The parcel has arrived!
on Melissa Hipkins (Rwanda), 21/Jun/2010 08:26, 34 days ago
May I first say thank you once again to all those involved in organising and contributing to the parcel. I believe Linda was the chief instigator and I have just had the delight in unpacking it. It has not been an uneventful journey between Rugby and here. Tracking it on the web was instructive but ultimately frustrating as I could see it getting closer but being in Nyanza for the week I was not able to receive it.When I returned to Busogo on Monday there was a general air of mystification. I had expected it to be already at the college campus but no-one had any inkling of its arrival. According to the itinerary on the website, it had been in Musanze for the best part of a week. One "C. Stamp" had signed for it at 10.27 on Tuesday 8 June- 6 days ago. Not a very Rwandan name and suspiciously open to misinterpretation. It was not at the post office and no-one could locate the FedEx office in the town. Perhaps it was still in the capital, but the tracking seemed to say not. I have to be very grateful to Dr Anselme Shyaka for taking the matter in hand and sending his secretary to Kigali. There she discovered the location of the agent in Musanze who had the parcel. How long it would have sat in this shack unclaimed is unclear but all is well now.Why was I in Nyanza last week? Well, the programme of practicals finally became unstuck and I was given 10 days off while materials and animals were assembled. I had just about finished the lectures and the students were fully occupied with other courses so I was not unduly missed. Initially I was only to have 3 days "holiday" but it became apparent when I was emailed the timetable my garden leave was to be extended. I left Anselme to explain to the Bamboo inn exactly when they could expect me back.I idled about for most of the time, doing a few odd jobs but I took the opportunity to revisit RADA or Rwandan Agricultural Development Authority. I had been before but had no opportunity to see what materials were available to help train vets for surgery. It was a very enlightening morning; they have lots of material that ISAE could do with and some glaring deficiencies. I met a charming Japanese vet, over here to advise and implement a programme of embryo transplant to improve the cattle breeds. She has been distracted by being roped in to assist with some emergency caesareans already. The conditions she finds once she gets on the farms are truly awful by the sound of it, real last resort stuff. Farmers seem to feel it their duty to try everything rather than call the vet and consequently the cows are basket cases before she starts. Dehydration and shock are serious problems and I think she has done well to save 2 out of 8 cases. It makes me think teaching students with a standing cow is a waste of time. They need to know how to deal with cases they will meet in the field and I shall compose some lectures to that effect.One thing that struck me on my return to ISAE is that the men on the gate seem more determined to enforce "security". I don't know whether someone has decided to crack down or they are practising in earnest for when the elections begin. Instead of waving the bus through the main gates in the mornings they now insist on all staff wearing their identity cards and getting off the bus outside the gates. The staff think it's a huge joke but with quite an undercurrent of grumbling. Their misgivings are justified if you consider that there is no effective fence around the place for more than half its perimeter.I am coming to the end of my stint at ISAE, the exams are set for next week and there are only practicals and revision to do. This afternoon the class have an exam in another subject so I am seated in the clinic building on the opposite side of the road from the main campus. The main road between Musanze and Gisenyi runs just outside and unfortunately it's a good straight road with proper tarmac in good condition. This gives all the drivers of buses, articulated lorries and vans carte blanche to race past blaring their horns despite the nominal limit of 40 kph. There is no pavement for the streams of people using the road as a highway into Musanze. Some days the people look like crowds thick enough to be coming from a football match except they have not been enjoying a good time. A certain purpose and grim determination pervade them. The women seem to be the burden bearers; enormous plastic sacks on their heads, recycled rice sacks, full of just about anything and if full of potatoes weighing well over 50 kilos. Just a few men pushing home-made barrows loaded with rice sacks or carrying long wooden poles for building, the poles whipping up and down on their shoulders. Bicycles are, however, a men only preserve, a seemingly Victorian attitude to the idea of women showing legs or astride a saddle seems the norm. Yesterday I had the illusion that dogs were back in fashion here; from a distance there seemed to be an army of dog walkers. In reality the women were taking sheep and goats, each one on a lead, to or from the market. The way they co-operated and behaved better than a lot of dogs would have done was an endorsement of habit overcoming instinct.With the advent of the parcel, some decent suture material I could contemplate surgery on cattle instead of just the long-suffering sheep. In addition to operating on sheep this week, I undertook to demonstrate laparotomy on two of the farm's local cattle. The first was about 6-7 months in calf and there was a call to perform a