College friends went as part of Veterinarians Without Borders program
Posted Oct. 1, 2009
There Dr. Beth A. Miller stood, looking at a goat with an untreated corneal ulcer and secondary bacterial infection. The former mixed animal practitioner lacked proper instruments or diagnostic equipment, let alone antimicrobial ointment. All she could do was advise that the goat be put in the shade and given some food. "Left untreated it could lead to blindness, but it probably was not a huge priority for the owner because she probably didn't have enough money to feed her daughter," Dr. Miller said.
Dr. Arlene F. Gardsbane brought about 350 doses of donated rabies vaccine from Merial on her trip to Liberia. The small animal veterinarian held rabies clinics throughout Liberia's capitol, Monrovia, for locals' pets. Dr. Beth A. Miller, a large animal practitioner, accompanied her on the mission. For a little more than two weeks the pair analyzed the country's needs relating to animal health care, disease prevention, and wildlife protection. (Photos courtesy of Christina Holder)
This was how the Arkansas-based veterinarian spent part of her summer—observing the conditions of animals in the African nation of Liberia. Dr. Miller (LSU '86) stayed a little more than two weeks this summer with her friend and fellow Louisiana State University alumna, Dr. Arlene F. Gardsbane (LSU '87), of Silver Spring, Md.
The pair was sponsored by the nonprofit organization Veterinarians Without Borders and hosted by Liberia's Ministry of Agriculture. They spent their time visiting government agencies, private farms, urban areas, and remote villages to gather data and identify immediate needs related to animal health care, disease prevention, and wildlife protection. Their goal is to raise awareness and funding to establish veterinary services in Liberia that will enable the country to produce its own food and protect its resources and human health.
Making effective changes
Dr. Gardsbane's brother-in-law, Paul Sully, served in the Peace Corps in the '70s and developed an attachment to Liberia during his time there. His enthusiasm proved infectious. Years ago, he convinced Dr. Gardsbane to collect money and teddy bears for Liberian children during its civil war, which lasted more than a decade.
On top of conducting rabies clinics, Dr. Gardsbane (above) interviewed local residents, including a man who
started an animal welfare society eight years ago. "He'd never been out of the country but recognized
animals weren't being treated well," she said. "It's exciting that someone there recognized (the importance of
"They're finally coming out of the war and trying to move the country forward. My brother-in-law in January said there were no veterinarians there, and asked if I'd like to help. I said, 'Sure, why not,'" according to Dr. Gardsbane, who had never done development work before.
Dr. Miller, on the other hand, had worked for 10 years at Heifer International, another nonprofit that promotes self-sufficiency in developing countries by using livestock as a "living loan" to help provide families food and livelihoods.
Dr. Miller has long been interested in cultures and lifestyles, but she never thought she could apply her interests to veterinary medicine until she started working at Heifer.
"I'm really interested in the owners of animals as much as the animals themselves. The real issue is we can't help animals and their health if we don't understand the motivations of the people keeping them," Dr. Miller said. "We, as professionals, need to know more about that to achieve the outcomes we want."
The two, under the auspices of VWB, began assessing Liberia's animal health system. During one of her interviews, Dr. Gardsbane spoke with an epidemiologist who told her rabies is considered endemic in the country; however, Liberia has no way to diagnose the infection properly. A veterinary diagnostic laboratory does exist in the country, but there are no laboratory workers to staff it, nor materials for most testing. Currently, United Nations Food and Agriculture Organization staff workers are training some Liberians to diagnose Newcastle disease and avian influenza.
Taking on the rabies epidemic
Dr. Gardsbane also heard that many human rabies cases go unreported. That's because cases are reported only if the person dies in the hospital, she said. In many cases, physicians send patients home to die, so they aren't counted.
Dr. Gardsbane conducted a rabies clinic in the yard of the Ministry of Agriculture after announcing it on a local radio station. About 350 rabies vaccine doses had been donated by her Merial distributor back home.
"I didn't know how many would show. I expected five or 10. We had 101 dogs and one cat," Dr. Gardsbane said. "It was very exciting. It also allowed me to look at the dogs—not that I could treat them, but it did give me an idea of what the dogs look like." The next day, Dr. Gardsbane vaccinated an additional 100 dogs against rabies in several neighborhoods in Monrovia, the sprawling capital.
The small animal practice owner said while dogs are considered pets—complete with "cute" names—they are treated differently than Westerners are accustomed to. Dogs usually are left to scavenge through garbage for food. They aren't spayed or neutered, Dr. Gardsbane said, "So every female dog over 6 months old is pregnant or lactating."
