Tricia not feeling good

Yes, we were expecting Tricia to get the usual traveler intestinal infection. We didn't know when or how it would happen.
Yesterday, Tricia woke up very sick, we thought it was a cold..... but it wasn't... It was a lovely African flue. We had to delay our plans. Hopefully we would leave to Tatouine on Tuesday instead of Monday.
Tricia is in very good hands, Jaber's mom is her own personal doctor. Tricia feels better today

Donkey Hoof and Dental Care at Domaine Sidi Mrayah

We spent the day with Malek Lakhoua at his farm, Domaine Sidi Mrayah, where he has over 2000 olive trees on 14 hectares. He primarily makes organic oil olive but has other products like donkey milk soap and essential oils. He keeps 3-5 donkeys and has volunteered at NGO veterinary events for donkeys. He is a human medical doctor but his first passion is his family farm where he hopes to  develop agri-tourism. He is interested in helping us improve donkey welfare and connect us with his local community. We agreed a good place to start was at his farm to show him some of the things we wanted to do for the donkeys of Tunisia.

Malek had a veterinarian (who was unfamiliar with farriery) do a little hoof care about a year ago on Cleopatra. Fortunately, the donkeys are used to Malek's frequent hands-on care and they all behaved like fancy well-trained horses - evidence donkeys often get a bad reputation for misbehaving, but in fact they are quite agreeable creatures.  (you can click on the photo to see full size)

a patient Dolchita calmly allows the first look

Tricia demonstrates a hoof trim with nippers, hoof knife and file

Malek gives it a try after finding a comfortable position

a very happy fast learner removes Ramses'  baby toe excess

The hooves were all long, chipped and very hard. We limited our care this first visit to just the front feet and were modest in the amount of hoof we removed because we did not want to stress the donkeys or cause lameness. Dolchita had a chunk of plant stubble wedged into a crack in the center of her toe (top right photo) demonstrating the importance of checking hooves frequently before problems arise.

Dolchita's left front (top) and right front (bottom) hooves before trim

Dolchita's toe after initial trim

Next project - the teeth! Malek said these donkeys had never had bits in their mouths and the teeth had never been addressed. Equines develop sharp points on their teeth which can diminish proper grinding of food and cause sores in the mouth. These points can be filed off to create a smooth beveled edge and more effective grinding.

Malek watches the teeth filing while Ramses checks out the tools in the background.

Listening to the magical sound of the file against the now smoothed tooth points

Malek, who is a human medical doctor, is very pleased with his new animal care skills

A successful veterinary care morning was followed by a delicious lunch and tour of his farm.

Homegrown cereal grains are fed to the donkeys

Frozen donkey milk waiting to be transformed into soap

Donkey care builds trust

Domaine Sidi Mrayah

We reached our destination and were greeted by the donkey welcoming committee.

Dolchita, the sweet favorite

Cleopatra, who is pregnant

Ramses, the curious weanling

After the introductions, we began our work gaining trust with Malek by building trust with the donkeys.

South to Zaghouan !

Our trip to Zaghouan to visit Malek Lakhoua's donkeys and olive oil farm was a beautiful rich experience in many ways.

Zaghouan is about an hour south of Tunis. We left with the sunrise to get an early start and avoid the city traffic and the heat.

En route out of the city and towards the countryside, we drove past ruins of a Roman aquaduct.

As we drove closer to our destination, we saw several examples of One Health (intersection of human, animal and environmental health) challenges. There were shepherds wandering with grazing sheep, goats and cattle amidst trash and stagnant water. We saw nomadic tents, loose dogs and donkeys.

Malek met us in an old section of Zaghouan with narrow streets, cafes, and an exquisite tiled community water source.

 

...and then we followed him out of town to his farm...

the town lies below Mount Zaghouan

Wednesday: Medivet Laboratories Meeting

Wednesday morning was very productive.

