From the 14th April until 17th we made another visit to complete the ABC and rabies vaccination campaign in Chauntra, Bir, Sherabling and Tashijong. This was my second camp so far and it’s been a very good and enjoyable experience.

Locals, monks and foreigners were very helpful. We also saw some interesting cases that required medical treatment.

First Day in Chauntra.

On the first day in Chauntra, two Indian vets came to learn our techniques and we exchanged some knowledge. I think it’s a very positive and enriching experience to learn different points of view.

In Chauntra we received 3 golden retriever cross puppies from Sherabling: two of them suffering from gastrointestinal problems and the other one with a cut on her thigh. This wound was sutured under anesthetic, and she was also neutered at the same time. One of her brothers suffered from severe dehydration due to vomiting and diarrhea: he was also showing very sever respiratory symptoms suggesting pneumonia. After 24 hours treatment with antibiotics, supplements, fluids, pain relief etc, he was sent back to Sherabling along with his brother, who was kept overnight with him for company. He started eating and walking around, and although he was still weak and had breathing difficulties, he was continuing the treatment and making steady progress.

Also from Sherabling came a small puppy suffering from mange. Some of the foreign visitors in Sherabling had found him in a very poor condition, so they took him to the monastery and raised some fund towards his treatment in Chauntra. He was treated topically and systemically and when we rechecked him the next day back in the monastery he was much improved... Playing and running around!

Possible Rabied Dog - Blackie.

In Sherabling we treated some dogs with bite wounds: the monks reported an aggressive dog in the area called Blackie.

They also brought some dogs for neutering while we were in our last destination: Tashijong. The last day they also managed to catch and bring Blackie with them, he had many bite wounds on the neck and was listless and apathies. They reported he had bitten more than 10 monks and also several locals from Bhattu; he had also bitten 3 dogs from the monastery, one cow and unfortunately he had also killed the little puppy with mange that was doing so well.

After a long discussion we decided his behavior wasn’t normal and that it was very likely that Blackie was rabid. It was decided to euthanize him for safety purpose. He was already sedated so he went peacefully. We advised to send the brain to Shimla for analysis and this is the only way to confirm rabies. While awaiting for the results we advised that all the bitten people had treatment and gave the options of euthanasia or strict post exposure quarantine for the bitten dogs. The monks opted for quarantine.

Scabies: extensive skin defected dog.

Another interesting case we saw in Tashijong was that of a stray dog showing sever generalized scabies with an extensive skin defect mainly on the lumbosactal area ( a big area with necrotic skin and exposed suppurating flesh.). He hadn’t eaten for 2 days and suffered from diarrhea, was dehydrated and emaciated. The man taking care of him was very worried as he had taken him several times to the vets for treatment but the dogs was getting worse.

We anaesthetized him to avoid any stress or pain and then cleared and flushed his wounds, then applied a mixture of placental extract and honey (known for its antibacterial properties, as well as a help to accelerate the healing process), followed by repellent spray to keep away the flies that were feeding on his exposed flesh.

Also we applied two different kind of lotions against scabies on the rest of his body and injected two different antibiotics and Ivemectine (against scabies), as well as fluids to rehydrate him. He went home with a long list of medication and his owner agreed to commit a long term treatment as the wounds would take a couple of weeks to heal but the scabies may take longer.

All in all the experience on the camps was really good, we got to see new places that don’t appear in any travel guides and interacted with the locals. I would like to thank all the people that gave us a hand and made this camp run smoothly, (from the people keeping away the flies while I was clearing the wound to those helping with translation while consulting). It’s those little acts of compassion and kindness that give meaning to life.

Dated: 8^th May 2009

I had the brief but fabulous opportunity to visit the Tibet Charity of Mcleod Ganj in Himachel Pradesh, India. After flying from London to New Delhi and a short picturesque flight to Dharamsala I was greeted by Thukjee a Buddhist monk volunteering with the Veterinary clinic. Dharamsala shelters the Tibetan Government in Exile where His Holiness the Dalai Lama resides, minutes walk from the headquarters of the Tibet Charity.

