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Veterinarian travels to Afghanistan

Published: 4/7/2009
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Dr. Susan Chadima returns to Kabul

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Read more about Dr. Chadima's work and travels

By Maddy Butcher

America overeats and overfeeds its animals.
Not all of us, of course, but enough of us to make it a national problem.
Dr. Susan Chadima should know. From her perspective as veterinarian at Androscoggin Veterinary Hospital in Topsham, Maine, she sees plenty of doting owners and overweight patients.
But within the month, Chadima will travel to Kabul, Afghanistan where the domestic animal scene couldn’t contrast more starkly.
“We struggle with animal obesity here,” said Chadima. “In Afghanistan, we struggle with malnutrition.”
While she works almost exclusively with small animals, she told me there are many similar concerns across the entire animal population there.


Safe to say there’s not a lot of “lite” or “low carb” pet food sold in Afghanistan.

We met at her Topsham office, just days before her departure to Kabul to work in a clinic there for three months. This is her fourth consecutive year working for the Veterinary Association of Afghanistan.

Chadima is pictured here with a Buzkashi horse.
Buzkashi (translated as “goat-grabbing”) is the national game. It’s a bit like polo, but with a gutted, headless carcass instead of a ball. Riders try to drag the carcass (which may be goat, calf, or sheep) across goal lines.
Buzkashi horses are a bit like our most prized show horses, the country’s crème de la crème.
This horse, similar to a quarterhorse in its size and confirmation, was brought to her clinic with a horrible infection in the fetlock area, she recalled.
[The Brooke is an international organization assisting equines and their owners in impoverished countries, including Afghanistan. For more information, check out thebrooke.org]
Most Afghan equines are beasts of burden. Chadima guessed that donkeys easily outnumber horses.

For us, spring means vaccination time, right?
No such thing for many Afghan equines.
It’s simply too expensive and too hard to get. Vaccination efforts focus on sheep, cattle, and other livestock, she said.
And then there are the counterfeit vaccines. Bogus medications are an ongoing problem, compounded by the high rate of illiteracy among farmers.

Chadima illustrated the huge obstacles for disease prevention with an example:
One woman brought her chickens to the clinic to be vaccinated. She understood the health risks associated with unvaccinated animals and paid about 10 cents per chicken to get it done.
Then the woman asked how much it would cost to vaccinate her dog. It would be $15, they told her. With the average Afghan subsisting on $50-80 per month, the dog’s vaccination would never happen.

For many Afghans (and for many Muslims elsewhere), dogs are considered unclean. Puppies may be stoned in the streets.
It sounds horrific. But one needs to appreciate the public health situation, added Chadima. With the very real possibility of disease spread, this situation can be at least a little more understandable.
“If a dog licks you,” she told me. “It can be very, very frightening.”
Only the wealthy can afford to have their pets spayed or neutered. When she was there last year, she was paying the clinic guard to bring in strays for her to spay and neuter. She performed the surgery, then re-released them. Not a perfect situation, but it still helped.
She said others thought there should be an effort to adopt out these animals. But to whom?

Diagnostic tools?
Forget about it.
No x-ray. No ultrasound. No lab work.
Last year at the home where she stayed, Chadima had electricity for four hours on every 3rd day. Keeping vaccinations refrigerated is a huge problem.

“You have to depend on your hands and senses to diagnose,” she said. “You see things you have never seen before." “You have to depend on your hands and senses to diagnose,” she said. “You see things you have never seen before. Often, by the time you see them, the animals have become really, really sick. People don’t have the resources to spend on vet care, so they wait [until things get critical].”

Not surprisingly, there is a comparable shortage of vets. And university-trained vets, she said, get paltry clinical training. Their theoretical training is sound; but their on-the-ground training is sorely lacking.
In contrast, the country has a fairly productive system of training “paravets.” These students, sponsored by their villages, get very little theoretical training but tons of clinical training. Paravets outnumber university-trained vets 4 to 1, Chadima said.

Good luck and Safe Travel, Sue!

