The Blue Vet Diary

It was the beginning of the summer, I was back in Switzerland and this time I was in love…

It was a clear case of “Love at first sight”, if this term can be applied to a veterinary clinic or to a place of work in general.

By now, I have had a number of opportunities of working at this clinic, which, after having seen and visited a large variety of veterinary establishments over the previous five years, is in my eyes getting very close to being “perfect” for me.

Let me explain….

Getting there for the first time, wasn’t that easy: Driving South from the Eastern shores of Lake Constance, I had to follow the juvenile Rhine, which is separating Austria from Switzerland, nearly all the way to the principality of Liechtenstein, a place of just below 40 000 inhabitants, signified mostly by expensive cars with unusual number plates and by one of the highest per capita incomes in Europe.

Just before crossing the invisible border into its capital Vaduz, I had to take a sharp right turn and followed the road, that was now climbing steeply into the mountains on the Swiss side. The Diesel engine of my old BMW was put to its physical limits along sheer endless serpentines and as the Rhine Valley disappeared slowly underneath a layer of clouds, I finally arrived at the small ski resort of Wildhaus, at just above 3500 ft. From here the road led through a number of high alpine plateaus, with the “ Churfirsten”, a ragged chain of mountain peaks, that resemble a row of shark teeth, to my left

and the towering summit of the Säntis mountain to the right. What I had entered, was the Toggenburg region, home to a thriving farming community where cows, sheep and goats outnumber the human population, where the main reason for road blocks are herds of livestock, being moved by men and women in traditional costumes from one pasture to another,

and where SUVs gather in the morning not at petrol stations to fill up with fuel, but instead at the local dairies, to offload their yield of the previous night’s milking sessions,

to produce the world famous Appenzeller cheese.

Here, surrounded by a landscape of mind-blowing natural beauty, just outside of the small village of Nesslau, Carla and Dani Leutenegger, a local veterinary couple, realised some years ago their dream: to build a meticulously designed veterinary clinic together with boarding kennels and a cattery right next door.

Although no longer owned by these amazing colleagues, the place still bears their handwriting in every tiny detail, all based on decades of professional experience paired with the ingrained Swiss love for tidiness and precision.

Nothing at this clinic was at its place by coincidence. Every piece of equipment, the fittings, the furniture and even the quintessential Swiss coffee machine were all of the best quality and a delight to operate or to work with. No expenses had been spared for the benefit of the patients, but also for the people who are working here.  Everything was labelled and there was a clear and obvious system in each draw and in every cup board.

The well lid consulting rooms were clear cut, spacious, very clean and uncluttered.

For dogs and for cats there was a separate waiting room area and individual inpatient facilities. The place featured not only a couple of operating theatres, but also a lot of diagnostic tools, as well as a CT.

At many occasions I caught myself thinking : “Oh, that’s the way we should have done it at my clinic in Surrey.” or “I wish, I would have had this hand tool or this machine…..”

The pleasure I took in the working facilities was matched by that for the Swiss and Croatian team that welcomed me. Always friendly, always polite, competent and always happy to help, especially when this involved translating for me frequently the challenging Swiss accent of our clients.

While living at the clinic, I could take Mia, my trusted Vizsla, for morning runs on the foot path along the Thurgau creek, that was running with its clear water through the freshly cut fields, just a stone throw away from the building.

In the evenings after the last patients had left the clinic, I could put on my hiking boots to explore together with my lucky canine companion the well signed trails of the Stockberg, the mountain I could see during the whole day from my consulting room window. Behind the building the more remote Ijental was waiting,

as was the Schwägalp on the other side of the village, just a short drive away.  Here one had access to the Säntis, a mountain of more than 8000 ft altitude and to the whole Alpstein massif.  

 

One morning, while sitting on the roof terrace of my new found veterinary Nirvana, enjoying my archetypal Bircher Muesli and the serene landscape around me, I, not for the first time, realised how hard and full of deprivation the life as a travelling veterinarian was….

There was no point to scream, as there was no escaping from it anyway…

With some surprise I realised, how many nerve endings could be found on the surface of a human body, while several layers of my skin were removed by a bearded stranger I had never seen before. I just tried to dig my nails deeper into the marble slap underneath me, while wondering what pain relief I might employ, once this unexpected assault had finished ……

“Go to No 5!” was what Irakli, the Georgian film director I was staying with, had replied to my question, where to go to experience one of the most intense sensations travellers have enjoyed for centuries when visiting Tbilisi.

We had been sitting on the landing of “SkadaVeli”, his unassuming, somewhat dilapidated house, right in the centre of the Old Town of Georgia’s capital. Despite its not very appealing outside, his place was a hidden gem with surprisingly modern rooms and a spotless bathroom and kitchen, which usually featured a good bottle of Saperavi. Here, one was in easy walking distance of the city’s beautiful churches and the cathedral, of the best cafes and restaurants, of the futuristic Bridge of Peace, which like a shiny reptile spans the dark water of the Kura river and just a stone throw away from the quirky clock tower in Ioane Shavteli Street.

Irakli was a well of knowledge when it came to Tbilisi, his city, and I was happy to follow his recommendation for a final excursion into the subterranean life of the Abanotubani district, before leaving Georgia.

