The Blue Vet Diary

It was 3 o’clock in the morning just North of Skopje, when the door to the compartment was pulled open and my girlfriend and I, together with an American couple, were told to step outside immediately.

Still half asleep we looked at each other when one of the police officers jumped onto the seats of the railway carriage and produced a long screwdriver. Within minutes the ceiling of the compartment was disembled and realising what was happening, I wispered to my partner, that we would be in for the Grandmother of all troubles if someone had planted anything there….

A few minutes later and after thankfully nothing had been found, we were again allowed to return to our seats and without a word of apology the officials left, heading for their next unsuspecting victims….

Hard to believe that this is now nearly 40 (!) years ago and at that time I had just finished my first year at vet school. Together with my Norwegian girlfriend I had hitchhiked from Hanover to Salzburg, where we boarded a train, that was carrying us over the following 36 hours from the North of Austria through Yugoslavia to Athens. The train ride was all but comfortable and the rudeness of the Yugoslav police and border guards was not only a nuisance, but the knowledge that we would also have to return that way, hung then like a dark cloud over our heads while we were spending our holidays in the sun on the beaches of Paros and Antiparos.

Once again I am standing in the center of Belgrade – not only my university course, but also a few decades of work are behind me, my then girl friend is now a respected lecturer in animal welfare at the vet school of her native Oslo, the state of Yugoslavia has ceased to exist and has been replaced by a handful of smaller, independent nations and somewhat disappointingly, there is no longer a train allowing this form of travelling….

There is apparently a night train that connects Belgrade with Thessaloniki, but if at all, it only operates during the summer months and as it is just the first day of May, I have come too early.

The views from the train journey have remained with me though and my plan is, over the following weeks, to learn more about the people of the Balkan, to walk across their mountains, to eat their food, to drink coffee, wine and raki, to listen and to talk.

I want to visit my friends and colleagues here and – hopefully – make a few new ones.

If all is going well, my route will take me from Belgrade to Thessaloniki in Macedonia, to Ioannina and the Pindos mountains, then through the whole of Albania and pass Tirana to the mountains in the North. From there I hope to cross into Montenegro, visit Dubrovnik on the Southern tip of Croatia, before heading North into Bosnia Herzegovina to travel pass Mostar and Sarajevo back to Belgrade.

Without access to a train, but being determined to cover the distance by land, the even more uncomfortable alternative of an overnight bus journey is the second best option…..

Having reduced my necessary belongings for the next month to whatever fits into a backpack, that can be carried with not too much effort over mountains, I am finding myself in the not very inviting surroundings of Belgrade’s central bus terminal and after an involuntary tour of pretty much the whole site, I arrive just in time at platform 5 where my international carrier turns out to be a somewhat worn mini bus that looks as if it had a former life as a busy airport shuttle. Slowly I am starting to understand the puzzlement in the faces of my Serbian friends, when I told them what I was planning to do and their subsequent question why I wasn’t flying….

Well, now it is too late anyway to turn and I enter the nightbus to Thessaloniki….

What follows is certainly not the most comfortable night I had in my life, but despite us covering over 600 kilometers and two border crossings in just under 11 hours, it doesn’t involve unfriendly border guards and thankfully no screwdrivers or any other household tools get involved.

At just before 6 am the next morning I am sitting down in a small cafeneon in Thessaloniki and order my first Greek coffee on this new adventure……

There are seven guitars hanging off the wall in Alistair’s living room and a couple of microphones are lying on the breakfast table – signs of a monastic life dedicated to music and lyrics…..

Born and bred just around the corner and living here ever since, Alistair is my perfect host in Manchester, this archetypal English city in the North, which – after so many years on the island – I am now visiting for the first time.

With its city center, where the wrought iron fenced facades tell of previous riches and of its now uncomfortable colonial history, where modern coffee chains mingle with addresses like Canada or India House. A place which features large deprived areas and yet not one but even two of the World’s most famous (and expensive) football clubs with the eternal rival – Liverpool – just a stone throw away towards the East.

