Vet nurse volunteering in Malawi

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Magical Malawi - a vet nurses experience

Fri 16th Dec 2016

One of the first recipients of the Centaur Bursary is Fiona McFadyen, a vet nurse who spent some time volunteering with us in Malawi. Fiona, over to you!

My name is Fiona, and I am currently voluntunteering as the first ever WVS bursary veterinary nurse, sponsored by Centaur Services - thank you Centaur!) with WVS at the Blantyre Society for the Protection and Care of Animals (BSPCA) here in Malawi, the 'Warm Heart of Africa'. During my 18th year of working for PDSA, I took a 6 month sabbatical to volunteer in Wildlife Conservation Research in South Africa in 2014 and subequently fell in love with Africa and travelling, and while there, I recognised the need for experienced veterinary volunteers amongst the smaller animal charities there. So it came as no surprise to my colleagues, friends and family when they discovered that I had barely been home a day, when I started researching my next volunteer project!

That lead me to discover the WVS website, where I promptly became, and remain a supporter of this animal welfare charity and the many amazing volunteer projects that that they run and also that they offer for registered animal charities worldwide.

Day 1

With no connecting flights from Botswana, I had to overnight in Johannesburg, South Africa. My day got off to a bad start when my taxi to the airport failed to arrive! Fortunately the lovely owners at the bed and breakfast managed to arrange a last minute replacement, getting me to the airport just in time!.

A two and a half hour flight later (including a free upgrade to business class!), I land at Chileka International Airport in Blantyre, Malawi. Clearing customs is an experience in itself, taking well over a hour - and don't forget your US dollars! It turns out that they DO have a card machine, but are very reluctant to use it! As I finally go on to collect my bags, I discover my large suitcase is missing! 

After another long queue to fill in the neccessary paperwork later, I finally get to meet Tarryn Roux, the managing director and co-ordinator of Mission Rabies and the BSPCA mass neuter project. As we drive into town, I am surprised at just how beautiful Blantyre is, surrounded by towering hills and a surprising amount of lush greenery. Tarryn drops me off at the volunteer flat, giving me a couple of hours to settle in, before I meet my colleagues and fellow volunteers, UK Veterinary Nurse Denise, and Aussie vets Liz and Paul Jenkins.

Day 2

Weekends during the neuter project involve outreach programs, where we head to the local villages and set up a makeshift clinic in a school classroom and wait for our patients to arrive. With Denise, Liz and Paul already having had a couple of days to familiarise themselves with the WVS/BSPCA injectable anaesthetic and neuter policy, I spend the first hour or so playing catch-up, familiarising myself with procedures and protocols ahead of the imminent arrivals.

Today we are in Chileka Village, at Kachanga School, a half hour or so away from Blantyre and as is usual for outreach programs, our first hour or so, is waiting around for our first cases to appear. As soon as word of our arrival spreads, the children start arriving with their dogs! Yes, children! there are 2 main reasons why outreach happens on weekends:

1) With no school at weekends, the classrooms are available for us to use

2) It is generally the children who are bringing the dogs in for treatment

Even from a distance, I spot that our first patient of the day has a badly ulcerated scrotum, once he is anaesthetised, Liz and Paul give him a thorough check over and discover that he has a very extensive TVT (transmissable veneral tumour) involving not only his penis, but his scotum and perineum as well. He is not a candidate for surgery, so they treat his wounds, prescribe antibiotics and start intravenous vincristine chemotherapy. Sadly, he has not yet been returned to us in order to receive his followup treatment.

With Chiku and Elson - 2 Mission Rabies staff also trained to assist with the BSPCA, outreach projects having registered and weighed the remaining cases - with the assistance of their child owners - we get underway with the sterilisations. By lunchtime, when the waiting list starts to wane, Elson goes out into the villages to round up more dogs. By the end of the day we have neutered 23 dogs - 13 males and 6 females - including one very obese 37kg lab cross bitch.

We pack up and head home, tired but pleased with our successful 12 hour day and head to Doogles, a local backpackers and bar, based just 5 minutes walk from our accommodation at the BSPCA for dinner and a well deserved beer! Then it is time to go home for an early night.

Day 3

Today is my first day of the CNVR (collect, neuter, vaccinate, return) project in the new purpose built veterinary clinic. Defense, BSPCA's very capable clinic assistant and dog whisperer extraordinaire has already rounded up 8 dogs and has headed back out to collect some more. Today we start at 9am, unpack yesterday's outreach project, prepare the theatre area for today's operations and set up the syringes and drugs ready for the first patient. When Defense returns, he registers and weighs the dogs for today, and restrains the dogs for premedication.

