The Blue Vet Diary

The year had just turn to 2081 and the New Year celebrations were still ongoing, when I travelled to Baktapur in the Kathmandu valley.

Nepal is in so many ways different from the rest of the world, and this includes the Bikram Sambat calendar, which is roughly 57 years ahead of the Gregorian calendar….

Baktapur is the birthplace of my local colleague Pranav Joshi, who very kindly allowed me to visit his clinic and to see a few cases together with him.

In a small sidestreet in Baktapur, Pranav is running together with his brother Sandeep, who is also his practice manager, a small veterinary practice and a basic learning center where he is trying to pass on his clinical knowledge of companion animal medicine to his younger colleagues. A deeply spiritual man, Pranav is always trying to combine his strong pantheistic believes with evidence based science.

The veterinary course in Nepal provides graduates with very limited skills and these center predominantly around the treatment of livestock.

The care of companion animals is left to just a small number of practices in the Kathmandu valley and even here only a few pet owners see the need to spend money on veterinary fees for their dog and even less for their cat. This is reflected in a maximum consultation fee of 1000 Nepalese Rupees in Kathmandu, which are circa £7/8 US$. It is half that or even less elsewhere.

Pranav and his brother are operating two sites: the smaller, but traditional one in Baktapur and a larger, more spacious one in an upmarket residential part of Kathmandu.

The latter site seems to fund the former, where only very limited services can be provided.

Pranav’s main caseload consists of family dogs of both Nepalese and foreign pet owners. Cats and other species are seen far less frequently.

Vaccinations, including protection against rabies and corona virus, play an important role and so does regular preventative treatment against ecto and endoparasites.

Commercial pet foods, produced in Nepal or in India, have a bad reputation, so that the majority of dogs receive home made diets instead. Unfortunately these in many cases are lacking sufficient amounts of Calcium and vitamin D, resulting in poorly mineralised long bones and ribs and subsequently in pathological fractures. Another common metabolic issue are, according the Pranav, dogs been fed strictly vegetarian diets developing cardiomyopathies.

Tick bourne diseases, including Ehrlichiosis, Anaplasmosis and Babesiosis, or a combination of all of these, are another problem frequently encountered and once stabilised, patients have to remain for weeks on medication.

Interestingly, Leishmaniosis doesn’t appear to be an issue in the Kathmandu valley, possibly due to the absence of its vector, the sandfly. The disease (Kala-Azar) is however of great concern for humans and for pets in the South-Eastern part of the country, as well as in parts of India and in Bangladesh.

Skin conditions like Hot Spots or lick granulomas are reflecting the UK caseload in a typical warm late summer. Here, similar to the UK, predominantly larger and long haired dog breeds are affected.

Pranav’s consulations are very social affairs with him being joined by usually two assistants and his patients usually accompanied by two or three family members.

Something that was new to me, was this unusual version of a Baskerville muzzle ……

As much I can see the comical side of it, I found that this would make it very difficult to read a dog that is stressed and I can not see the design catching on in European veterinary practices.

The clinic in Kathmandu is one of the very few places in Nepal with an inpatient area and the ability to offer hospitalisation over night and on weekends.

Numerous newspaper articles and thank you cards displayed on the walls in the waiting room leave no doubt about Dr Joshi’s popularity as a vet and people are prepared to travel long distances to see Nepal’s “Dogfather”.

It just wouldn’t be right to talk about hiking through the Himalaya as a veterinarian and not to dedicated a few lines to the canine inhabitants of this region.

The dogs of this harsh environment differ somewhat from the ones I came across in Kathmandu.

In the city, clearly size matters. Not too small, to be able to compete with other canines for sparse food resources, but also not too big, for not appearing to be a threat to humans in their environment.

Most of these usually very gentle creatures, all cross breeds of some sort, don’t seem to have a specific owner, they rather claim a defined patch on a street and are there tolerated as part of the street life. They live off whatever is given to them by caring residents and shop keepers, and they are at times surprisingly choosy about what they eat and what not.

