Vets without borders: how volunteering in underprivileged countries can revive your passion (Proceedings)

As a full-time practicing veterinarian with the typical type A personality, I haven't given myself ample time over my 27 years to actually venture out — to be adventurous. Adventurous to me? After twenty-six years of practice this year I finally gave myself the "gift" of dropping my Sundays, in favor of a more "normal" 5 day workweek. Having said that, most who know me would say that I continue to err on the side of being overly committed; doing my own emergencies, giving my cell phone number to my clients and availing myself to them 24/7. As a veterinarian I'm committed to my practice, my patients, and my clients! Yet, throughout my twenty-seven years I never realized something was "missing." I had no idea the Peruvian Amazon would soon change my idea of "normal" and cause me to learn that something was, in fact, missing.

As many of my clients are, Jeremiah, a long time friend and client is in the entertainment business. He is an independent producer, writer, and documentary filmmaker. HIs current project, Fixing Fido, is a documentary that explores the idea of man's best friend, and is partly told throughout the eyes of veterinarians going around the world — often to remote and underdeveloped areas of the world. Jeremiah, a dog lover himself was on the hunt for a good story and had recently been filming in the "Gateway to the Amazon," Iquitos, Peru, which sits about 600 miles northeast of Lima. Jeremiah was so incredibly affected by what he saw, he began looking for another veterinarian's journey to film. He shared with me some footage shot of a few veterinarians and the amazing work they did in Iquitos and in surrounding towns. I saw so many things that touched me, and I truly felt incredibly sorry for these poor animals. Every few months I'd see Jeremiah and his dog, and finally he asked if I would take off for a couple of weeks around Christmas and New Years to travel to Peru and work with Amazon Cares, the U.S. based nonprofit helping these suffering pets, a term I'll use loosely now, and will explain why later. I felt compelled to join him and his team to do what I, as a veterinarian, knew I needed to do.

The idea to leave my practice to go on an international trip? Unimaginable! Christmas and New Years is a relatively slow time for my clinic in Los Angeles and I have to say I was looking forward to some quiet time. And, I was already doing a lot of pro-bono work in my clinic, which I am consistently happy to do to return to the community that which I love. However, when Jeremiah showed me images from Iquitos and Amazon Cares it really moved me. In the end I felt compelled to venture out and to do what I, as a veterinarian, was initially trained to do — help animals in dire conditions. I could do a little research, I could guess, and I could speculate, but truly, I had no idea what I was getting into.

Preparations weren't easy; and it started with inoculations which only specialized doctors keep on hand and are able to certify. I needed yellow fever vaccines, diphtheria, malaria prophylaxis, not to mention an updated passport. Of course, I had to shop for all the necessities—mosquito repellant, jungle hats, sturdy hiking shoes, rain gear, and what would soon be my best purchase — a bright headlamp to illuminate my surgical fields. I also found myself collecting things from my clinic that Amazon CARES and I would need. From my office I shipped a box containing isoflurane anesthesia, examination gloves, disposable surgical caps and masks, ivermectin, and suture material. I also reached out to my friends at Pfizer Animal Health to see what they would be willing to contribute for the cause.

We flew from Los Angeles to Atlanta on a red-eye, spending the day in Atlanta until our evening flight to Lima, Peru. Arriving in Lima at about 1 in the morning, we then spent the rest of the morning in the airport ready to catch our connecting commuter flight to Iquitos at 8 a.m. Iquitos is the world's largest city that doesn't have a road leading into or out of it. The only way you can get there is by air or water. And for me, getting there would soon prove to be the easy part.

Despite it's location in the middle of the Amazon jungle there are a number of cars, but the main mode of transportation in Iquitos is via "moto-taxis." These are half motorcycle up front with a rickshaw-type covered bench-seat for people attached in the back. Though designed for 2-3 people, you'd often see half a dozen people piled in, boxes, bags, fruit and, yes, dogs hanging precariously onto the shaky frame. I hopped on one which took me from the small, one terminal, Iquitos airport to Amazon CARES clinic near the Plaza d'Armas — the central part of the city, something every Peruvian city seems to have. On this simple twenty minute ride, this daunting task finally dawned on me, as I counted no less than 100 dogs, skinny, malnourished, and mangy, all running (or sleeping) on the streets. It didn't look like any of them had owners! They looked up at me with those sad eyes, and I felt helpless! I hadn't been there more than an hour, and I already felt depressed.