A triple combination injectable anaesthetic protocol is used here, as is typical of charity neuter projects worldwide and I am fortunate to have used similar protocols before. First the patient is premeded with Xylazine, once that has taken effect, Defense brings the dog to the prep area and assists Denise with placing the I/V cannula and she administers the ketamine/diazepam induction, gives the long acting antibiotic, metacam, tramadol (bitches only) and ivomec.

Today's dogs have already been vaccinated by Mission Rabies, so we don't need to do this and can concentrate on other treatments. Once prepped for surgery, the patient is transferred to the theatre table, fluids are administered during surgery and a 'top-up' anaesthethic is at the ready - usually diazepam/ketamine combination for I/V administration, due to a large donation of propofol,this is currently the top-up of choice.

With Denise preparing the patients and on GA duty today, I am in the theatre area, doing GAs, topping up, giving the vets equipment and sorting the instruments for sterilisation - both todays kits and those from outreach. When not assisting Denise, Defense also assists with the top-ups and GA's and transfers the next patients to the operating table.

With the hectic nursing schedule apparent, Liz and Paul are happy to place their own patients in the recovery area. This has been a fairly routine day with only 11 neuters - 6 males and 5 females and 1 walk-in consultation. We finish at around lunchtime and clean up while Defense takes the dogs home and head into town.

Day 4

Today I am in the prep area and Denise is on theatre and steri kit duty (we alternate duties daily) Defense has brought us 6 dogs and we are expecting another 3. We are due to meet Tarryn for a late lunch and Liz and Paul are planning to spend their days off in the African Bush and need to head off late afternoon. With 6 females and 3 males completed, we finish at around 1pm, including clean up and finishing the weekend's sterilisation of kits. Defense takes the dogs home as we wait for the local man to collect his 3 dogs - he also paid for the 5 in1 dog vaccine (rabies is free of charge) and has also left a donation to BSPCA which is very nice.

Tarryn takes us to a lovely little cafe called La Carvena, where Liz and Paul order chicken burgers while Tarryn, Denise and I opt for the roasted vegetable 'panini' which is very yummy!

Day 5

Today is our day off, with the vets Liz and Paul being away to Majete Wildlife Reserve, Denise and I decide to have a lazy day, popping briefly to Doogles to use their wifi. Later, we head out to dinner at Chez Makys, where I have the Mongolian noodles and Denise the stirfry. At about 6000 kwacha (£6) for dinner and drinks and 3000 kwacha for the taxi, not a bad night out!

Day 6

Today Denise and I decide to make the most of our day off and explore Blantyre. However our start is delayed when a very sick dog is brought to the clinic. The poor thing is very thin with marked muscle wastage. He is also seriously dehydrated and has nasal and ocular discharge. Distemper is our presumptive diagnosis and we obtain permission to instigate fluid therapy, clean him up and make him comfortable, but we know his prognosis is poor. With the vets due back that evening, we await their diagnosis.

Once he is more stable, we head into town - we find Denise her elusive earplugs at the only chemist in town to stock them and then find the tourist information centre. After that we head to the local market, a quintessentially local affair. We meander through coming out at the other end of town, not sure where we are but planning to catch a local taxi bus back to the town centre. Soon, however, we recognise La Caverna and realise we are close to 'home'. So we continue walking, heading to Mugg and Bean for a quick lunch before catching a local taxi bus to the shopping centre. Local taxi buses are definitely an African experience, where the 12 seater quantum is filled to capacity - and capacity means the number of people who will fit in - often up to 20!

But at 150kwacha (15p) per journey, it is definitely a cheap, cheerful (Malawians are very friendly) and a crazy way to travel!

We arrive back at the flat, check on our sick dog and await the news of Liz and Paul's bush adventure, before asking them to check our patient.

Day 7

Today Liz and Paul re-check our sick dog, his distemper prognosis is still poor and with a better ocular exam possible, it appears he has 2 ruptured eyes and so a decision was made to euthanase him.

Today we have 11 neuters, 6 male and 5 female, one of which has an umbilical hernia in need of repair, and another with a large pendulous mass for removal.We also had a bitch requiring her 2nd treatment of Vincristine therapy.

After finishing around 2.30pm, we stopped for lunch before returning to the clinic to pack for tomorrow's outreach program.

Day 8

Today, we are ready to leave by 7am, this time heading slightly further afield to a village an hour and a half away, along sandy bumpy African roads. We set up in a classroom at Nkhalongo Primary School and await our first patients. When they fail to appear in the first hour - due to the fact its the 7th day Adventist religious day, so most of the locals are at church - Elson and Chiku go off in search of dogs in the surrounding villages and bring them back - with their owners permission of course!

