Update from Ethiopia - November 21, 2008

Skin diseases are among the most common in Africa. This cow was diagnosed based on the appearance of the skin as having streptotrichosis, or an infection with an organism named Dermatophilus congolensis and often associated with tick infections such as the tick Amblyoma. This animal has the typical lesions of this skin infection and is infected with several ticks, including one which is engorged with blood.


Dr. Kassa Bayou identified these ticks in his hand as belonging to the Amblyoma species, the type tick which may carry Cowdria ruminantium, an organism that can cause a serious illness in cattle called “heartwater.” It is also associated with skin infections with the organism Dermatophilus congolensis.


To be able to conduct a large practical exercise for the Community Animal Health Workers (CAHW’s, commonly called “cows”) being trained in this VETCAP, the Ministry of Agriculture trainers had to negotiate with the local village chief, an elected official, to all us to work in his area and to promote the people brining their animals to a central facility to allow us to conduct a mass vaccination campaign. The village chief met with us with one of his children, and was happy to facilitate this training since it benefitted his people through providing vaccinations for blackleg and deworming injections with ivermectin at no cost to them.


We are doing this training in the Benna-Tse May “Wareda,” a political division roughly equivalent to a county in the U.S. The map sketches out where CAHW’s are now located in local “Kabele’s,” roughly equivalent to a township or municipality.


Our soldiers interacted very well with the Ethiopians. SGT Tom York liked to show the children hand-held video games and had a great time with them; he also had a hard time getting his hand-held game boy back. And yes, that’s REALLY his name. He is a distant relative of THE Sergeant Alvin York of WWI fame, played by Gary Cooper in the movie by the same name and which this Sergeant York amazingly had never seen!

Update from Ethiopia - November 20, 2008

Interesting expressions can be found the world over. This one was on one of the offices at the Ministry of Agriculture where the training for Community Animal Health Workers took place. Unfortunately, we were unable to discuss the meaning of it and how they interpreted its message.


Cattle in southern Ethiopia are much like those in other parts of Africa, but we did see some “wattle” cattle (note the pendulous skin under the cow’s throat) there that we had not seen elsewhere.


Cattle graze the open lands here so their owners have the same dilemma facing that American cattlemen to identify them. In southern Ethiopia ear “notching” and skin “carving” systems are often used in most creative ways to identify cattle. This is an interesting contrast to the U.S. where a major effort on the part of the beef industry has been targeted at eliminating hot iron brands as a means of ID in order to reduce the damage to hides they cause. The hides of these cattle in Ethiopia are clearly damaged, and it does cause a reduction in their value. Part of this CAHW training is targeted at improving hide quality, particularly in goats whose skins provide leather for export markets which have been important to the Ethiopian economy. The primary damage to goat hides appears to be caused by external parasites, not ID systems such as those in these cattle.

Update - November 18, 2008

Lantana plants such as these responsible for a condition called photosensitization in the cattle who consume it. This and other types of plants cause liver damage in the animal. The damaged liver is then unable to remove pigments absorbed from green plants in the animal’s diet, thus leaving the pigments its body.


The “photodynamic” pigments absorbed through the GI system from ingested green plants reach the skin and are activated by energy from the sun, thus causing serious “burns.”


The skin of cattle afflicted with photosensitization can heal if the liver damage is not too severe, but the previously affected areas can still be seen.


Man-made bee hives placed in acacia trees facilitate harvesting of honey.


Vaccines against anthrax (caused by Bacillus anthracis) and blackleg (caused by Clostridium bacteria) were stored without refrigeration in the classroom we were assigned to use. In the interest of safety, we removed them. These vaccines were produced in Ethiopia but we were unable to determine any information about what particular species of Clostridium the blackleg contained, or any specific information on the anthrax vaccine.


A few broken anthrax vaccine bottles were in the classroom. We were assured that this was a killed vaccine, meaning that it contained no live Bacillus organisms, but we were insistent that they be removed before the classes began.

Update from Djibouti & Ethiopia

November 11, 2008

Dear Family and Friends,

Happy Veterans & Armistice Day 2008 from the Horn of Africa. We are preparing for our last VETCAP mission, this one to Ethiopia so this will likely be my last message with any information to speak of.

Since returning from Uganda, the 354th Civil Affairs Brigade Functional Specialty Team has been joined by a third U.S. Army Veterinary Corps Officer, MAJ April Ulmer. She is overlapping with us before CPT Coenen and I depart on the "Rotator" flight from Djibouti on December 11, one month from today. MAJ Ulmer came from her post in Aviano, Italy and CPT Coenen will return to her station in Hawaii. MAJ Mickey Moppin is the fourth Veterinary Corps Officer here at Camp Lemonier, serving with the Surgeon's Cell. Mickey has the distinction of being the first MVPH (Master of Veterinary Public Health) graduate from the NCSU CVM. Dr. Jay Levine deserves much credit for starting and sustaining that program that is proving its value by producing graduates like Mickey.

The four of us occasionally convene "official Veterinary Corps Officers' Calls" at the "11 Degrees North" (our Djiboutian latitude) as pictured. NOTE: official "beer cards" assure moderate alcohol consumption here on Camp Lemonier!

Lately we have expanded our scope of work. On November 3 CPT Coenen was called to consult on a Military Working Dog (MWD) "Ben" who was depressed and off feed. Ben is a seven year old bomb detector dog who came here from Japan. He has been with only two handlers during his career, the current Sailor having been with him over three years. After a physical exam, abdominal radiograph, abdominal ultrasound, and needle tap of his abdomen it was determined that he was bleeding into his abdomen and needed surgery soon.