The charity itself is a well founded organisation that aims to help the Tibetan Exile community in all areas, supporting volunteers in the local hospital, and running an entire Veterinary clinic to provide services for the many stray dogs in the area. Given the compassion of the many monks and nuns in the area, most of the strays are well cared for, fed, and brought for medical attention when required. Routine sterilisations and rabies vaccinations are performed on a regular basis. Unfortunately I missed out on participating in one of the neutering and vaccination drives where the charity extends its services to far flung villages and towns. During my short week with the charity I worked with Sarah, a Scottish vet also helping for the month, and Stine, a Danish vet nurse. The clinic is self contained with basic medicinal supplies for anaesthesia, fluid therapy, parasite control and common ailments. It was a slow week with only 15 local dogs brought in for neutering, partly due to a national holiday, December 10th celebrating His Holiness’ Nobel Peace Prize. During the week many locals would drop in and we also treated puppies with vomiting and diarrhoea, mange cases, puppies with broken legs (due to the madness of drivers on the narrow roads), orphaned kittens, flea allergies, transmissible venereal tumours, and simple infections. With access to the Veterinary Training Hospital 3 hours away, the more traumatic cases did have the option of radiography and more specialised care when required. Access to pharmaceuticals, including vincristine for the treatment of TVT’s was also impressive, especially given the common nature of these tumours.

Though we all found the pace slower than our usual hectic clinics, working with the volunteers who deal with these strays everyday was enlightening. The locals are extremely grateful for the presence of a clinic open almost every day for animals in need. Tsering Thundup the director of Tibet Charity is very welcoming and supportive of visiting veterinary staff, and expresses a very practical approach to treatment of the stray dog population. His aim to raise awareness of the importance of neutering and vaccinating the stray dog population, is highlighted by the high percentage of rabies related deaths in the human population in India.

The atmosphere of Mcleod Ganj and its Tibetan community is one of compassion and I learned more in one week amongst them than I have in a long time, anywhere else. I would hope to return to Tibet Charity with the opportunity to travel on a neutering/vaccination camp to neighbouring communities and use my skills to even more effect, in a country that needs their stray dogs to be cared for in the manner of the Tibetan Charity.

Drs Sonya Yu and I joined final year students from Denmark, Maria and Louise, in New Delhi to head up to McLeod Ganj for 3 weeks of volunteer work with Tibet Charity. Sonya and I had never been to India before, and the thrill of Delhi was in stark contrast to the incredible scenery of the Himalayas that greeted us on arrival.

After settling into our accommodation at a neighbouring guest house, we had a patient waiting for us even before we’d had any chance to settle into the clinic at Tibet Charity (T.C.) House. Getting straight into the work was the perfect way to settle our minds with something more familiar after 3 days of cultural revelations. Even after half a day in the clinic and the upstairs classrooms, we got a sense of the very relaxed, very welcoming atmosphere that we thoroughly enjoyed for the whole 3 weeks.

The first people we met were 2 volunteer English teachers, Shaun and Tanya, an American couple who were coming to the end of their stay. In the clinic, we were finally introduced to Bishan Das, or Vishnu, the vet nurse already held in high esteem from Louise’s experience of the previous year. Many other people entered our circle of companions over the next few days, from Bhum the general fixer-of-everything, to Rinzin, the lovely Tibetan English teacher, and of course, the Director, Tsering Thundup.

Our clinic was a smallish, but well setup room with the most efficient use of space as one would ever find in any clinic, anywhere in the world. And this was where we began with a street dog with mange. Mange, as we learnt very quickly, was an extremely common affliction in street dogs, as frequent preventative treatments was near impossible to carry out.

The work in Himachal Pradesh involved 3 main components: local work in Dharamsala neutering street dogs and treating any diseases/injuries of dogs caught or brought in by concerned locals; setting up neutering camps in regional towns, again also treating any medical conditions; and finally the rabies vaccination program carried out everywhere we went. The latter probably carried the least significance for us personally prior to our time there, but for reasons described below, was eventually realised for its true value in controlling the disease.