We drove to Soukra to Medivet Laboratories (http://www.medivet.com.tn), a veterinary pharmaceutical company, where Jaber has two colleagues. The first part of the meeting focused on speaking with Dr. Imen Hadj Ammour (veterinarian). She told us about the products Medivet manufactures and distributes. She also shared details about working with rural donkey owners because she has volunteered numerous times for Tunisian donkey welfare NGOs.

One of the common actvities at the NGO veterinary service events is administering anti-parasitics. We discussed challenges of deworming Tunisian donkeys - many live their whole lives without receiving anti-parasitics. Most owners do not have the resources to maintain a anti-parasitic program.

Ines, Imen, Tricia and Jaber

One example of oral paste for internal anti-parastic treatment of donkeys

She feels the Tunisian donkeys experience a constant exposure to parasite eggs and as soon as they are dewormed, they are reinfected in high numbers. One time purge deworming may not only be ineffective but can also be harmful. As veterinarians, we know a massive die-off of internal parasites can cause intestinal bleeding, obstructions, diarrhea and death. We agreed this is a concern when we appear with good intentions at a veterinary intervention and administer dewormer to the rural donkeys.

She also had stories to tell about how to convince owners to discontinue certain unhealthy and inhumane practices. Telling owners to stop old practices simply for the health of the donkeys, or for humane or religious reasons may not result in adoption of new behaviors. To elicit a change in human behavior, she has found that tapping into people's fear of being sick is one way to convince them to change. If their donkey is sick, they might get sick from contact or from eating the meat of the diseased animal.

Another tactic to elicit change is with gifts. This worked well to address the practice of the owners deliberately cutting grooves in the animal's body for the harness to embed into. The owners of donkeys without body wounds received gifts such as halters, but the owners of donkeys with wounds did not get the gift. They knew if they arrived at the next event without the injured donkeys, they would then get the gift.

She explained Tunisia has about 1400 veterinarians and perhaps only 3 or 4 perform dental procedures on horses. If we identify a high prevalence dental disorders and oral lesions in donkeys, this may be a very welcome area for training and service.

Imen said Medivet would donate products for our activities, and we are very appreciative of this offer. Thank you!

The second half of the morning, we met with Dr. Ines Ben Jbara, who also works for Medivet and is  looking to expand the product line of Medivet.  In addition to her work, she is actively involved in the International Veterinary Student Association (http://www.ivsa.org/). This organization, founded in 1951, brings veterinary students together to "benefit the animals and people of the world by harnessing the potential and dedication of veterinary students to promote the international application of veterinary skills, education and knowledge".  Ines said the students are eager to learn, network, and have opportunities for activities. One of the active committees is animal welfare and the current chairman is Tunisian. We will pursue establishing a relationship with IVSA Tunisia as an avenue to link our efforts for the donkeys with students. You can check out their activities on facebook (https://www.facebook.com/IVSATunisia and  https://www.facebook.com/ivsapage).

On an aside, we saw several blacksmith shops on the main road to Soukra close to Medivet. No time to stop today, but we want to talk to local craftsman about tool design before we leave Tunisia.

Veterinary Colleagues, Hosts and Volunteers

Veterinarians generally enjoy the camaraderie of fellow veterinarians. This was especially true on Tuesday when we met with Dr. Emna Brour from El Abassia (Kerkennah Island) and Dr. Ahlem Lahmar from Tataouine (yes, Star Wars fans, we mean the Tataouine). It was enlightening to share stories of veterinary medicine training and practice with an international flavor.

Veterinary colleagues: Emna, Jaber, Tricia and Ahlem

Each time we have the opportunity to talk about our donkey welfare project objectives with regional veterinarians, we are able to define more realistic actions. These two veterinarians expressed an interest in improving their equine dental and hoof care skills. We exchanged information about the different tools we use such as hoof knives, nippers and the toeing knife (the modern version of the butteris). We discussed challenges of restraining animals who are not used to having their hooves trimmed or having a speculum used for mouth examinations.  We also talked about how the demographics and attitudes of donkey owners can vary from community to community.  For example, on Kerkennah Island, the women are responsible for the donkeys because many of the men seek employment off the island.