Abanotubani is home to a dozen bath houses, all connected to the hot sulphur springs, which  are emerging here from the ground. Their 40 degree warm water is running through a small stretch of land before disappearing into the nearby river. The hot springs had given the city its name and many visitors like the great Russian poet Pushkin have written about the memorable experience and about the health benefits of visiting the local bath houses:

Today’s bath houses vary greatly in design and in comfort and it is possible to book both private rooms or to visit the public areas which are gender separated.

I was travelling alone and to get a more genuine impression how the locals were using their bath houses, Irakli had suggested to visit one of the two public bath houses.

Less than an hour later, I was standing in-front of “Public Bath No.5” – an institution in Tbilisi, with a history that is dating back nearly 100 years. Both the hammer and sickle emblem on the front, as well as typical soviet style mosaics in the rooms downstairs confirmed that this was a place more for the local community, rather than the more upmarket and elaborate decorated Orbeliani Bath nearby, which was the preferred choice for foreign visitors.

10 Georgian Lari, equivalent to less than £3, got me inside without the need for a reservation, and a further 2 GEL secured me a cup of tea for the end of my visit.

Once I had placed my clothes into one of the spare lockers, I was issued with a pad lock (without a key) by the supervisor, who looked like an archetypal Caucasian prison guard, wearing above his trousers just an undershirt instead of a uniform. A large ring on the table in front of him, featuring the keys for all the pad locks that had been issued, left no doubt that no one was leaving this place without the consent of this man….  

Dressed with just a towel, I progressed into the main room, where I managed to take a shower once I had found out, how to create an ambient temperature, by operating the different taps protruding from a complicated system of leaking plastic and copper pipes above the shower cubicle.

Next I immersed myself into a pool of boiling hot water which – as I felt – far exceeded the 38-40 C that had been advertised.

Only with a fair amount of will power, I lasted close to 5 minutes in the pool and – before passing out – I felt ready to progress to the main part of the procedure – the “Kisi”.

Red like a lobster and still slightly dizzy, I stumbled over to one of the nearby marble benches, where the Mekise or “Head-Scrubber”, who looked like the angry brother of the supervisor, motioned me to lay down, before setting to work…..

And here, any resemblance to what could have been considered something like a massage, immediately vanished…..

The “Kisi” – as I now found out – is more of a thorough cleaning procedure, where, with the help of a glove, which has a surface similar to the outside of a coconut shell or to an industrial utensil that is commonly used to remove congealed food particles from frying pans, the unexpected and – through the heat of the hot bath – sensitised surface of the skin is mechanically stripped away…..

While the glove was doing the damage, I was wondering, how desperate Pushkin must have been to write poems about this place and that he must have considered the bullet that eventually killed him, as the lesser evil.

When my skin was just a single raw nerve, a bucket of water was poured over what was left of me and my body was lathered with a thick layer of soap, which was then washed off with another bucket of water.

Eventually I was allowed to stagger away from the marble slap and while my place was taken by the next victim, I tried to regain consciousness with the help of a cold shower.

A short while later, I was sitting back in the spartan locker room, with the domed ceiling as the only decorative feature, and while my still shaking hands were holding a small glass of black tea, the prison guard inquired, how I had enjoyed my first stay at a Georgian bath house….

The sun had already set when I re-emerged from the bowels of Bath No 5 and while walking back to the safety of “SkadaVeli”, I was surprised that my body wasn’t in more pain. It was followed by an excellent night’s sleep and when I woke up the next morning, I felt so great, that I am already looking forward to my next visit to Tbilisi and to the bath houses of Abanotubani.

I was in a bad way….for a whole day and  for a couple of nights I had been struggling with abdominal pain and none of the painkillers I had thrown at it, had made much of a difference. Declaring defeat, I had managed to get a last minute flight with a Ukrainian carrier out of Tbilisi and via Kyiv to the UK.

My monosyllabic taxi driver had refused to issue me with a receipt for the cash I had given him for his reckless driving through the unlit suburbs of the Georgian Capital. At least he had dropped me at the airport in time and at that point I just didn’t  had it in me any more to pick a fight over it. Eventually the crowded Tupolev  lifted off the tarmac and we were  heading North over the Caucasus mountains towards Russia, while I was emptying the remaining content of my stomach into the waxed paper bag, that I had found just in time in the back pocket of the seat in front of me……

This was eight years ago and it had been a miserable way to finish my first visit to Georgia. And while a couple of gastric ulcers and a gallstone were telling me, that I had taken on a bit too much by running my own veterinary clinic and at the same time trying to attend a lot of vet meetings all over Europe, I knew that I had to be back to this city and to the colleagues there.

Much had happened in Georgia, when I finally shook hands again with Giorgi and Dato, who had once taken me on an epic road trip across the country and along the unstable border with Azerbaijan to the North of Armenia.

The state of the roads, the speed and the insane overtaking of and by cars still gives me nightmares.

It was a good, not only to seeing them both alive and in good health, but also to learn that Dato had finally disposed of his Mercedes, the deathtrap that had undergone a DIY LPG re-fitt, resulting in a sizeable liquid gas canister placed right behind the rear seats (where I was sitting….).

Several completely burnt out car wracks alongside the road had indicated that this, in combination with a non-existent traffic etiquette, had been a very bad idea….  

This time around with the help of my local colleague and fixer Mariam Chkhikvishvili, I was able not only to reconnect with Dato and Giorgi, but to visit also their places of work.

Giorgi was busy performing a dental procedure on a small dog, when I visited him at Vetlife, a new and well equipped clinic in the city centre.

