It was my second day at clinic today, although I could have gone on outreach due to many of the vets being ill. I arrived just in time to see a dog having a wound on its elbow cleaned and sutured. First it was given a local aesthetic and then the area was shaved using a blade - it would have been a lot quicker with a razor. The area was then scrapped clean using a scalpel to make the wound fresh and remove any dead or infected skin. Suturing occurred next in a broken pattern. It was sutured in two layers, one under the skin and one on the skin. Just before the suturing was complete an antibiotic - penstrip - was added under the skin to stop any infection. The area was then sprayed with antibiotic and iodine was added. In the dogs hind leg, it was given antibiotics and vitamins intramuscular. I was surprised to see that the dog was not given a collar to wear so there was nothing from stopping it licking the wound. In England, the dog would have been given a collar.
The dog with ear ache that I had seen previous in the week was brought back in for a check up. It was on a three day course of treatment and today was the last day. The ear looked much better and the vet was happy with how it was healing.
The day at the clinic was very slow as there were only two patients in the afternoon. One dog was coming in for an anti-rabies injection, whilst the other was a small puppy that appeared dead other than a slight breathe. I couldn't understand what the people were talking about as it was in twi (the local language of the Ashanti region), but a short while later the owner took the puppy away without any treatment. It is just like England in that the cost comes first before the treatment.
Monday 26 August 2013
Ghana - Clinic
The 30th July, my first day in clinic. I saw a number of different cases being brought in throughout the day. As they don't hand out appointments like they do in England, the clinic could go from being very quiet to being very busy quickly. The owners would just turn up when it suited them.
The first patients that were brought in were a group of puppies that looked very dehydrated. They were also extremely dirty and smelly, and it appeared that they were not that well looked after. They were given their booster vaccinations and dewormed.
Soon after a dog was brought in that seemed dead, however, after a little while I noticed that it was breathing very slightly. It turns out that dog had had a lot of diarrhoea and to make things worse, it had had its since yesterday, meaning that the owner didn't care enough to bring the dog in before it got even worse. The dog was put up onto the table and there is just led still. After preforming a clinical examination, the vet noticed that the dog had injection marks on its arm, which meant that they man had lied that the dog had not received any treatment. The vet couldn't treat the dog as any other injections could kill the dog. In the end there was nothing that the vet could do but make the man leave and take the dog back to the place where it had first been treated.
A well looked after dog was the next patient through the door. It looked to be in good condition - the coat was clean with no sign of ticks or fleas. The owner said that the dog had not been eating, but that it had also not been sick. The vets were about to treat the dog when I saw the same problem that I have seen so many time in England - the owners can't afford to pay for the treatment or they are not willing to pay so nothing gets done to help the sick dog. The dog soon left after receiving no treatment at all.
During the slow times of the clinic, usually around lunch time, everyone occupied themselves by reading, eating or even sleeping.
After a very quiet period at the clinic the well looked after dog returned with more owners. This time the owner brought some deworming tablets and some vitamins before taking the dog back home. It seemed that the owners were going to treat the dog themselves when they got home as it was cheaper that way.
Another puppy was brought in as it was vomiting. it was given antibiotics, vitamins, promethazine and oxy. Soon after another dog that was not eating was brought it. This dog was given Dexa, Penstrip and vitamins. This dog had been vomiting yesterday so it was coming in today as they have to come in for 3 days of treatment.
Just as in England, the table is cleaned between patients, however, unlike England, every dog is made to wear a muzzle. There are also a lot more people in the consulting room as it doubles up as an office. At times it could get very squashed.
A tiny puppy of only a few weeks old was brought in by the owner in the hope of getting it vaccinated. However, the dog was too young so instead they dewormed it and sent it on its way.
A dog with an ear ache was brought in soon afterwards. The owner had tried to help the dog by pouring palm nut oil into its ear and giving it antibiotics. When the vet heard this she burst out laughing. After looking into the dogs ears, she got some cotton wool and dabbed up the rest of the palm oil - thankfully there wasn't too much left! The dog was then given antibiotics and vitamins. As the dog was so scared due to the amount of people in the room at the time, he emptied his bowels everywhere and he growled and wiggled a lot in an attempt to get free.
