Veterinary Outreach Programs Discussed at AAEP
The equine side of veterinary medicine was founded in the furrows plowed by equids. Today, when most vets exclusively care for animals kept for pleasure and sport rather than work, some have taken it upon themselves to reach out, to go beyond personal success and into the realm of significance.
"There's a large part of the world that depends more than ever on working equids," said Jay Merriam, DVM, of Massachusetts Equine Clinic, in Uxbridge, Mass., who moderated the first-ever official session on equitarian initiatives during the 2009 American Association of Equine Practitioners (AAEP) Convention held Dec. 5-9 in Las Vegas, Nev. Merriam defined an equitarian as "one who serves equids with compassion, and whose only reward is their improved health and welfare."
For years the equitarians met during a Table Topic session. The 2009 Convention marked the first time the subject was presented as a full afternoon session that featured 11 speakers.
This reflects the AAEP's new focus on these outreach efforts, which Merriam credited to the attention and efforts of 2009 AAEP President Harry Werner, VMD.
Dr. Jay Merriam talks about veterinary outreach.
"Equine welfare is at the heart of the AAEP's strategic planning; it's what we're all about," Werner said. "What's really wonderful here is that we're expanding our vision and conscious definition of what equine welfare is."
Along those lines, the AAEP will help coordinate equitarian projects. Whereas projects were previously run by individuals or small groups, often without a public schedule or contact information, veterinarians interested in volunteering on these campaigns will be able to "shop" online for an effort that suits their skills, level of commitment, and schedule.
Why Should We Care?
"Nobody walks out of this room today without a philosophy of change," was the charge given by Derek Knottenbelt, OBE, BVM&S, Dipl. ECEIM, MRCVS, from the Philip Leverhulme Hospital at the University of Liverpool, in the United Kingdom. Knottenbelt, who's worked for years in sub-Saharan Africa, presented an emotionally compelling argument for outreach that left many in the audience visibly moved.
One illustration was a video of an emaciated, severely lame gray horse struggling to haul an obviously heavy load across a set of train tracks. Whipped by its handler, the animal struggles hard for several moments, slips, and falls. He noted that evidence such as this and a host of other similar examples might make one turn away from the issue, resigned.
Our perceptions are that these people are cruel, barbaric, inhuman, and inhumane, he said. But he went on to make the point that while the handling and treatment of these animals might appear to be cruelty, that's not the case.
"It's cruel, but it's not cruelty," he explained, saying cruelty is what we see when people should know better. This is cruel, because life is cruel. Starvation and overwork are a result of poverty, necessity, and ignorance.
The pressure on families using these animals to work is immense, he said. If the animal is unable to work, the family literally starves, or, often, the work falls to the women and children. There is no safety net.
Replacing the animals is not the answer. He posed the questions: in these locales, where would one buy fuel for a machine to do the same work? And with what money? How would it traverse the terrain? When the machine breaks down, it persists in the environment for 100 years, whereas a dead donkey is gone in two weeks. Working animals are a sustainable resource that does little to no environmental damage. They are crucial, irreplaceable players in the world economy, Knottenbelt noted. They are the perfect employees: honest, hardworking, reliable, safe, always available, self-repairing, patient, and they give their all for the most minimal of pay--water and a handful of grass.
And so they must be cared for.
Equine veterinarians are uniquely placed to provide this care, as they understand perfectly the necessities of equine health and the implications of failure. While the scope of the overall issue is immense, Knottenbelt made it clear to his audience that small interventions, such as tetanus and rabies vaccination, can make a huge difference to an individual animal and the family it supports.
Individual veterinarians then took to the podium to describe projects in which they have been involved. Some of these were group affairs, while others were individual efforts. Some have been consistently successful over years of building relationships during repeated visits, while others have struggled, perhaps now serving best as cautionary tales to those who would organize their own campaigns.
Here are a few of the projects discussed.