Having for a few days updated myself on the newest ideas in veterinary care at the grand location of the converted Victorian Central Railway Station, my focus is now on checking out the local music club scene and for this I decided Alistair couldn’t be better suited.

Staying for another night and following his advice I am setting out late on Saturday evening, strolling through the densely populated city center towards a small Jazz club in the Northern Quarter.

Walking along the old canal, passing Gay Village, I am approached by the towering figure of a guy in drag with a faux fur coat and on 14 inch stiletto heels, trying to usher me into one of the local bars. I have to smile and decline politely, but while carrying on with my walk, I can’t help feeling like a fly that just had a close encounter with a praying mantis…..

A few minutes later I am entering the already packed Matt & Phredd’s Jazz Club and after finding myself somewhat lost in the crowd, nursing my first Cuba Libre of a few that night, I notice that a chair just next to the stage appears to be still vacant.

Utilizing my German genes, I am seizing it (even without having a towel….) and luckily only a couple of hours later I become aware of a “Reserved” sign on which I have been sitting the whole evening…..

At that point however it didn’t matter anymore…

Shortly after my arrival, Terri Shaltiel and her band are entering the stage and the audience is being treated to a great fusion of soul, blues and R n B. A bit of Amy Winehouse, a bit of Aretha Franklin and of Gladys Knight with some impressive instrumental solos adding to the mix.

In the breaks, while sharing drinks with Bolee, the bass guitarist, I am once again reminded how small the world is, when it turns out that he had served in the British Army in both Hanover and Paderborn, exactly at the same time when I was studying there veterinary medicine and when I started with my first job mainly treating farming animals.

Time for another drink and for more “Sweet Things” by Terri Shaltiel….

There are these irritating first five minutes that are hurting when going for a run in the morning. The whole body has to follow the mind, accepting that from a state of total rest and immobility all systems have to be activated to reach three times the previous heart rate, to adapt the body to the cold and to move in a fast and balanced way.

It is 6.00 am at the beginning of December and while stepping out of the quirky surroundings of Mama Shelter, my home in France for a few days, I am reminding myself that I am not really an early morning runner, but if you want to experience a still sleeping city this way, you need to bite the bullet…..

Following a brief uphill section towards Notre Dame Du Mont, the road descends towards the habour where the sea food venders are busy setting up their stalls. At this time of the day there are hardly any cars on the roads and I am able to run along the waterfront of Quai de Rive Neuve towards Parc Emile Duclaux where I was fortunate enough to enjoy a reception together with my French colleagues in the glamorous Palais du Pharo the previous night.

Built by Napoleon III in the middle of the 19th century and towering over the entrance of the habour, it gives this rough Mediterranean seafarer city a more respectable front.

Turning South here, with my body now fully awake, I am faced with the main challenge for this run: finding a route uphill to the Basilica of Notre Dame de la Garde before sunrise.

Despite it is overtowering the whole city and the surrounding countryside, I am finding it surprisingly difficult to see this landmark among the narrow streets of the 7th arrondissement. Several times I am stranded in some dead end roads adding to the mileage of my morning run.

Eventually my system of moving in roughly the right direction and using all roads leading uphill, pays off and I find a small pass heading directly to this beautiful church.

There are just a few minutes to spare before the sun is rising behind the mountains in the East, covering the whole city into a warm orange glow.

This spectacle only lasts a few minutes, which is perfect as my body is now cooling fast and I am starting to head downhill through the streets and staircases of the 6th arrondissement

towards the column of Place Castellane, which featured in Conrad’s now over a hundred year old and so fittingly named novel “The Arrow of Gold”.

No time though for me to sit down and read, but instead to give it a final push uphill for a warm shower and a hard earned breakfast at Mama Shelter.

Rashid’s Lexus had just left Dubai’s alley of skyscrapers and while the silently running air conditioning was keeping an ambient temperature inside the car, we were driving through the desert with the blue water of the Persian Gulf on our right side.