By this time, we have had several children turn up with their dogs so we get started in what turns out to be a busy day! With myself doing the inductions and Denise on GA duty, we keep the vets busy, production line style and of course, we had an audience with the children watching the surgeries intently.

At around lunchtime, the wind met the heat of the sand throwing up a (not so) mini-tornado. As the local children screamed with joy and chased after it, all we could see through the open plan windows of the school the short sand storm that followed. Sadly, it was over so fast non of us managed to capture a photo and once it was over, the children quickly resumed their observations, and it was business as usual! 23 dogs later - 13 female and 9 males plus 1 cat was brought in for rabies vaccination, we are finished. Whilst Elson dropped the last of the dogs home, we had fun taking photos of the children who loved not only having their photo taken but also seeing themselves on screen.

Liz and Paul then joined them for a game of football - with tied up plastic bags being their ball, while I was exhusted just watching their antics! It was after dark by the time we returned home, although our work wasn't quite done, as we had to sterilise enough kits, towels and spare instruments to last us through tomorrow.

Day 9

Leaving at 7am, we headed to a village not far from where we were yesterday, this time setting up in Dziwie Primary School. En route, I made a quick stop to the airport to pick up my missing suitcase, which was finally delivered to Malawi yesterday. Despite being assured the airport opened at 7.30am, I was informed that it would be another hour before I could retrieve my bag.The others agreed I should remain with 1 car and driver while they went ahead in the other to set up.

By the time I arrived, we were still waiting on our first clients - not surprising given the amount of local people we passed on the road, dressed in their sunday best were en route to go to church. But soon they came, although it was a quieter day with just 16 neuters (12 males and 4 females) with all of them requiring rabies vaccines.

By late afternoon, with no more dogs appearing, we packed up earlier than usual and Paul got mobbed by all of the children, as he handed out the rest of the sweeties he had brought for them! Even several of the adults queued up for a sweet treat! Then we watched an adult football match, as we waited for Chiku to return from taking the last dogs home.

Another successful outreach weekend over, we decided we deserved a treat and headed to Doogles for dinner before yet another early night.

Day 10

With a 9am start at the clinic, today we enjoyed a 'lie-in', compared with the early start of the weekend, before unpacking the outreach supplies. Defence brought us 4 dogs before heading back out on BSPCA business. But as a local ex-pat German man brought us 8 puppies and 1 bitch (the other bitch ran away before he could catch her) we still had 13 dogs to operate on (7 female, 6 males). One had a pyo, another had a mammary tumour and the 9 dogs which also required rabies and the 5 in One Vanguard vaccines.

Today turned out eventful for me too, while bringing in a xylazine sedated dog - something I am very experienced in doing so from previous Africa projects, she suddenly whipped her head around and latched her teeth into my arm. The bite wound itself was fairly minor, but because it did break the skin, after we finished for the day, I had to go to the local private hospital for anti rabies Post Exposure Prophylactic (PEP) vaccination. Given that I am already vaccinated against rabies, this requires just 2 immunity boosting vaccinations on day 0 and day 3.

Fortunately I was able to take the rabies vaccine schedule with me to the hospital, as this was was indeed much needed! We finished up the day with food shopping at Shoprite, an African supermarket chain before dinner.

Day 11

Today is the vets last surgical day as tomorrow is our day off, with 8 females, 2 male cryptorchid yorkies, a cat spay, and a kitten with a fractured radius and ulna we are kept busy enough. With even more walk-in appointments than usual, we already have half a dozen or so neuters, lined up for the next vets coming on the next neuter project!

As its the last day, we also give the clinic a more thorough clean and tidy, before heading out to our farewell dinner for Liz and Paul, with Tarryn and her husband Andre at a quaint little Italian called L'Hostaria.

Day 12

Today is the start of our 2 days off and Liz and Paul decided to take advantage of this and their last few days by heading north to Lake Malawi. Denise and I meet up with Tarryn to visit the old BSPCA clinic, where the rehoming kennels are still active, as funding in still much needed to complete the new premises. When the original site, owned by the Municipality, was suddenly and unexpectedly sold, the frantic hunt was on to find a new property, which is still being developed.

As Denise and I are volunteering here at the BSPCA for 6 more weeks, over coffee that afternoon, Tarryn outlines her plan for Denise and I for the next week. A stock take of the clinic is first on the list, followed by helping to build the new cattery, a day of community nursing, and of course tending to the sick animals of Blantyre here at the clinic.

