Last Day in Todos Santos

It`s our last day in Todos Santos - hard to believe! It's a gorgeous sunny day here in the mountains. It`s passed by very fast. Marjo and I arrived in Guatemala almost 3 weeks ago. It`s amazing how quickly we fell back into the routine. Things that I noticed last year (like the barking dogs and the roosters and pig noises all night long) are just familiar backgound sounds now.

We finished our last spay clinics yesterday. As Kate mentioned it`s very very cold in the AM and even once we heat the room enough to start, it's still cold and a challenge to keep the patients warm. When we surgically open their bellies, we see steam rising from the belly, something we never see in the OR at home. The focus is to be quick and careful with the spays so that we don`t have complications after. If the dogs aren't eating or comfortable the next day or even that night, we recheck them at their homes.

A Todos Santos take on a "Pet Kaddy"

Pila keeps warm during the cold AM hours

We had a couple of cancellations because one community is worried that their dogs are being poisoned and they took their dogs away to Las Ventosas for a couple of weeks to keep them safe. Unfortunately last night we got a call from a woman to say there was a poisoned dog in the street. Kate and Marjo grabbed some drugs and supplies and headed out there. The dog was convulsing and too far gone to save so he was humanely euthanized. We need to talk to the municipality to try and find out who is doing this - but we may never know who.

We've split up into groups of 2 today to do our final housecalls and rechecks. There are a few dogs that are too aggressive or lame to bring into the clinics so we're going to their houses to vaccinate them. This morning Anne Marie and I were a team and we got to try and vaccinate Hueso - our escape artist from last year. She's much the same so once the family had her in the small storage room we just quickly vaccinated her - no chance for a full physical but she`s in good condition and eating well. We also vaccinated the lame old dog from the hostel we are staying all. We'll also leave some pain meds for his arthritis. Same with Marcel, a lame old dog that lives near the old Hispanomayan School.

We`ve accumulated quite a little pack of dogs that hang around us, looking for food but also very happy for the attention. Walking down the main street towards our spay clinics this week we often had a retinue of Nosey, Bobbi, Marcel and now Pila, the little puppy that Anne Marie and Kate rescued. She`s is proving amazingly resilient and becoming less afraid and more puppy-like everyday.

Pila enjoys a break behind the Los Pablos clinic

Andres takes a stint walking Pila

I'm finding it quite amazing how much attention Pila is getting. Many times a day people will stop me and ask me her name and whether she is "macho o hembra", a boy or a girl. They seem quite taken by her which I find surprising given how many dogs - and puppies - there are around. Many times a day I`ll hear "Pila? Como esta Pila?" and look up to see a kid hanging out a window asking how Pila is doing.

2 Todos Santeran children want a photo with Pila.

Pila is booked on my flight and now all I have to do is find the right-sized carrier to bring her home in. I think she'll adapt well to life on the West Coast of Canada.

Todos Santos prepares for Christmas

and the team prepares to head home.

2 Tortillas per Kilogram of Dog

Benita (our Spanish-Mam Interpreter)
taking a patient's history from some children in San Martin.

You learn some unexpected things when you work in a foreign country. The dogs in Todos Santos aren`t fed dog food and a routine question during our exams, especially if the dog is thin or the owner reports it isn`t eating, is to ask what they are feeding the dog and usually the answer is 'tortillas'.

During our clinics in San Martìn we learned that it takes 2 tortillas per kilogram of dog to keep a dog in good body condition. This was our 1st time working in San Martìn. Our clinic was set up in a disused classroom and we were billeted in local families homes, two of us per house. At one house the woman keeps her dog in the yard - so he doesn´t roam and can´t scavenge. So we know that all he gets to eat is what she feeds him and what she feeds him is tortillas only. She feeds him 30 tortillas per day - which she makes by hand as well as all the tortillas for her family - and he is in good body condition. He weighs 15 kg so now we know that it takes 2 tortillas per kg to feed a dog.
Things they don`t teach you in vet college.

The clinics in San Martìn went well but the people there are less familiar with our project so it took awhile for word to get around about what we were doing. The dogs seemed skinnier than the ones we`ve been seeing in the communities so far and we`re not sure why. We`d love to think that it`s our influence but it`s more likely that they have access in El Centro to the slaughterhouse and meat markets. Maybe it`s a combination.

One little puppy in San Martìn broke our hearts.