About 100 km South of us in Abu Dhabi I was planning to visit someone I had secretly followed for many years and we had finally arranged to meet….

After about an hours drive the car was coming to a hold infront of a sizable building in the suburb of Khalifa City and from the stifling heat outside, I am stepping into the airconditioned waiting room of the German Veterinary Clinic both established and managed by Katrin Jahn.

About 15 years ago this petite blond women, who like me had a mixed British/German professional background, had turned her back on Europe and after a short period of working as an assistant in the region, had decided to open her own clinic in the outskirts of this desert city.

I remembered reading an article about Katrin and her clinic in a veterinary journal some years ago and I immediately thought that one day I would have to visiting this adventurous colleague and her team. The conference in Dubai finally gave me the opportunity….

While I was stitching up injured pads on a rainy afternoon in Virginia Water, Katrin was neutering cats in sunny Abu Dhabi. While I was concerned about the heating of my clinic in the winter, Katrin was concerned about her airconditioning. While I was advising families which were moving to the Middle East about the dangers of heat stroke and dehydration, Katrin was advising families that were moving to the UK about import requirements and the importance of pet insurance cover.

At the entrance door of the clinic I had noticed an “Investor in People” plaque, a “Cat Friendly Gold Standard” Award and a “Fear Free Practitioner” sign and this is immediately backed up by the welcoming and at the same time very clean and professional looking interior that indicates a strong commitment to customer care and a dedicated and organised team.

Despite being very busy, Katrin – with an inviting smile – takes herself a lot of time showing her foreign (for her actually not so foreign…) visitor around:

The clinic has well lit but functional consulting rooms. A comfortable mat on the floor indicates that a lot of examinations and treatments are performed on the ground to reduce patients’ anxiety. Treats are readily available in all rooms to make the visit to the clinic especially for stressed dogs as enjoyable as possible.

For cats there is a dedicated waiting area and the cat boarding room has been fitted with self designed, noise reducing cages with both climbing and hiding opportunities.

The clinic has its own laboratory and to the rear a dedicated animal behaviour and training unit.

The whole setup including the shining, beautifully tiled flooring gives the impression as if standing in an elegant German small animal clinic somewhere in Munich or Stuttgart on a nice summer’s day.

Despite being a foreigner, Katrin has managed to established and to grow her business from scratch. Unsurprisingly the clinic has proven to be very popular especially with Abu Dhabi’s expat community and not less than 60% of the patients are cats. Consultations are frequently performed – with the support of the whole team – in multiple languages.

Like her own personal history, Katrin’s team has a very international background and it is not difficult to appreciate that working here certainly has a strong appeal.

To stay up to date with recent professional developments and with new treatment ideas, Katrin is a frequent visitor of international veterinary conferences and of online courses.

Being very impressed with that what I have seen, I leave Katrin with her patients and we are heading back to Dubai.

While looking through the car window, leaving the well attended houses of Khalifa City behind us, I summarized that despite the geographical distance and the cultural differences of the places where we worked, there were so many similarities between Katrin’s clinic in Abu Dhabi and my small place in Surrey, with just one difference: whatever I had done in Virginia Water, Katrin had done just one level better in the Middle East….

(or when the fine line between architecture and jewellery becomes blured……..)

Entering the center of Dubai coming from the international airport, you can’t fail to notice a structure that appears to originate from out of this world and that resembles more an alien spaceship or an oversized piece of beautifully crafted jewellery, rather than a building.

I am a great lover of the outdoors and I feel more at home in the mountains or in a small cottage at the seaside than in an urban environment. I am also of the firm belief that nothing man-made can rival the beauty of nature. However, having seen the cathedral of Mont Saint-Michelle in Normandy or the Messner Mountain Museum at the Plan de Corones in Northern Italy, I appreciate that the margins can be very slim…..

I – admittedly – had not prepared myself for Dubai and I only learned while standing infront of this object that I was looking at one of the Emirate’s newest attractions : The Museum of the Future !

