Mongolia Update (August 18-23)

August 18, 2014

Today dawned with a little sadness as I recognized this was my last week in Mongolia and there was still so much to do before leaving. I have been writing teaching handouts and clarification pieces for the veterinarians so that when someone isn’t there, they have documents to refer to. I love the looks in their eyes when a new piece of information locks in and they are able to use it with their patients. It took me awhile, but I finally am comfortable enough to hold impromptu teaching sessions, well, that and there is finally a couple minutes of “free time.” The clinic has been so busy, that a time when there was a free veterinarian was difficult. Today, things finally slowed down enough that we could gather 1-5 people and have a session. As these young veterinarians move forward, I pray that they have many people to come in and mentor them. Although their knowledge is good, the implementation of the knowledge and the overall application of techniques need to be honed. It is easy to treat the immediate problem for which a person brings their pet into the clinic, but to address the entire animal by obtaining a complete history and performing a comprehensive exam is so important to the welfare of the animal and it is easy to overlook. It was a good reminder for me as well with my return to the USA.

Today was also interesting as the power was a little less trusty. It went out in the morning, but thankfully did come back on. The fallout from this is that when we went to lunch, my food (meat of course) was not completely cooked. I ended up grabbing something else at the mini market, because I didn’t want to risk getting sick again! Dinner was a lot better with my food being cooked, and then I was given the adventure of going to a hair salon in the basement of a building where my hair was greatly shortened. A bit shorter than I am used to and what was requested, but the woman did a lovely job. Another first, getting my hair cut outside of the USA.

August 19

Apparently, yesterdays teaching sessions went over well, because now the veterinarians are asking for more impromptu sessions. Of course, the first one they asked me to do, I didn’t have anything planned, but that is quite alright. “The Coughing Dog” was a great topic and not one that I would have thought to make a handout for previously. Most non-medical people do not realize how “coughing” can mean so many things – bacterial or viral infection, parasites, heart disease, asthma, bronchitis, cancer, and the list goes on. This also took us into evaluating various lung patterns on radiographs (x-rays). Hopefully, they will start using the books more frequently – especially those with pictures – to be able to recognize different patterns in the future. I know there are times, I still need a refresher and reminder of the various pattern and what they mean for the patient. We also worked on parvovirus. A disease that is preventable with vaccination, but unfortunately many people don’t realize it. I can’t tell you how many puppies would be lined up in cages, set up to their IV fluids, receiving medications, and being cared for, but just don’t make it. They are so tiny and usually at the beginning of their lives, but they aren’t able to pull through. It breaks my heart here as it does at home that lack of education of the people causes so much suffering in the animals.

I went out to Ultziit again to visit with the Spence family and two other Americans that are over for the Fast Horse Training. Tom and Johnny have been coming to Mongolia for the last 15 years or so to teach veterinarians – specifically to care for horses. I am so impressed by the work and dedication that they provide to the Mongolian people. I cannot say how many lives (both animal and human) their training has saved over the years. They spoke of veterinarians that are using a stethoscope for the first time and hearing hearts beating after 20 years in practice. It is amazing! Johnny also shared about a wonderful program that he has been involved with recently called Victory Junction, a camp for children with chronic illness and disease that allows them to have a week where their disease does not stop them, does not control them. This camp is amazing and such  a blessing to have available to children.

Despite having another wonderful time, I just wasn’t feeling good overnight, but finally got some rest. I think I had a fever and it finally broke overnight. Not sure if it was the undercooked food from the day before, but am I glad that it didn’t progress to have me end up in the hospital again!

August 20

I had a day off today to get some more shopping done, to start packing, and to go to the Ensemble – a Mongolian cultural show. It was an amazing event! The throat singing and music were interesting and I have no idea how the throat singing works (you should not only hear it, but watch it!) The craziest part of the show was the contortionist. My joints still feel sore just from watching her. Absolutely amazing!

It is really hitting me that I will be leaving soon. I miss my husband, cat, family, and church, but I really want to stay here!

August 21

I have been reminded again about the difficulties in practice here. Here, I am “the specialist.” The one with experience. The one that is supposed to have the answers. Today, I was faced with a pup that I knew what needed to be done, but I didn’t have the equipment, medications, or specialists needed to treat the pup. At home, it normally comes down to money – people can afford to treat or not, they want to treat or not. There is a specialist somewhere that can take care of the situation in many cases.