It seemed that the clinic was busy in the morning and after lunch, which is the same as the clinics in England that I have been to. The only difference is that they are no scheduled operations. During my month stay I didn't see one operation take place at the vet clinic, and neither had many of the other volunteers.
Another puppy was brought in for a check up on a wound it had on its front paw. The wound didn't look infected so it was cleaned and antibacterial spray was sprayed on the wound. It was then given injections before heading home. Soon after a dog came in with scar marks down its back. It was just coming in for a check up and it seemed that the burns were healing well. The owner was hoping to use the dog as a security dog so the vet told his how to go about doing this. She said that you had to limit playtime and its contact with people.
All in all, today had been a rather busy day at the clinic. It was a lot busier than I was expecting after I had heard the others complain at how slow it was.
The first patients that were brought in were a group of puppies that looked very dehydrated. They were also extremely dirty and smelly, and it appeared that they were not that well looked after. They were given their booster vaccinations and dewormed.
Soon after a dog was brought in that seemed dead, however, after a little while I noticed that it was breathing very slightly. It turns out that dog had had a lot of diarrhoea and to make things worse, it had had its since yesterday, meaning that the owner didn't care enough to bring the dog in before it got even worse. The dog was put up onto the table and there is just led still. After preforming a clinical examination, the vet noticed that the dog had injection marks on its arm, which meant that they man had lied that the dog had not received any treatment. The vet couldn't treat the dog as any other injections could kill the dog. In the end there was nothing that the vet could do but make the man leave and take the dog back to the place where it had first been treated. A well looked after dog was the next patient through the door. It looked to be in good condition - the coat was clean with no sign of ticks or fleas. The owner said that the dog had not been eating, but that it had also not been sick. The vets were about to treat the dog when I saw the same problem that I have seen so many time in England - the owners can't afford to pay for the treatment or they are not willing to pay so nothing gets done to help the sick dog. The dog soon left after receiving no treatment at all.
During the slow times of the clinic, usually around lunch time, everyone occupied themselves by reading, eating or even sleeping.
After a very quiet period at the clinic the well looked after dog returned with more owners. This time the owner brought some deworming tablets and some vitamins before taking the dog back home. It seemed that the owners were going to treat the dog themselves when they got home as it was cheaper that way.
Another puppy was brought in as it was vomiting. it was given antibiotics, vitamins, promethazine and oxy. Soon after another dog that was not eating was brought it. This dog was given Dexa, Penstrip and vitamins. This dog had been vomiting yesterday so it was coming in today as they have to come in for 3 days of treatment.
Just as in England, the table is cleaned between patients, however, unlike England, every dog is made to wear a muzzle. There are also a lot more people in the consulting room as it doubles up as an office. At times it could get very squashed.A tiny puppy of only a few weeks old was brought in by the owner in the hope of getting it vaccinated. However, the dog was too young so instead they dewormed it and sent it on its way.
A dog with an ear ache was brought in soon afterwards. The owner had tried to help the dog by pouring palm nut oil into its ear and giving it antibiotics. When the vet heard this she burst out laughing. After looking into the dogs ears, she got some cotton wool and dabbed up the rest of the palm oil - thankfully there wasn't too much left! The dog was then given antibiotics and vitamins. As the dog was so scared due to the amount of people in the room at the time, he emptied his bowels everywhere and he growled and wiggled a lot in an attempt to get free.
It seemed that the clinic was busy in the morning and after lunch, which is the same as the clinics in England that I have been to. The only difference is that they are no scheduled operations. During my month stay I didn't see one operation take place at the vet clinic, and neither had many of the other volunteers.
Another puppy was brought in for a check up on a wound it had on its front paw. The wound didn't look infected so it was cleaned and antibacterial spray was sprayed on the wound. It was then given injections before heading home. Soon after a dog came in with scar marks down its back. It was just coming in for a check up and it seemed that the burns were healing well. The owner was hoping to use the dog as a security dog so the vet told his how to go about doing this. She said that you had to limit playtime and its contact with people.
All in all, today had been a rather busy day at the clinic. It was a lot busier than I was expecting after I had heard the others complain at how slow it was.
Ghana - Back to Genesis Pig Farm
I thought today, Monday the 29th July, was going to be my first day at the clinic. I had now been in Ghana over two weeks but never been to the vet clinic. However, due to the new outreach timetable that they had devised, I was back on outreach and back to Genesis pig farm to preform two more castrations each. 