Ahlem is a large animal private practice owner in Tataouine and is planning to host us next week to visit donkey owners in Tataouine and the surrounding areas. We look forward to making initial contacts with the community and are hopeful we can organize an event there soon. Emna has contacts with the community of donkey owners on Kerkennah Island and has offered a place for us to stay there as well as helping us organize a community event and volunteering her skills for a veterinary service event.

They are both hopeful they can join us for several community events and are interested in furthering donkey welfare in Tunisia.

Of course, the meeting would not be complete without a little Tunisian food !

Salad with Tuna

Seafood Pizza (including squid)

Aknowledgments

We would like to express our gratitude to those who supported us to get to Tunisia. Acknowledgements often come at the end of the project, but we want to say thank you now!

We are especially thankful to University of California at Davis, Blum Center for Developing Economies (http://blum.ucdavis.edu/) for awarding us the grant to address the connection between animal and human welfare in Tunisia. Now that we are here, we see this connection more clearly and how much there is to be done.

The Donkey Sanctuary  (http://www.thedonkeysanctuary.org.uk/)  generously offered advice on how to approach communities of donkey owners and provided educational materials.

Eric Davis, DVM from the University of California at Davis, International Animal Welfare Training Institute (http://www.vetmed.ucdavis.edu/iawti/index.cfm) provided consultations and tools, both of which are being put to good use.

We would like to recognize Dr. Kurt Kornbluth of the University of California at Davis, Program for International Energy Technologies (http://piet.ucdavis.edu/) for his continuous support. We are collaborating with him to develop the new D-Lab One Health courses (http://piet.ucdavis.edu/?page_id=908). We hope to return to the US to brainstorm ideas for improvements to donkey related veterinary tools and cart equipment utilizing local materials and resources.

Last, but not least, we would like to send a big SHUKRAN to G David Miller, our UC Davis International Agricultural Development adviser, for encouraging us to turn our homework assignment into a real world project!

One busy week, many thanks!

We’re in the middle of our day between meetings but we’d like to pause to reflect on the first week of our project. Fortunately, we didn’t lose much time adjusting to the culture here. Jaber is a native Tunisian and Tricia was welcomed into his family’s home. She has found the people and the food very easy to digest ! However, it quickly became clear to us that a great deal of time and energy is required to begin to meet our immediate project goals and create future endeavors.

We are extremely grateful for Jaber’s numerous professional veterinary and medical contacts who have shared their experiences, interests and ideas. They are an amazing resource and wealth of information about the health status of donkeys and the economic situation of the owners. We've primarily been in urban Tunis and have seen donkeys, mules and horses pulling a variety of poorly designed carts. Our first impression is that the urban working equines are in most need of intervention. Most of them have the dull look in their eyes of an exhausted animal. They are thin, have bleeding around their mouths, and pressure sores from carts, scarring on their front legs (from being hobbled) and chipped hooves.

We are fully engaged in our meetings and even though we are eager for hands-on veterinary work we see the value in taking our time for conversations. We listen carefully and let go of our preconceived notions of how things get done. All these discussions are building a strong foundation of colleagues with shared visions for Tunisia and the donkeys. Even with internet and skype available to us to network, there is no substitute for person to person connections and seeing the donkeys at work.

Even though we are centrally located, driving from our home base to the various meeting places takes a great deal of time due to the heavy traffic around Tunis. There are no rules of the road here in Tunisia. Cars stop and park wherever they want, traffic lights don’t work, police randomly stop cars, pedestrians and bikes ignore racing cars, and dead vehicles are abandoned.

Tunisians are busy hard working people - there is a constant buzz of activity. Scheduling appointments to meet up requires patience and a fair amount of flexibility. We've found the best way to make contact is by telephone. Appointments are often set up on the spot and we shift directions to catch up to people as they are available.

