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Week 3

(7-  15 September  2004)

Dr. Cheng

Dr Cheng, Associate Professor at the Veterinary Faculty, UPM was keen to join the training programme in Bali, arriving at Denpaser a day late (due to her own cat in KL becoming sick), Dr Cheng joined the field clinic and after the first day extended her trip for an extra three days.  Dr Cheng has been an ardent supporter of first of all, the Kempen Kembiri and later the Klinik Kembiri, the success of this clinic is largely due to Dr Cheng’s enthusiasm and proactive attitude.  Dr Cheng organised other vet faculty teachers to volunteer for the clinic and also helped write the inventory lists and get together the necessary equipment. 

Dr Cheng visited the Yudisthira Laboratory, which had just opened the week before – 1 September.  The Laboratory is part of Yudisthira’s vision to raise the standard of veterinary medicine within Bali and Indonesia.  Through the Laboratory and the learning the Yudisthira vets will be able to understand more about disease, enabling further diagnostic abilities and therefore increasing the practical treatment and  prognosis for the owned animals.  The Laboratory will also be part of the ongoing research into the street dogs skin diseases, and may change the way in which these dogs are treated in the field and emergency clinics.  The Laboratory will at least create options, at most it will radically improve the diagnosis and help to improve the welfare of animals island – and potentially – nationwide. 

(pics1 &2)

Dr Cheng, coming from an education background, was enthused by the training of the Laboratory staff.  Coming away from her first visit with productive discussion and ideas for further development and new techniques and tests available to the staff. 

Dr Cheng has a thorough and trained eye and coupled with her vast experience of veterinary medicine her knowledge has been of great benefit as she shares solutions and options for animals who suffer from diseases which are common in Malaysia as well as Bali.  This has been a consistent issue for Yudisthira who often invite vets who work in western countries and don’t have the same incidence of diseases (or indeed some diseases don’t exist at all) and therefore the Yudisthira vets have not previously had the resources or people to request information from. 

Dr Cheng’s time with the Field Clinic has also been productive, analysis of asepsis, disinfectants used and also treatment for puppies not old enough for neutering has been invaluable.  The Field Clinic has not been as hectic as the last two weeks with Dr Lim and Dr Natasha, as the Yudisthira programme revisits and does follow up work every two weeks.  This means that during the second week, the Field team go out to the homes within the Banjaar and check the dogs who were neutered and spayed 2 weeks previously and gives any additional follow up treatment, the team will visit once more to check the dogs in another two weeks completing a three time check in total for each dog.  Each dog is only counted once and the records kept ensure accurate analysis of the programme, through this analysis it has been proved that the mortality rate since Yudisthira’s beginning is 0.3%.  This in itself is outstanding. 

Dr Cheng got her first opportunity to observe and perform early age neutering (EAN) for a male 10 week old puppy.  A 10 week old female puppy was also spayed the same day and Dr Cheng was impressed with the technique and the speed of the operation, not forgetting the careful monitoring of the anaesthetic.  Dr Cheng waited with the puppies until they had fully recovered from the anaesthetic and were on their way home. 

Dr Cheng joined the Street Team at the end of the week and was exposed to another side of Yudisthira’s work.  Catching and treating sick dogs, neutering and spaying and being reactive to calls from the public about emergencies involving dogs that need help.  Part of both the Street Team and the Field Clinic work is to collect samples for DNA, skin scrapes and blood smears for further analysis at the Laboratory (and as part of an ongoing research project with UC Davis USA).  Dr Cheng was on hand to teach the Street Team a new biopsy technique.  This technique will help to evolve the analysis and findings of skin disease in Bali dogs. 

During her visit, Dr Cheng also joined the Yudisthira’s Kindness Club at a school in Denpasar.  As a teacher herself Dr Cheng was impressed by the interaction and opportunity for learning through the syllabus that has been developed.  On her last day, a visit was arranged to the Yudayana Veterinary University, the school is the main source of Yudisthira employees and the students now use the Field Clinic to gain their practical experience before graduating. Dr Cheng’s lasting impression was that the University lacked some resources, such as the students had one microscope between 12 students, in Kuala Lumpur this ratio is one to six students.  However this University is one of the first to introduce a module of animal welfare ‘Concepts’ by WSPA was first launched two years ago here which aims to teach young Vets about the importance of welfare and it’s implications within their livelihoods. 

This visit has been interesting and has opened up a resource, given fresh ideas to shared problems and made the foundations for a productive working relationship between Yudisthira, SPCA and UPM.  We make a great team. 

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Dr. Cheng's Comments

Comments on Vet Training in BALI

Dawn Peacock who arranged my week at the Yudisthira Foundation wrote to ask why I hadn’t sent in that ‘one page on the week’ and she was clearly concerned as she asked – was it so horrible that I couldn’t write about it? No it wasn’t horrible – but I am a slow writer, and have to apologize for it, Dawn and others.