Pretty unfazed by what is happening around them, they are no real car or motorbike chasers, but unusual vehicles (eg street vendors with recorded anouncements or irritating tunes) can quickly rise them from their state of slumber.

Near butcher shops (usually operating without any means of refrigeration….) and religious sites, the number of dogs tends to increase and here also packs of dogs are a not uncommon.

In the mountains, the size of dogs tends to vary more and with most dogs being connected to a specific household, their physique needs to meet the requirements of their purpose.

Small spitz and terrier like dogs are not uncommon and nothing coming near a dwelling is missing their attention.

At higher altitudes, thick fur is a basic requirement, especially if dogs are kept outside the whole year. These dogs are usually not allowed into the upstairs living quarters in traditional houses, but they live together with or near the livestock in the basement or in the yard.

Seeing chained dogs was thankfully a rare sight and in most cases dogs had the freedom to roam, which might include accompanying a hiker from one village to the next, as in the case of this adventurous canine.

Despite a lot of young lambs, kids and chickens being a constant feature along the path while walking through mountain villages in the Himalaya, I never witnessed one of these dogs chasing them or trying to chase any of the local wildlife.

Clever dogs learn early in life, to stick closely to the youngest members of a family

and the ultimate state of existence is definitely to find yourself as the resident canine in a Tibetan monastery…..

Regardless of a mostly inadequate diet of human food scraps, livestock fodder, mule dung and whatever can be scavenged on the trail, and living a life in the abscence of any kind of meaningful veterinary care, most of these dogs of the mountains were in a pretty good overall condition, usually somewhat undernourished, but without any overt signs of skin or fur defects, growth deformities or signs of infectious diseases.

And what about cats one might ask?…….

They too exist in the remoteness of the mountains, but due to the competition from dogs, monkeys and indigenous wild predators, who might even consider them as a potential food source, cats in general appear to have a far less visible existence in Nepal and they do not enjoy the same life as eg their Mediterranean cousins.

When I woke at two thirty in the morning, I noticed that more snow had fallen and the water bottle I had forgotten outside, had frozen solid over night. After adding another layer of clothing, I staggered out of the cave of damp and mouldy matresses, which I had shared with Ryan and Jeremy, my two Canadian fellow hikers, for the last few miserable hours.

In the dining hall, as far as one could call it that, at least some hot tea and porridge was waiting for us.

We were in Dharamshala, which, at 4400 m above sea level, is the last human habitation before crossing Larke Pass at over 5000 m.

As high camp go, ever considering the remoteness and the limited means of supply, Dharamshala was still a shit hole. Kumar, our trusted mountain guide, had warned us to stay clear even of Dhal Bhaat here. The Nepalese national dish is normally a safe choice (if no meat is involved….) in tea houses in the mountains.

However, it was the best shit hole and in fact the only place in this remote part of the country, not far from the border to Tibet, where one could get a few hours of rest and shelter before crossing the pass.

Over the last couple of days, we had left even the hardiest yaks and most of all alpine vegetation behind us and only a few solitary birds were able to survive in this hostile environment.

The main – of course unheated – room, where we had spent most of the time since our arrival the previous day, reminded me of the inside of a refrigerator, that hadn’t been cleaned for a while.

One of the windows was shattered and an icy wind was entering through a large gap in the door frame, with the door being kept shut with the help of a couple of abandoned shoe strings.

And yet – we were the lucky ones, having found a place here and not in the building next door, which consisted of plane breeze block walls and a roof of corrogated iron, which was supported only by a few flimsy sticks.

Whiling away the time here, with the help of meaningful conversation or the odd card game, only worked so long……

If the dining room was bad, the kitchen, which for good reasons was poorly lid, was worse and only recently boiled or deep fried food items could possibly be consumed here.

The cutlery and crockery for nearly one hundred people was rinsed without the visible use of any detergent in the nearby stream.