Our first camp was at a satellite school of the main TCV School in Suja. Over the next couple of days, we had an excellent time staying on school grounds, and during the day, operating on local strays caught for us by the students. There were many unforgettable scenes of Tibetan high school students crowding around our makeshift surgery tables set up under the open skies (with tarpaulin sheet prepared in case of rain) in the courtyard of one of the student dormitories. One thing we found time and again here and in some of the places in and around Dharamsala, but perhaps less so in the bigger cities of India, was the excellent condition many of the stray dogs were in, being looked after so well by the animal loving local (Buddhist) population. As with many of our camps and road trips, there was a visit to one of the nearby monasteries, where we also attempted to find some surgical equipment left there the previous year!

From Suja, we drove to Tashi Jong, another beautiful Buddhist monastery, for another couple of days of surgery. Here, we were hosted on the first night by the head monk, the Rinpoche, and one of the senior Korean nuns. Like everywhere else, we could see evidence of previous camps, with numerous dogs carrying the distinct ear notch, as proudly pointed out by Vishnu. After 2 days, we had neutered over 15 dogs, and treated many for mange, as well as vaccinating many more. Again, there was a very friendly attitude from the locals, who openly showed their appreciation of our work, and as we left, we were to humbly accept several Buddhist shawls from the residents.

After nearly a week away, we very much looked forward getting back to our new "home". We spent a couple of days unwinding, during which Vishnu took us up for an inspiring ascent into the surrounding mountains, followed by a gruelling descent, as our fitness failed us dismally, while Vishnu and his wife effortlessly cruised ahead.

Shortly after this, we were to experience first hand the horrors of the disease we were here working against. One of the TC staff was bitten by a stray dog, whom we later confirmed on suspicion as being rabid. Reports followed later in the day, while we attempted to get the human immunoglobulins for the staff member, that several other people and dogs had been bitten. This set the scene for the next week or so as we attempted to catch the rabid dog and begin inoculating as many of the local strays as possible. For the first time during our trip, there was an element of seriousness and heaviness in the air as we thought about the immediate and long term repercussions of what had happened. It was like nothing we had experienced before, and put into perspective our fortunate position in life, since once we had left India, we were no longer living with this threat that locals lived with everyday and with complete acceptance.

It also brought about many interesting discussions among us in regards to protocols for such situations. Factors to be considered were:

- extent of our involvement as a charity organisation operating under strict regulations of local authorities;

- the effort (or lack thereof) of local authorities in catching dogs suspected of having rabies, and the manner in which this is carried out;

- dealing with animals suspected of being bitten- there were several different thoughts from various persons involved, from local vets to foreign vets to medical texts and resources;

- educating locals on the whole rabies disease process; and

- taking into account the very important issue of Buddhist philosophy on matters of euthanasia.

Ultimately, we did not progress far beyond dealing with the immediate situation only. There are several similar programs being carried out around the world, some with many more years experience. Even still, there are no protocols set in concrete, and as we found, it is the immediate situation that is most important to be attended to with the short time available. Together with the plans for long term practice of TC, this will hopefully create an ‘ecosystem’ amongst the stray dog population in India, which seems part and parcel of daily life, that will minimise the propagation of rabies. And the long term future of organisations such as TC require the continual supply of volunteers from the developed world, something we aim to contribute to for many years to come.

Good afternoon teacher !

How are you teacher ?

Thank you very much teacher !

Politeness, attention and gratitude – these are a few of the very positive adjectives that describes the wonderful Tibetan students I was so lucky to teach for a month at the youth centre of Tibet Charity (april 2008). One other is “joy” by the way – also very important. We really had lots of great moments together, I and the students.

In Denmark ( my home country) I teach adult foreigners Danish, so I am used to teaching, but never taught English to any-one before, so I have to admit that I was bit worried before entering the class for the first time. But after 5 minutes in there all my worries were gone. You just need to be there and sense the atmosphere before you really know what you will do, but when you have done that, it really feels like a big privilege to be there and share your knowledge with students that really want to absorb every single bit of the English language you bring them.