Providing a 24 hour service for their clients and placed in the ground floor of a multi-storey building, this small hospital employs a number of veterinary specialists, able to see patients in six small consulting rooms with a minimalistic interior design, making them perfect especially for feline consults.

The clinic features both a CR radiology system as well as ultrasound facilities in dedicated rooms. A large preparation area in the centre of the hospital leaves ample space to perform both dental procedures and to get patients ready for surgery in the well equipped operating theatre.

Vetlife is a fairly new set up and the place wasn’t overly busy when I visited.

This was different at Dato’s place, which struck me as a pet owner’s dream and a nurse’s nightmare.

The clinic was heaving with clients, staff and patients, with no defined distinction between the public and the private areas, probably with the exception of the operating area.

Clients clearly loved this busy place and quite a few of them were staying with their pets, while these were receiving their treatment. As Dato was once again busy risking his life on the unpredictable Georgian roads, I was greeted by the always positive and smiling Izi Miminoshvili and by Tamuna Kakubava who was managing the whole place in a calm und controlled way.

As in most urban practices these days, the majority of the patients were cats and smaller breed dogs, plus a not  inconsiderable number of large and sometimes very large guard dogs.

With no own testing and licensing organisation for veterinary medicines established in Georgia, the permission to sell and to use these drugs is mainly based on previous FDA or EMA accreditation. In addition to this, a lot of human medicines are been used on pets in Georgia.

Vaccines are readily available, but often declined by pet owners as being too expensive or considered unnecessary, despite the fact that cases of distemper, parvovirosis and even rabies are not uncommon in this part of the world.

Unsurprisingly vector borne diseases like ehrlichiosis, anaplasmosis and leishmaniasis are a common presentation as well, usually due to the failure of using the prophylactic treatment options available.

The use of monoclonal antibodies for atopic or arthritic patients, as well as any online pet health services have yet to arrive in Georgia. 

Pet health insurance is at the moment not available and clients have to expect to pay between  30-60 Lari (GEL)/ £10-20  for a first opinion consult in Tbilisi and probably less in the countryside.

At Mariam’s clinic I noticed another feature that I had so far just seen at vet schools: an examination room with several consulting  and treatment tables !

Client confidentiality is far less of a concern here and pet owners don’t mind watching another animal receiving treatment on the table next to them or that the treatment of their own pet is being conducted in a semi-public space. The more important issue is, that they are allowed to stay with their pet.

While most clinics didn’t open their doors before a very civil 10 am, the work for most Georgian colleagues is then often relentless, with hardly any time for a break until the doors close at about 6 pm – as always – subject to emergencies…..

Some of the Tbilisi practices offer an out of hours service, but there is no obligation to provide it and there is no centralised organisation of the service.

All clinics I visited were computerised and card payment was the universally accepted way to settle the vet bill.

Getting post graduate training is not easy for my Georgian colleagues. With only a small companion animal veterinary association with less than 100 members at the best of times and with virtually no funding, it is difficult and financially risky to organise continuing education events. The vet schools, of which there are now several, mostly privately run establishments, provide very little companion animal education for qualified vets, so that colleagues have to travel abroad, commonly to Turkey or to Russia, to acquire new skills.

So far there are no corporate veterinary groups in Georgia and clinics are owned by individual owners or by veterinary partnerships. With no training courses available for veterinary nurses, the teams usually consist of vets with different levels of experience and lay staff running the reception and performing unskilled work. Young graduates or final year vet students are often task with nursing duties. 

Unsurprisingly Georgia and especially Tbilisi has over the last two years seen a considerable increase of Russian and Belarusian pet owners. These are met by an similar influx of – predominantly male – veterinarians from these countries. A development that is seen with mixed feeling by the local profession. Some veterinary businesses have integrated the newcomers into their teams, often resulting in English been used as the lingua franca in the clinics, while others are less inclined to offer any employment, seeing them as potential competitors in an already tight market.

Georgia and the Caucasus region as a whole, have always been a meeting point of different cultures, religions and people and its complex geo-political position has had a great influence on the veterinary professional in this region as well. Georgian colleagues like Izi, Mariam, Dato and Giorgi are providing a truly remarkable service to their clients, despite an often challenging working environment and with very limited resources. This has only been possible by remaining responsive and open to changes and to opportunities when they arise and by understanding themselves as members of an international profession with the open sharing of skills and knowledge for the benefit of the patients in their care.

Let’s hope that at my next visit to Tbilisi, they have progressed further on this journey.

Driving along the Georgian Military Highway, leaving behind me the world heritage site of the castle of Ananuri,

and heading North towards the town of Stepantsminda, I had to cross the over 2000m high Jvari Pass, where the green meadows of an Alpine plateau offers an ideal pasture for large herds of sheep.

Crossing the highest point of the pass, it was impossible to ignore the numerous wood fires places and the corresponding “Halal” signs at the side of the road.

Here the local shepherds were offering their fare to hungry travellers.

I personally found the signs, which were indicating that here the sheep were exsanguinated without prior stunning, somewhat off putting, but I appreciated that this was the traditional way of slaughter, that had been practiced in these mountains for hundreds if not for thousands of years and that, if done correctly, the suffering for the animal would be fairly brief (and yet still too long if you looked at it through the eyes of a vegetarian…..). Furthermore, taking a more holistic view, I thought that these animals had probably a far better life, than their cousins in our world of industrialised farming. Rather than being kept in narrow enclosures to grow and being, at the end of their lives, transported over long distances to a slaughterhouse, these sheep were born on these mountains, free to roam under an open sky for most or for all of their lives and then finally killed in a (hopefully) fast and efficient way in familiar surroundings.