The Emergency Medical Facility allowed surgery to be conducted there, with Drs. Coenen and Moppin scrubbing in. There was a tumor on Ben's spleen which led to a total splenectomy and as is routinely done with MWD's undergoing belly surgery, a gastropexy ("stomach tack") to prevent future problems with bloat.

By evening Ben had recovered from general anesthesia but with an attitude, as the picture gives evidence. With luck he will be evacuated from the theater soon to recover and hopefully return to duty with no metastasis of the tumor. Ben's handler had been hoping to retire him in the near future and to adopt him into a well-earned retirement. CPT Coenen, MAJ Moppin and MAJ Ulmer did a great job on this. MWD's represent an investment of many thousands of dollars and countless hours of training time. This level of care keeps them going as part of the force.

Even though the weather has been milder and this past week it rained heavily in Djibouti (a RARE event), the days are still hot.

The black flag flying at Camp Lemonier means the heat index is too high for vigorous exertion or exercise. Even in cooler times of the year the humidity is high and the peak daily temperature gets > 90 degrees F; in the hottest times of the year 120 F is normal.

Posters on Camp Lemonier remind all assigned to take their malaria preventative medications as prescribed.

I take mefloquine hydrochloride once a week as do most serving here. Malaria is less prevalent here than in the other countries we have worked in but with the recent rains we expect to see a rise in the Djiboutian mosquito population and an increase in the risk.

The guidance from the Commander of the Combined Joint Task Force – Horn of Africa is posted for all to see.

Admiral Greene's guidance emphasizes that we are "Helping Africans Solve African Challenges" through the "3 D's": Diplomacy, Development, and Defense partnerships to increase Security, improve Stability, and strengthen Sovereignty in the Horn of Africa.

Our VETCAP projects are good examples of this guidance in action. The projects are coordinated with the Embassies / Department of State (= Diplomacy), funded by the U.S. Agency for International Development (= Development), and conducted by the 354th Civil Affairs Brigade, Functional Specialty Team (= Defense).

USAID partners with Non Government Organizations as much as possible, such as on animal health initiatives evidenced by the poster promoting camel vaccinations and health care that we saw on our pre-deployment site survey (PDSS) for the next VETCAP in southwest Ethiopia to start later this week.

The Ethiopian VETCAP will be a change from our previous ones elsewhere. Rather than treating animals we will be training 28 new Community Animal Health Workers (CAHW's, called "cows") in Key Afer, a remote town whose name translates into "Red Earth." We traveled there on October 26th with LTC Wyesa Dinka, our Ethiopian Liaison Officer to meet with the pastoralist association officials who will conduct the training with our assistance.

The classes will be held between November 23rd and December 5th. It will be a challenge because these are adult learners, most will be of low literacy, and at least four languages will be involved: Ahmaric, the Ethiopian national tongue; Benna, the local dialect; a second local dialect spoken by a couple of the trainees; and English. The curriculum is a standard one which has been established by the government. We will emphasize as much hands-on training as possible. On our survey trip to this area we visited a local clinic run by Americans Drs. Trent and Tabby Cox, both veterinarians who graduated from Texas A&M and who have trained CAHW's at their clinic. They have been in this area of Ethiopia for seven years as missionaries with the Christian Veterinary Mission.

The photos show some of the CAHW's they trained spraying goats and cattle for ticks. Their clinic has the only cattle head gate that I have seen in Africa, made by Priefert from Mount Pleasant, Texas. Ticks get much attention from a medical viewpoint because they are so prevalent in East Africa and bring along with them infections that seriously affect livestock production.

The Cox's treated us to a delicious Benna meal of greens, potatoes and maize/sorghum griddle cakes, accompanied by Ethiopian coffee.

The greens are leaves of the moringa tree and are very nutritious, a source of beta-carotene, Vitamin C, protein, iron and potassium. http://www.treesforlife.org/our-work/our-initiatives/moringa Our hosts cooked them with some potatoes and they tasted much like collard greens to this Louisiana native. The bread was as close to southern corn bread that I have had in six months, and along with the husk coffee (made from the covering of the coffee bean which was discovered in Ethiopia) and freshly ground pepper paste, it comprised the best meal I have had in Africa.

Our trip back to Addis Ababa from Key Afer proved the old saying from Pliny the Elder (I think): ex africa semper aliquid novi, or "out of Africa, something always new" .... certainly new to us, some newer than others:

calves still nursing cows way past weaning time (happens even in North Carolina!)....

"wonkay" (spelled phonetically) sheep on the road with their white bodies and colored, mostly black heads ....

cylindrical "barrels" high up in trees that turn out to be placed there for bee keeping

LOTS of water flowing beside and across roads causing lots of erosion ....

and spectacular morning views in Arba Minch ("Forty Springs") of forest and lakes hundreds of feet below and miles beyond. We returned to Djibouti on Halloween and began planning the final stages of the VETCAP.

As a final shot I'll send some photos of the outstanding group of Soldiers and Sailors that I have been working with.

The group photo was taken the night we said goodbye to LCDR Steve Kummeth (second full row, center), commonly called "Beaker" before he redeployed to the U.S. The quality of my comrades is exemplified by the guy standing to my left, at the right end of the first full row. Sergeant First Class Sean Berk is an Army Reservist who started his Army career on active duty as a tanker and deployed in the Balkans on OPERATION JOINT GUARD in 1997. He later joined the Army Reserve and became involved with Civil Affairs. When deployed to Iraq his vehicle was hit with an IED (Improvised Explosive Device) and he suffered some hearing loss.