Thankfully someone must have had the good sense to position the toilet shags a bit further downhill….

No surprise then, that despite the early start, we were rearing to leave this place to cover the final 700 altitude meters on our circuit around Manaslu, one of the fourteen 8000+ meter giants of the Himalaya.

Most members of our team were by now on various means of pharmaceutical support, with a combination of Diamox and Paracetamol having been the overall favourite choice.

At exactly three o’clock, being led by the imposing figure of Pasan, an experienced native mountain guide, who had crossed the pass many times before, we started walking slowly uphill, but without the help of any way signs whatsoever.

Soon we were overtaken by our porters, who despite their small frames carried up to three times the weight of our own backpacks.

After a while, a few black and yellow metal poles started to appear, confirming that we were indeed on the right track, along the Northern edge of the remainder of the Larke Glacier. As the darkness lifted slowly, the landscape around us revealed itself as generally very forgiving , with no steep drops or exposed passages. Just gentle, but relentless hills to climb, with numerous false summits.

Eventually, as the rising sun started to burn the clouds away, we found ourselves in a grand theatre of white mountain tops including Larkya Peak, Cheo Himal and Hindu Peak, which were towering above a sea of white cotton wool that extended all the way into the horizon.

As the altitude increased, our progress slowed dramatically and short breaks became more frequent. I started to feel dizzy and noticed a slight headache, but thankfully no nausea, so that my rich supply of chocolate bars continued to provide me with much needed substinence.

Passing the 5000 m bar, was a small achievement, but it still took nearly an hour, before the remaining 100+ altitude meters were finally covered. While stopping once again to catch my breath, my thoughts went in deep admiration to alpine pioneers like Reinhold Messner, who had been able to function and to eventually scale Mt.Everest, which was another 4 kilometers higher, without the use of supplementary oxygen.

I decide that 5000 m above sea level would be my personal limit and that I would be happy to leave much higher peaks forthwith to someone else. There is enough to see and to enjoy at lower altitudes…..

After nearly eight hours of climbing, we finally reached the pass, but unsurprisingly it was a pretty windy and not particularly welcoming place. Hands were shaken, a few obligatory photos taken and then our guides were keen getting us to a lower height as fast as possible.

The descent into the Pongkar valley was much steeper than the previous climb and the use of light crampons proved essential to avoid any slipping.

Slowly the much darker panorama of the Annapurna range was opening up in front of us, and below the moraine of the once giant Ponkar glacier, which appeared to have all but melted away.

The descend took another six hours and just when fresh snow was starting to fall in heavy flakes onto the path, we arrived in Bimthang, where a wood panelled dining room with a blazing central fireplace and much needed hot drinks were awaiting us.

What awaited us in Lho, was a truly medieval scene:

On the unpaved road we walked in a mixture of drenched soil and mule dung. Chickens, cattle, dzos and an ownerless horse were blocking our progress, as the rain was just starting to fall in heavy drops like lead from a grey sky.

The eyes of small children with dirty faces were following us from a safe distance, from unlid living quarters above low stables in the basements of ramshackle dwellings.

Various bones and a discarded mumified yak skull were littering the road.

It had been a long hike today. Starting at the small hamlet of Ghap on the Manaslu Circuit Trail, we had trekked along the steep banks of the Budhi Gandaki River in the heart of the Himalaya. With the help of precarious suspension bridges, some of which showed signs of severe battering from falling rocks, we had crossed the river a few times.

Walking into the centre of the village, we passed a white stupa, where dried juniper twigs were smoldering on a small fire. After enjoing a few final meters of solid pavement, we finally arrived at our destination, the somewhat misleadingly named “Hotel” Tasidele.

Here our room for the night consisted of two beds, four walls, a not consistently working power socket and at one end of the room there was a small window, that was so dirty, that it was impossible to look outside. At the other end of the room, the window consisted just of a pair of closed shutters, with the rest of the window missing all together.