The castrations were a lot better than the previous ones as there was a lot less blood. It also helped that the pigs were calmer and the testicles were a lot smaller. We also injected a number of the smaller piglets with vitamins and dewormed them. Some of the injections were given under the skin (subcutaneous) whilst other injections were given directly into the muscle (intramuscular). When the injections are given intramuscular you must make sure that you aspirate, pull back, to make sure that you haven't hit a blood vessel. Whilst we were there one of the piglets went into shock after it had been given an intramuscular injection. The needle had gone into the blood vessel so the syringe had been emptied into the blood, rather than the muscle. We quickly noticed the problem and sprayed the piglet with water to try and bring it out of shock. Thankfully it was soon back up on its feet and wandering around with the rest of the piglets.
Sunday 25 August 2013
Ghana - Outreach again
I was up early in the morning to wash the rest of my clothes. I was getting the hang of hand washing but getting all of the soap out was not always easy.
We were back on outreach today, visiting more sheep and goats. They were being vaccinated against foot rot and being dewormed. I seemed to be getting the hang of the drench deworming, although some of the animals were not very happy with the whole procedure. Thankfully there were a lot of people to help hold down the animals.
After the first sheep and goat farm, we went on to another farm, called Kumah Farms. Whilst we were there, we were introduced to the Chief of the local area and owner of the farm. He was second in the national agricultural award for Ghana. His farm was a mixed farm, having a variety of animals, ranging from alligators to rats to grass cutters to deer. They also had all of the common animals such as sheep, goats, fish, rabbits and guinea pigs. (I later found out that the guinea pigs and rabbits were bred for eating rather than as pets, and the rats were fed to the alligators). The fish were biologically kept as the populations were controlled naturally - the population of Tilapia was controlled by the catfish. At this farm we were also deworming the herd of sheep and goats.
The third and final farm that we visited was more of a small community than a farm. The sheep and goats were kept in the villagers houses so that we didn't had to chase after them and then released to roam around the village. I had no idea how they knew whose sheep and goats belonged to who. The small community was very run down and the smell was pretty horrific. Many of the local children followed us as we walked between houses to the animals. They were all poorly dressed and it was clear that they were not going to school.
We tried to teach some of the children how to play hopscotch and joined in with a couple of skipping games. They were all very friendly and seemed to enjoy having us to play with. This village was a far cry from the area that I was staying in just the other side of town.
We were back on outreach today, visiting more sheep and goats. They were being vaccinated against foot rot and being dewormed. I seemed to be getting the hang of the drench deworming, although some of the animals were not very happy with the whole procedure. Thankfully there were a lot of people to help hold down the animals.
After the first sheep and goat farm, we went on to another farm, called Kumah Farms. Whilst we were there, we were introduced to the Chief of the local area and owner of the farm. He was second in the national agricultural award for Ghana. His farm was a mixed farm, having a variety of animals, ranging from alligators to rats to grass cutters to deer. They also had all of the common animals such as sheep, goats, fish, rabbits and guinea pigs. (I later found out that the guinea pigs and rabbits were bred for eating rather than as pets, and the rats were fed to the alligators). The fish were biologically kept as the populations were controlled naturally - the population of Tilapia was controlled by the catfish. At this farm we were also deworming the herd of sheep and goats.
The third and final farm that we visited was more of a small community than a farm. The sheep and goats were kept in the villagers houses so that we didn't had to chase after them and then released to roam around the village. I had no idea how they knew whose sheep and goats belonged to who. The small community was very run down and the smell was pretty horrific. Many of the local children followed us as we walked between houses to the animals. They were all poorly dressed and it was clear that they were not going to school. 
We tried to teach some of the children how to play hopscotch and joined in with a couple of skipping games. They were all very friendly and seemed to enjoy having us to play with. This village was a far cry from the area that I was staying in just the other side of town.
Sunday 18 August 2013
Ghana - Sheep Ecthyma
The next day we were up at 5 as we had to be at the vets early due to the outreach that we were going on. We were back to the sheep and goat farm that we had visited the day before, but this time we were removing an infection from around their mouth, called Ecthyma (or sometimes Orf) .