In Uganda he was the Operations NCO for our VETCAP there and took his turn working the cattle, as you see him framed between Ankole horns in the photo. He's a great soldier and is the mission commander for the Ethiopia VETCAP. They just let me go along for window dressing. Having somebody with little hair, and what there is of that being gray, lends the appearance of gravitas to the mission even if it isn't deserved.

The last photo is of my "Retirement ceremony."

The day I turned 60 in September was when I would have started drawing my Army retirement pay, but since I was on already on the payroll, that will have to wait. Suffice it so say it was an honor to pass that milestone in the company of Soldiers, Sailors, Airmen and Marines. Only Soldiers are in this photo but we proudly serve with all the rest.

The Ethiopia CAHW Training VETCAP is 13 Nov – 8 Dec. CPT Amanda Coenen and I get on the "Rotator" flight for the U.S. one month from today, Dec 11, 2008.

See ya'll soon - all the best!

Jim Floyd, DVM
COL, VC, USAR (Ret)

Kampala, Uganda - October 16, 2008

Dear Family & Friends:

We have completed our month-long VETCAP (Veterinary Civic Action Project) at Internally Displaced Persons (IDP) camps in Gulu & Umuru Districts and are now in Kampala awaiting transport back to Camp Lemonier, Djibouti. We worked at 41 sites over 20 treatment days in this, the third VETCAP in northern Uganda this year, the 1st in Jan-Feb and the 2nd in Mar-Apr. The response to the cattle treatments at the initial missions was excellent based on a sampling of weight gains estimated by heart girth measurements.

Our U.S. military team from the Combined Joint Task Force - Horn of Africa was joined by faculty and students from the veterinary school at Makerere University and Veterinary Officers from the Uganda Ministry of Agriculture Animal Industry & Fisheries. We treated a total of 78,604 animals including 23,903 cattle (sleeping sickness prophylaxis, deworming and external parasite treatment), 23,394 poultry (individual birds vaccinated against New Castle Disease Virus, primarily chickens but also many ducks), 14,061 goats & sheep (deworming and external parasite treatment), and 2,400 pigs (dewormed as individuals). We also vaccinated about 4,000 dogs for rabies.

CPT Amanda Coenen and I were the two U.S. Army Veterinary Corps officers on this VETCAP. We concentrated on preparing the pharmaceuticals at our two sites, Amanda with "Team A" and I with "Team B." Both of us focused on cattle since that was the most labor-intensive part of the work at each site, involving herding and physically dealing with animals ranging in size from less than 50 kg up to >500 kg, many being Ankole cattle with LARGE horns.


There was a surprisingly large number of intact males. Bulls are used as plow animals and relatively few are castrated. The "cattle crushes" in which the treatments were administered were constructed at each site by the villagers in the IDP camps from local materials, primarily logs and limbs from trees held together with nails, rope, and in some cases bark. It goes without saying that this was a challenge.


This area in northern Uganda has been contested between the Ugandan Peoples Defense Forces and the rebels of the Lord's Resistance Army led by Joseph Kony. The LRA is still active in the Southern Sudan and neighboring countries; they have abducted thousands of children as "child soldiers," causing the rural populace to move into IDP camps so that the UPDF could protect them. In addition to armed attacks, ambushes and raids, during the conflict mines were used by both sides, resulting in the loss of life and limbs by the people.



Many of the people are now moving back into their former homes and the population of domestic animals is increasing, but the IDP camps still have many people in residence.

I will attempt to attach a few pictures but the number will be restricted because of internet limitations until we return to our base in the Horn of Africa.

All the best!

Jim

Countdown in North Uganda

Dear Family and Friends:

We have 9 mission days to go, over the half-way point on the Gulu, Uganda VETCAP. Today is the Muslim holiday marking the end of Ramadan so we are not working; make up for it by working this coming Saturday. Yesterday our team processed 1562 cattle and hundreds of goats/sheep and poultry in Lalogi. The other team did about half that number of cattle, but it all depends on how many the people bring at each site and how efficient we can get them through the villager-constucted working facility.


This is a picture of Stella, one of the vet students from Makerere University working with us. She was holding her own during a lively discussion during a break.


The animal in the "crush"/chute looks about like I felt yesterday after too much sun and too many trips up and back along its length. Not exactly like a Temple Grandin-designed working chute in a western Kansas feed yard, to say the least! And this is one of the better ones we have used.

Hope the pictures get through. Internet connection is dicey here; have to use a cell phone connection and purchased air time minutes.

All the best! Things going well here and the cattle and other animals have really benefitted from the U.S. efforts provided through USAID, the U.S Embassy and the Combined Joint Task Force - Horn of Africa.

I can't respond to all email messages because of the iffey connection but hope you are getting the pictures and messages as I can get them out.

Jim

Email to friends and family (8/08/08)

To: Family and Friends

We are back in Dar es Salaam and getting ready to get on Air Force C-130 to head back to Combined Joint Task Force - Horn of Africa in Djibouti. Our VETCAP (Veterinary Civil Affairs Project) in Tanzania is completed. We were able to positively affect about 62% of the total cattle in the Tanga district in the NE of the country. I will attach the latest UNEDITED version of my "HOA Diary" which you may find amusing.

We visited a dairy processing plant in Tanga day before yesterday and we were impressed by their progress since having started such a facility only a few years ago, and demand for dairy products being relatively low. They could use a national dairy checkoff program but they don't even have mandatory pasteurization laws yet. I'll also attach a few pictures of the last couple of days, including a very friendly dog that CPT Amanda Coenen befriended, some donkeys mixed in with the cows, and a few spectacular ticks on cows.