However, the place was occupied to capacity and once entering the dining hall on the first floor, which appeared like stitched together by planks of wood and single glazed windows of various shapes and sizes, one was enchanted by the warmth of the central fire place and by the cacophony of English, Nepalese, Korean, French, German and of all the other languages that are spoken on the great hiking trails of the world.

Soon a bottle of the local beer and the customary Dhal bhaat appeared on the table in front of me and the day finished in lively conversation coupled with a sense of belonging to a community of likeminded hikers and travellers. Despite the material shortcomings of the place, here was something that is so often missing in our digitally controlled and regulated, but socially sterilized modern world.

On the next morning, the weather had changed and while the sun was rising on a cloudless sky, the village awoke being surrounded by snowcapped mountains. A few villagers were attending the central giant prayer wheel

and once again the smoke of burning juniper branches was engulfing the stupa.

Looking up at the hill in the West, there was a tryptichon of the local monastery, framed on each side by the golden summits of Naike and and for the first time of Manaslu .

“Old is Gold” was printed in fat letters on the windscreen of the vehicle that was standing in front of our hotel in Kathmandu the next morning.

While feeling slightly mocked by this statement, this slogan wasn’t helping to instill more confidence in me about travelling in Nepal.

There is the common misconception, that hiking on the mountain paths of the Himalaya is dangerous. The mountains are safe (may be with the exception of the very high altitudes), the real danger here is found on the roads and in the air. Nepal has one of the worst road traffic accident statistics and I was more concerned about the six hour journey (which then turned out to take nearly nine hours….) to the mountains in this giant steel tin, than about the whole hiking trek ahead of us.

Thankfully the discomfort from my infected tooth had settled and , pumped full with a cocktail of medication and with encouragement from hiker friend and dentist Graham and his daughter Angela in the UK, I had finally decided at least to give it a try and to go for a couple of days into the mountains, before coming to the ultimate decision to continue or to turn.

Leaving everything that I didn’t want to carry over the next 18 days at the Royal Singi Hotel, we – a team of British and Canadian hikers, together with our Nepalese guide – were setting off.

Taking one of the seats in the front of the bus, I noticed, that we were under the protection of both Hindu deities Ganesh and Kali.

In addition to this, each seat was fitted with a depiction of a pair of hands in a praying position. What could now possibly go wrong ?…

I have to admit that the reassurance resulting from this, convinced me less than the sizable “Volvo“ sign at the front of the bus.

Trusting that at least the vital parts of the chassis of the vehicle had its origin in Sweden – the interior fittings definitly had not……- we started slowly rolling out of the city, heading West towards Pokara.

The eternal traffic jam out of Kathmandu had not only the effect that our journey took much longer than expected, but the advantage that we were driving past abyssmal drops next to the road with an agreeable speed, especially while our driver was busy having extended conversations on his mobile phone (with Ganesh ?!…..).

Finally we turned off the main road and the direction changed from West to North – towards the deep valleys of the Himalaya.

Steel and rubber were now stressed and strained at their utmost and I pittied the old diesel engine while the bus laboured uphill on untarmaced roads.

Here, another definitley non-Scandinavian retrofitted feature of the bus came into its own : a multitone church organ, which sounded the first few tunes of “Happy Birthday to You” ahead of each turn we took on the mountain roads.

This, together with a firm belief in Darwin’s law of the survival of the fittest (or largest), ensured that we avoided any head on collision with any (bigger) vehicles and we finally arrived unscathed at the trailhead.

Our adventure to round the Manaslu Himal could finally start.

Sitting in a street cafe over my copy of the The Himalayan Times, I am treating myself to the customary milky tea and a deep fried doughnut. My breakfast is not likely to cost more than 50 cent, a mere fortune compared to the 5 rupees ( 4 cent) I had paid for the newspaper….

The day hadn’t started well. I had struggled to find some sleep and when looking into the mirror in the morning , my face was lopsided due to a painful swelling below my left eye.