Dr. Gardsbane encountered many dogs with dermatologic problems including: scabies, mango worms (the larvae of the myiatic fly Cordylobia anthropophagia), and obvious trauma from dogfights. She also noted that few dogs were older than the age of three—coinciding with the end of the country's civil war.
"Dogs are eaten still in Liberia, because people don't have food or at least a consistent source of good protein," Dr. Gardsbane said.
Liberia has no wildlife sanctuary or zoo, and she saw monkeys and chimpanzees kept as pets. Dr. Gardsbane also saw how prevalent bush meat is in Liberians' diets.
"My feeling is if we can interest the people in raising small ruminants and fish along with training animal health care workers, then people will, hopefully, turn away from bush meat," Dr. Gardsbane said. "Unfortunately, in a lot of places, it's preferred. People don't want to eat the sheep and goats, because that's their wealth or savings for an emergency."
Veterinarians Without Borders started in 2001 when a Los Angeles veterinarian began performing veterinary
relief work around that city. The nonprofit's scope now reaches internationally because of its sponsorship
of the trip by Drs. Gardsbane and Miller (right) to Liberia.
Badly needed services
Dr. Miller couldn't say exactly why they have found no practicing veterinarians in the country. She speculated that most may have fled because of the war, and perhaps the ones who stayed were killed.
Liberia doesn't have a veterinary school. Before the war, some veterinarians trained in other countries such as Ghana, which has a veterinary school, she said. Others call themselves veterinarians after attending a brief training class to be a veterinary assistant or short animal health seminars held by the government before the war. They could do minor surgeries, had access to veterinary pharmaceuticals such as lidocaine, and could administer antimicrobials and vaccinations. Villagers trained to give first aid are called paravets, but they do not have any supplies or equipment, so they are no longer active.
"I'm really interested in the owners of animals as much as the animals themselves. The real issue is we can't help animals and their health if we don't understand the motivations of people keeping them. We, as professionals, need to know more about that to achieve the outcomes we want."
—DR. BETH A. MILLER,
LITTLE ROCK, ARK.,
ON HER TRIP TO LIBERIA AS PART
OF THE VETERINARIANS WITHOUT BORDERS PROGRAM
"If they can get medication, no one is preventing them from injecting and no one is there to protect the public," Dr. Miller said. "Really, it's an unregulated situation. People need services, but there's no one trained to provide them and no government standard to make sure services are appropriate."
Looking to the future
Dr. Miller said any future work by volunteers should start with conducting a survey on animals in the country and identifying the diseases they carry. She has developed a number of other proposals that were given on behalf of VWB to the Liberian Ministry of Agriculture's animal health services.
"We want to give them a sort of shopping list that says if you want to strengthen the livestock sector, as well as the public health sector, you need to make sure the (international) donors know you have these needs," Dr. Miller said.
Getting more people trained at the village level in proper animal care also remains a priority, Dr. Miller said. She envisions a pilot training program in community animal health being made available. A person from each community—likely women, as they are responsible for livestock—would be trained in animal first aid. They would learn the signs of a sick or injured animal and how to take a temperature, stop bleeding, do a physical examination, and analyze feces.
Dr. Gardsbane hopes to see improvement in the training of paravets and community animal health care workers in small animal medicine.
Drs. Miller and Gardsbane hope their list of priorities and someone empowered to improve the animal health system can put Liberia on track.
"We felt like if we could just get an assessment done, we think that a lot of people are going to be excited about the potential. Hopefully, there are grants out there," Dr. Gardsbane said.
Continuing to help
Dr. Thomas W. Graham, president and CEO of Veterinarians Without Borders, said applying for grants is the organization's main priority right now. VWB has been working with other nonprofits and companies to boost its donations. The organization also has received offers for help on grant proposals. Funding would go toward dealing with public health issues in Liberia, specifically, rabies.
Dr. Graham said the organization will direct its efforts toward eradicating rabies in and around Monrovia. He said estimates show 200 human cases of rabies annually in the country.
"It's very visible and something we can have success with. Eliminating it in the capital is crucial and something that is doable," Dr. Graham said. "To say we're eliminating rabies in Liberia is a big bit to take. That would take more time, resources, and money than we can access in the near future."
All this has happened in the four months since VWB started the Liberia initiative. A number of small yet important hurdles must still be overcome, such as just getting enough money for a Web page that can easily accept donations, Dr. Graham said.
"I think we've got good people in place to get things done," Dr. Graham said. "We're getting off on the ground running."
Already, Drs. Miller and Gardsbane feel as though their trip was a successful one. They encourage other veterinarians to look into reaching out to other cultures and having a more global consciousness. Dr. Miller said this applies not only to veterinary students but also to veterinarians.
"It's good for vets in practice just to know there are other things to do with a DVM," she said.