caesarean. I was prepared at least to bring the uterus to the wound and estimate the size of the calf but to return it if it was obviously too small.There is no designed space to operate on cattle at the college. The cattle races are not ideal being too low or too wide and there is no cattle crush. The clinic's animal accommodation block has no rails or rings that could be used to secure a halter. The possibility of operating near the race by the clinic is ruled out by its proximity to the road; the thought of the crowd we would pull from the passing throng made me shudder. The race in the middle of the college itself seemed the best option.After a lot of adaptation using planks of wood and branches of trees, the race was made more escape proof. The cow, secured with two halters, was placed at the end of the race with the decent floor and we began. After an initial nervousness, the cow settled very well and the laparotomy went ahead as hoped with a couple of students as assistants. The calf did indeed prove too small and was returned to continue to full term. The student who helped suture the flank and skin showed real flair for the work and got on with it instead of the customary dithering.The afternoon's session was very different. This heifer was barely pregnant so exposing the calf was not really practical. She initially reacted very little to clipping and shaving but as soon as I began to inject local into the muscle she took off. If it hadn't have been for the use of two halters she would have been gone. As it was she broke half a dozen needles and a syringe with her bucking and twisting before I was able to complete the anaesthetic. For all my extolling the merits of not sedating cows I decided this one needed slowing down. Despite the sedation she still plunged and kicked without notice, not reacting to cuts or manipulation but probably resentful of her lack of freedom. It's a shame that because of this I did not let the student assistants do anything for fear of their safety. But at least they can see that the precautions we take in case of trouble are worth while.At the beginning of the week ,we had identified a farmer's cow as being heavily pregnant; he estimated that she was probably overdue to the date given by her insemination. I don't like doing caesareans on cows who have not yet started calving naturally and we agreed we would not operate until she had been calving with no progress. On Friday morning the circumstances were just so. The heifer was down at the clinic on the other side of the road from the campus where the facilities for operating are worst. When I approached her with the intention of putting on a halter and perhaps leading her up to the place we had operated on the other two cows she put her head down at me and made to charge. Oh! I thought, one not to play with; better find a way of doing this without taking her the half mile to the campus. She wasn't too bad in the race by the road once we had two halters on her and we worked out a way to secure her in the big room in the office block of the clinic.The windows of all rooms in even the lowliest of houses in Rwanda have bars securing the window spaces. One good design point of the clinic is that the widow casements are on hinges that allow the window to be lifted off. Without the fear of broken glass we could use these bars to tie the halters and have a good enough light to operate inside the room. The floor is really too smooth for cattle but sand liberally spread under her kept her feet secure. With all the class as spectators and the farmer in the front row all went gratifyingly well and a nice live heifer calf was delivered, albeit the calf coming backwards complicated the operation a little. The students closed up the wounds and everyone was happy, the farmer particularly so as female calves are more valued than bull calves.I have been in contact recently with Gavin Mitchell, sales manager of BCF who make ultrasound scanners in Scotland. I had asked him to see if he had any old models that might have been used in part-exchange that perhaps he could send our way if the college paid the shipping costs. He replied that he was sympathetic to the idea and he'd look into it and see what came up. I thought I had better let Anselme in on the idea and make sure that the college would indeed pay for shipping. He surprised me by saying the college had a budget for medical imaging they had not yet used; he had had the idea of getting an X-ray machine. For an institute that deals almost exclusively with cattle and small ruminants and never has dogs or cats near the place, an X-ray would be inappropriate. I told Gavin that there was the opportunity for the college to explore the possibility of a new machine with maybe the part-exchange as back up.I had looked at their web site to see what they had and remarked on some very slick looking portable machines with large monitoring screens; ideal for students to see what was going on. What's more, these screens are supplied wirelessly so no cables to get in the way.Yesterday Gavin has offered the college a demonstration model of the latest battery operated scanner with 2 monitoring screens for£1000.00 all in including shipping. The machine alone is estimated to be worth £6000.00 That is extraordinarily generous. I earnestly hope that the usual bureaucracy and requirements for a tendering process will be bypassed to take advantage of this offer with as little delay as possible. I have yet to present this to Anselme who in turn has to sell the concept to the Rector, the head of the whole institute.