At the Amazon Cares Clinic I met Molly Mednikow, its founder, and Dr. Esther Pena and Dr. Miguel Pena, the local veterinarians. My pre-shipped box had arrived, as well as a refrigerated cooler from Pfizer. The spark in their eyes as they opened the boxes of supplies was incredible and priceless. We then sat and planned for the next several days' work—I could hardly wait to start giving back.

Over the next two weeks we "worked" at a number of locations. We would go out in the morning to locations typically crawling with hundreds, maybe thousands of stray dogs and cats. Most of these strays were extremely undernourished, typically suffering from severe dermatologic conditions, almost all intact, and probably never vaccinated. We set up makeshift surgical facilities in venues ranging from an old butcher shop sitting above the open market in Belen, to a small, town meeting center in Santo Tomas, to an outdoor area at the Amazon Cares shelter. Obviously none of our "suites" had lighting or ventilation, and in addition to the blistering heat and humidity, we were contending with bees, wasps, biting flies, and red fire ants. Our assistants and other volunteers were spending as much time keeping these insects off and away from our surgical sites as they were prepping and assisting!

Though some of these animals were brought to us for the free services we were providing, most were homeless, living on the streets trying desperately to fend for themselves—sadly, often unsuccessfully. One morning, before heading out to Santo Tomas, Dr. Esther showed me a beautiful Husky at the clinic who had a cantaloupe-sized, fixed mammary tumor which she did not feel comfortable removing. Knowing our surgical venue would be inside the town's meeting facility, we brought her with us. Though without the luxuries of my surgical laser, electrocautery, and lighting, I carefully dissected out this monstrous tumor and spayed her. She recovered beautifully!

The next day, one of the local restaurant owners whom we met while eating at his floating restaurant, brought us a dog he saw trying to swim across the Amazon River while he was out fishing. The dog had this rather large laceration on his side, probably from a boat propeller, which needed to be sutured. He became one of the many success stories during my 10 days in Iquitos. In all, we treated, medicated, vaccinated, and spayed or neutered over 100 dogs and cats! This was, by far, one of the most rewarding weeks in my veterinary career!

It was difficult for me to comprehend what I was witnessing on the streets without speaking with the locals. Was it neglect, abuse, or the result of poverty? I was so curious how this problem developed, and what, if anything, was being done to prevent it. Interestingly, many of the locals have pets and really seem to love them. Granted, many are used for "work" purposes, such as for guarding businesses and for home protection, but still most have them as pets. Of course, these family "pets" were rarely allowed to venture into the homes—most would sleep outside. I did meet a few families who seemed to value the bond enough to let their pets into their homes—definitely the exception. The big problem lies in the fact that these areas are very poor and families barely have enough to feed and clothe themselves and their children, let alone spend on pet care. Though most were in agreement that spaying and neutering were appropriate measures, they all balked at the price—even though the local veterinarian would perform the surgery for $25.00! So, when a pet would become ill, the natural course for them was to let the pet run away and hope that it could survive. Now the streets are crawling with dogs and cats trying their best to do just that.

I wish I could say that this horrendous situation was isolated to Iquitos, Peru. Unfortunately, it isn't. This problem runs rampant in many poor, underprivileged, or underdeveloped countries throughout the world, and more needs to be done to help. I am thrilled to say that there are a number of organizations like World Vets and Amazon Cares that are bringing in teams of professionals to volunteer their time to do what they can to make life more bearable for these sad creatures. I worked with two veterinarians from Australia, one from New Zealand, and two veterinary students from the University of Lima on my trip to Peru. What I found most noteworthy, yet equally as embarrassing and disappointing, was how few veterinarians from the U.S. volunteer their time for this worthy, absolutely necessary endeavor. The two Australian veterinarians told me that at least 75 percent of their graduating class will go on such an expedition sometime during their first ten years of practice, many participating in several. We need to get off our behinds, find (or make) the time, and sign up to do what we, as veterinarians, have been sworn to do!

On my second to last day in Iquitos, I met this 14 year old girl working in her family's store. As I walked into the store to buy an ice cream cone, I couldn't help but notice the adorable Cockapoo sitting on her lap. I asked her if her dog is allowed into her house with her, which she told me "yes." I then asked her if she ever let her dog go onto her bed with her, and she looked at me with a very coy expression, and answered me again, "yes." So happy to hear this answer, I asked her what she wanted to be when she grew up. She looked at me, gave me a big smile, and said "a veterinarian!" This was a first! We have a golden opportunity before us to help kids like this see how wonderful it is to help the helpless, to see how great our profession is, and possibly to impact how they can someday help bring this much needed change from within. We need to become better ambassadors to improve the plight of our animal friends all over the world, and we need to do it sooner than later!