While still admiring the beautifully crafted, rounded outside of this ring shaped structure that was covered in long lines of arabic calligraphy two thoughts crossed my mind:

The first was that thanks to Vassiliki’s generosity an entrance ticket for this attraction was actually in my luggage as part of my speaker’s pack.

The other had to do with another innovative and disruptive woman who I deeply admire and who I always imagine to have been the ultimate nightmare for builders and for structural engineers around the world: Zaha Hadid.

This stellar figure of global architecture was a great champion of organic forms in all her designs and to realise her ideas she constantly put computer programs and new construction materials to their absolute limits. Ikonic buildings like the London Olympic Aquatics Centre, the Guggenheim Museum in Vilnius, the Bergisel Ski Jump Tower in Innsbruck or the above mentioned mountain museum in the Dolomites were the results.

The unique design of this beautiful structure is however credited to Shaun Killa, but without being an expert on these matters I wouldn’t be surprised if Zaha Hadid – who passed away far too early – had at some point an influence on Shaun and his team.

Stepping into the building a couple of days later, I was immediatedly struck by the brightness of the light that was entering the huge hall from all sides through the beautifully crafted letters of a poem by Dubai’s ruler Sheik Mohammed.

The eyes are struggling to find any straight lines here with the walls, the staircases and even the elevator shafts resembling natural curves.

Bullet shaped capsules are transporting visitors to the different floors and a couple of huge helium filled silver dolphines are effortlessly floating through the hall and the individual corridores.

The organised tour through the complex, which is starting with a simulated journey into space is – I find – then struggling to match the uniqueness of the building itself, but possibly with one exception: the genetic bank.

As in a vision from a Stanislav Lem novel one enters a darkened room where small glass vials with colourful hollograms of all living and extinct creatures are suspended from an invisible ceiling and the seemingly infinite columns of floating spots of light in this room leaves you with both an idea of the complexity of the biodiversity on our planet and at the same time with a feeling of dread that genetic storage facilities like these might indeed become a necessity in the not so far future.

“Wolfgang, you have to come to Dubai !”

Sitting at a table at the historic fortress of Vysehrad overlooking Prague last June and looking into the dark eyes of Vassiliki Stathopoulou, one of Europe’s foremost veterinary gastro-enterologists and daughter of a Greek business man, I realised that resistance was futile……

Six months later, just 36 hours after my return from Latin America, I was standing on the tarmac of Dubai International Airport at the Persian Golf – a place that had so completely not been on my personal list of places to visit and yet, here I was enjoying comfortable dry 25C at 7 o’clock in the morning at the end of November.

Vassiliki truly was a women on a mission and this one was no trivial undertaking: bringing the first International Companion Animal and – of course – Equine Veterinary Conference to the Middle East.

Achieving this as a foreigner and as a women was even more impressive and I was very happy lending my support as a speaker at this inaugural event, especially as I had been asked to give a presentation on one of my favourite subjects: Professional Collegiality and the Global Veterinary Family.

This wasn’t too difficult as my mind was still full of so many fond memories of the times I had spent with many – for me – previously unknown collegues in South America over the past few weeks. In many cases their trust and their hospitality had been very humbling.

As it turned out, Dubai and the 1st Middle Eastern and African Veterinary Conference would not be any different.

Once adjusting to the futuristic skyline and to the splendour of some of the buildings,

I found myself again in the company of colleagues from all over the world meeting one another regardless of their religion, their nationality or their political orientation, unified just by the desire to learn and to become better in the work we are doing. The only difference here was that the delegates from Lima which mainly came from the Americas were now replaced by a genuine mixture of Europeans, Africans, Asians and by colleagues from the Middle East.

The people might have been different but the engagement with new technology like artifical patients to practice venipuncture procedures at the exhibition or their interaction with the speakers was not only the same but possible even more intense, considering that it was the first time that something like this had found its way to the Middle East.

The Emirates are certainly not short of funds (especially at the moment with sky high global oil prices), but good resources do not necessarily translate into good skills and certainly not into ethics.