But first, however, as Tarryn is heading to towards Lake Malawi herself this weekend, she offered us a lift and granted us an extra couple of days off if we wanted to go!

Lake Malawi - here we come!

Day 13

The 2nd of our scheduled days off, today we enjoy a lie-in, before I head to the hospital to spend the afternoon waiting for my 2nd and final rabies PEP. Then its off to Doogles for the free wifi, but I am still unable to successfully submit my blog to WVS. So I head home to pack for our trip to Lake Malawi.

Day 14

We are up early today, to stock up on bottled water from the local garage for our trip, and I head back to Doogles and finally have internet success - my blog has gone through!

An hour or so later we are picked up by Tarryn and her husband, as they are going to the lake anyway, we were given the time off and they very kindly drop us off at our lodge en-route to theirs. As our trip was last minute, we didn't get the chance to say a proper goodbye to our vets, Liz and Paul, so we hope that we meet them on the way. Sadly though, they have taken a different route back, so we don't get to meet up with them. Thank you, Liz and Paul Jenkins - you guys were awesome! Safe travels and Happy Adventures!

More than 200km away, the trip to Lake Malawi takes over 4 hours, but when we arrive in Cape Maclear as the sun is setting (it is dark by 6.15pm in spring in Malawi), it is absolutely stunning.

We are staying at a backpackers called the Funky Chichlid, who offer a volunteers discount, so costs us just 4000 kwacha (£4) per night

After dinner and drinks while watching and listening to a local band playing by a bonfire on the beach, we stay up too late chatting with fellow travellers, before we head to bed, where we have the dorm to ourselves.

Day 15

Over breakfast, we arrange a local boat guide to take us on an island tour. The Lake and its forest covered hills is beautiful. At 600km long, 100km wide, bordering 3 countries, with its crystal blue water distant horizons and its waves lapping at the shore rivals, Lake Malawi, is truly an ocean in a landlocked country. We head to an island where we park up to snorkle with the bright couloured chichlids, the brightly coloured fsh

Denise is an experienced snorkeller, but I have never done it before and being allergic to chlorine, I have never learned to swim well, but the water is so clear that I can see the fish well enough without snorkelling. I give it a go and its incredible! Just as I am brave enough to venture out further in the calm bay, our boat guide hastily tells us its time to move on. When we get the next point, the lake is choppier, colder and the uneven rock surface below changed the depth too quickly and sporadically for me to be brave enough to attempt to 'swim', but I did get back in the water!

We relax for a while, watching the African Fish Eagles soar amongst the Boabab trees before heading on around the islands. Much to our delight a Fish Eagle soars down, wings spread and feet in the water to swoop a fish out of the water right in front of us, and returns to her nest to feed her babies while her mate stands guard in a neighbouring tree. Enjoying sundonwers on the way back to shore we get a repeat performance from another fish eagle. Still too fast and too choppy on the boat for decent photos though! Then back to Funkys for dinner, drinks and another very late night before bed.

Day 16

After one last paddle in the lake before breakfast, it is sadly time to leave. Despite the cleanliness and clarity of Lake Malawi, Bilharzia is a very high risk here, and in general in Malawi and so prazequantel treatment will be required when we get back to Blantyre.

Day 17

Today we have to start the stock take of the entire clinic. Denise takes the consumables and I have the drugs. Despite the task, the day flies by, although a couple of  dog vaccinations and a coughing dog (possible Bilharzia) make a good distraction!

Day 18

We continue with the stock take, see another coughing dog - kennel cough this time, do a vaccination and check over the new admission to the BSPCA's shelter, still based at the old site. She is shy, but happy and healthy. Denise's visa is due for renewal this week, and mine expires next week (border visas are only granted for 30 days in Malawi) so we head to the Immigration Office in town. Several counters later we finally have our visa and head to Doogles for the wifi and beer.

Day 19

With no clients to see today, we concentrate on the stock take and re-organising the store cupboard. Just as we are finishing, BSPCA'S May Valentine arrives with several baskets of stock that we must sort through too. But finally we finish and head home for a nap before dinner.

Day 20

With today's outreach postponed until tomorrow, there is little to do today, except for a general tidy of the clinic and packing and sterilising more swabs, instruments and handtowels.

We do have 1 patient though, an 8 week old kitten called Sparkles whose owner, in near hysteria, wakes us at 6.45am, convinced Sparkles has rabies. Turns out Sparkles is salivating due to the caustic ulcers on her tongue from licking disinfectant. We keep her overnight for observation and analgesia anyway. After some pain relief Sparkles is a much happier kitty and regains her ability to eat. We are hopeful in sending ger home tomorrow.