When stopping my car and walking up to one of the fireplaces, I realised that I had arrived too early for lunch. A freshly slaughtered carcass was hanging on a hook,

but the fire hadn’t been lid yet.

“Dicid minut ! Ten minutes!” the shepherd shouted in my direction, being uncertain if I was Russian or someone from further afield.

Taking him by his word, it left me with enough time to have a closer look at his dogs….

Not far from the fire place, there was a huge Caucasian Shepherd, which dwarfed the Rottweiler that kept him company.

Both dogs remained relaxed and not overly interested in my presence, but I have to admit that I was relieved that they were kept on a chain and I remained at a safe distance.

The purpose of these dogs, which grow up together with sheep, is to guard, rather than to herd the flock. In this part of the world (and now also in many parts of western Europe), these dog have to stand up to, and to fend off predators like wolfs and bears, for which a domestic sheep or lamb would be an easy catch.

When hiking in the mountains – even worse if you bring along your own dog – you certainly don’t want to come across one of these canine giants near a herd of livestock….

You rather meet a wolf or a bear!….

I didn’t envy my Georgian colleagues, who occasionally have to treat these huge animals.

“ The Rottweiler is useless and the Caucasian is small for his breed.”, the shepherd said in broken English, standing suddenly next to me. It appeared that he had figured out that my Russian wouldn’t get us very far…..

“The meat is ready!” he added, before walking back to the barbeque.

Not even eight minutes had passed and sure enough, a large skewer with big chunks of coarsely cut meat was waiting for me.

A pinch of rock salt was the only seasoning and a large piece of plain breed the only accompaniment.

And yet – it was delicious !

The meat was firm but not chewy, it had a distinct ovine taste, somewhat amplified by the salt, but not adulterated by additional herbs or by a sauce. Eating it with a hunting knife and bare fingers as the only cutlery, under a blue sky, surrounded by Caucasian mountains, certainly enhanced the experience and I couldn’t think of a more fitting dish, when travelling in this part of the world.

Not for the first time, I had to throw common sense over board and break all the rules. I was standing at an altitude of 3200m above sea level at the bottom of the Gergeti glacier in the Georgian part of the Caucasus, not far from the border to Russia, about to do something really stupid….

To get to this place, I had flown at short notice to Tiblisi and had driven across the mountains, before leaving my car near the iconic Holy Trinity Church, which is arguably the most famous motif in the whole of Georgia.

Ascending constantly for 2 hours, I had reached the Arsha Pass at nearly 3000m.

What awaited me here was probably one of the most stunning mountain views I have ever seen:  Mt Kazbeg, towering by a large margin over the surrounding summits, was right ahead of me, but separated by a deep gorge, which had been cut in millions of years by the once giant glacier.

After resting there for a short while and enjoying the view, I had then carried on pass the beautifully located and expertly built Alti Hut. Its more Alpine design had its origin in a cooperation between a Georgian business man and Swiss, German and Czech carpenters and engineers and some considerable EU funding. The wood panelling as well as the vintage posters of well known Swiss ski resorts and mountains on the inside walls of the guest room looked very familiar to me.

   

From here it had been a more gentle incline to the glacier, but walking at this altitude, each step took considerably more time.

Standing at the bottom of the glacier, I recalled the lessons I had learned at a glacier course in Norway many years ago: “Never walk on a glacier on your own. Always rope up. Inform people where you are going and when you are planning to arrive…”. All very sensible points, but all not very practical in my situation and hence all to be ignored…… At least I had the good sense to bring along light crampons and a sturdy hiking pole, which had to make do instead of an ice axe in case that I slipped.

The glacier had to be crossed to reach my place to stay for the night – an old disused Russian weather station, also known as Bethlemi Hut, at 3650 m above sea level, half way up to the summit of Mt Kazbeg, the fabled mountain, which according to legend had been the site where the Titan Prometheus was chained to a rock after stealing the fire from the Olymp to give it to humanity. To make his fate a bit more unpleasant, he was then visited every day by an eagle, which was feeding of his liver…..Being a god himself, this didn’t kill him and he even regrew a new liver over night, but the eagle had the bad habit of returning every day….

This admittedly was the least of my concerns when I started walking up on the solid but very abrasive ice of the glacier, which was covered with rocks and with centuries worth of decaying plant and animal material. Slipping here would have been painful and would probably have resulted in a certain wound infection.

While progressing slowly but with a lot of care, I suddenly heard some steps behind me……a rider with a pack horse was passing me! This was both an unexpected as well as a welcoming sight: if a horse could make it across the glacier, so could I!

And sure enough, following roughly in the track of the horses, I eventually made it safely to the other side.

Climbing here another steep 100 or so meters, I had arrived at the iconic building, which, as I would soon find out, presented me with the two sides of the old Georgia and of travelling in many parts of Eastern Europe in general.

During my research for this adventure, I had come across a number of stunning images of this former meteorological station, which is now used as a mountain refuge and the basecamp for all ascents of Mt Kazbeg.

But what I found was sobering…..