To remove the Ecthyma we were using a pair of forceps to scrap off the infection. The animals were not that happy with the whole experience but it would be beneficial in the long run. After scraping off as much of the infected area that we could, we would apply iodine to the area to promote healing and stop any of the areas from becoming re-infected.
Ecthyma, or Orf, is spread through direct contact with an infected animal. Symptoms of Orf include Papules (solid elevation of skin with no visible fluid) and Pustules (small elevations of the skin containing cloudy or purulent material). These are often found on the lips and muzzles of sheep and goats.
To remove the Ecthyma we were using a pair of forceps to scrap off the infection. The animals were not that happy with the whole experience but it would be beneficial in the long run. After scraping off as much of the infected area that we could, we would apply iodine to the area to promote healing and stop any of the areas from becoming re-infected.Ecthyma, or Orf, is spread through direct contact with an infected animal. Symptoms of Orf include Papules (solid elevation of skin with no visible fluid) and Pustules (small elevations of the skin containing cloudy or purulent material). These are often found on the lips and muzzles of sheep and goats.
Ghana - Farms and Newcastle
I spent the rest of the week on outreach at numerous different farms. We were many visiting sheep and goat farms, although we did treat a number of turkeys.
Most of the farms in Ghana look the same. They contain a flock of sheep and goats mixed together and often a couple of chickens or turkeys will be roaming around. The barns will be falling apart and made from wood. The ground is not particularly clean as any rubbish gets left on the ground. Some of the larger farms will have armed guards manning the entrances, which was a little frightening as they carried semi-automatic machine guns around with them.
We were worming the sheep and goats, as well as giving them vitamins and antibiotics. Everything seems to be given vitamins. The de-wormers were given through drench - so down the mouth. This was more difficult in the larger animals as they didn't want to open their mouths and they had long horns. You had to hold on to their top jaw and squeeze until they opened it. The injections were a lot easier especially as the others were very helpful in showing me where to place the injection.
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The turkey's were the easiest to inject as they would stay still once they were held upside down. They were also being vaccinated against Newcastle, which is becoming an epidemic in Ghana.
Newcastle Disease is a contagious disease that affects many domestic and wild avian species. The disease is zoonotic so can be passed from avian to human. The disease is passed through the infected bird's droppings and secretions from the eyes, nose and mouth. Newcastle disease spreads rapidly when birds are kept in confinement and are particularly common in commercially raised chickens and turkeys. If humans are exposed to birds with Newcastle disease, it can cause mild conjunctivitis and flu-like symptoms.
We were worming the sheep and goats, as well as giving them vitamins and antibiotics. Everything seems to be given vitamins. The de-wormers were given through drench - so down the mouth. This was more difficult in the larger animals as they didn't want to open their mouths and they had long horns. You had to hold on to their top jaw and squeeze until they opened it. The injections were a lot easier especially as the others were very helpful in showing me where to place the injection. 
The turkey's were the easiest to inject as they would stay still once they were held upside down. They were also being vaccinated against Newcastle, which is becoming an epidemic in Ghana. Newcastle Disease is a contagious disease that affects many domestic and wild avian species. The disease is zoonotic so can be passed from avian to human. The disease is passed through the infected bird's droppings and secretions from the eyes, nose and mouth. Newcastle disease spreads rapidly when birds are kept in confinement and are particularly common in commercially raised chickens and turkeys. If humans are exposed to birds with Newcastle disease, it can cause mild conjunctivitis and flu-like symptoms.
Tuesday 13 August 2013
Ghana - Return to the Pig Farm
On Monday the 22nd July, we were back on outreach and back to Genesis farm to check on the pigs. All of the pigs seemed to be fine and the wounds looked to have healed. We each then got to preform another castration. Like last time, after the castration, the pigs were given some more injections.
Whilst I was waiting for my turn to preform the castration, I spotted a scrotal hernia in one of the younger piglets. However the vet didn't treat it as he didn't have the right equipment there. Back in England, the vet would have carried around a number of different tools in the back of their car, however, in Ghana, the vet gets everywhere by taxi so they only carry around what they can manage.
We also checked up on the two pigs with an abscess. One had had an abscess on its leg, which burst when a scalpel was pressed against it. A green mush liquid came out which meant that the area was infected. The second pig had an abscess on its abdomen. This abscess did not pop and the liquid that eventually came out was a lot more solid. The wall of the abscess was a lot thicker than the first and the size of the abscess did not go down after the liquid was removed. Both of the abscess had occurred on joints for we hoped that the pigs would now be able to move the joints a lot better.