Day 21

After seeing to Sparkles in the clinic - she will go home this afternoon, we head to Manasa village for our Outreach Community Nursing Clinic - something I particularly enjoy.

Malawi is one of the worlds poorest countries, and the people here live simply. There is no running water or electricity or toilets, if they have one, they are outdoor longdrops, and the modern commodies that we take for granted are simply unattainable here. The people are friendly and welcoming as we go door to door, and by lunchtime we have seen 26 dogs, all of which are dewormed, and most of them will require neutering at the next Neuter Project in a couple of weeks.

As Mission Rabies has already been to this area, there are only a few dogs that require vaccination, but we also treat multiple ear wounds caused by nasty biting fly, see a TVT, 3 flea allergic dermatitis,  2 mange, a dog with a traumatic pull injury to his right hind, a puppy with a spinal injury following being hit by a bicycle, a neurlogical puppy and a dehydrated, anaemic tick fever puppy. We take the latter 3 puppies back to the clinic for hospitalisation and further treatment.

Given that the spinal puppy also develops mild tremors, the 2 litter mates also require observation for the onset of further possible rabies symptoms.

We round our day off by heading to HS Winehouse in Namiwawa district - more of a bar than winebar and with no veggie options on the menu, we head on to Bombay Place in the town centre for dinner instead. As restaurants close early (often by 9pm) we only just made it before they locked the doors.

Day 22

It is our weekend off, but the 3 sick puppies need seeing to -  I take care of them on Saturday, before heading to a local Arts and Crafts sale at the local La Caverna cafe. In the afternoon, May takes us to the local supermarket - Chipiku, where I am finally able able to buy some cheese! (after 4 weeks of trying!) Chipikus is one of the cheaper supermarkets here in Blantyre and though its our first visit there, we are impressed with the choice available. On Sunday, Denise sees to the puppies while I have a lazy day, venturing out only to Doogles for the free wifi.

Day 23 - 24

With a last minute change of plan, we find ourselves with little to around the clinic. Our Tick fever puppy is well enough to go home, on a course of doxy. The little neuro puppy is also well enough to go, but as his litter mate is to stay in for pain relief and further assessmen of his spinal injury next week, the decision is made to keep them both for company. Tuesdays are advertised as a walk in clinic day, so we have to be present at the clinic, but today, sadly, not a single patient turns up!

Day 25

Today we head to the rehoming kennels, still at the old BSPCA site to do a health check, worm and flea the 11 dogs there. Nala, the new admission that we health checked and vaccinated last week, also nèeds a behaviour assessment to assess her suitability for rehoming. She is initially scared, nervous but approachable, and within 10 minutes is eating from my hand and demanding cuddles. She is head shy though and shows submissive-defensive behaviour with sudden movements near her head, but with patience and TLC and the right home, I think she will be an exceptional dog. We try to introduce her to her new friend, but she shows little interest in him. Dogs at the BSPCA are generally kept in pairs for companionship, and often good friends are housed together.

We are also asked to do a behaviour check on Bingo who has developed some bad habits lately. He is housed with his littermate, and two 5 month puppies.

He is clearly the dominant member of the group in that teenager way, but his behaviour, barking and mouthing people appear more attention seeking than problematic - not surprising considering he has been at the kennels for the past 6 months -since he was just 12 weeks old! 'Mouthing' (where the dog grabs your hand in his mouth in a non aggressive non threatening way) appears a common trait in Africa dogs as a sign of affection (local community dogs are not pets, so often receive little in the way of human affection but respond quickly and with enthusiasm when shown). I am confident he will settle down when he finds his forever-love home. Everyone else is happy and healthy, athough a few are overweight.

Four 12 week old puppies are also there, though just for boarding, but of course we need to have a cheeky cuddle before we leave.

Day 26

With little going on at the clinic this week, Denise and I are granted permission to go to the Lake of Stars Arts and Music Festival at Chintheche Inn, Northern Lake Malawi.

It is a 600km - 10 hour bus journey (delayed further by a puncture!) from Blanytre to Mzuzu and a further hour by taxi to Nkhata Bay. It is a long but beautiful journey and we are exhausted when we arrive. We are staying at Unu House, a small African art gallery owned and based in a local village, selling the wears of local men and women who handcraft the jewellery, art and woodwork. After freshening up, we head to the nearby Njaya Lodge for dinner.

