky of stars. Overall, we had a great time in Ghanzi, not only because we were able to see so much, but also because the trip allowed us to see a completely different part of the country (and a little bit of Namibia) as well as some incredible wildlife. 

Camping in the Kalahari

This past week was probably the busiest yet (hence the lack of blogging). Allie and I got to see and do so many things that it would be impossible to list them all in a single post. Instead, I will briefly mention some of the highlights from the past few days.

Monday - I performed my first cat spay! The clinic obtained three female cats from the BSPCA and allowed me and another veterinary student from the University of Glasgow to sterilize them. Dr Mbatshi guided us through the procedure and offered help and tips when necessary. I was able to locate  and ligate both ovaries and the cervix before removing them and closing up the incision. Mbatshi is an excellent and patient teacher, and the surgery went smoothly. Hopefully I will have the opportunity to practice my spay technique over the next few weeks so I can become more comfortable with the procedure.

On Monday night, Allie returned from Thailand. I'm very happy to have her back and have enjoyed hearing stories from her trip. 

Tuesday and Wednesday - Allie and I went into the clinic in the morning and left for Jwaneng in the early afternoon to continue working with the baboons. However, first we had to make a stop at Erik's house to pick up camping supplies and got to hold lion cubs that he and Marlize are rehabilitating. After arriving in Jwaneng, we drove around the mine and adjacent game park trying to get a better sense of the number and size of the troops. At sunset, deterred the baboons from sleeping in the office areas by shooting a shotgun (loaded with blanks) at them. It seemed to work temporarily, but the baboons returned the next evening. We chased them off again before heading back to Gaborone. 

Thursday - We started off with a cat castration in the morning (unlike the first time, all of the tools functioned properly). After we finished, we went into one of the consultation rooms to help with the morning appointments, but we were quickly called out to help in the other consult room. A client had brought in 3 cats and 1 dog to be euthanized. He was moving to Canada and not able to take them with him. The vets reassured him that euthanasia was the best option in the situation. I found it difficult assist in putting these animals to sleep, especially the cats, which were young and healthy. Therefore, Allie suggested that we use the animals to practice spaying. That way, at least their deaths would serve an academic purpose. It turned out that the cats had already been spayed, so instead we pretended as if we doing a splenectomy. Although it was still a sad and an unfortunate situation, we were grateful that the animals gave us an opportunity to learn. In the afternoon, we helped debride and stitch up a couple of bite wound injuries, and Allie did a dental (I don't do well with teeth-related things and decided to observe). 

Friday - Friday brought in a few more bite and hit-by-car injuries. By this point, we've seen more gruesome injuries than we can count. We both agreed that some of them made us feel a little queasy. 

Saturday - At 8am, Penn's International Internship Program students met at the front gate for a weekend camping trip in the Khutse Game Reserve in the Kalahari Desert. We were picked up by a massive Land Rover that seats 11 people and is designed for game viewing. Our guides, Chris and Kenny, drove us from Gaborone to the Kalahari. The drive lasted 4 hours. Seeing as there were no windows on the vehicles, and half of the drive was on unpaved, we arrived at the camp site with a thick layer of dust and sand on our faces and hair. We ate a quick lunch, set up our tents, and headed out for an afternoon game drive. On the drive, we spotted yellow billed horn bills, lilac breasted rollers, ostriches, a jackal, and an african wildcat and headed back to camp just before sunset. Kenny cooked a delicious dinner and we drank some very fine boxed wine before ending the night talking around the campfire. Upon our request, Chris gave us a brief synopsis of the history of Botswana. Unlike other African countries, Botswana was never colony, but rather a protectorate. The country is also fortunate to have had some very strong leaders, such as Khama the Great, and a wealth of minerals (including diamonds). Today, Botswana is one of the wealthiest and most politically stable African countries. However, Chris also mentioned problems that desperately need to be addressed, such as gender inequality. Due to the lack of women's rights, Chris said that being a woman in Africa is like hell on earth. In fact, Chris's own mother was an extremely vocal advocate of women's rights, and she was killed because of it. He also discussed the practice of witchcraft and black magic, particularly among politicians in election years. In extreme cases, black magic can involve abducting a child (usually male) and sacrificing him for his blood, which is believed to be an extremely powerful substance. It is common knowledge that people here believe in and practice black magic, yet it a subject that is rarely acknowledged. I hope to read more about some of these issues and others that Chris described to us and discuss them more in future blog posts. 

Sunday - We woke up early to watch sunrise before eating breakfast and packing up camp. We returned to UB this afternoon, only to pack for a week-long trip to Hansi starting tomorrow that will involve performing pregnancy diagnoses on beef cattle and darting giraffe. 

The Orphans

Orphaned animals come into the clinic on a pretty regular basis. They include dogs and cats that have been abandoned by their owners or puppies and kittens that have gotten lost or been rejected by their mother. In the wild, rejection of offspring is thought to be a mechanism of natural selection. The mother invests her time and energy into the babies that are most likely to survive and go on to have offspring of their own. 

However, as a person and a vet-in-training, my primary instinct is to want to help the orphaned animals, and I couldn't help but become emotionally attached to one of this week's patients. 

A client brought in a small pitbull puppy whose mother had picked it up by the head and shaken it around violently, causing trauma to the skull and brain. When we first saw the puppy, it was crying continuously, its head and face were extremely swollen, and its nervous function was so impaired that it could hardly walk. By the next day, however, the puppy's condition had improved tremendously. The swelling had gone down, pain had diminished, and mobility had improved (despite the fact that it was circling to the right). The veterinarian's were very pleased with the progress, and I spent the morning monitoring (but mostly cuddling) the puppy. When the owners came in later, they decided that they did not have the time or the money necessary for the dog to make a full recovery, and they chose to euthanize the dog. 