Dr. Sue Chadima checks in from Afghanistan:

Chadima traveled to the Afghanistan Veterinary Association office in Mazar-e-Sharif and offered this news:

As the road from Kabul begins to climb out of the plains, our direction heads into the Hindu Kush mountains and towards the Salang Pass. Constructed in the 1960’s, the Salang Pass and Tunnel provides a direct link between northern and central Afghanistan – areas of the country that for centuries were separated from each other by the first snows of winter.

The road is jarring. The scenery is spectacularly rugged with snow still present on the peaks and in the ravines. Tiny settlements of nomadic Kuchi are seen with their huge flocks of sheep and goats grazing the summer grass.
The Salang tunnel is unlike any tunnel you have driven through in the US. The multiple sections have very rough roadbeds, poor ventilation, and most lighting is provided slits cut in concrete or through rock face. It is no surprise that it continues to be a treacherous location in winter, and the site of potential fatalities even in peacetime.

Having successfully reached the pass, the road begins to drop, the land opens up, and you get your first glimpse of northern Afghanistan - areas of green valleys, arid badland-like desert and vast open plains – the steppes of central Asia that will reach all the way to Russia. It doesn’t take too much imagination to envision Genghis Khan and his hordes galloping in the distance.

Mazar-e-Sharif is only 30 odd miles from the Uzbekistan border. (and a 6-7 hour drive). At a much lower altitude than Kabul, Mazar is hot, sprawling, relatively modern city with wide paved roads radiating out from the Shrine of Hazrat Ali – Afghanistan’s holiest pilgrimage site.

The AVA office is about 0.5 km from the center on a main road.

Being close to the border of the old Soviet Union, life and customs are different here. Our first night, Dr Safi’s stomach was bothering him, and our host recommended 100 gms of restorative Vodka which was declined. I see more women in burkas here – both blue, and others that are all white, but Mazar is supposed to have a more liberal attitude towards women, women’s education, etc than other parts of the country. However, it is here that I had my first real discriminatory experience since I’ve been in Afghanistan – and it involved an ice cream parlor!!

Enjoying the relative freedom of being able to walk the city streets accompanied by 3 Afghan men (I don’t walk anywhere in Kabul), we decided to try some of the justifiably famous Mazar ice cream. Our first stop was a street side vendor with lots of table and chairs outside. Oops! I was not welcome to sit there, let alone be served, and they tried to usher me into a small dark interior space behind a curtain where my companions were not allowed.
We decided to move on and found a different ice cream shop a few blocks away. This time I was allowed inside and we were shown to a small table at the very back of the shop. Being the only woman present, I received a few stares, and the men at the nearby tables vacated the premises with minutes of our being seated. Maybe they had finished their ice cream. Either way it was delicious –hand churned, with a huge amount of butter fat, and well worth the effort it took.


The AVA building dedication went very well, with attendance by a large delegation from a World Bank Mission review team and all kinds of provincial dignitaries. Lots of good photo opportunities.
The building is lovely, but as with all things here, the challenge now is to have the people, skills, training and programs to really make things work. Building buildings is the easy part and the part that the western aid donors do best.

I played my weekly round of golf on Friday morning, which is one of the highlights of my week - a wonderful change from the city.
There is a pack of 6-8 dogs that live on the course, and this Friday morning, for the first time in my life, I saw a real den with mother and babies - right near the 1st tee!!!!! She had dug a hole under a small rise in the earth, and we would have missed it completely except all of a sudden the mother dog appeared from nowhere - running in the opposite direction to distract us from her family's home, but then we looked carefully and there were the bundles of fur.
It was all quite remarkable. The dogs are semi-feral. Of course I would love to catch them and do some vaccinating and neutering, but am not quite sure how to get it all managed.

On another note, we at the DCA guest house are now the proud parents of 4 chicken children (so named by Esan, one of our guards). Raymond, my Irish neighbor, keeps 5 hens and 1 of them had turned quite broody, so Raymond decided that the best solution was to get some fertilized eggs for her to hatch - a brilliant decision, as this hen was clearly meant to be a mother and is devoted to her new babies. We are all enjoying them.

In an attempt to deal with Trouble's, our mentally unstable dog, behavior, I started him in Prozac 2 days ago. Prozac here is a fraction of the cost in the US, and after 3 doses, I think I can say it is helping.