Day 27

This morning we head to Nkhata Bay to explore the small lakeside town and after a quick brunch at a quaint little cafe called Kaya Papaya, we look for an ATM to withdraw some cash (the machines were not working in Blantyre before we left).

However a power cut in town means we are unable to do so and this proves to be an on-going issue. Fortunately there is an ATM at the festival which accepts Denise's credit card (not debit cards) otherwise, we would have had very limited funding for our trip! The lakeside setting for the festival at Chintheche Inn is beautiful and there are two stages set up for entertainment - with the main acts starting in the evening. We relax and mingle while enjoying the festival atmosphere and we bump into several people we know from Blantyre!

When we decide to call it a night however, our taxi is nowhere to be seen and eventually turns up 2 hours late, so we arrive back at Unu House, well into the wee small hours.

Day 28

Today we decide to arrive at the festival for the start of the evening entertainment. After lunch at the Dive Inn, with views of the bay on both sides, we watch the locals sell their wares at the Lakeside before deciding to catch a taxi bus to the festival.

Taxi buses are a truly African experience - usually 10-12 seaters, they depart when they are full - at one point there were 23 people on our bus! Stopping frequently to pick up and drop off, the 40mile journey took 1 1/2 hours - twice as long as a regular taxi, but at 1300 kwacha (£1.30!) this is definitely a bargain and an interesting way to travel!

Tonight is the busiest day at the festival, although the atmosphere is not as intense. One of the main acts, Faith Mussa is particularly enjoyable and we even get to meet him after his performance, thanks to a young Malawian man who befriends us!. Today we catch a taxi from just outside the gates and so arrive home at a more reasonable hour.

Day 29

Today we are early, as we want to see a friend from Blantyre perform his martial arts dance routine. However our taxi fails to turn up and we miss his act. On the way to lunch we bump into another friend and catch a lift to the festival with him. This is the quietest day of the festival and in-between acts, we browse the stalls selling traditional African wares, picking up a few gifts.

Day 30

Given the 11-hour journey, we decide to make the most of our last day in Nkata Bay and get the night bus home. We spend an enjoyable afternoon at Makoya Village, a local backpackers set in the style of a local village, right on the Lakeside. It is beautiful here and provides many free activities for its guests and we regret it was fully booked when we decided to come to the Lake of Stars quite last minute.

Too soon, our adventure is over and it is time to head back for our journey home. We take a taxi the 47km to Mzuzu, where we discover not only has our Axa coach been downgraded, our booked seats have been given away and we end up on the back row for the very long very uncomfortable journey home.

Day 31 - 33

Another quiet week at the clinic, although we do vaccinate 4 adult dogs, a boxful of 5 adorable puppies and a very cute beagle puppy and redress our kitty with the fractured leg which is healing well. We do however receive word to expect the arrival of 2 possibly rabid dogs for assessment and observation in the rabies quarantine area.

But alas, when Defense goes to collect the dogs, they are nowhere to be seen...

Day 34

With the next 2 week mass neuter program due to begin tomorrow, Denise and I complete the packing of the equipment, we need for outreach and await the arrival of the new vets. Lisa and Jocelyn arrive late afternoon, after their gruelling 22 hour journey from the UK. We take them to Chipiku's for food shopping and as they are too tired to cook, we head to Doogles for internet and food.

Day 35

Today is the vets first day here at the BSPCA and they are thrown straight in at the deep end, with the outreach weekend. Our day starts early, leaving at 7am, as we head to Ngumbe Village School and set up our makeshift theatre there. Unusually for outreach, we have 5 dogs waiting already, so we make an early start with the local children lined up to watch as usual.

Things quieten down towards the afternoon, but we still manage to neuter 17 dogs - 12 males and 5 females. We also see a 5 month old dog, with one ruptured eyeball and the other eye protruding, the sight has long gone. As blind dogs rarely cope well as local village dogs, we recommend euthanasia, but the owner declines and we have no choice but to send him home.

Returning to the clinic around 6pm, we repack enough kits to last us through tomorrow.

Day 36

Again we leave by 7am, this time heading to a school in Lunzu village, where we are directed to a classroom still full of desks and litter. We rearrange the furniture and sweep the floor before setting up theatre. We have a bit of a slow start with dogs appearing intermittently, instead of the usual groups.

This surprises us, as Chiku and Elson had informed us there was much interest in the neuter project, during their recent Mission Rabies campaign in this village (they vaccinated 700 dogs!)

However, by late morning we discover the reason for the lull - the villagers are all attending the funeral of a local teacher today. By lunchtime we have no more operations waiting, although we are expecting a few after one pm, We take advantage of the break to head to the local market to stock up on fruit and veg - where the average cost is about 200kwacha (20p) -or 600 kwacha for a dozen bananas!