A run down, unheated building, that could easily have featured in a Solzhenitsyn novel. Filthy, unlit corridors, some broken windows and no proper sanitation. The communal area, which was hard to find, was cluttered and uninviting and the whole place was in a state of neglect, which was testament of the absence of a well organised and funded national mountaineering association. This certainly wasn’t the Alpen Verein….

No wonder that most professional tour organisers preferred to let their clients stay in tents around the building, despite the ground been littered with pieces of broken glass, rusting metal and various sorts of rubbish in general.

A small private enterprise had occupied the (also unheated) basement, where they provided some form of hospitality by selling poor food for horrendous prices.

Matters didn’t improve, when I was shown my place for the night….

A damp, also unheated room, where the remnants of cheap soviet style wall paper was peeling of its mouldy base; with four bunk beds, which were thankfully covered with a faux leather lining, that regretfully, after having seen decades of use, was torn in several places.

Welcome to the Gulag…..

On the bunk next to me I found Dimitri, who was just half conscious and trying to find some sleep, after having successfully attempted to summit Mt Kazbeg in the early hours of the morning.

When matter couldn’t deteriorate much further, I decided to find a reception to at least pay for my night’s stay. But then, everything changed….

Down the corridor, there was a single glass door that emitted some warm light and when entering,  my whole body felt the presence of a small wood burner at one end of the room.

Here a group of men were gathered around a table which was laden with bread, cucumbers and tomatoes, cheese and cold meats, while red wine and home made brandy was flowing freely. The lively conversation, that had accompanied the feast, stopped abruptly when I  passed through the door – I had entered the realm of Jonny, the custodian……

Once I had introduced myself, referring to the reservation I had made just the previous day with the help of my Georgian landlady, I was invited to the table to sample some quite remarkable homemade brandy, which was then followed by the insistence to try the bread, the cheese and well pretty much everything on the table.

It soon became clear, that this was the only show in town and there were just two ways to stay in it – by telling some good stories or by contributing to the feast. By being both a vet and a traveller, there was no shortage for the former, while the latter could be organised in form of another bottle of wine from the small restaurant (which unsurprisingly had no guests….).

As the evening drew on, it turned out that over the decades, famous mountaineers like Reinhold Messner or the Russian singer and songwriter Vladimir Vysotsky had been sitting at this table and attended Jonny’s or his predecessors’ court.

Jonny was one of these fascinating individuals who don’t need to travel to meet people or to see the world – the world was coming to him.

Sitting in this small, somewhat cluttered room, adorned with images and memorabilia of friends, mountain guides and personalities of the last 100 years, with pack horse drivers, mountaineers of different nationalities and Georgian guides entering his court at regular intervals, Jonny just had to lean back, chain smoke his thin hand rolled cigarettes, enjoy whatever beverages his visitors had carried in their backpacks or on horse back across the glacier and be entertained.  

With steadily increasing alcohol levels, it then became time for the – at least in this part of the world – inevitable toasts. They included not only absent friends, friendship, the mothers (and women in general) and – on my account – a praise to the Georgians as the Caucasian unifiers, which was – needless to say – well received.

As the evening drew on, Lasha, a bearded mountain of a man, sitting on the other side of the table, got hold of the battered guitar, that had been resting on the floor next to the table, and gave a perfect evening the final touch with some Georgian songs.

Yes, may be I had to climb a mountain for it, but finally I had found it, the famous Georgian hospitality ! 

In the meantime even the sky outside had cleared up and the mountain tops around us appeared in a warm evening glow, so that the whole atmosphere around the Bethlemi Refuge didn’t appear quite as depressing.

The conversation, the smoking, the laughing and the drinking went on well into the night and probably much longer than would have been acceptable in a much more organised refuge, but as I finally settled into my decrepit bunk next to the now snoring Dimitri, I thought to myself that such is the life in the Caucasus – not everything is perfect or working as it should, but this in return leaves room for spontaneity and human warmth, which so often appears to be missing in our over-regulated societies.    

 

The sun had not even risen behind the towering Tomorri mountains far in the East, when I crossed the town square of Berat, Albania’s “White City”.

A small gang of large, but benign stray dogs was happy to see me and a couple of them came running towards me in the hope for some early morning food hand outs.

I had to leave them disappointed though, but at least with some gentle patting behind the ears for their efforts.

Walking along Rruga Antipatrea, I passed the local baker, who enjoyed a cigarette in front of his small shop after finishing to prepare the fresh rolls and croissants for the day.  

Along a narrow cobblestoned alley, just behind the Xhamia Mbret mosque, I headed for Rruga Mihal Komnena, a straight road passing right through rows of old Ottoman houses, which gave the town its name.

This well maintained street, lined by elegant cypress trees, provided the only access to the ancient castle on the hill.

 

As the thermometer had gone past 35C for the last few days, only the early hours of the morning provided a sensible opportunity to explore this World Heritage site in the middle of the summer.

 

Just when the sun was rising above the mountains, I reached the castle wall and standing by the flag pole at the Southern end of the complex, the strategic benefit of having a stronghold here became apparent. Standing at this place, it was possible to overlook not only the town below and the Osumi River, but it was also possible to look far into the fertile valleys of both the heart of the country in the East and in the West towards the Adriatic Sea.