As much as I admire the fast progress this part of the world has made in so many fields over the last two decades, one can not overlook that the human factor and the enjoyment of life with an element of reasonable restraint mighty at times appear forgotten. Excusions into the desert these days are no longer done on camel back but in Paris-Dakar style with highly powered, tyre pressure reduced SUVs…..

Even more encouraging than, that issues like responsible breeding, lifelong learning and collegiality were here addressed as part of the scientific programme right from the start.

As with all new ideas, it is not important that the first step is big, but it has to go into the right direction.

Sitting one evening during my stay in the desert at night and sharing a traditional meal with new friends from yet another corner of the world, I felt very grateful for having been part of this new project and I hope that Vassiliki’s vision will see many happy returns…..

It doesn’t happen very often in these days of conveyor belt serving multinational coffee chains that people are happy to queue in front of a cafe and wait for the best part of an hour before claiming their seat.

This however is not an uncommon sight at 825 Avenida de Mayo in Buenos Aires where coffee (and art and literature) lovers from all over the world want to walk in the foot steps of Albert Einstein and Frederico Garcia Lorca to enjoy the hospitality at Cafe Tortoni.

This Argentinian cultural institution is a manifestation of the close link the city has to Paris and to Mediterranian Europe. Established by a French immigrant in the middle of the 19th century, inspired by a similar cafe on the Boulevard des Italiens in Paris, the establishment became fast a magnet for writers, artists and tango dancers in the Argentinian capital.

Following a entertaining chat with two British travellers in the queue who – as it turned out – lived not more than 10 miles away from my house in Surrey, I was finally guided to my table in this timeless temple of Art Noveau, of busy waiters, of continental pastries and artisan coffee.

Just a few days ago I had finished reading Paul Theroux’s “Old Patagonian Express” and the account of his time in Buenos Aires when he was enjoying the cafes and restaurants of the city with Jorge Luis Borges as his tour guide.

As Borges was apparently a very frequent visitor here – as indicated by a wax model (of not quite Madame Tussauds’ standard) in a corner of the cafe – I was wondering if they might have ended up at one of these tables as well ?…..

If so, they must have made an odd couple with the blind spiritual leader of a whole nation guiding one of the world’s most famous – yet surprisingly negative – travelwriter through the best restaurants in town while jousting constantly with their extensive knowledge of but differing opinions on central figures of world literature.

While the main hall of Cafe Tortoni was exclusively frequented by foreign tourists (like myself….), the side rooms and the basement continue to be the setting for readings, intellectual gatherings and both jazz and tango events.

No such things today though, so that I am left just with my imaginations while enjoying the grande surroundings, one of my final coffees in Argentina and a somewhat average Tiramisu which I recall to be much better on the other side of the big pond…..

In front of me, on a blue table top, I am looking at a syringe, three vials of local anaesthetic and the skull of a dog……

Sucking gently through a silver bombilla on his maté, Juan Jose Krauss, the man who introduced veterinary dentistry to Argentina and in fact to many other countries in Latin America as well, is giving me a private lesson on facial nerve blocks.

The final stop of my journey through South America had brought me to Buenos Aires, where I had to grasp the opportunity to pay the great man a visit at his small and intimate clinic which he shares with Guille Manigot – another big name in Latin American veterinary medicine – who sees dermatology referral cases in the room next door. Both Guille and Juan Jose have shared their knowledge with countless veterinary students and colleagues for decades and they have contributed to global treatment guidelines which have transformed the way companion animal care is provided today around the world.

The day had started with me getting lost on my morning run through the large nature reserve which is separating the centre of Argentina’s capital and the Rio Plata. Not only was the park more sizeable than I thought, I was also distracted by several encounters with a creature that I had seen a few times in my own practice – the Argentinian Tegu.

These more than half a meter long lizzards live happily in their burrows in close proximity to the busy town centre and they considered me a real nuisance disrupting their sun bathing sessions which are usually held in the middle of the jungle path.