The most likely cause for this was a molar abscess and with the help of my local contacts and following the advice of my dentist friends Angela and Graham in the UK, I had no other choice than checking myself in with one of the dental clinics in Kathmandu.

Bad timing ….. the probably most serious health issue I had for the last ten years, had struck me just a day before meeting up before a three week hiking trek, that is due to take me to some of the remotest parts of the Himalaya, where even the most basic medical care will be several day marches away…..

Fast forward three hours and I have made the aquaintance of Luna, my local dentist in Kathmandu. After popping the abscess with her dental probe (which seemed to give her more pleasure than me….) and taking an X-Ray, to my surprise, Luna declared that I could keep my tooth. After having three root canals drilled out and the abscess flushed, I felt much better. To make the most of the still lasting local anaesthesia, I headed straight for the Kaiser Cafe in the Garden of Dreams, one of the few green spaces in the city, and enjoyed a slice of cheese cake and a latte before the pain was due to set in….  

Even better, I was joined by my colleague Pranav from the neighboring city of Baktarpur, who had seen a few cases at his branch in Kathmandu.

Buoyant and still completely painfree the next morning, I was confident that I could start on my trip the next day and with a swing in my step I saw Dr Luna for a follow up check. What I had expected to be a brief procedure, lasted another 45 minutes with a lot of probing and prodding, with the result that in the evening, at the meeting with my team, I was , despite the antibiotics I was already taking, in agony…..

With the help of some painkillers, I managed to survive the evening, but it didn’t help, that we all had to sign a declaration that we were aware, that an emergency airlift from the mountains would cost at least 7000 $, and that we ultimately would have to pay for it.

With me already on medication even before the trip, I wasn’t very confident that my travel insurance would bail me out if it would come to this…..

Another sleepless night and serious doubts if I should start this new adventure…..

Not a lot of vet schools can claim to have their own subway station and the one at “Tierspital” in Zurich, is making for a pretty cool entrance. Walking up the ramp to the exit, surounded in neon-blue light, gives me the impression of walking on the bottom of a swimming pool or of entering a fancy night club.

For a change (due to my working commitments during the day), I am visiting this veterinary faculty not during daytime, but at night and my guide this time is not the dean, but an equally unique vet student.

Luregn and I had met in Lima at a conference and it had taken me a while, before taking him up on his offer to show me their small animal clinic and – even more interesting for me – the university’s skills lab, where artificial models of animals and their organs offer an alternative to painful procedures on living patients.

First a visit of the small animal clinic though….

At night veterinary clinics all go into their very own stand by mode. With the waiting rooms and the halls mostly devoid of pet owners, the work of the remaining staff is focused on the care of the inpatients and due to the lower risk of being interrupted, on the writing of scientific papers on brightly lite computer screens.

For us too, it is a good time to take a closer look

at the green and red illuminated, state of the art, temperature and air controlled, noise reduced recovery cages ,

at the sophisticated air lock systems, which help to keep pollutants as low as possible,

at the batteries of simulantiously running infusion pumps, which are always a good indicator for the complexity of the treatment the patients at an intensive care unit receive,

at a room which is exclusively dedicated to dialysis, where the lives of patients with renal failure can both be saved and maintained without functional kidneys for a while,

and basically at a good example of how the clinical training of veterinary under graduates in the 21st century can look like.

Luregn is making an effort to make the tour of the clinic as comprehensive as possible, so that it is already late, before we are entering the skills lab in one of the historic buildings of the faculty.

You might be forgiven for forgetting that fact, when entering the futuristic looking central area of the lab.

Here models rule and no living creature is coming to any harm…..

The dark horse on the right side of the room, fitted with all the important internal organs for students (and vets) to touch during a rectal examination looks familiar :

It costs about the same as a small car and I have seen one just like it over a year ago in Dubai. Most modern vet schools seem to have one these days and in the case of Zurich, the head of a second, equally expensive one (made to 100% from silicone) is resting wrapped up in moist towels in a huge refrigerator near by, to maintain it in pristine condition.