If they aren't attached when you get this it will be because the connection bombed.

We head to Kenya for next VETCAP on August 12, just next week.

All the best!

Jim

Tuesday, August 5, 2008

Our last day of the VETCAP mission involving animal work. We meet at the Ministry of Agriculture office with Mama Safe, Freddy Manju and the others who have participated. Dr. Shimbolu, the veterinarian in charge joins us today. We will have a local TV station covering our activities. LTC Pope hands out certificates to the Ministry personnel and to our contract drivers who have been taking us around.

We depart to the south once again and work about 600 cattle today. Dr. Shimbolu takes active part, including herding the animals, which goes pretty much as usual. Dr. Shimbolu explains that his career has progressed from the ground floor up. He began working as a layman first and then obtained a two-year certificate, and then a veterinary degree (I believe that was his progression). He has served in different locations in Tanzania, and for about the past six years in Tanga.

After our day we head “home” and at the hotel we meet to plan the trip back to Dar es Salaam and get the unused items ready to leave with the Ministry personnel. We have left over pour-on permethrin and dip tank permethrin, ivermetin injectable, FMD vaccine, rabies vaccine, New Castle disease vaccine, injectable antibiotics (tylosin, oxtytetracycline, and penicillin-streptomycin), and antibiotic spray (oxytet and gentian violet “purple spray”). We also will leave the remaining “gun” syringes made in West Germany and the parts from those that broke down, and needles. We also prepare some to FMD vaccine, pour on and ivermectin with “Jane” the desk clerk who we had agreed to help with her 16 cows but now we are unable to do because of “protocol” with the Ministry. We are OK with leaving the treatments but she and her brother will have to do them.

We settle up our hotel bills, mine amounting to 1.885 Million TZA shillings. That night have supper at the Kiboku (Hippopotomus) Restaurant, joined by 1LT McCoy and SFC (MSG?) Rodriguez of the Civil Affairs team stationed in Tanga. The best item on the menu for the money is the mishikaki, or beef which is grilled on a skewer. One shiskabob skewer of six pieces of “steak” is 4,000 TZA shillings, or less than $4 U.S. Goes well with a Tusker or “Kili” (Kilimanjaro) beer and chips (fried potatoes) and a salad of cucumbers, tomatoes and a slaw which is pretty tasty.

Monday, August 4, 2008

We depart the hotel with the convoy and equipment, pick up the Ministry of Agriculture extension personnel and travel to a new site on the coast, south of Tanga toward Pangani. The site is off the road a short distance with one of the standard triangular concrete floor holding pens connected to a “crush” raceway which leads to a dip tank with a new green tin roof. This dip tank is full of dark liquid and we are told it has been “charged” with acaricide.

The cattle are already lined up so we begin work with our standard protocol of FMD vaccine (3 ml SQ), ivermectin at 200 mcg/kg (1 ml/50 kg or 110 pounds), and run through the dip tank. The sides of this facility are sturdy but the design is not conducive to the cattle moving from the triangular holding pen into the raceway/”crush.” The triangle is not round, there is no crowd gate, the sides are not solid, and the cattle probably have a memory of the dip tank. It all equals the same situation whereby the cattle are forced into the “crush” by stick wielding Tanzanians who flail away at them until they move, usually one a time into the crush for processing and dipping. All going according to plan.

These cattle are in pretty good shape although they are particularly “ticky,” with virtually all having large numbers of ticks on their bodies. By sitting down and letting one group walk by me, and pretty much over me for that matter, I am able to get some good photos of ticks on teats and other areas that I had not previously captured “on film” (digital film, that is). The group of cattle that I am taking images of is held near the entrance to the holding pen and I help keep them held close until for some reason the group of “cowboys” heads them back in the original direction from which they came. At the same time they shout back at our folks in Swahili and gesture angrily, none of which I understand other than to realize that they are P.O’d.

LTC Machera tells us that they arrived late and were trying to get into the holding pen with their group ahead of another group that had been before them. They left in a huff, and in a few minutes a few of them came back to continue the “discussion” with some of the Ministry folks. I am concerned that it might turn a little rough but eventually they leave and work continues.

By the end of the day we have worked about 800 cattle. CPT Coenen befriends a couple of dogs, one a tan colored male named “Simba” (Lion in Swahili) and the other a black and tan female whose name sounds like “Baretto” or something like that, but we are unsure if it has a meaning. They are friendly and enjoy getting scratched. “Baretto” gets 2 ml of albendazole as a door prize for showing up, just in case she’s wormy. Both are tossed in the dip tank by the Tanzanians who claim them. They both swim to safety but Simba seems to have his feelings or pride a little wounded and diverts around the back of the dip tank instead of coming back to the side where we are standing. Baretto is none the worse for the wear and shakes it off as an unchanged, but now “dipped” dog. We depart and head back to Tanga.

Friday, August 1, 2008

On the way to the day’s work site we stop at the Ministry office and Mama Safe gives me the report from “Mkwakwani Vet Care” that the blood sample we gave to Dr. Shimbolu yesterday showed “few Theileria prioplasms.” As it turns out that cow had been vaccinated for East Coast Fever (I had noticed a circular ear “button” (looked like an RFID tag from the US) but did not notice that it was the evidence of ECF vaccination. Because of this status, the recommendation was to treat with “30% OTC” (300 mg/ml oxytetratcycline) or “inject with “(1) Butalex /Parvequone and (2) Oxytetracyclines.” Mama Safe explains that this recommendation is because of the previous vaccination.