We have also realized the business meetings we set up usually involve eating food and  general visiting and bonding. Not that we're complaining, but it does slow down the process of moving forward. Social activities are offered and of course, it is rude to say no. (Tricia was taken to a hamman (turkish bath) in Arianna a few days ago by the very charming mother of a veterinarian we were meeting with).

The days are long and hot but the week has been very productive. We are looking forward to the next steps. Tomorrow we will be in Zaguan visiting with Malek and his donkeys at his olive oil farm.

Patience and persistence pays off

Today we had to head into central Tunis for meetings. It was a slow start amidst lots of traffic and we were driving around in circles as several arranged meetings got canceled and rescheduled. Patience and persistence triumphed.

Jaber put his cellphone networking and multitasking skills to good use and we were able to make our meeting with Malek Lakhwa a priority. We were hoping he would be a key community partner for our project because he has participated in donkey veterinary service events, owns an olive oil farm, and is an entrepreneur as well as a medical doctor.

We were not disappointed in our meeting. Malek listened carefully to what we wanted to do and offered his farm and community connections. Malek was full of information about the status of donkeys in general in Tunisia and local craftsmen who make harness equipment. He told us about his volunteer efforts with NGOs and the attitudes of local residents towards their donkeys, where many place little value on the donkeys. The owners use the donkeys mostly for transportation and don't understand their behavior which results in rough treatment. We talked about addressing human behavior changes and hope in school age children. He shared his concerns about the increase of donkeys being butchered for meat and the poor conditions of their transport and quality control of the meat. 

Just as we were talking about the welfare of donkeys, a cart went by with a thin mule who looked very stressed and had sores on his mouth and squinting runny eyes. The drivers were friendly and told Tricia to pet the mule. It was hard to walk away and not give advice or treatment.

Malek is very fond of the four donkeys he owns and is keen to improve the health of donkeys in Tunisia. It was inspiring to hear about his entrepreneurial adventures of making soap from donkey's milk (he is the only person his donkey, Cleopatra, will allow to milk her). We also began brainstorming about marketing the soap and agri-eco tourism ideas involving donkeys. Anyone interested in buying donkey milk soap or a working vacation on an olive oil farm and going on donkey hikes?

We agreed respecting local culture and starting small to build a good foundation is key for actionable plans to become realities.  We made arrangements to visit his farm in Zaguan on Wednesday which is about two hours from Tunis.

Tricia Andrade and Malek Lakhwa

Donkeys donkeys everywhere!

A donkey waiting to work near an abandoned vehicle reminds us the life span of a working equine outlasts that of an automobile.

Camel Consultations and Human Connections

There is something universal about the connection between humans who love their animals and the veterinarians who provide care. We listen to the human being, and we treat the animal; in the process we show our caring for the person. If we are lucky, that person expresses their caring for the veterinarian. It may come in the form of money, a handshake, or a dozen eggs. Today, it was a camel ride.

On a drive Saturday, we passed by a seaside area with three camels in a parking lot. As we approached the camels, the owner saw we wanted to take pictures and began to ask for money. Jaber told him Tricia was a visiting veterinarian and the photo opportunity quickly turned into a veterinary consultation.

The camels were a family and the yearling had recently eaten an excess of fibrous cereals. We asked all the right questions about history, inspected the package of probiotics he had administered, and learned about his home remedies, which included vinegar. The camel was recovering from a depressed appetite, but was still weak from acidosis. We made our recommendations to discontinue the vinegar and try baking soda and beer.

The owner expressed his gratitude for our concern and offered Tricia a ride on the Momma Camel. Needless to say, this was a novel experience even though she is an experienced equestrienne.  The owner further showed his trust in us by handing Jaber the leadline.

UC Davis School of Veterinary Medicine Ambassadors. One animal at a time.