The large pig on the left side of the room is new to me and the injection side on the neck , fitted with an electronic sensor to confirm the correct needle placement, is looking well used.

Luregn opens a draw and out come the at first sight bizzare looking heads of a dog and a cat. Certainly not something to hang on the wall, but instead very useful probs to practice the intubation of these species for anaesthesia or resuscitation. However – made in blue or in green, they would have looked friendlier….

There are a fair number of fluffy dog and cat models, which very much remind me to the ones I had built some years ago at my clinic to be used at the First Aid courses we where running for clients for a while.

The models here are also fitted with artificial hearts and lungs and the model of a frontlimb of a larger breed dog is inviting even the most unskilled vet student to take a blood sample, without being afraid to fail the dog or – even worse ? – infront of an expectant owner.

Turning off the light and putting these patient and never complaining creatures back to bed, I appreciate how much veterinary education has progressed, even just during my lifetime.

Another early morning run….

Passing well attended “Shrimp Cottage” on the right side of the road,

this one is taking me all the way downhill to the shore and by that, to one of the UK’s last remaining working fishing harbours, where trawlers of various shapes and sizes share the calm but tidal waters of the Channel with a small marina of sailing and leisure boats – all sheltered by a half a mile long break water.

Today, it may be a good place to spot purple sandpipers, but this used to be the site from which over 2000 American soldiers departed for Utah Beach, now nearly 80 years ago, to risk their lifes to free not less than a whole continent.

I am in Brixham, on the coast of Devon.

Driving here from Surrey, I had passed Stonehenge.

Watching hundreds of visitors circling the monument at a great distance, I remained puzzled about the appeal of the place.

I have to admit, that I consider it as one of the most overrated tourist attractions on the Globe. In my ignorance, I see it as not much more than a circle of a few big stones on a field, which can – very comfortably – be seen from the inside of a car while driving along the nearby, usually congested road.

Investing not less than £23 (!), one can obtain the permission to do the same on foot, from more or less the same distance. One will not be allowed to touch a stone, one will not even be allowed to walk among the stones…..

In contrast, the real attraction of this part of the world – I would say – lies right ahead of me this morning , and there are nearly 3000 miles of it, which can be walked and run on, which can be touched and can be thoroughly enjoyed for free around the year. It is called the “English Coastal Path”.

May be a bit long for a single morning run, but filled with endless artefacts of history and art, unique wildlife, a fair amount of wind, rain and bad weather in general, plus never ending stunning views – especially here in Brixham.

Having enjoyed the colourful, iluminated view of the fishtown area of Brixham the previous night,

I am heading East this morning, towards Berry Head.

Ignoring the puzzling stare of the old fisherman at Grenville Cottage,

I narrowly avoid being pounced on by a blue silverback with fetching sun glasses……

Pressing on, I pass a stretch of beach, that contains the largest collection of perfectly shaped skipping stones I have ever come across.

Sorry, but no time to try it out though….

This is followed by one of the UK’s tide bells (above) , which is part of an art installation, that is supposed to remind us of the fast changing climate and of the rising sea levels as a result of it. But at least today, I am in luck and the bell is not ringing….

Following the now ascending coastal path, I am first trespassing on to the terasse of the rather grande Berry Head Hotel,

I am crossing a stretch of Northern cloud forest and finally I find myself faced by the barrels of the sixteen cannons of an old battery.

Luckily there is a small gap in this imposing defense installation, so that after all , I manage to reach the lighthouse on the top of the cliff and with that, a spectacular view of the South facing coast and of the English Channel.

Here the exposure to the wind and to the force of the waves, which are working relentlessly on the rocks, is very different.

Now it is all the way a combination of tail winds, downhill running, but also passing of a large number of dog walkers with happy canines and even of a single lifesized metal sculpture of a rhino in a frontgarden, before I return to the starting point of my morning run .

I doubt that a few large stones in a circle on a field can match this…..

Well, time for a coffee….or two….