This is the story of Coco. Coco is a tiny Chihuahua (1.6 kg, about 3.5 pounds) that was given large amounts of vodka and had fallen off of a bed two days previous. Now, she has torticollis (her head and neck are tilted around making the head almost look like it is upside down), nausea, and anisocoria (her pupils were of different sizes). She also has bulging of her skull between the eyes. Normally, one would place her on oxygen, monitor her blood pressure, and a wide variety of other things (MRI, CT scan, etc), but I can’t do any of those things here. Thankfully, I have access to the Veterinary Information Network (VIN), which includes veterinarians, including specialists, from around the world that I could request help from. We were able to find some Mannitol – a medication that helps decrease brain swelling – at the corner pharmacy, so we could start that treatment. Sadly, there is no overnight care or monitoring here, so she was sent home with her owners with instructions to come back first thing in the morning. We all prayed that she would survive the night.

We also had a young kitten (maybe 3 months old) come in that had fallen off of a balcony. The family had never had a cat before and were watching her for a couple days. The family knew nothing about cats, so they left her on the balcony while they went away for a short time. They couldn’t find her upon their return on the balcony and finally found her on the ground 4 floors below. She had a broken leg (fractured femoral neck) and a pneumothorax. Thoracocentesis was performed to remove the air, and we will have to see about the leg. It is a type of fracture that can be repaired, but could also potentially be left to have the femoral head dissolve on its own. We will wait and see what happens over time.

That evening as a thank you, I purchased pizza for the entire clinic. Something that is so simple and easy that it is one of the most common things to do in America, but for them is often cost prohibitive. For about $45, I was able to blessed with their joy and fellowship.

August 22

I gave my farewell devotion this morning and was brought to tears multiple times. I, of course, stood out as emotions are not often shown in Mongolia. I on the other hand tear up at Hallmark commercials, so it wasn’t a far stretch for me to cry now. There were hugs all around and such amazing love, support, and acceptance. Thank you for allowing me to be here and to hopefully have made a difference!

The clinic itself had a slow day, but we continued to work with Coco. She even began to show her Chihuahua nature again and started to growl at me. She had some nystagmus (rotation of her eyes) today, but wasn’t rolling quite as much. She still has significant swelling of her head, but I think she may have a chance. Perhaps will never be 100%, but she has a chance to live. Enkbeyer is doing a great job. Although he is quiet and hasn’t needed a lot of help, I am happy to have become his friend.

Coco on her way to recovery

Coco on her way to recovery

I tried not to cry when the time came to say good-bye, but that didn’t happen. I was able to keep most of the tears in until I started to walk away. A part of me will remain here forever.

Dinner and then the trip to the airport went well, until I realized I had neglected to hand over my apartment keys!  Oops! The airport allowed me to call Mary, but due to the way security is set up, no one is able to come and get the keys. They will need to be mailed to the next shuttle (person traveling over to work at the clinic) when I get home. I did get to have a lovely conversation with a Pilipino woman that had just finished a trip around Mongolia. Despite living in California for the last 56 years, she still travels all over the world. I will keep her in my prayers as she was so sad that all of her traveling companions are passing away. She was very sad.

Final devotion, Final picture

Final devotion, Final picture

August 23

Despite a lot of turbulence, the flight home was good. I was able to get more sleep than on the way to Mongolia. The man next to me was a lovely gentleman from Thailand, that now lives in the USA. He travels frequently for work, and was excited to get home to his wife and high school aged twins. He recommends a trip to Thailand, I think that is a good idea!

I was then double blessed upon arrival to see my husband and Laura and Steve – friends from church that offered to pick me up. After a short chat, we walked out to the parking lot where we were also met by more church members – Gary, Ann, and Addi – I didn’t expect to see them 3 hours from home, but they were in Chicago and saw my plane landing, so they hopped into the van and found us in a parking lot at O’Hare without a telephone call or anything. If God wasn’t in that, I don’t know what else to say!

Thank you to everyone that has followed my journey. I hope that it will happen again. I will share more in the future as tidbits of my time in Mongolia come back, but the great story of this trip is over. Perhaps it is just the beginning of many more though!

May you be blessed and find a way to make life a little bit better for someone around you today.

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