Upon check up we saw that the abscesses had drained well so all we did was spray some more antibacterial spray on them. We then spotted another pig with an abscess so we attempted to pop it. This abscess was a lot runnier than the others, but the same colour. This time when cut it burst, spraying the liquid all over the person who cut the skin.
After the castrations and the abscess checking, I noticed that some of the piglets had managed to escape the pens. After placing them back in we noticed that they had escaped again. It seemed that they were standing on the mother, who was led down, and stepping over the gate.
Whilst I was waiting for my turn to preform the castration, I spotted a scrotal hernia in one of the younger piglets. However the vet didn't treat it as he didn't have the right equipment there. Back in England, the vet would have carried around a number of different tools in the back of their car, however, in Ghana, the vet gets everywhere by taxi so they only carry around what they can manage.
We also checked up on the two pigs with an abscess. One had had an abscess on its leg, which burst when a scalpel was pressed against it. A green mush liquid came out which meant that the area was infected. The second pig had an abscess on its abdomen. This abscess did not pop and the liquid that eventually came out was a lot more solid. The wall of the abscess was a lot thicker than the first and the size of the abscess did not go down after the liquid was removed. Both of the abscess had occurred on joints for we hoped that the pigs would now be able to move the joints a lot better.Upon check up we saw that the abscesses had drained well so all we did was spray some more antibacterial spray on them. We then spotted another pig with an abscess so we attempted to pop it. This abscess was a lot runnier than the others, but the same colour. This time when cut it burst, spraying the liquid all over the person who cut the skin.
After the castrations and the abscess checking, I noticed that some of the piglets had managed to escape the pens. After placing them back in we noticed that they had escaped again. It seemed that they were standing on the mother, who was led down, and stepping over the gate.
Ghana - Genesis Pig Farm
This was the first time that I had worked with pigs and I didn't realised how noisy they are. Every time you grabbed one they would scream and whine and wiggle, which made giving them injections particularly difficult. It was lucky that they were only small piglets as restraining any large piglets would have been more of a challenge and the noise would have been a lot greater! To try and combat the noise the men that worked on the farm would hold the mouth of the pigs closed.
After giving the piglets the iodine shots, we moved on the castrating the bigger piglets. I was surprised to find out that we were all allowed to have a go at castrating a pig. A number of us were still at school and not qualified vet students. I was last up so I was able to see a lot of other people go first. I had seen the others get covered in blood and had the pig kick and scream throughout the procedure.When it came to my turn it seemed as if they had saved the largest piglets for last and the ones with the largest pair of testicles. Before my castration I went over and over and over the steps of castrations in my head. The way that they performed the castrations in Ghana were a lot different than the many I have seen in England. To start with, only a local aesthetic was used, and no suture material was used. The wound was left open, exposed to the elements. To cut off the blood supply to the testicles we used the epididymis/sperm cord to tie around the vessel rather than any suture material. Another major difference was how sterilised the procedure was - or should I say unsterilized. The same needle and scalpel blade was used for all of the pigs and changed because it was blunt rather than to stop disease spreading. Also, the equipment was put on the farm wall rather than on a sterile tray, which meant that the chance of infection was a lot higher. It seemed to be a miracle that the animals hadn't all died of infection yet.
I managed to perform my first castration with relatively few problems. I had had difficulty holding the testicle firm so that I could inject it with lidocaine, but thankfully this pig had been one of the quieter ones. I then had to shave the area using the scalpel blade, which was quite a challenge. In England the vet would have used a razor. The incision was next, where again I struggled to hold the testicles in place. I was not used to force needed to cut through the skin of the pig. I managed to squeeze the testicle out of the layer, whilst also getting blood all over myself. Finding the epididymis also proved to be a little tricky as I had no idea what it looked like. Thankfully, with the guidance of the over vet students and volunteers I was able to locate it. Clamping the blood vessel was the easy bit and tying off the blood supply was not too bad. Back in England we would have used sutures to tie off the vessel, but this was Ghana and they do it differently.As this was my first time performing a castration and I had no idea how tight to pull the epididymis around the vessel, I accidently pulled it too hard and it split. Thankfully this gave the vet a chance to show us another way of tying off the vessel. He looped the testicle around itself so that it knotted. you could then cut the testicle off. The second testicle came out a lot easier as I was not as new to the procedure.