Project Samana Samana is an isolated peninsula on the northeast coast of the second-poorest country in the Western Hemisphere--the Dominican Republic. Cacao, coconuts, and tourists are the economy, and all three of these are frequently transported on the backs of donkeys, horses, and mules.
In 1993 Samana had one veterinarian, who had no formal training and was working without pay. That's when Merriam made his first trip to the peninsula--a route he has retraced once or twice a year ever since.
Over the past 17 years Merriam has taken veterinarians, vet students, and techs to the area, where they receive both "altruism and education," Merriam said. At this time more than 150 veterinarians have participated, along with more than 100 students and 150 veterinary technicians.
They set up local clinics over the course of a week, twice per year, during which the volunteers assist local vets and students to provide as many services as possible. Over the years this has translated to the performance of more than 900 castrations (all under general anesthesia with only two deaths, both due to tetanus), administration of more than 4,000 doses of dewormer, and treatment of all types of conditions, including tropical diseases not seen in the volunteers' usual practices.
The group also introduced a giant donkey jack--which Merriam called, "the most beautiful animal I've ever seen"--to improve the available bloodlines and produce more durable animals.
As well as providing services, the volunteers are training local vets and owners and encouraging compassion. Merriam also noted that locals seeing female volunteers capably and gently handling animals, making decisions, and using tools has reinforced concepts of female ability and empowerment in the community.
Equine podiatrist Steve O'Grady, BVSc, MRCVS, of Northern Virginia Equine, participated in a Project Samana trip in June 2009, along with his daughter, Jendaya.
O'Grady performed a farrier clinic for local students, demonstrating correct shoeing on three cases. He also donated knives, nippers, and chaps to their best student. The group is hoping to bring along a Spanish-speaking farrier on future trips.
O'Grady shared some of his experiences, including the observation that tourism has largely been a detriment to animal health in the area. As more tourists are visiting the area and participating in trail rides, the trails are eroding badly. Locals replenish the trails with rocks, which are hard on the animals' feet, causing lameness.
Merriam discussed common traits that Project Samana and other successful initiatives possess. The groups:
- Work with the locals. Allow them to decide what the area needs are and invite you to come.
- Have a local initiative, serve a defined area, and focus on quality care within that area.
- Return regularly.
- Have a clear and defined goal.
More information on Project Samana can be found at Web.me.com/jgmerriam.
The Fast Horse Project The horse is a revered creature in Mongolia; there are 3 million people in the country and 2 million horses, which factor largely in the people's history and culture.
Their national horse racing festival, Nadam, dates back to 1250--as do many of the veterinary and horse management approaches used today. But because the racehorse is such a revered figure, it's also an excellent teaching model; people are eager to learn how to better care for these animals.
Enter Tom Juergens, DVM, of Anoka, Minn., and John Haffner, DVM, of the Middle Tennessee State University Horse Science Center in Murfreesboro. These veterinarians responded to a call for aid from Dr. Gerald Mitchum and the Christian Veterinary Mission, who asked for American vets to come over and teach modern equine veterinary medicine and surgery. That call has led to annual seminars for past 10 summers, which have become the leading source of continuing education for equine medicine and surgery in Mongolia.
Prior to the 1991 collapse of USSR, vets in Mongolia were public and provided free services. When that infrastructure fell apart, Mongolian veterinary medicine was essentially left stranded. Veterinary school graduates were learning out of 50-year-old Russian textbooks and never touched an animal over the course of their education. They graduated and were sent out into the field without any medicine or resources.
Horse races in the country consist of endurance events. The horses are ridden en masse by children across the countryside, often in hot weather. Traditional horse management dictates that horses are not to drink on the day of a race, and treatments for exhausted animals include bloodletting and cutting. Predictably, many horses die.
Veterinarians administer intravenous fluids to an exhausted racehorse in Mongolia.
"They don't do this because they don't care about their horses--they do it because they care about their horses and they don't have any alternatives," Juergens noted. "Any time we saw a horse die, people were crying. But they do it because they have no alternatives."
So how would one introduce modern treatments without insulting traditional culture?
