Nearly two months into our stay at NUOL, our support and training work with the PAHWs (Primary Animal Health Workers) has taken shape well. The PAHWs are providing lots of interesting exchanges and useful feedback.
A village mentoring visit with the PAHWs is set up by one of the Animal Health lecturers at the University, who also provide some ambulatory services to the villages. A morning visit means we can ask the visit host – one of the PAHWs – to hold back his animals from grazing for us to do some practical work. Each village started with 3 PAHWs trained, but attrition and their other responsibilities means we usually have 2 present, occasionally 3.
Our team consists of me and Thom, Lampheuy – our coordinator and translator, an Animal Nutrition specialist, lecturer and PhD student – and one of the Animal Health lecturers, often Sisawat. Sitting outdoors with the group, I check record books and ask about cases they have seen, which leads us into case discussions. We review clinical signs, probable diagnoses, treatments and outcomes. The PAHWs are questioned about what specific support they need from the team. We then move on to practical work, using what ever animal is available to practice restraint and handling, physical exam and evaluation. I’ve introduced deworming of dogs, and we have also been discussing and sometimes applying flea treatment. Before leaving we have distributed 10m. ropes suitable for casting cows, and large gauge needles which may sometimes be useful in relieving bloat – an oft-cited killer of cows in the rainy season.
At some visits we have a sick animal to work with, always an excellent learning opportunity. This week in Douneane village we saw a cow 1 month fresh with a lame leg, which one PAHW had treated the 2 previous days. We were able to review case reporting (presenting signs, history, findings, treatment and rationale), restrain and examine her, discuss the probable diagnosis and the indicated treatments, estimate the weight of the cow, calculate drug dosages, and have each PAHW draw and administer one injection. We covered nursing care, ie the need for provision of water to an animal with restricted mobility, the effect on milk production and the well-being of the calf of withholding water. Our conclusions were that she had a normal temperature, thin body condition, and a hock injury which was improving. I also took a fecal sample to do a float back at the lab.
Yesterday in the lab I floated the sample in saturated sugar solution and demonstrated a moderately heavy load of GIN eggs (validating our deworming treatment of the previous day). I was working alone with this first sample to investigate what equipment was available, the condition of microscopes, etc., but on my way out of the lab I saw Sisawat and asked if he would like to see the slide. Sisawat and a vet student, Souksawat came with me, and we collected another veterinary program lecturer, Sitisai, along the way. Once she saw us in the lab, the lab supervisor also came in and took a look. When I left, Sitisai was taking a picture of the slide. This very simple technique should be readily transferable to the teaching program and provide a good rationale for treatment programs in the villages.