The wound is not sutured up so after I had finished I sprayed antibacterial spray on it. The pig was also given antibiotics and vitamins through intramuscular injections in their neck, and then the pig was released. The second pig that I castrated was a lot more lively than the first. The vein connecting the testicles to the body was as thick as my finger. Fortunately there were no more disasters and, although the pig wiggled and kicked out lots, the procedure was relatively simple.
The day was very interesting and I thoroughly enjoyed the operation and the chance to actually perform it. It had been a long tiring day but it had been worth it!!
Ghana - Post 1
I arrived in Accra at 11:00 pm on the 12th of July. It was extremely warm and humid and the airport was buzzing with activity, even though it was really midnight. Early the next morning I got on a coach to Kumasi, and 5 and a half hours later I arrived at my host family in the centre of Kumasi. I was staying with a number of other vets.
Tuesday the 16th of July was my first day at the Vets and we were on outreach. We visited a farm to vaccinate cows against a strain of pneumonia. Around 60 cows were due to be vaccinated. I thought that this was going to be quick, however, this was Ghana and they do everything differently. Each of the cows had to be lassoed individually by a man running around like a cowboy. Then each of the cows had to be tied down securely so that they couldn't swing their heads and spear us with their horns. One of us would then run over with the automatic syringe and inject them. The whole process took a lot longer than it would have in England - there were not crush crates or strong metal fence posts.
The next day we were back on Outreach and visiting another farm. This farm was one of the biggest farms in Ghana. It was a huge poultry farm containing over 250,000 'battery farm' chickens. although they had 9 chickens per square metres, they did seem to be some room to roam around. They were not true battery farm chickens as they were not kept in small individual boxes. We may have headed to one of the largest chicken farms in Ghana, we were actually at the farm to vaccinate the 5 cattle that they had. This farm was no better equipped than the last farm so as soon as the man attempted to lasso the first cow the others ran away and we spent the next couple of hours searching for 5 cows. In the end we gave up the search and left the farm having only vaccinated two cows. 
Ghana
I recently spent a month in Ghana with a company called projects abroad on the Veterinary Project. Over the next few posts I will talk about all of the things that I did. It was an amazing experience and one that I will not forget in a long time. I met lots of amazing people that I will miss!!
Sunday 11 August 2013
Prolapsed Uterus in Ewes
A prolapsed uterus was the most common problem that I saw during the lambing season. At the farm I was staying on it occurred in a handful of sheep, and after speaking to the farmer, it seems that it happens to a few sheep every year.
It is very important that you spot the problem early so that you can prevent the condition from getting any worse and still have a successful pregnancy. However, if a ewe has had a prolapsed uterus in the past, it is likely to happen again so the ewe is likely to be culled.
It is very important that you spot the problem early so that you can prevent the condition from getting any worse and still have a successful pregnancy. However, if a ewe has had a prolapsed uterus in the past, it is likely to happen again so the ewe is likely to be culled.
One way of treating
the prolapsed uterus it to provide the ewe with a harness, which are very
useful in situations where the prolapse is detected early. There is also little
trauma to the sheep or risk of contamination. However, they must be fitted
carefully to prevent sores developing and inspected regularly. The harness
applies pressure to the abdomen of the ewe and will stop the uterus from
prolapsing again. Although lambing can occur whilst a harness is worn by the
sheep, it is advised to keep a close eye on the sheep and remove the harness
after the ewe going into labour.
Another way of treating a prolapsed uterus is to use a Plastic
retention device. The device in placed inside the vagina
and held in place by ties. They work
better in mild early cases. Or the farmer could choose to use a Buhner suture. This has to be put in place by a vet as done wrongly it could cause more damage. The sutures must be removed for lambing and for examination of the ewe's reproductive tract when labour is suspected, and they are difficult to retie.
The farmer that I was shadowing found that the harnesses worked better for him so he only used the harnesses rather than the retention device or suturing, although other farmers may say differently. As I only saw the use of a harness, I think it is best that I only really talk about that method of treatment.
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