“He’s a good chap in his way. Serious. Not one of those noisy bastards at the Continental. A quiet American.”

This is, how Fowler, the main protagonist in Graham Greene’s novel “The Quiet American” describes Pyle, the charcter in the centre of his narrative. It is set during the French Vietnam war, when Greene was stationed as a war correspondent for “The Times” and for “Le Figaro” in Saigon. Written between 1952 and 1954, he correctly predicted in this novel that America would eventually been drawn into the conflict.

Considered by Greene as one of his “entertainment” works, the story also contains numerous autobiographical parallels to the life of the author at the time.

Like Greene, Fowler is a middle aged man, caught in an unhappy marriage with a catholic wife who is dening him a divorce. Fowler is portrait as worn, bored and cynical. Like the author he his struggling with periods of depression. He works as a reporter for a British newspaper and he is a frequent visitor of the Hotel Continental, at that time one of the most famous buildings in Indochina.

But unlike Fowler, who has his own, very humble flat just off Rue Catinat, now Durong Dong Khoi, Graham Greene used to stay directly at the Continental and if so, then always at room 214.

Located at the corner of the building, on the second in an elevated position above the street, the room allowed an excellent view of the square infront of the Opera and of Rue Catinat – more or less the centre of Saigon.

It is said that Greene preferred this room, because he could see from there, while writing, who was coming and going in Saigon.

This is reflected in the novel, as Fowler would have had to position himself at this part of the hotel to state that : “I had seen him last September coming across the square towards the bar of the Continental: an unmistakably young and unused face flung at us like a dart.”

Most – if not all – of the book was conceived in this room and after thoroughly enjoying it as my travel companion while touring Vietnam, some parts came so much more to life, once I had grasped the opportunity of staying at this room at the end of my trip to this country.

Although most of the interior is unlikely to be the original from the time of Greene’s stay, the hotel has tried its utmost to preserve the overall atmosphere of the room.

Imagining Greene sitting by the window (probably without airconditioning), the room – facing South – must have been very hot at times. I wondered if he managed to stick to his customary 500 words a day writing routine during that time, while filing at the same time his regular reports to London.

An unusual feature – I found – were the two columns that are right in the middle of the room. How many times did he run into one of them I wondered….

Another detail I noticed, which is likely to have remained from the time of Greene’s stay, were the very low set door handles. It was the same with all the doors in the hotel. Placed in the lower third of the door, they probably reflected the average height of the builders over 100 years ago. Today’s visitor they strike as unusually low placed and this stand in a stark contrast to the height of the ceilings.

The hotel used to be one of the main meeting places of politicians, military leaders and journalists from the end of the Second World War until the end of the Vietnam War in 1975. One can imagine all the important and at times historical conversations and events that took place behind these unusual doors.

The Continental is no longer the most luxurious hotel in town. The view from the room’s window towards the Mekong is obscured by modern high rise buildings that are dwarfing the old colonial dwellings and if you are looking for a well frequented hotel bar, it is probably better to head for the roof tops of the near by Rex or for the Majestic Hotel next to the river.

However, the hotel still has its charm and staying at room 214 made reading “The Quiet American” a far more intimate affair.

There were two things that had to be done while travelling in Vietnam – taking a motorscooter taxi and visiting a veterinary clinic.

Throwing all caution to the wind, I found myself on the backseat of a Honda Airblade within 30 seconds of ordering a ride on “Grab”, the Vietnamese version of Uber. How dangerous could it be?…

Squeezing ourselves through the dense traffic in District 1 wasn’t a big issue,

but speeding with over 80 km/h over the bridge to the other bank of the Mekong, was certainly not for the faint hearted…..

The local motorscooter helmets, which resemble just a harder version of a baseball cap, offered very little re-assurance.

During our ride I spotted the first scooter riders with pets. Without doubt, most of these predominantly small dogs clearly enjoyed their ride and appeared to have adapted re-markably well to this unusual form of transport. Some even sported a safety harness and most of them were quite protective of their personal carriage.