Unfortunately, this type of situation occurs in veterinary practices all over the world, not just Africa, and is one of the most frustrating parts of a veterinary career. The animal had a good chance at a full recovery, but wasn't given the opportunity. All I could do was gently pet the animal as the vet administered a lethal dose of phenobarbitone. 

Fortunately, later in the week, I had the opportunity to meet two more orphans and on a much happier note. Erik (the wildlife vet) and his wife Marlize (another one of the vets in the practice) have been given the honor (and challenge) of raising two orphaned wild animals: Kali the leopard and Kelele the lion. The two originally lived in Marlize and Erik's house (along with 6 dogs and 8 cats), and then moved to large cage. Recently, they built an extensive outdoor confinement area including trees to climb and a jungle gym to allow more freedom of movement. They will likely spend the rest of their lives in the backyard because they would not be able to survive in the wild.  

It was incredible to be able to see (and touch) such beautiful animals so close up. They have become so used to human contact that they let Marlize and her daughter play with, pet, and kiss them, just like any other pet. However, Kelele and Kali's natural instincts are still there, and we were warned not to make sudden movements around the leopard and told that the lion likes to "play rough." Overall, I was happy to see that the leopard and the lion will have the happy ending that the little pitbull puppy unfortunately did not. 

Monkey Business

On Monday and Tuesday, I accompanied Erik, one of Botswana's four wildlife veterinarians, to Jwaneng for a consultation.

Though the town of Jwaneng itself is unremarkable, it is home to the world's largest diamond reservoir. The mine is renowned for the quantity and the quality of the precious stones found there. In fact, one of the diamonds from Jwaneng recently sold to a US buyer for $27 million US.

Unfortunately, the mine is also home to a large quantity of baboons. The reason for the consultation was the number of complaints about the animals being made by mine workers. The incidents reported include baboons breaking and entering, raiding kitchens and offices, stealing lunches, and even attacking some individuals.

We departed Gaborone early Monday morning and arrived at Jwaneng a few hours later. Immediately we had to go through "induction," a nearly 3-hour-long orientation program to familiarize visitors and workers with the mine's security, health and safety procedures. The mine is divided into so-called green, blue, pink, and red areas, with the red being the heart of the mine. Security measures increase the closer you get to the red area. Even leaving merely the blue area requires randomly conducted strip searches. During the sessions we also learned about the reward (up to 30,000 pula) given to individuals that identify diamonds and report it to the proper officials. Unfortunately, I did not notice a single glimmer amongst the gravel, and left empty-handed.

We spent the rest of the day observing the baboons both in the mine and in the surrounding game park. The goal was to establish baseline, to figure out the number, size, and location of the baboon troops. After a private night game drive, we settled into our accommodation: an observation tower that we converted to our camp site for the night. Though I wasn't necessarily expecting to camp out in the Kalahari desert in near freezing weather, I fell asleep with an unbelievable view of the stars and slept extremely well.

We woke up early the next morning to check on the baboons and figure out where they moved to during the daytime. The afternoon was spent interviewing workers about their personal experiences with baboons. Though many people expressed concerns or frustrations over the problems caused by the baboons, many admitted that they enjoy seeing and having the animals around.

I enjoyed getting a taste of wildlife management and camping in the bush. I can also say that I have been inside the world's largest diamond mine. More importantly, I learned the many ways in which the diamond mines benefit the people and the country of Botswana as a whole (for ex. by subsidizing the education of Botswana's citizens).

Now I'm back in the clinic for the rest of the week.

Our ride

Entrance to the game park - where we want the baboons to be

Large baboon 

The morning migration 

Practice Makes Perfect

"It's easy. Just like riding a bike."

This is how Mbatshi, one of the veterinarians in the clinic, described placing a catheter. Once you've done it, you never forget how. It becomes second nature.

I didn't find this piece of advice even remotely helpful earlier in the week as I tried time after time to stick a needle in the cephalic vein of numerus patients and failed every single time. The real thing is not at all like the styrofoam covered tubing that they have us practice on in vet school, and I found myself becoming increasingly frustrated and disappointed.

By Wednesday I had gotten to the point where I almost wanted to stop trying. I didn't want to go through the embarrassment of missing the vein (yet again) or make an animal suffer due to my incompetence. However, Mbatshi and Lawrence, another vet, gave me a lot of great tips and really challenged me to keep trying. They would not take no for an answer.

Since Allie left for Thailand on Tuesday, I've become the only student in the clinic. Whereas last week I could always turn to Allie for help or pass off a job that I didn't feel comfortable with, this week there was no one to turn to or hind behind.

Finally, I stopped getting preoccupied with the details: At what angle do I hold it? How do I know how deep to go? Instead, I made an attempt based on feel alone and was rewarded with a flash of blood inside the catheter, a sign that I was in the vessel. Two days later, I still may not get it every time, but I feel much more comfortable with the skill.

First success!

This is only one example of how much I have learned this week and how much confidence I have gained. I was also able to perform my first solo cat castration, scrub into a reconstructive eyelid surgery and a pyometra surgery, and assist when a dog crashed during surgery rather than moving away and letting someone else take over.

Reconstructive eye surgery

Solo castration 

Fractured radius and ulna

Mbatshi was right in the end. Like any other skill, placing a catheter is like riding a bike. I just had to take off my training wheels (and fall a few times) before learning how.