Written in late August, during Afghan elections:

The international press is full of news about the national elections in Afghanistan, so I thought this might be an appropriate line to send you a couple of lines, and let you know that I'm fine, and provide a little bit of perspective from a low profile veterinarian on the ground.

Today, Wednesday, is a national holiday to help keep people home and off the streets. I am ensconced at the "Park Palace" having a leisurely morning, and sitting in the communal garden with my laptop.
I think I will be spending a lot of time here over the next 4 days - tomorrow on election day, no cars are allowed on any streets. Friday is the weekend, and all offices are always closed which will also be a day for enhanced post-election security, and probably Saturday or maybe Sunday will be the 1st day of Ramadan which is also a holiday.
So with a 4-day holiday in front of everyone, many people are taking the opportunity to go visit family and relatives in Pakistan or elsewhere - they will give up the opportunity to vote in exchange for a vacation, and avoid any potential security issues. I'm approaching the entire thing kind of like an ice storm in Maine - I have everything I need and am enjoying the change in schedule - PLUS we have electricity and the weather is perfect.

There is a huge white blimp with security cameras that is tethered in the stadium, and floating above the city. I try to remember to smile and wave when I am outside.

The UN, USAID, many NGO's have sent a lot of their staff out of the country and encouraged them to take vacation time. They have been replaced by hoards of international reporters and election monitors. The whole thing is a bit of a circus.
Everyone I know just wants the entire exercise to be finished. The pictures you see of enthusiastic crowds at election rallies are largely people without jobs and who are being fed a big, good meal - a major attraction.
The original field of 41 candidates has been narrowed somewhat as several have withdrawn and given their support largely to Karzai. Among the remaining candidates is one whose primary qualification seems to be that he was a "boy genius" and graduated from university before he was a teenager, and another was a finalist on Afghan Star - an American Idol type show.
Karzai, Ashraf Ghani and Abdullah Abdullah are the 3 most serious contenders. But in a country with a huge illiteracy rate, subsistence level farming, massive corruption at the highest level of government, and perhaps up to 1/3 of the country that may not be participating in the election due to insecurity/insurgency/Taliban it is hard to appreciate what impact or real change this election will actually have.
Good governance would be far more appreciated and effective, and that is not dependent on an electoral process which some people dismiss as a western exercise and others have completely unrealistic expectations from the results.

The attacks of violence that do occur are horrific and sickening, for the innocent civilians that are killed, for the dedicated western military personnel that are so committed and doing an exemplary job in a country and culture that many of them do not understand, and for the young men who are brainwashed into thinking that blowing themselves and others up can possibly contribute to creating a better society.
I approached it in a way that I would never consider in the US, - anesthetized the dog, cut off the exposed bone, and left everything else alone. So far so good, and if it all works out, it will be a lesson in helping Mother Nature by sometimes doing less rather than more.
You know as much about the explosions that have occurred and the isolated episodes of violence as I do. There are traffic security check points everywhere right now, but none of this really affects our work at the AVA office where we are located next to an experimental farm on the edge of the city.
The new AVA veterinary clinic that we are building is almost finished. and hopefully next week we will start moving some equipment in and getting set up to start offering services.
I have an Afghan-American friend who left for the states yesterday, but who took me for a walk and shopping trip in the city 2 days ago. I bought 10 copies of the English Rosetta Stone computer program for far less than the $500 it costs in the US!

A small dog (18 lbs) showed up with a leg that had been broken for at least a few weeks. It was trying to heal and relatively stable - the dog was actually walking on the leg, but part of the tibia was sticking out from the skin.
I approached it in a way that I would never consider in the US, - anesthetized the dog, cut off the exposed bone, and left everything else alone. So far so good, and if it all works out, it will be a lesson in helping Mother Nature by sometimes doing less rather than more.

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4/10/2009 Jen
I'm a highschool senior looking to be a vet. When I decided to be such I knew that I also wanted to be able to help people and their pets around the world. I was not sure if that was even going to be possible, after reading this article i'm so excited to know that I can follow my dream!

   
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