We had treated the animal with injectable OTC (note: it was 100 mg/ml; we don’t have any Tetradure or 300 mg/ml) at 4 mg/kg as per label dose, leaving two additional treatments for the following two days. Our references on ECF vaccination state that the modified live organisms are injected simultaneously with oxytetracycline or followed seven days later by parveqone or buparvequone. Not having any clinical experience with ECF, we estimate that our treatment of that cow with OTC was according to the recommendations and leave it at that.

We go to another new site today which is a good ride from Tanga. We stop on the way to pick up a village elder who is dressed in a long robe and has short, white hair. He looks every bit the wise man. We arrive at an area with a circular corral constructed of acacia branches, about 20 yards in diameter with a “crush” leading off one end with no funnel or narrowing where the crush joins the circle. Trouble to come? We are accompanied by two mini-buses of about a dozen midshipmen from the US Naval Academy who are visiting CJFT-HOA and Tanzania. They visited a well drilling site yesterday and are to spend part of the day with us.

We set up the vehicles to the side of the crush and the Tanzania’s start running the cattle through. I am asked to give the middies a briefing on what we are doing. There are not many questions although a few arise during the briefing and after as they observe. The first question was about how thin the animals appear, to which I respond that they are in good shape for Zebu cattle. Most are in pretty good body condition, the grazing not having been too bad thus far this year. They are asked to participate in herding the animals, which three or four of them do and are pretty game.

The amount of whipping of the cattle that the Tanzanians are engaged in is clearly worrisome to a few of the middies, as it has been to us. I explain that this is their way of doing business and we have not set this VETCAP up as an educational program in cattle handling, although we might want to do that as part of a future effort to promote the faster working of the animals. One female midshipman asks about how animals are slaughtered and I confirm from LTC Machera that the slaughter process is universally of halal type by cutting the throat. One middie asks if we are pregnancy checking; he had some background on a ranch somewhere I am told. Dr. Machera mentions to the group of middies that we are also interested in maintaining a healthy supply of animals to provide food for the people and to reduce zoonotic diseases. The middies depart by late morning.

At midday CPT Coenen and I are asked to conduct an ante-mortem exam on a 150 kg heifer who is to be slaughtered. She is tied by the legs and in lateral recumbancy. She appears healthy and is slaughtered by having her neck cut and bled, which mercifully goes pretty fast. We conduct a post mortem exam and she is clean. Many of the Tanzanians gather wood for a fire with four posts set at each corner about two feet in height and from which a frame is made of green wood for the meat to cook. The first pieces put on the “grill” are liver, kidney and tongue, followed by muscle. It is brought first to us for sampling and is not bad, especially with a little salt which they have.

The village elder who had been present yesterday when we had examined the cow with the fractured metatarsus speaks with me. He speaks very good and deliberate English, better than other Tanzanians I had encountered yet. He expressed the opinion that the advice we gave to slaughter the cow was very good and he appreciated that we had given it. That made me feel much better about the previous day’s business, having seen the disappointment in the faces of those responsible for that animal.

It turns out that all of the cattle we are working today are owned by one man, the only one so far who I have seen wearing a cowboy hat, or what could pass for one. He is on the ground herding with the others and is a somewhat larger man than the average. MAJ Azes (sp?), one of the physicians from the Tanzanian People’s Defense Forces, tells me that he began with only three cows. He is obviously very smart or very lucky, or a combination of both. He also may have other means of livelihood but I can’t determine that.

Toward the end of the day the animals, which are tending to be larger, are not moving out of the circular corral and into the “crush” lane very well. It’s taking a long time to finish up. They try to cut out a group from those in the corral and herd them over to the crush entry, which typically ends up with many rejoining the main group despite being hectored and beaten vigorously by a number of stick-wielding Tanzanians. The problem is that they can’t readily see the small opening to the “crush” lane as an escape route, and until we get some of the workers to step away from the other side of the “fence” right by that entry they are also seeing people in their “flight zone.” It is one of the more frustrating episodes we have had when it comes to seeing the consequences of poor facility design. The irony is that the cattle are largely contained by the brush corral and the stick fences, which the Tanzanians admirably repair with strips of bark “twine” as the fence becomes weak during the day.

I decide to make the conduct of a cattle handling course a long term goal, and will make efforts to see if we can make that happen in the future. I predict it will take a few years and that the best way to do it would be through the Tanzanian Ministry of Agriculture, which has good extensionists like Fred Manju and Mama Maud Safe who have worked with us every day. Dr. Shimbolu, the Ministry veterinarian who we have met with twice, told me that they conduct training for these laymen every few months, which is apparently effective given my estimation of their understanding of the diseases we are working with. My impression is that Tanzania is ahead of the other countries we will visit, including Kenya and Uganda with regard to its Ministry infrastructure and extension system, so it would be the place to start.

I note that a few cows have the yellow ear button that the ECF vaccinated cow we treated a few days ago had. Closer exam of these tags shows them to have “ECF vaccinated” printed on the edge along with an ID number. We close up shop at day’s end having worked between 1200 and 1300 total cattle. I confirm from our Tananian PDF physicians that “sleeping sickness” in humans is not a disease of high incidence now and that controlling tsetse flies in cattle is a way to reduce the disease in people; they also express that cattle can be a reservoir for some trypanosomes that affect people. Upon return to the hotel we learn that Saturday CPT Coenen and I are to accompany LTC Pope and MSG Holland to conduct a PDSS (Pre-Deployment Site Survey) with LTC Machera and Mama Safe to the sites that the next VETCAP phase will work at in November.