She came in with a dog that was getting sterilized and she stayed in our clinic (which was held in one of the classrooms in the local school as classes are out until January) through the afternoon till the other dog woke up from his anesthetic.

She was very small and skinny and ate ravenously when we gave her some of our food.

A little puppy curls up beside her adult housemate as he recovers from sedation for his sterilization procedure.

After the other dog`s procedure she went over to curl up beside him on his blanket and they both slept the afternoon away until the owner came to get them. He carried the bigger dog home and a little boy was supposed to carry the puppy home but we saw them way down the main street with the old man carrying the big dog and the puppy trotting along beside - and the little boy nowhere to be found. About 20 minutes later the little puppy came trotting back in through the gate all by herself and back into the classroom. We had to carry her back and find her house - where they hadn`t realized she was gone.

The kids in San Martìn were great. Because school is out we were an attraction so we had groups of them hanging out with us as we recovered the sedated dogs. They chatted away, asked about all our equipment and were particularly fascinated by our hot water bottles.

Back in El Centro we did two more days of clinics and last Monday we started our spay clinics for the females - which we`ll do all this week.
Hasta luego.

A rainy market day in San Martin.

Los Pablos

Team meeting

We had an incredibly busy day today at Los Pablos. We haven´t counted up our final numbers today but we´re estimating we saw 125 to 150 dogs today. Lots of vaccines and some chemical sterilizations of the males. It´s been interesting rechecking the male dogs we did in 2009. Their testicles are still present but usually palpably smaller, firmer, often assymetrical.
We made appointments for the females for next week when we do our surgical spays.

Again it was great to see some familiar people and dogs. We saw one of the 3 puppies we saw last year with Rawant´s owner. All grown-up and feisty. His name is Muñeco, very healthy. Most of the dogs are very fearful and can be challenging to handle but a few of them are incredibly relaxed and friendly - often dogs from the same households so it likely has a lot to do with how they are raised. Saw Terri - the shy little black and white dog we spayed last year. She's very timid and fearful this year.

Terri - very shy at the clinic this year

Many of the dogs we are seeing are not as skinny as before. Some quite healthy and with one dog we actually had to have ¨the talk¨about being too heavy. Still seeing a few of the venereal tumours (TVTs) which is depressing especially in dogs that have been sterilized - just not soon enough! Hopefully we´ll see the incidence of this decrease as more dogs are sterilized before being sexually active. It´s a treatable disease but requires once a week IV injections for 4 to 6 weeks and we are not here long enough to do this and it can´t be done by anyone in Todos Santos after we are gone. One owner is willing to go to HueHuetenango every week for 6 weeks for treatment if we can find a vet willing and able to do the treatment. That´s a 2-3 hour bus ride there and back. We´ll look into it for her.

Tomorrow we are off at 6 AM to a new community for the next 3 days. We expect the clinics will be busy.

Roberto and Marjo consult with 2 clients

Todos Santos on my Mind

Back in Canada for a couple of days now and I do find myself thinking alot about Todos Santos. There were challenges working in Todos Santos, not the least because of the different languages (Spanish and Mam) and conditions, but there was also unexpected joy and fulfillment there as well. While there, we were up by 5:30 AM and going steadily all day until we climbed the hill back up to Las Ruinas after dinner, and fell into bed.

It was an all-immersing experience.





Most of the team hadn't worked with each other or even met each other before meeting up in Guatemala City but we pretty quickly got into an easy working relationship that felt very comfortable and mutually supportive. We had great team leaders in Marjo (head tech and Todos Santos guru) and Kate (our head vet) and when we lost Kate, who was due back in Canada after 1 week, Enid (Vice-President and VWB/VSF Coordinator of Canine/Feline programs) very capably and seamlessly stepped into Kate's shoes for the remainder of the project, bringing her own special warmth to the team.

We had 2 amazing translators from Todos Santos: Benita who speaks Mam and Spanish, and Andres who speaks Mam-Spanish-English - his English much appreciated by those of us with more rudimentary Spanish.

Andres also got to accompany us on many of our hikes as we carried patients home after surgery or did housecalls to follow up on all of our medical and surgical patients.

Both of these people were essential in communicating pet histories and homecare instructions as well as medical advice.

As mentioned in previous posts, various Todos Santos community leaders were also very helpful and supportive - helping with electrical supply, water, truck transport, keys, locating rooms for the community clinics or even speaking with pet owners and answering their questions or concerns.