By 1:30pm more children and a few adults arrive with their dogs, and we are back underway - this time with the audience we have come to expect! Despite the lull we still manage to neuter 22 dogs - 21 males and just one female. We also saw a young dog with a nasty humeral osteomyelitis from an old bite wound, not wanting a 3-legged dog the owner opted for euthanasia rather than amputation.

One of our last patients of the day suffers a very stormy recovery with lingering neurological symptoms, so we bring him back to the clinic for observation overnight.

We drop a young boy and his still wobbly puppy home on our way back to the clinic - where we discover the power is off again.

So it’s off to Doogles for food and wifi.

Day 37

A bit of a mix-up today means we have no Defence and no neuters waiting for us. Probably not a bad thing as we still have no power and a limited amount of surgical kits. We do have a male doberman and 2 cats (1 male 1 female) turn up for neutering so after we unpack from Outreach we get started on them.

We also have several walk-in appointments - an arthritic dog, a dog with multiple mammary masses and a comatose dog, which was hospitalised overnight and Defence has brought the spinal puppy (who has improved but not enough to return to village dog life) his previously neurological friend and another dog from the shelter with a lump on her head. We pack up as may surgical kits as possible, with our now limited supply of drapes ready for autoclaving.

With the electricity still off, we are unable to cook so we head out to Chez Makys for dinner.

Day 38

Today we have 17 dogs waiting for us - 10 girls and 7 males, which is more than enough, considering the power is still off, so we still haven’t been able to sterilise more kits. May pops in and takes pity on us and goes out to bring us much needed coffee and sandwiches. Finally at around 2pm, the power comes back on and we frantically sterilise kits before the power goes off again!

One of the puppy spays has a fair amount of bleeding from her skin (erlichiosis probably) so we body bandage and hospitalise for observation. Her 2 litter mates also stay in as they live too far away for Defense to take home this evening. Our kitty fracture also stays in as she is non weight bearing today.

We finish at the clinic just after 5pm, and start to get ready for our dinner out with May, but just as we are leaving we have one of today's spays is rushed back bleeding from her wound. She is fairly collapsed and is bleeding but the abdo tap is negative, so again it appears to be non abdominal. She is also showing signs of recent trauma - the jaw around her canine is fractured, and the tooth needs extracting. Shock fluids are instigated and she is body wrapped and we monitor her closelyfor the next few hours (our night out now effectively cancelled) Both she and the puppy show signs of improvement across the evening.

Day 39

Today is our day off but the poorly pets still need seeing to. Vets Lisa and Jocelyn are heading to Liwonde Nature reserve this morning so when Destiny bleeds again when her dressing is removed, they decide to open her up, for piece of mind. She does have non-descript clots but her ligatures are fine and so they close her up, redress her and we continue with the oxytet and vitamin K1.

The puppy continues to improve, his friends go home and kitty is happy. Denise and I provide their nursing care for the rest of the day. By evening the patients are stable and Denise and I head Doogles for wifi and r&r and a catch-up with our Malawian friends.

Day 40

Again, I am up early on my day off to see to the 3 in-patients - they continue to steadily improve through-out the day. The vets arrive back, having had an awesome in the bush and we head to Chez Makys for the quiz night.

Day 41

Today we neuter 10 dogs - 7 female and 3 males, including one with a bite wound to his scrotum. Despite the small number it is a fairly chaotic day, and we still have to pack for Outreach. Defense also brings us a dog with a 'broken leg', but it turns out the leg isnt so much broken as missing! Apparantly the owner took her to the local vet a few months ago, after a snare injury but couldnt afford the treatment costs. So he left her to heal, instead, due to pain or infection, she chews it off! She presents to us with 2inches of bare bone sticking out the humeral stump!

And so we finish up the day with Lisa and Jocelyn performing a fore quarter amputation,  a scapulectomy.

It is 7pm by the time we leave the clinic and she still needs frequent checks through the evening, so again we miss our planned night out with May.

Day 42

We are up early to see to the in-patients, the amputation, whom the vets have named (hop-a-long) Cassidy, is doing well, but the distemper dog is still very sick. Today's outreach takes us to the village of Likulu and Mission Rabies' John also joins Elson and Chiku to help us. Despite a lull in the middle, we still have 17 dogs  - 9 female - one of which is pregnant, 8 male and one just for a rabies vaccine

By late afternoon we have several adults watching the surgery - including the School's headmaster and the children become very excitable and crowd as we recover the last patients of the day, demanding photos and screaming with delight at their images on screen.