The subtropical park, the wildlife, the huge city just a stone throw away and this all near a busy shipping lane – it all reminded me of the nature reserve near the Marina Sands Complex in Singapore where the Rio Plata was replaced by the Strait of Malacca.

Just in time and with burning muscles I had arrived back at my hotel near the Peace Palace which very fittingly was located next to the National Museum of Arms.

Juan Jose had very kindly collected me from there and following a brief sight seeing journey through the center of Buenos Aires, we had ended up in his clinic, discussing injection techniques and the benefits of different local anaesthetics while my host was enjoying his herbal infusion.

In commercial terms veterinary medicine in Argentinia continues to be very poorly funded with – according to Juan Jose – a consultation at the local vet costing not more that 10 $ even in the capital.

Both Juan Jose and Guille have managed though to find their niche, living reasonably comfortable just from their knowledge and their person skills with a decent work – life balance, without the need for a lot of staff or equipment, leaving in the surgery fridge enough space for a few bottles of excellent Argentinian Cava to be able to celebrate from time to time a treatment success in style.

With a lot of thought given these days to complex ideas on how to reduce stress and anxiety levels in a progressively corporate working environment, we might overlook how with much simpler means this can be achieved as well.

It was easy to see that the little clinic of my friends in Buenos Aires is a business with a soul where local pets will find excellent treatment and care, but I wondered if anyone in this beautiful city would be able to carry on with Guille and Juan Jose’s work in the same way.

When saying goodbye I considered myself again lucky for having had a further opportunity to visit a magical veterinary location at the other end of the world……

Oh the wind, the relentless wind of El Chalten!…..

If I talk about wind, then I mean the sort of wind like you haven’t witnessed it before: constant, gusting, merciless, unforgiving wind that knocks you off your feet, wind that after a while becomes irritating. Wind that can make a fairly undemanding hike in the Andes a dangerous undertaking.

El Chalten is a small village in the Southern Andes, circa 200 miles North from Puerto Natales.

To get there I first had to cross the border into Argentina where – I have to admit – the very public and frequent reminders that “The Malvinas are Argentinian!” made me for the first time slightly uncomfortable travelling with a British passport.

About 100 miles behind the border I reached the regional center of El Calafate, which is located on the shores of the huge Lago Argentino which is supplied year round by the ice and melt waters of the Parque Nacional Los Glaciares in the West.

Changing buses here, I took the epic “Ruta 40” further North, towards the equally large and cold Lago Viedma, before turning West towards the mountains. For this journey I was lucky to get a front seat on the upper level of a double decker coach, which was providing me with a perfect panoramic view.

In this arid landscape virtualy devoid of any but the hardiest vegetation , with hardly any human settlements and just the cadavers of some unfortunate guanacos in the fence alongside the straight, endless road telling a tale of an most unpleasant death, my heart went out to the first brave people who tried to cross this land on foot or on horse back.

Sitting on my front row lounge seat sheltered from the elements like the pilot of a low flying plane, I felt a bit like a fraud enjoying the unforgiving countryside around we with the snowcapped mountains on the horizon.

It was just before sunset when I arrived in El Chalten and I had to fight my way against the wind along the highstreet towards my next residence – an individually designed and lovingly constructed tiny house which was condensing a living room, a kitchen, a bathroom and a double bed – all of comfortable size – on not more than 8 sqm. Possibly a bit tight for a family but perfect for me. Despite its lightweight construction I was also pleasantly surprised how little it appeared to be affected by the constant storm outside…..

Why is ElChalten such a windy place?

If you take a look at the map, you appreciate that the whole of Patagonia is wedged between the cold current on the Pacific side and the warmer current on the Atlantic side. The further South you go, the more likely it is that these temperature differences will result in strong wind and in storms. Cap Horn has been and still is feared because of this by seafarers from around the world.