Two other people from Todos Santos were also a huge support to the team during our stay. Roman and Christina (and their family) opened up their home in Las Ruinas to the team and made us feel incredibly welcome

- and their generosity continued throughout our stay with much-appreciated thermoses of coffee, with loan of a gas heater to help keep our post-surgical patients warm, and many other kindnesses. They also gave us the opportunity to to see 2 documentaries on Todos Santos Cuchumatan that gave us a little insight into some of the history of the community over the last 30 years. Their tienda (store) across from the municipal square was always a welcome place for coffee and chat during our downtime.

One of the unexpected pleasures (for me at least) of the time in Todos Santos was the enforced return to very basic medicine. With one of the VWB/VSF-Canada mandates being sustainability, we worked with equipment and supplies that are or would be locally available, not with what we were used to at home. Surgery and medicine became much more dependent on our 5 senses and on the "art" of veterinary medicine - and many team members commented on how rewarding (though challenging) this was. Walking up and down the mountainsides on our housecall rounds, and focusing on basic factors such as homecare and TLC, was a very peaceful and uncluttered experience.

The people of Todos Santos were very gracious and I hope I've learned from their patience and stoicism. I very much appreciated it that they have been willing to let us come there and work with them and that they have entrusted us with their pets' care. The relationship with their pets can appear quite different from 'back home' but their affection and bond with their pets was clear.

There are many pets that I met that I continue to wonder about:

Terry the Rottweiler who was doing incredibly well as we left; Terri the gentle little black & white dog who stole my heart; Nosey our mascot who was always so happy to see us and who could never get enough love and attention - as well as her little black buddy, dubbed Fritz, who appeared at 4 AM on our second-to-last day in Todos Santos and made himself right at home at Las Ruinas and at Roman and Christina's tienda ... Tuzo and so many other pets that we met.

To my team mates, it was truly a privilege to work with you all

(Merci beaucoup - gracias a todos).

Erin and Jeff - you both pitched right in seamlessly and helped where needed, in what must have been a doubly-strange environment (Todos Santos and the sometimes graphic world of veterinary medicine - sorry again about the dinnertime conversation Jeff!!).

Marjo, Kate and Enid, thank you for your inspired and always supportive leadership. It was a great experience working with VWB/VSF and the memories will endure.

What I'm left with is a strong desire that the work, which started several years ago in this community, continues to build on what was accomplished last January and continued this November/December. We saw many people who asked us when we are coming back, and there are many issues that could be worked on together with the community, and with other international partners and funding. It al leaves me with a very strong sense of hope and possiblity for the people and animals of Todos Santos Cuchumatan, and I'm grateful to have been allowed to be a small part of it.

some todos santos challenges

It´s Day 11 in Todos Santos and Day 9 of the clinics. We´re into our spay clinics now and doing follow up housecalls on patients - and also some housecalls on other dogs. As we´re walking down the street or along one of the hillside trails, people will come up to us and ask if we can check their dogs out because there is something wrong. We´re pretty limited in what we can do here as we have limited drugs and limited equipment and no diagnostics - such as labwork or x-rays - no diagnostics except our eyes, nose, hands and ears.

All our post sterilization patients are doing well. It can take them a day or so to start to eat though some eat within a few hours. For the ones that aren´t eating we do a housecall and check their temperature, check for infection and pain. we can treat with pain control and with antibiotics. With some of the patients all that is needed is good old-fashioned tlc: keeping them warm till they are more active and feeding them palatable food.

Terry the rottweiler is doing well. He is eating well and comfortable - the swelling is all gone and he´s been seen walking around town. When we go to check on him, he growls and barks at us and is too aggressive to pill any more so he is definitely feeling better.

Yesterday we did our last male sterilizations - timed so that so if they have complications they´ll occur before we leave saturday and while we can do something about them. There were 2 dogs that were too aggressive for the owners to handle so they couldn´t bring them into any of our clinics but the owners really wanted to have them vaccinated against rabies and sterilized. Yesterday we gave the owners some oral sedatives to feed the dogs and had them lure them inside with food so that we could try and catch them. It took all day but by the end of the day they were confined and slightly sedate and we were able to restrain them enough to sedate them further and sterlize them at the houses. We are hoping this helps with the aggression.