Both small children (usually without a helmet) as well as pets were transported this way and I never saw a single scooter accident. So it probably wasn’t that dangerous after all ?

Finally we arrived in front of the British International School in Ho Chi Minh City. On the other side of the road, a 3 m tall red cat was just about to scale the side of the building,

while a young boy was sitting on the wall below , reading from a book to his Greyhound.

These two sculptures were my first inpression of the world of Animal Doctors International, a British run veterinary group operating in Laos, Cambodia, Vietnam and now also in Thailand.

Will Thomas, its founder and CEO, had very kindly agreed to meet me at their clinic in Thao Dien.

The visual journey continued when I entered the waiting room area, passing on the front door plaques of IATA, IPATA, an isfm Cat Friendly Clinic Silver award plus a 2023 nomination for the Best Animal Hospital in Vietnam.

Using an appealling combination of bamboo, marble flooring, indirect lighting elements and a small tree growing through the reception desk,

I was not only impressed, but I also felt that if so much thought had gone into every detail of the outside appearance of a practice, it would be highly unlikely that this standard wasn’t matched by a similar degree of clinical excellence behind the scenes.

I wasn’t to be disappointed.

First I met Will, a Bristol graduate and certainly not your usual company CEO. Very down to earth, in T-shirt and with a large colourful tatoo decorating the length of his left arm, he welcomed me in the clinic’s board room.

As remarkable as the man, was the story of his veterinary business.

“ It all started when I travelled to Laos. I fell immediately in love with the place and I never returned home!”

This – as I found out later – was less than 10 years (including a global pandemic !) ago and since then Will had established ten clinics all over Indochina, in countries with different political systems and different native languages. All of theses clinics provide a standard of veterinary care for companion animals, that was completely unheard of in most of these countries.

In addition to this, ADI is doing a lot of conservation work, runs an elephant clinic, organises spay and rabies vaccination clinics and provides continuing education for local veterinary colleagues.

Following my visit to Will and his team, I found visiting their website at http://www.theanimaldoctors.org both entertaining and quite impressive. The website even offers a 360 degree walk through the clinic in Saigon.

Back to my visit though…..

Will explained, that small animal veterinary medicine is still very underdeveloped in Vietnam, but undoubtedly the demand for state of the art veterinary care was absolutely there.

Will’s teams consist of a combination of both local and foreign veterinarians with a huge range of different academic backgrounds.

Native vets are providing nursing tasks and are at the same time upskilled by their foreign colleagues. Postgraduate education of staff members is happening online or by attending international congresses in Asia or further afield.

The consulting rooms of the clinic were functional, absolutely spotless and fitted with well thought through features like wall mounted examination tables and climbing opportunities for cats (some of them may be a bit too high ?…..) and all rooms were fitted with anxiolytic pheromone diffusers.

There was a large, well equipped prep-area and separate in-patient areas for dogs and for cats. Modern diagnostic imaging equipment in a dedicated room, as well as an operating theatre with an oxygen generator and a lot of monitoring equipment were further features.

The clinic offered boarding facilities and had a separate physio therapy area.

Veterinary fees at ADI, with a price of about 20 $ for a consultion, are understandably higher than at other small animal practices in Saigon (where some vets are only charging for any treatment provided), but they are still considerably lower than at similar clinics in Europe or in North America.

ADI’s clients are according to Will a combination of mainly Vietnamese pet owners and understandably a fair number of expats living in HCMC.

There is a large case load of infectious diseases, including parvovirosis and distemper, but thankfully only very few cases of rabies in all of Vietnam and no recent cases in Saigon and the Mekong delta.

Another frequent problem are tick borne diseases and parasitic diseases in general.

“And trauma cases ?” I asked, wondering about all the dogs I had seen riding motorscooters.

“Ah those……Lots! We see them all the time!”……was Will’s reply, before I got ready for my next scooter ride back to the other side of the Mekong river……