 

This clearly was a place of connection, of trade, of interaction between the people coming from the mountains with those coming from the Sea. One of the meeting points between the Ottoman and the Habsburg Empires with many features in the landscape to tell about this century old blending of cultures. The vineyards on the hills mirrored those in the Wachau in Lower Austria, the old Byzantine church on the Northern side of the castle wall

reminded me of the ancient structures I had seen at Mount Athos in the Northern Aegean, and Gorica Bridge, right below me in the valley, connecting the two parts of the town for over 200 years, as well as the mosque right next to it, could also have featured in many places in Turkey.

 

And yet, this was a view which would have been very difficult, if not impossible for me to obtain much earlier in my life, when Albania had very much isolated itself from the rest of Europe, representing a white spot on the map – a place you knew very little about, a place you by-passed on your journey South, a place that was characterised more by hearsay and by prejudice, than by the interaction and communication with the people who lived there and by the features and the beauty of the landscape on the ground.

 

While Berat and Albania in general and its people appear to have escaped their recent history of political oppression and isolation, and are now thriving in an environment of cultural exchange, economical opportunities and renewed professional interaction, other countries might be heading into just the opposite direction…..

 

 

Abdominal wounds had been opened and closed for the last 8 hours and the sharps containers beside the operating tables were starting to fill with used needles and scalpel blades…..

I was coming to the end of my demonstrations of common suturing techniques and despite my feeble attempts to engage my students with the application of some basic advancement flaps, a technique to allow tension free wound closure for sizable skin defects, I noticed that one by one they were drawn in by the far more engaging presentation of my colleague Alex Bogdan Vitalaru next to us, who had started talking about fluid rates and maintenance doses for critically ill patients, while making use of an unused plaster board at the new but yet unfinished veterinary hospital building, which we were using as a venue, to pen down his calculations.

There was no doubt that here was a far more skilled lecturer at work and declaring defeat, I decided together with my group to join the fast gathering crowd, for the final 15 minutes of a day of clinical workshops.

Despite a lot of unexpected challenges, not only this day but the whole event had been a complete success……

Just a year ago, I had arrived in Tirana with my backpack on a shaky, at times crammed, run down overland bus, knowing not a soul in the capital of this Mediterranian country.

Using the FECAVA network of veterinary colleagues and friends in the neighboring countries, I eventually got in touch with Ilir Kusi, Dritan Laci and Enstela Vokshi, three dedicated companion animal practitioners from Tirana. Over dinner, they explained that there was no small animal veterinary association in Albania, but that unsurprisingly the demand for continuing education and knowledge gain was huge. It became soon apparent, that everything just needed an initial spark….

Within a few weeks a basic constitution was set up, an organisation established and a board appointed.

Drawing in the help of BSAVA’s President Carl Gorman and the always helpful team at Woodrow House, Albanian colleagues were able to tune in to a BSAVA webinar and as a result of this, Nao and Patrick Hensel, dermatology specialists from Basel in Switzerland, booked their flights to Tirana to provide a whole day of dermatology CPD before the end of the year.

In September our Albanian friends attended the joint FECAVA/WSAVA Congress in Lisbon and were granted WSAVA observer status.

In the meantime, planning had already started to gather equipment and funding to organise a two day continuing education event including both lectures and practical workshops in June of this year, to cover a range of different areas of companion animal care.

Paul Cooper, former EVDS President, with whom I had already travelled to Yerevan in Armenia a few years ago, was once again happy to follow me to Albania, to talk about veterinary dentistry and to run a wetlab on the subject. This would again require him to modify a locally sourced compressor to drive his dentistry equipment.

The same response I received from Alastair Hotston Moore covering soft tissue surgery and from Alex Bogdan Vitalaru talking about internal medicine, nephrology and about the placement of all sorts of tubes and catheters into critically ill patients.

All of them are seasoned lectureres in their fields and if not engaged with clinical work, they are more likely to be found in the departure lounge of an international airport heading for a veterinary conference, than at home with their families. Yet all of them were happy to joining me on this adventure and to provide their knowledge on a pro bono basis.

While BSAVA and FECAVA covered most of our travel expenses, our Albanian colleagues were looking (extremely well) after us during our stay in Tirana.

Veterinary equipment providers required just a little nudge to part with necessary gear and disposable materials, like suture material or catheters, so that eventually two suitcases full of books and equipment travelled with us to the Balkan.

However, as always with these events, something doesn’t work out or goes wrong at the last minute……

Unfortunately, Paul had to bail out due to a serious family issue, but although this meant that we had to cancel (in fact just postpone….) the dentistry workshop, both Alasdair and Alex were more than happy to bridge the gaps in the scientific programme with additional lectures of their fields of expertise.

The venue for the workshops – a brand new veterinary referral hospital – which was supposed to be ready by now, turned out to be still a building site….

Here a clear list of requirements, two days of hard work by the whole clinic team and possibly a hint of Alemannic pushiness got the place ready just in time.

Then Alex contacted us on the night before the event, informing us that his flight from Bukarest had been affected by a hail storm and that he was uncertain to make it in time….

Luckily, with soaking wet trousers (which is what you get when you book a front row seat with an Irish low cost carrier…..), he arrived at 1 AM at Tirana airport.

When at 9 o’clock the following morning just 10 delegates had turned up (instead of the 30+ registered colleagues) at the excellent conference facilities of the Intercontinental Hotel in the center of Tirana, all we had to do was, to enjoy another coffee, remind ourselves that we were not in Switzerland and sure enough, at 9.30 the room was filled with nearly 60 delegates…..

From here onwards, everything went swimmingly, with lectures on wound closure, abdominal surgery, stress free feline consults and internal medicine.