Thursday, July 31, 2008

Dr. Shimbalo (Sp?), the ministry veterinarian we met on the first day we arrived, was at the office site where we always pick up Mama Safe and Freddy, et al. We discuss how the work is going and the animals we treated yesterday. He takes the EDTA blood sample we drew and will have a smear done for tick borne RBC parasites, not failing to mention that we should also have taken a lymph node aspirate in any case of suspected tick borne disease. We have a good discussion of therapies they use. They use label doses (“manufacturer’s recommendations”) of drugs such as oxytetracycline and pen-strep, which is what we did yesterday with our treatment of the more mature cow with OTC injectable at 4 mg/kg. They stay with label doses and train their field workers to do this. I assume that these antimicrobials are effective at those doses because they may not have been used widely, although the isometamidium (“Veridium” or “Samorin” by trade names) that are used for prevention and cure of trypanosomiasis are certainly widely used. He also mentions that stacking treatments such as buparvaquone (“Butalex”) for theileriosis/East Coast Fever along with the babesiosis treatment we have, imidocarb (“Imizol”) i.e. the same as “Diampron” that we used in Devon in 1979, and even along with OTC as combination therapies is an ok practice. They do not like multiple antigen vaccinations, however; hence their reluctance to immunize with both FMD and Lumpy Skin Disease at the same time.

We go to a new site for working animals today. An old unfilled dip tank reveals just how deep they are. I estimate the depth is ten feet at least. This one has not been used in a while. A nearby concrete walled building has “16-3-1980” etched in the concrete to memorialize its construction date. I am told by Anna, one of the Extension workers who rides out with Amanda Coenen and me today, that the square tank to the side of the dip tanks is for conserving water and premixing the dip. Still not sure the exact function but that sounds good. In any event, we are not using the dip tank and the number of cattle to be worked is relatively small. By the end of the day, which we declare over by about 11:30 AM, we have only worked about 200+. These are small herds and the cattle are somewhat thinner on average. One of the young men has an “Alabama Crimson Tide” t-shirt. I take several pictures and will send to the Auburn crowd.

I do a stand up interview for the “Combat Camera” crew which is composed of Air Force personnel, including one still photographer, one motion picture cameraman with a Sony, and one who is a Public Affairs guy. I manage to talk about cattle infectious diseases and how the Tanzanians work their cattle for longer than necessary, but they keep prompting me to talk more: “Why is this mission important to the CJTF-Horn of Africa?” “What would you say to students who might be visiting here about what you are doing?” “What has been the greatest challenge?”

I talk about the importance of tick borne diseases here in East Africa and about how CPT Coenen and I lack clinical experience with the particular ones they have in abundance. I mention that we treated an animal with signs of East Coast Fever yesterday and that it was the first one I had encountered, along with all the FMD vaccines being the first I have administered. I mention that it would be great to have our veterinary students from NC State here to share in these clinical experiences, emphasizing that our knowledge of Foreign Animal Diseases is critically important to our ability to keep the US free of them.

While I am talking Amanda takes a look at a cow that had gone through the “crush” earlier and then had injured her leg in a fight of some type. Her right rear metatarsus has a complete fracture on the distal end above the fetlock. This is a mature cow; the fracture is not at the epiphysis but it is complete; not compound yet but it will be if given the chance. She is standing but cannot bear weight on the right rear, obviously. Although we discuss making a splint and using the small amount of water activated casting tape we have, it is obvious that there is no way to stabilize the fracture and the best course of action is slaughter and salvage. With the help of Freddy, Mama Safe and Major (Dr./MD) Asez (sp?) of the Tanzanian Peoples Defense Force who is with us every day along with LTC (Dr./MD) Macheka (sp?), we inform the owners and the village head that the prognosis for successfully healing the fracture is hopeless. I help the 300 kg cow, who is in lactation (she also has a neck bell, indicating some worth) at about 5+ years old, to walk to a shade tree and then we depart.

We have no firearm with which to shoot her or drug that we could use to euthanize her, which would not be appropriate for slaughter anyway. I am guessing that if they do slaughter her they will cut her throat. Very sad that we couldn’t help her or them, but it would have been hopeless given the location and nature of the fracture. We considered going through the motions of splinting her but CPT Coenen and I agreed not to and also convinced Mama Safe of the wisdom of this. She and the Major talk to the owners and people, who I hope understood.

We leave and return to the hotel by 12:30 PM in the early afternoon, a very light day. We believe that there was a failure in communication which prevented any numbers of cattle being treated today. CPT Coenen takes on the task of arranging the two “VETCAP” boxes with drugs and equipment so we can better find things. She is doing a great job. Don’t know about me.

Wednesday, July 30, 2008

Mujambo (Hello),

On the way to breakfast the spider monkeys are on the roof of the passageway between our wing of the hotel and the lobby and dining room/bar.


I stop to take a couple of more pictures of a mother and baby suspended on her chest, and another who is eating mango or papaya right outside the window. The light is not good so the flash automatically goes off, scaring them. Malaria prevention day for me so I take my weekly mefloaquine (Lariam) pill in the morning with breakfast.

We depart at usual time, stop at Ministry office to pick up Mama Safe, Freddy and the others and head back south to Pongwe, taking the “shortcut route” to the site that we departed on yesterday. A few cattle are there, supposedly restricted by arrangement to no more than 100 today at the “crush” site. We are to concentrate on goats and sheep, which we do. We begin by administering FMD vaccine (2 ml rather than the cow 3 ml dose SQ), ivermectin injectable, and Drop-On pour on deltamethrin. Quite a “goat rope” as the Massai capture them by their hind or front legs, one to three at a time and bring them up to us to treat and then be marked with a crayon. We adjust the dose of the ivermectin and pour on to the smaller size of the animals, some are babies and others more mature and of some size, including a few Billies. The ivermectin sting some of them quite badly when administered SQ, with a few running off and rolling on the ground or twisting their necks pretty wildly.