To add to this El Chalten is located right next to a giant freezer – the Glacier National Park – which features one of the largest continental areas covered by a thick layer of ice outside Antarctica. Just imagine a slightly opened fridge door in the heat of the summer and the draft the temperature difference will create.

Further more El Chalten is located at the end of a long valley with a nearly perfect North-South orientation with any wind been funneled through the small gap between the mountains towards Lago Viedma in the South.

With this exposed position, El Chalten is not only one of the windiest places but also one of the coldest places in Argentina. While during my stay the temperatures hardly reached double figures, Buenos Aires was enjoying more enjoyable 25 C…..

So why then travelling to this cold and windy place ?……

The answer was given the next day when I set out after breakfast hiking West towards the mountains to another unforgettable sight in the Patagonian Andes: the Laguna Torres – an icy lake littered with floats and small ice bergs from the decaying edge of the vast ice field at the other end of the lake.

I don’t know what it is, but the sight of millenia old lumps of glacial ice in the water never ceases to fascinate me and as it appeared also several dozens of fellow hikers……

This trip was followed the next day with a long hike to the main highlight of the region – the Argentinian answer to the Torres del Paine : the towering peaks of Mt Fitzroy.

Named after the captain of HMS Beagle who had travelled up the Santa Cruz River in 1834, the sheer beauty of this mountain is attracting every year thousands of hikers from all corners of the world.

I was extremely lucky that once again the weather was outstanding (which is not very often the case…..) allowing a perfect view of the whole mountain, which is the gate keeper of the huge glaciers towards the Pacific side of South America.

As beautiful as the view was at the foothills of this giant, as brutal was the wind up here, forcing every visitor behind even the smallest rock for shelter and making any extended stay all but impossible. Standing here (or trying to…..) I was not surprised to learn at it took until 1952 (just a year before the climbing of Mt Everest) before a fearless team of French climbers had manage to summit this iconic mountain.

At sun set, exhausted, but with another wonderful memory in my luggage I stumbled back into my tiny house, now satisfied and ready to continue with my journey further North.

Returning from my hiking trip in the Torres del Paine National Park, I am once again strolling pass the World’s End Bar in Puerto Natales and notice that the dog with the suspected ruptured cruciate ligament hasn’t made a lot of progress.

Spending most of the day lying in front of the Bar and checking who is passing by is now his main occupation, but when getting up, he is still displaying an obvious limp and running is out of the question.

I had noticed in Puerto Natales a considerable number of – mainly long haired (because of the weather in the winter) – homeless or semi-homeless dogs. I make this distinction, as there appeared to be a grey zone with dogs which didn’t seem to have a specific owner, but which remained just in one street and which benefited from comfortable dog houses or other means of shelter that had been arranged by animal lovers in the local community.

All these dog appeared to be reasonably well fed and socialised and most of them seemed to belong to a local group of dogs. One of these “street gangs” appeared to have taken residence in front of the “Wild” Cafe which featured not only their resident canine who was the proud owner of his personal spot inside the building near the bar

but also this group of dogs which were sleeping both underneath or on the chairs infront of the establishment. There wasn’t a better place I thought for a veterinarian to have a coffee….

The usual comings and goings in the street didn’t interest the gang too much, but that changed at once with any event that differed from the regular passing of just cars or pedestrians.

This included motorcyles, cars with faulty exhausts and tuned engines or the appearance of a dog that didn’t belong to their patch, including dogs inside passing cars. From a state of near comatous sleep the whole pack would immediately jump into action to investigate, challenge and then ideally chase off whatever had dared to disturbe the peace in their neighbourhood.

Thankfully this paroxysms involve just barking and some chasing – I never witnessed a physical attack. Even with passing dogs this often meant that the dog in question was challenged, investigated and – if the other dog was reasonably confident and didn’t try to intimidate the pack – finally allowed to pass or to retreat.

However, within seconds the street could be full with half a dozen of dogs and it was just a matter of time that this would go wrong…..

A fair number of the dogs showed some forms of gait abnormalities with some dogs virtually running on three legs all the time. Most of these injuries were surely caused by an encounter with a passing car.