But with a few of the dogs arriving mid afternoon, it is 7pm by the time we return to the clinic and head to Doogles for the wifi.

Day 43

Today we head to a school in Mapadzi village, the rural location fools us into thinking it will be a quiet day, but It turns out to be the busiest day so far, with 25 dogs neutered as well as the 13 dog castrates and 12 bitch spays, we euthanase a dog with a pyo and a tvt, send one dog with away who is far too skinny to risk a ga, another agressive dog has to be dog-catchered in the back of the truck then netted, but he becomes so stressed and with his tachypnoea not settling we decided its too risky to go ahead.

We also see a dog with a broken leg and they are offered amputation or euthanasia but the boy and his dog simply disappear instead! The children are less rowdy today, but crowd around the car to wave us off.

We arrive home at 6.30pm to no power and we unpack and head to Doogles for food and wifi

Day 44

With no power, we are unable to resterilise the weekend's op kits but fortunately we have enough for today's 10 operations - 6 spays and 4 castrates. We also euthase the distemper dog, a dog with a bilaterally fractured pelvis, and a very skinny badly dematted old dog. 

As we have have no means of cooking without electricity, we head out to Veg Delight for a very tasty dinner.

Day 45

The power is still off this morning, but we are given a gas camping stove on which to cook, however the power comes back on later. Defense has brought us 6 dogs, and some local expats bring us 4 more (so we have 3 females and 7 males)

We also euthanase a fractured pelvis, see a dog not eating with bad skin and we also admit a puppy with gastroenteritiss since her vaccine a few days before.

As we tidy up the clinic, Lisa and Jocelyn head to Cape MacLear for their days off.

Day 46

As today is our day off, Tarryn had offered to see to the in-patients this morning. But with the puppy, now looking so much worse last night, Denise and I decide its best if we see to them on our days off. She is brighter this morning, but still vomiting too much to receive oral medication, but as the day goes on, she becomes less fearful and quickly learns to enjoy a cuddle.

Cassidy is also less fearful, happier, and getting around well. with the area of wound breakdown looking pusy, I add in manuka honey to her treatment protocol.

With the patients seen to, I head back to bed, but soon May calls me about a dog with 'its guts hanging out' 10 days post spay. She does indeed have a large hernia with about about 30cm intestinal content prolapsed, and it clear she has chewed off some. With the vets over 200km away, at the lake, I obtain permission to flush and resuture (the alternative being euthanasia) She slowly, but steadily recovers well.

Day 47

As I saw to the inpatients yesterday, Denise deals with them this morning, and I do the afternoon meds. Nihow is still vomiting, but less so. Cassie's wound is doing well, and Callie, while still at risk of peritonitis, is doing surprising well. Lisa and Jocelyn return from the lake that evening, and are happy with their progress

Day 48

Today is the vets last day in the clinic - and in Malawi.

We only have 3 dogs today, a bitch spay, a dog with multiple masses and Cassie needs her wound resuturing. Niwho the puppy is well enough to go home and Callie is still doing well. Joceyln also sees a newly required dog where the owner in just seeking advice re her first ever dog.

As is the vets, Lisa and Joceyn's last day at the clinic we are heading out for dinner at Casa Mia, followed by cocktails at the Protea.

Day 49

So, today Lisa and Jocecyn leave, having completed 44 neuters in their 2 weeks here, as well as having seen multiple consultations, removing several masses m an exploratory laparotomy and scapulectomy. Thanks guys - it was great meeting and working with you!

Day 50 - 55

Aside from another hernia repair, several vaccinations and a couple of sick dogs, the week goes smoothly for Denise and I. Soon, Friday comes and it is time for us to leave, Denise on to Tanzania and myself to South Africa, before returning home after 9 months volunteering in Africa.

Fiona's last word

Volunteering in Africa as a veterinary nurse is an incredible experience, not just because working for these small charities such as the BSPCA which is a rewarding experience where you really do make a difference, providing an otherwise unavailable veterinary service to the local community and their animals, but experiencing quintessential Africa is a humbling experience.

Malawians in particular are especially friendly and welcoming. Doogle backpackers is a good place to meet locals and tourists alike and to chill after work. There is often no electricity or water here, meaning no real ways to cook, or even use an ATM (but most of the locals live that life everyday, often walking many miles to fetch water) But, despite the limitations volunteering for a charity in an undeveloped or developing country, it is an experience that I would truly recommend.

Thank you WVS and Centaur services for giving me the chance to be able to help at BSPCA Malawi!

Fiona McFadyen

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