I find one goat who is three-legged lame, not sure if it relates to the SQ injection it obviously received (blood from injection site on neck) or from injury received at same or earlier time. It would bear weight on that leg if the other leg was held up but went back to non-weight bearing lameness when let go. Could not palpate a fracture or dislocation, so I gave that goat to over to the Lord and moved on. We end the day pretty early, about noon or so.

Two sick cows to look at. A mature milk cow with fever of 105.9 degrees F in good flesh and “sick for three weeks.” CPT Coenen and I do a physical exam: lungs clear, HR = 72 BPM, not anemic on vuvlar or oral mucoas and no signs of vesicles or erosions; peripheral lymph nodes not enlarged above those we feel on all the cattle that we have felt. She is not pregnant; her right rear quarter is hard but not inflamed and the milk is not abnormal. We treat with injectable oxytetracylcline and give enough to repeat the treatment for two more days, and give a multivitamin injection.

The other animal is a calf about 180 kg who is weak and has clear nasal discharge. The pre-scapular lymph nodes are very enlarged, about the size of a small orange. One of the animal health workers points out that the parotid lymph nodes are also enlarged. Temperature is 102.9 degrees F, not clinically anemic and no erosions/ulcerations/vesicles on oral mucosa. We diagnose East Coast Fever and treat with buparvanone (Bulalex). Based on what Dr. Mwossa told me, if we were being paid for this call we should get it now; the chance for survival is not good. We also give that one over to the Lord and to her Massai owner, and then depart. We took a blood sample in an EDTA tube from the cow and intended to do a smear to look for RBC parasites but managed to not get that done today; will try tomorrow and perhaps add ECF treatment to her if we have the chance to get it to the owner.

Kwaheri! ("Good Bye" in Swahili)

Tuesday, July 29, 2008

Departed Mkonge Hotel at about 8 AM and proceeded south of Tanga to Pongwe where we left the hard paved road in the middle of town and turned right through a “farmers market” of produce that was very lively. We then headed into the country where the scene shifted markedly from previous days. Now we are in more “farming country” with sisal plantations (not well tended) and cultivated corn (passed a field of > 4 acres), plus some houses that appear to be more prosperous, of brick construction but far between. Gives the feel of a “plantation.” We get to a dip tank and crush area with several Massai tribesman there, confirmed by our driver from Dar named Menonu. Mama Safe from the Ministry of Agriculture is upset that the “crush” allows the cattle to step outside the foot bath area because the poles are set to the side of the concrete, not in the holes in the pipe that was set in concrete. Nonethless we proceed and eventually work about 500+ animals but at slower pace than previously.

The Massai are good “cowboys” (and “cowgirls” - more than in previous days), but the crush is problematic and only holds about 5-7 animals at a time. By mid afternoon they are gathering individual animals outside of the gathering pen for us to pour on or vaccinate with FMD and inject with ivermectin. This being done by the younger Massai or women while the others still try to work them through the chute. Eventually they weary of it and start picking off individuals in the holding pen and catching with ropes or hand power to manhandle and then we injection and pour on. Many ticks including what appear to be Boophilus and perhaps, what I’m told is the Heartwater Bont tick Amblyoma (another tells me it’s Ripecephalus, the vector of East Coast Fever). Will send pictures to the parasitologists at NCSU for key out. We eventually work 500+. The chief Massai wants CPT Coenen’s phone number, dirty old man that he is despite his robes and dignity. We head back a different way, getting to Pongwe on back roads that get us to the hard ball quicker and more to the north than where we originally turned off. We reach the hotel and some of us meet a travel agent to discuss possible group travel to Zanzibar over the weekend. Then a group, including newly arrived “Combat Camera” specialists (Air Force) go to the “Hippopotomus” restaurant (Kiboko…in Swahili) for a pleasant supper and several beers (I drank Serengeti).

Email to friends and family (7/28/08)

Staying busy in Tanzania. We worked 1400+ cattle today including the two whose pictures are attached.





One is of a cow that may have had "lumpy skin disease" associated with a Caprivirus, or that's my best guess right now. The other cow picture is of a black and white animal probably with Holstein genetics that has a bad case of photosensitization on the white haired areas with less skin pigment.

Fairly common based on the several we have seen in the past couple of weeks. Since we are not working with local vets (there are some but not many) I haven't been able to confirm diagnosis on anything.

It's hot here but very nice on the whole with temperatures getting to the 90 F range at mid day but not unpleasant and nice in evenings as a rule. We are in the beginning of the dry season and the cattle are mostly in pretty good condition. They are concerned with East Coast Fever caused by a tick borne blood infection that attacks red blood cells, and also "Nagana", the cattle form of Tsetse Fly borne sleeping sickness, also caused by a blood parasite. All of us who are not native here are on anti Malarial drugs (mine is once a week) so these diseases are just a fact of life for man and beast.

If you are interested, Google "The Battle of Tanga" and read about the British invasion of Tanga in November, 1914 at the beginning of WWI when Tanzania was part of German East Africa. We are staying in Tanga where the British made an amphibious landing of sorts, also known as the "Battle of the Bees" because they had as many angry African bees to worry with as well as with the Germans who then managed to push them out with a force inferior in numbers.