Again it was time to visit a local colleague……

Just a few blocks away I had noticed a green bungalow that turned out to be one of the local veterinary practices and as before I turned up unannounced…….

Following a short wait in the busy reception area, I was greeted by the friendly face of Maria Jesus Garrido Bauerle who spoke an excellent English which made the conversation so much easier.

Maria had set up this small practice just a few years ago in the house of her mother and she was running it with three other colleagues.

Without any hesitation I was given a tour of the place and a few minutes later I found myself in the operating theatre helping to sedate a feline patient with a cat bite abscess – here in Patagonia as well a very common injury.

While the cat was falling asleep, Maria talked about her difficulties to obtain some basic medication and of their often prohibitive cost. For the sedation of the cat we had used a combination of Xylazin and Ketamin – something that came out of fashion over thirty years ago in the UK , but something that still continues to be popular in some veterinary practices in Continental Europe as well. Dexmedetomidine, a much better choice, which can be reversed with Atipam, was a drug Maria and her colleagues were aware of, but according to Maria the sourcing was a real challenge.

Here I was…being directly confronted with some of the global problems of my profession which I had debated with my colleagues in Lima just a couple of weeks ago: stray dogs and the access to basic veterinary medication. Yet these had never been problems of any great concern in my own practice (stray dogs were nearly always collected by their owners within a matter of hours and supply shortages of veterinary medication were rarely an issue. If so, these were in most cases limited to newly launched medicines that had turned out to be much better than anything else that had been used so far). Despite the fact that Chile isn’t a third world country and Puerto Natales didn’t seem to be the poorest place in Patagonia, my colleagues were struggling with these issues on a daily basis.

The price for a standard consultation in Maria’s practice was circa 20 $, but none of her patients was insured and spending money on pets wasn’t very high on the agenda of the people here. This was apparently even worse on the countryside.

Unfortunately it had some serious consequences:

In an economy traditionally based on sheep farming and with dogs that were not regularly vaccinated and treated against parasites, Eccinococcosis, an infection with a special kind of tape worm, is a huge problem. The parasite can affect humans, especially children. As an intermediate host for the parasite, infected people develop cysts in the liver, the lungs or even in the brain or occasionally in the eyes with severe and debilitating symptoms and occasionally with a fatal outcome. In some parts of South America according to the WHO the prevalence level is as high as 5-10% in humans and up to 95% in slaughtered animals….

Maria and her colleagues are going to great length to inform pet owners about this, but encouraging regular preventative treatment and good hygiene remains an uphill struggle.

Somewhat better is the situation with rabies, another serious zoonotic disease. Although not completely unheard of, according to Maria they haven’t seen a case for many years now.

Maria’s resources were limited though and when I arrived at the practice, another dog was driven off with a splinted leg as it was fractured but an operation for this condition was only possible in Punta Arenas which was over a 2 hour’s drive away.

I saw some similarities with the working conditions I had found at the other side of the world in the polar regions of Sweden and Norway where pet owners had to decide between many hours of travelling or surgery performed under not ideal conditions because of a lack of equipment or skill (or both) or even the hard choice to have a dog or a cat put to sleep as no feasable alternatives could be provided.

Despite not having an anaesthetic machine, X-Ray or ultrasound facilities, Maria and her team remained upbeat and provided the best service possible under these circumstances.

Once again I could witness what difference the internet had made to my colleagues in these remote parts of the world: continuing education of very good quality was provided in the form of online lectures and the local colleagues – despite living hundreds of kilometers apart from another – were helping each other at least with much appreciated advice. If this was not enough to help a patient, vets were reaching out to specialists at the nearly thirty vet schools in Chile or at clinics in the metropolitan areas of Latin America or in Spain.

This was unfortunately of only limited use for the street dogs of Puerto Natales: without owners or well funded charities in this remote corner of the world, treatment – if any – was confined to some short term pain relief courtesy of the local veterinary practices or – in the worst cases – just euthanasia.