Juergens and Haffner started with a core group of local veterinarians, using translated PowerPoint presentations, notes (which are now bound into textbooks and used in the veterinary school), and wet labs to demonstrate and allow the vets to practice relatively simple procedures, such as giving intravenous fluids, placing a catheter, and performing a basic lameness exam.
The approach is a spin on the "teach a man to fish" concept; as Juergens explained, they can spend their time in Mongolia performing 40 castrations, or they can teach 40 veterinarians about aseptic techniques and antibiotic therapy, resulting in 200 successful castrations in the long term.
This year Juergens and Haffner also helped local veterinarians organize seminars for the herders in order to provide client education and market their services.
Over the 10 years of the Fast Horse Project, 400 vets have received training. Now expanded to all provinces via the core group of trainees, modern medicine can be seen in use throughout the country. They have also established a pharmaceutical network, giving veterinarians access to equipment and drugs such as ivermectin, sulpha antibiotics, and local anesthetic.
Juergens said the project has given him "a new perspective on veterinary medicine." He also keeps his clients back home abreast of project developments. Many clients volunteer funds, giving them ownership of the project as well.
Juergens said he feels the success of any equitarian project is dependent on identifying needs of a community, meeting those needs with quality, culturally relevant teaching materials to leave behind, taking time to establish trusting relationships between vets and owners, and following through with consistent teaching and mentoring.
For more information on the Fast Horse Project and Christian Veterinary Mission, see cvmusa.org.
In our backyard: Outreach at home Richard Markell, DVM, owner of Ranch & Coast Equine Practice in Encinitas, Calif., had found great success on all standard parameters of veterinary practice. A sought-after orthopedist for top-level sport horses, he described his role as "Ferrari repairman." But something was missing.
"I felt like I had to do something (to give back), but I was just too busy," Markell stated.
Then one day 10 years ago he decided to stop in at the Shea Center, a therapeutic riding center he passed every week on his way to see clients in Los Angeles. He offered to manage the horses' health care and donate supplies for the program. He now visits the program every week.
At that time the group had three horses. Today they're the second-largest program in the United States, with 35 horses that service more than 600 riders and 1,000 volunteers throughout the year. Markell advises on the animals' health program and helps select new horses. Therapeutic riding horses are working animals; if they don't work, they've got to go. So long-term health and soundness are key.
"It is the highlight of my week," Markell said. "The program gives me far more reward than I could ever give to them."
Dr. Richard Markell of the Shea Center talks about veterinary outreach.
Markell's point was if traveling around the world isn't feasible for your life or your practice, helping a local group can make a big difference, too.
There are more than 1 million charitable organizations in the United States. So how do you pick? Markell advised attendees to ask themselves the following questions:
- What lights you up? What are you interested in?
- What is the group's community reputation?
- Who are their board members?
- What are their goals?
- How long has the staff been there?
- Is the group growing?
- How do they track their success?
- Is it a 501(c)(3) federal standard nonprofit organization?
- Do you personally know any donors?
- Where does the money go?
- Does the organization have sustainable plan?
- Will your time and money go to "patching the Titanic," or is it well spent?
- If considering a therapeutic riding group, are they accredited by NARHA (an organization that oversees equine therapy programs in North America)?
Markell noted that a group doesn't have to be large to be worthwhile--some grassroots groups do great work.
Markell reviewed the "three Ts of philanthropy: time, talent, treasure." A vet doing service is taking time from his/her practice and family, and that's donating, too. He noted all charity is good, regardless of commitment; do a little today, a little more next time.
Equitarian efforts have been under way for decades, but they are benefiting from new emphasis and organization from the AAEP. Numerous projects are in progress. Whether joining an established project in a developing country, starting their own, or reaching out at home, veterinarians who want to participate can choose their own level of commitment and horse owners can support them in these efforts.
About the Author
Erin Ryder is a former news editor of The Horse: Your Guide To Equine Health Care.
POLL: University Equine Hospitals