Doing the housecalls takes quite a bit of time as we have to walk to each house and there are no street names or numbers. We just have to ask someone local to show us where the owner lives. we´re treating almost all the patients outside. the people here have been very friendly and very patient.

It´s time for dinner - my guess is the menu will be potatoes, frijoles, chicken and tortillas. My team mates have mutinied with the tortillas and though we get served dozens of tortillas with every meal, I´m the only one eating them anymore and finding it hard to represent for the whole team.
Got to keep strong and healthy for tomorrow.

Terry

The dogs were quiet last night. Most nights we are serenaded through the night with dog packs barking and howling, and chronologically-challenged roosters crowing all night long. Yesterday was our 5th day in Todos Santos and our first cold rainy misty day here. People were staying inside and it seems even the dogs were staying close to home. We all had our best night´s sleep.

We´re starting to gel as a team and getting a routine down. Every morning we meet at 6:30 AM and carry the supplies and equipment to whichever Todos Santos community we are in that day. We are a strange sight as we walk through the streets carrying big green supply cases, duffel bags and 3 tables - though not as strange as the 1st day we arrived on the ´chicken bus´from Huehuetenango and carried all our packs and luggage up what seemed like a steep goat trail up the mountain to Las Ruinas where we are staying.

We´re doing the canine chemical sterilizations this 1st week as well as the rabies vaccines and flea treatments. If there are any complications from the sterilization, they usually occur in 72 hours so we want to be finished our last one while we are still here to monitor and treat patients. So far no serious complications.

If patients come in sick we treat as best we can with our limited supplies. While doing a housecall on a post-procedure patient, Kate saw a Rottweiler lying by the roadside and looking very weak and emaciated. Terry (many of the dogs here have english names like Doggy, Smoky, Scooby etc) the Rottweiler had been sick and not eating well for awhile and eating nothing for the last 3 days. He turned out to have a severe infection of his prepuce, probably from getting bitten by another dog, and was getting septic and was in quite a bit of pain. He was treated with subQ fluids and antibiotics and pain control and the following day, Roberto (one of the team and a Spanish-speaker) and Andres (our English-Mam-Spanish translator) carried Terry to the community we were working in that day and we kept Terry there all day to treat him with IV fluids, IV antibiotics and more pain control. We kept him warm and dry and later in the morning the little boy from the family came with 2 buddies and his grandfather to visit the dog and to try and get him to eat. Terry wouldn´t eat for us but when the little boy offered him cookies, Terry gobbled them down. The little boy stayed there most of the day feeding him when Terry wasn´t sleeping and by the end of the day, Terry´s vital signs had improved and he was looking better.

Roberto and Andres carried Terry home at the end of the day yesterday and the family set him up in a confined area sheltered by a tin roof. They built a good fire beside him to keep him warm and covered him with a blanket. We asked them to feed him some good soup and meat (most dogs here are fed tortillas and bones and whatever they can scavenge).

Late last night before climbing back up to Las Ruinas and bed, we checked on Terry and found him looking brighter, eating and drinking well. We left the family 2 hot water bottles and said we would be back in the morning.

This morning we went back to check on Terry before our clinic started at 7 AM. He was standing in the area by the fire and the owner told us he was walking around a little. He was eating well and they had been feeding him sopa de pollo (chicken soup). The hot water bottles we had left them were warm and obviously recently refilled to keep him warm. We checked him out and things were looking much better. Gave him his morning antibiotics and told them we would be back at the end of the day and would visit twice and day until he was OK again.

This afternoon we´ll continue with the male sterilizations, rabies vaccines and parasite control. This weekend we start spaying the female dogs that we´ve vaccinated this week and whose owners wish them spayed. We continue through next week until Friday. Rabies control is really important here as all the dogs run loose and there is quite a bit of fighting.

At the end of the day we´ll head back up to Las Ruinas. I´ll keep my eye out for Domingo Mendoza Ramirez. He is about 70 or 80 years old and every day I see him working hard in his fields, building a fence out of maize stalks, to keep animals out of his fields. We chat: he asks me where I´m going and how I am. After we chat he always says:
Nos vemos mañana. We´ll see you tomorrow.

It´s been an incredible experience here in Todos Santos so far. A combination of old-time James Herriott type medicine with the housecalls and limited supplies and more modern medicine with the prophylactic sterilizations and vaccinations we are doing.

Nos vemos mañana.