The Bali Street Dog Foundation, or the Yudisthira Foundation,   had a very organized Street and Field team by the time I met the members in September 2004. Initially, I was amazed at the amount of driving around – not only of the two vans that managed the daily dog sterilizations, but of the 4WD that carried the visitors and the volunteers. 

There seemed so much to manage, organize and yet again reorganize in addition to the goings-on of the Street Team and Field Clinic. I think this happened because the lab staffing was not yet settled as the lab staff was still training on the job, and the ongoing Malaysian Vet training Program did muddle up that training schedule moderately, and the samples and cases that would come in (without appointment of course, animals don’t get sick on appointment) still got everyone a little excited. However I got used to it, and the Bali traffic as well.

I arrived on Monday mid-morning and after lunch at Sherri’s was taken to the new lab. There wasn’t much going on except for some slide-reading-training by the vets Drh Komang and Drh Ani and Helen, the volunteer, so after I had done the lab tour, met Nana and Drh Iwan and seen the exciting Babesia infected red cells I sat in the corner and sort of ruminated and dozed as I had left for the KLIA airport at 4 am after a sleepless night of packing and was not in very good shape 12 hours later.

I spent Tuesday, Wednesday and Thursday with the Field Clinic and was taken aback (mouth open) with the skill and ease with which the drivers and catchers caught the dogs in the nets. They spoke easily with the people of the Banjars and they were well accepted. I looked too Balinese – I learned how to stay out of the way and not open my mouth – the Balinese were shocked at the awful Bahasa that came out from it.

The vets had no problems estimating the anesthetic doses, there were no anesthetic casualties at all, and the top-ups went really smoothly. 

I had a flashback of me at the first few Kempen Kembiris in Kuala Lumpur weighing the dogs on a digital scale with a chart and calculator next to me, giving the drugs iv and running around giving iv top-ups of the same – but those days our drugs were donated and we didn’t have quite the same combi’s. Besides … the owners we had in Kuala Lumpur City were a fairly demanding and excitable lot compared to the Balinese – the Balinese at the Field clinic reminded me of the buffalo, cattle and goat farmers we visited with our ambulatory clinic back when I was a Vet student. They were calm, moved about with the minimum of fuss and didn’t chatter. There was the odd giggly lady who would march her dog in on its hind legs but that was rare.

Only the kids bopped up and down with Lita of the Field Clinic as she did her education bit with all the fun stuff – there were always about 20 kids by the time the session was over and they all mobbed her – they seemed really excited by all the quizzes they got and everyone was trying to get their answers heard.  It was nice to hear them having fun.

What about the surgery ? The asepsis wasn’t perfect but it was pretty close, and hearing that the mortality rate for the past 6 years had been like 0.3 % (since 1999) was impressive.

I didn’t do any spays because my incisions were going to be too large I felt, but I did some castrations. The Bali vets were doing like 1.5 inch midline incisions on dogs that were 17-25 kg in weight.  I can only hope I’ll get that small one day. 

I was put with the Street Clinic on Friday. Our first bit of work was on about a four–foot wide bit of sand pavement on Batu Bulan – there was a very bad skin case, followed by castration of a black dog. I learned where was a good place for the recovery from anesthetic- down one of the many side roads that only motorbikes can drive down.  I also learned not to fall into the drain – it was about 5-foot deep. Where the Field Clinic had folding tables, the Street Clinic had the back of the van and when business got really good, the road side or the back seat was for castrations. There was a whole line up. We just kept going. Everyone did the ‘client education’ bit – no-one didn’t talk to the people who came over to check us out. That was really important.  Promotion is such a vital component of the entire campaign and here I am holding up the news flash. I will go home and kick myself Dawn.

I had the chance to sit through a whole Kindness Club Session with Drh Puspa and Komang . Helen was there too, for her first time. I could easily understand what was said, and it was pretty clear – simple Bahasa Indonesia. The kids were thrilled – first, something fun to have! A privileged class they were in that school – I saw a few kids from other classes peeping in with huge eyes, and then, stickers AND puppets! Too much!

Then Abang Komang giving out stickers WOW! Getting to go out to the map and sticking little dogs on to it – heaven.  And the message – simple things to do with your dog, sterilize, feed right, bathe and keep clean, see the doctor, vaccinate – they even learned huge words like distemper, parvo, ancylostoma, sarcoptes scabei and demodex.  I asked the kids around me if they had dogs – they all did, Brownie, Doggie, SiManis, Kinglar, Rosa and Piko owned by Indra, Adahari, Devi, Alid, Runggus and Effan respectively. There might have been better effect on the kids if a lapel mike was available – there was an awful lot of background noise from all the school around and Puspa was trying to talk really loud. I don’t think we have this yet in Malaysia – we should . Something to work on with The Malaysian National Animal Welfare Foundation when I get back. They have their AGM Oct 9^th I think.

Thank you all at the Yudisthira Foundation for having me there, for letting me ride and work with the teams, listen to the hum of activity, the ribbing and back chat, the camaraderie – reading about the Foundation doesn’t half tell you anything about how right it feels to be spending the days doing something very positive about the welfare of dogs with a whole bunch of people who have chosen to do this for a living.