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Working in post-conflict and developing countries
  1. David Love

Abstract

David Love works in challenging situations that are not without risk. Here, he describes how his veterinary degree has allowed him to expand his career horizons beyond what may be considered normal for many British veterinarians

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AS a veterinarian, I have always considered myself to have a broad scientific education, an inquiring mind and a diverse range of interests and expertise. I guess I owe that, at least in part, to my introduction to the profession courtesy of Weipers, MacIntyre, Jarrett and others, during my time as an undergraduate at Glasgow.

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My postgraduate excursion into anaesthesia at Liverpool added to that diversity and even ignited a spark of interest in engineering design, while I was developing a portable anaesthetic unit for large animals, which was aptly named the ‘Love machine’ by my colleagues.

Various escapades in practice, industry, research, government service and inter-national marketing helped seal my fate as a generalist, and I have the BSE crisis to thank for my involvement in the food industry, meat hygiene and my introduction to public health. Sometimes, given this ‘Jack of all trades – master of none’ status, I have discovered hidden talents and interests that have helped me to develop and enjoy my professional career in spite of the challenges thrown in to disrupt my efforts.

As a clinician, I understand livestock production, health and disease control and have the ability to go back to basics when the need arises. I am familiar with snippets of the associated specialised disciplines (enough to have a meaningful discussion with experts) and at worst can always ask someone who knows!

While doing my slaughterhouse stint in the wake of BSE in the UK, I was forced to become interested in water quality and waste management, something that again allowed me to address my ‘frustrated engineer’ component.

Joining the aid circus

Afghanistan, Pakistan and Sudan are all countries on the Foreign and Commonwealth Office's (FCO's) ‘essential travel only’ list, and certainly not among the most popular tourist destinations. Afghanistan is an amazing country, not unlike my adopted home of Switzerland – its mountains, lakes and rivers, sunshine and snow provide stunning scenery, and there is even a fledgling ski resort. However, restricted movement, security concerns and a lack of basic essentials and luxuries demand a creative approach to daily life.

My initial involvement in the ‘aid circus’ led me to Afghanistan, and my first introduction came through a cold call from a Dutch non-governmental organisation – someone had suggested I might be interested in a challenge. The project was aimed at providing support for rural veterinarians in northern Afghanistan to encourage better disease recognition and provide prevention and treatment options to try to improve agricultural outputs for local farmers. Clearly, in a world without bells and whistles, you have to be somewhat sensible in your aspirations, and particularly ensure ownership and cooperation from those you are trying to help. Providing basic equipment (a motorcycle, a cattle crush, some syringes and needles, a thermometer and some medicines) means that the local paravet – following his (or her) six-month period of training in animal management and disease recognition – has some chance of success. Through extension services, the NGO provided guidance in running a practice business, as farmers were not used to having any service or, indeed, paying for it. It really was a lesson in back to basics.

Longer-term involvement in Afghanistan, working in the food safety and public health sectors, reinforced my belief that without clean and safe water, production of safe food was well nigh impossible. Most international colleagues quickly learn and accept that dirty water is the cause of much pain and discomfort, but in a Muslim country with strict rules on alcohol, there are few alternatives for quenching one's thirst. As a result, we depend on buying bottled water for our personal needs; however, millions of Afghans and their animals do not have that luxury, and often even the bottled water is contaminated with microbes.

Sustainable improvements that offer clear benefits do not have to cost the earth as these before and after views of a paravet's clinic show. (top left) The clinic was originally accessed through the hole in the wall (the cattle crush can be seen on the roof, which is where it had been put). In contrast the new clinic (top right) has a neat shop front appearance. Inside (bottom left and right), some simple changes make a big difference

Designing and procuring equipment for laboratories, border inspection posts, slaughterhouses, cold-rooms and waste management systems, as well as training staff in basic hygiene, inspection and sampling techniques, developing sustainable water purification systems for remote locations and some ‘real’ vetting, have all helped to enrich my experiences.

Change management

Much of the work involves the introduction and management of change, trying to provide support for the improvement of livelihoods and agricultural production. Since people generally do not like (or want) change, attempting to persuade senior government staff that the changes will bring future benefits becomes a serious challenge and usually involves drinking copious amounts of green tea in large groups where everyone has a private agenda.

Delivering more practical training is also necessary to teach new tasks and techniques in clinical care, meat inspection, border inspection, sample collection and laboratory methods. Such training usually has to start right from the beginning.

Most developing countries (and many civilised societies) suffer the same restrictions, and one needs to be able to look past the immediate ‘hand-out’ mentality. However, without doubt, farmers are always pleased when they are provided with a ‘miracle’ cure since, in many cases, the loss of one animal means the loss of their herd and livelihood.

For me, the most important lesson has been to learn to be patient, to ask, listen, understand and interpret the needs of the people and their animals, and to minimise the introduction of hi-tech and non-sustainable solutions. Improvements to clinical veterinary practices need only be modest and, with support from the local village community to provide suitable buildings, the benefits are clearly visible. State-of-the-art Western-style premises in the wrong location too often survive as unused mausoleums. With some common sense and by encouraging ownership and participation, bite-sized progress and simple improvements work, and can be managed by local staff (many of whom have no basic education).

Finding work

As with most working environments, the relatively small community means you soon get to meet the other people involved in your areas of interest. There are a couple of websites dedicated to the search for ‘experts’; however, many of these are required for potential jobs and often several consulting companies will be competing for the same contract.

As an independent consultant, I am usually paid for days worked and often provide my own insurance (medical and evacuation); due to the current FCO advice, the premiums are usually quite steep. I get offers of work through personal contacts and my CV is constantly being revised and updated to meet the keywords in newly proposed terms of reference. Contracts vary in terms of duration from a few weeks (often difficult, as time is extremely short), to several years (where the targets are more related to providing infrastructure and change management).

Being paid by the day, I am always looking towards the next contract and trying to understand the minds of those who write the terms of reference for the project. Living in these environments is sometimes extremely frustrating although the work is generally very rewarding, and I have made long-lasting friendships with many local people and expats.

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