Must run before email fails, as it seems to do from time to time. -- Jim

Monday, July 28, 2008

Left at 8 AM, usual time for VETCAP departure from Hotel Mkonge, in convoy of four SUV’s and one van. Picked up Ministry of Agriculture (Livestock?) folks including Mama Safe and “Freddy” plus others to head to Pongwe site, same as Friday. We are told to expect 900 animals but by the end of the sunny, hot day we have worked >1400, including 40 owned by one of the Ministry extensionionists to whom we give 40 doses of FMD vaccine and enough injectable ivermectin to treat 40 cattle @ 400 kg; good deal for him. I get some sun on my face, neck and arms as the temperature gets into the 90’s (F) by my estimate.

Amanda Coenen and I are asked to inspect two goats who will be slaughtered for lunch. We do an antemortem inspection and then a post mortem, with able assistance from one of the Ministry personnel who is pretty spiffy at finding the parotid and retropharyngeal lymph nodes. Despite the busted gut and hair on the carcass, we pass them both as essentially healthy. I am befuddled by feces in the spiral colon I mistake for a lymph node chain, but other than that don’t look too bad. At lunch, which is not ready until about 4 PM, the boiled meat, liver, bananas and cucumbers / onions are not too bad although I pass on the liver, as always.

We finish up and return to the hotel. I commandeer Menano, our driver, to take me to the Tourism kiosk in town to ask for location of Commonwealth Graves Commission cemetery. Same guy there on Saturday tries to talk me into getting him to tour me there rather than showing me on the map. I decline and will find it on my own. After cleaning up and sending emails to Mother, Twila, and also to Family and Friends along with pictures, I walk to the Tanga Yacht Club and have fish and chips along with a Bushmills and water and then a Tusker Beer for supper. All in all a good day.

Friday, July 25, 2008

New site south of Tanga off road leading back to Dar es Salaam going by the airport toward Pongwe. Close to habitations and to more built up area than previous sites. This site was next to a dip tank of same design as the one at our first site several days ago, but the cattle at this site had already been dipped. We worked 1400+ cattle through the corral / “crush” here. Longer corral and more sturdy but each group had to be herded to the entrance that lacked an efficient gathering area to funnel the cattle into the chute. With brute force the Tanzanians beat the cattle into the chute. Numerous Ministry of Livestock local extensionists do the injections.

CPT Coenen and I first started out marking the cattle with colored markers but then passed that over to some of the extensionists. Hot day again and I got a bit of sun, although this time I borrowed sun screen from Amanda who is red headed and also fair skinned. On each of the days so far we have started out by leaving the Hotel Mkonge and traveling to a Ministry of Ag/Livestock office to pick up Mama Safe (Safe’) and “Freddy” who head the team of extensionists. Today was the first day Mama Safe did not accompany us. She was dressed up this morning when we arrived and looked to have other business to attend to.

After returning to the hotel at work’s completion, we cleaned up and then walked to the Tanga Yacht Club for some refreshments and then supper. One has to buy a temporary membership for either a day or a few days, and then a book of chits for various denominations summing to 5,000 Tanzanian shillings, or about 5 dollars U.S. (exchange rate when I converted at airport was $1 U.S. = 1,060 Tza shillings). Yacht club gets more crowded as the night wears on. We were among the first to arrive when we got there at about 6:20 PM or so.

Thursday, July 24, 2008

New site with numerous cattle to be worked. Left the hard paved road and travelled well into the countryside north of Tanga. A circular corral had been built using Acacia tree limbs and branches; thorns made it not unlike barbed wire. A chute / “crush” had been constructed at the opposite end from the entry to the circular Acacia corral. We worked about 1300+ cattle through by 1730 hours when we departed. Protocol was same as yesterday: injectable ivermectin, FMD vaccine, and pour on deltamethrin. Because ivermectin was running low I returned to Hotel Mkonge to retrieve more. Previous resupply mission retrieved additional FMD vaccine. Round trip took about 1.5 hours. When I returned they had run out of ivermectin 10 minutes ago. Locals provided some cooked goat and banana for lunch.

Wednesday, July 23, 2008

Went to a new site today with a more sturdy “crush” and larger, more “Brahma” acting cattle. More like working them in the southeastern US with typical Brahama cattle cries when they are in the chute being vaccinated, etc. Vaccinated 377 for FMD and treated with ivermectin injectable plus pour on permethrin derivative (deltamethrin) Bayer product “Bayticol.” One calf with lymphadenitis was bled and blood heparinized and EDTA preserved for smear tomorrow for East Coast Fever, trypanysomiaisis. Getting there north of Tanga we drove through several villages with cultivated areas of corn and cassava. I noticed what appeared to be number of ricin plants growing off the road. Several large centipedes / millipedes in the area.

Monday, July 21, 2008

Third day of working cattle at the crush and dip tank. Amanda Coenen went to vaccinate chickens while I stayed to work the cattle. Back at the hotel I send an email and some photos to friends and family back home, including


(1) some of the meds we are administering (isometamidium Cl injectable for trypanosomiasis /"Nagana", ivermectin injectable dewormer),


(2) abscessed lymph node on animal suggestive of prior bought with East Coast Fever (Theileria parva infection),


(3) engorged tick removed from cow with > 2 ml blood taken from tick (plenty more left), and


(4) an animal going through a dip tank after other medications.

We take our cues from the Tanzania vets who asked for certain meds and support, which we provide. Pour on ectoparacides are being used most other places but in this location they wanted to use the dip tank, which occasionally gets a dog thrown in for good measure.

My connection is slow and may not handle all these photos but will try. This is the closest to a blog I can do right now.

All the best -- Jim Floyd
Tanga, Tanzania - VETCAP mission