The breaks between the lectures provided ample opportunities to engage with our colleagues from Albania and from neighboring Kosovo and North Macedonia (who had travelled several hundred kilometers to attend the event) and to enjoy the view over Tirana’s central Skanderbeg Square and the rapidly changing skyline of the capital.

Starting the workshops the following day already at 8 AM proofed to be less of a problems, with many delegates now keen to put their newly aquired knowledge into practice….

The day finished with the obligatory signing of the CPD certificates and the handing out of a number of veterinary manuals and volumes, provided courtesy of both the speakers and of BSAVA. A final photo of the slightly drained but happy lecturers and delegates on the roof of the new clinic building concluded our memorable visit to Tirana.

“One moment in annihilation’s waste,

one moment of the well of life to taste –

the stars are setting, and the caravan

starts for the dawn of nothing – Oh, make haste !”

Once again I was enjoying a quiet moment at the “Garden of Dreams” – one of my favourite places in Kathmandu.

Sitting underneath the sacred words of the Persian Sufi poet Omar Khayyam, I was appreciating how true they still felt even after a thousand years had past and how relevant they were for my own journey to Nepal.

The “Garden of Dreams” had fascinated me, as soon as I had set foot in it at the beginning of my trip.

To understand this, you need to understand Kathmandu.

Nepal’s capital is dirty, noisy, chaotic, at times confusing and yet…beautiful!

It has nothing of the wide spaces of the countryside of Nepal’s borderlands to India. The perennial smog obscures the view of the tallest mountains of the planet and the fumes constantly attack your airways, resulting in a chronically blocked noise and a lingering cough.

But then, Kathmandu is so different, so unruly and in that aspect so entertaining, compared to any place you might find in Europe or in North America. It is no surprise that this was one of the favorite hideouts for the hippy generation, half a century ago, which still is fondly remembered in places like Freak Street.

However, walking through a small opening in the wall of Kaiser Mahal on the outskirts of Thamel, you find yourself in a completely different world.

Suddenly you notice birds singing, there are less traffic fumes and the greyness and the dust of the streets is replaced by the green colour of a nicely maintained lawn and of the leaves of trees, by colourful displays of flowers and by the calming effect of the clear water of beautifully arranged ponds and fontaines.

When sitting down for a drink at the colonial cafe

a chipmunk might be running over your shoes on its search for the odd bread crumb and you start noticing a strange crop of bats in the trees above you , waiting for the sun to set at the other end of the Garden.

Exploring further the playful beauty of the place, you will come across a hidden water cascade behind a false perimeter wall

and you will find a statue of Vishnu’s consort Lakshmi, promising worldly riches just around the corner, once your have passed a decapitated sphinx…..

Not far from there, a quote from Voltaire’s “Candide” reminds us of the importance of cultivating our gardens and it appears that here even the walls have made room for the trees….

I was coming to the end of my journey to Nepal and my boots were bearing the marks of over 300 kms of rugged mountain paths, of the exposure to snow and ice and of getting drenched during downpours and river crossings in the Manaslu and Annapurna regions. They had been caked in mudd and dust in the jungle and the grasslands of Chitwan and from walking through the traffic and the leftovers of human habitation in Kathmandu and Baktarpur. The leather was bone dry and at places it was still covered with the silt of the banks of the Rapti River. Most of the profile of the soles was gone and the strings were struggling to hold the boots on my feet.

It was then, when I was approached by mobile shoeshiner Rakish, who offered to take care of them. After retreating from the blazing sun on Tridevi Sadak to a shadded set of stairs nearby, Rakish set to work and we started talking….

After having to close his shoe repair shop a while ago, Rakish had moved into the mobile shoe care business and while my boots underwent a complete transformation, he talked about the life in Kathmandu away from the tourist areas, of his family, of the daily struggle to make ends meet, but also of the beauty and joy of the multiple festivals and celebration in his city.

Eventually, my boots looked better then when I had bought them

and I had found the perfect companion for a final adventure in Kathmandu.

After all, there was one more place I had planned to see and this had to be done at night…..

Just before sunset the next day, Rakish and I squeezed ourself into one of the numerous, hopelessly overcrowded minibuses, where my average European physique put me at a clear disadvantage, unless my legs miraculously would have grown another set of joints.

But the contorsion didn’t last very long and after a jouney of about twenty painful minutes, we exited this rolling tin can and found ourselves just off Kathmandu’s Eastern Ring Road, not far from the banks of the Bagmati River.

Descending towards the river bank, the streets became narrower and more crowded. Infront of every house, I noticed golden flagstones, most of which were covered with orange paint and small offerings of marigold flowers , various fruits and grains of rice, to honor the Hindu deity protecting the individual dwellings.

At a small ashram, we came acrossed the first sadhus, who exchanged some kind words with Rakish. But rather than carrying on towards the river, we then turned North and moved away from the crowds along the river bank, until we stood in nearly complete darkness infront of a large Hanuman statue that was covered entirely in orange dye.

We had arrived at the now deserted Gauri temple, placed right next to the dark, putrid water of the river. Only when climbed up towards the nearby bridge, I noticed that there was a lot of movement on the steep river banks and underneath the bridge and just then it became apparent to me, why this place was dedicated to the Monkey God….

Now on the other side of the river, we climbed a small hill and passed some more temples, before we then followed a narrow track into a small forest. Stumbling over a number of tree roots, I appreciated that I had chosen my warm, but sturdy hiking boots for this nocturnal outing.

Eventually we had reached the highest point of the path and now, heading South again, we were walking towards a magical bright light, rhythmic music and the clapping and cheering of a large crowd.

In front of us, stretched out on both banks of the river, lay Pashupatinath, one of Nepal’s largest and most revered historic Hindu temples, dedicated to Shiva, the goddess of fertility, but also of death and destruction.

Here, witnessed and celebrated by well over a thousand spectators, the bodies of recently deceased citizens of Kathmandu, wrapped in orange shrouds, were been burned on piles of wood, doused in oil.

Several of these fires were lining the Western bank of the river, while on the other side of the river there was singing, clapping and a colourful display of religious flames. On the roof of the temple a woman was wildly dancing in a trance, while down in the river a poor soul was busy moving on with the help of a metal pole, the remains of the funeral piles, which had been dumped into the water.

Groups of colourful sadhus, visitors from all over the World, numerous stray dogs and an equal number of monkeys, who both kept a respectful distance from one another, as well as local citizens, some in brightly coloured sarees, others just in their street clothes, were lining the steep river bank to give the deceased a dramatic sending off.

Before us was a spectacle that has been as old as the place itself and a tradition that, despite the already terrible air quality in the Kathmandu valley, is very unlikely to change or to disappear anytime soon.

Witnessing the burning piles for a while and absorbing the singing, the chanting and the shouting around me, it once again reminded me, why Kathmandu continues to be such a strange, chaotic and yet enchanting place.

Eventually the fires burned down and the crowd, at least for that night, dispersed.

But rather than calling it a night, Rakish, because of my profession, was insistent that we paid the Chunchun Baba, a sadhu for dogs, a brief visit.

Tucked away in a number of shacks made of corrugated iron, just a stone throw away from the world famous temple, a holy man and his dedicated followers were looking after more than 200 dogs.

Been invited on to the complex despite the time of the day, the “Baba” explained that he was the Fourth in a line of devoted men dedicating their lives to the caring for Kathmandu’s dogs.

Passing a huge pot on a wood fire – containing the following day’s meal for all canines on the site – the Baba was leading us to his small ashram, where the center piece was a lifesize, decorated copy of his predecessor, Having spotted just a few dogs kept in small cages or on a chain over night, I did not feel too inclined to investigate this place much further and I sensed not for the first time, that deeply rooted religious beliefs were not neccessarily a guarantor or even a useful basis for good animal welfare, especially when it involved the day to day care for large numbers of animals.

Leaving the Baba some banknotes to fund a few more pots of canine dinners, we left the compound and after passing a similar facility next door, which was dedicated to bovine species, we decided to end this memorable nocturnal excursion and by this, my journey to the East.

Early the next morning, there was a plane to catch and another part of the (veterinary ?) world to see……

It was surprisingly easy, finding a cab at 5 AM in Thamel and with the exception of the discomfort of riding in a car with a completely worn suspension, my short jouney to the magnificent stupa at Boudhanath went very smoothly.

Nepal is predominantly a Hindu country, but especially in the mountainous North, there is a strong Buddhist presence, due to the influence from neighboring Tibet. Stupas, gompas, mani stones and poles with colourful prayer flags had been common sights for me, while I was hiking in these regions.

The large stupa at Boudhanath, in the North-East of the Kathmandu valley, is one of the most important Tibetan Buddhist monuments outside of Tibet and many devotees of this peaceful religion, living in the South of the country, are gathering here.

Arriving early in the morning, was making for a more intense experience, as most shops and restaurants were still closed and the site was mainly left to worshippers. Many of them were humming the sacred words “Om mani padme hum” (“Praise to the jewel in the lotus”), while performing “kora”, a steady, strictly clockwise walk around the monument.

Some were making use of the prayer wheels, which were placed along the outside wall of the stupa, others were carrying their own permanently rotating prayer wheels, while a few were even prostrating themselves in regular intervals all the way around the structure.

Behind a low wall, inside the outer rim of the structure, were a few mats, where more prayers and prostrations were performed.

As in the mountains, dried juniper twiggs and herbs were smoldering in low fires in metal drums and red clad monks were walking at the outside of the kora with small smoking metal containers in an act to enhance their prayer and to fend off evil spirits.

The same devices could later be found at the entrance of all shops and restaurants around the site.

Similar to many religious sites in Nepal, a number of local dogs found a peaceful existance here

and considerable sums of money were spend by the visitors on bowls of corn and grains, to feed a huge flock of resident pigeons,

of which many had made a temporary home on the huge dome of the stupa. To meet all needs of these residents, plastic basins were regularly filled with fresh drinking water, so that the birds could quench their thirst and take a morning bath.

From the gompas outside the square, the monotonous and yet so characteristic chanting of the monks, the sounds of their horns and of their drums was adding to this sea of colours, smells and noises, as the sun was starting to illuminate the top of the building, which was displaying the watchful blue eyes of the Bhudda, below the thirteen golden steps leading to Nirvana.

Although whole football teams could be seen partaking in this active form of worship, the majority of people performing the kora appeared to be of an older generation and for many of them, the colourfully dressed local women, offering warm tea from large thermos flasks on a low ledge, covered with isolation mats, were providing a much appreciated opportunity to rest and to observe the atmosphere in peace and thoughtful reflection.

A truly memorable way to start another day in Kathmandu….