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I came to live in Central Africa because of the wild mountain gorillas. But they aren't the only animals that need health care around here.
When it comes to wildlife medicine, we (MGVP) are the major resource in Rwanda and the adjacent areas of Uganda and the DRC. There are district veterinarians who take care of farm animals, a handful of small-animal veterinarians who work in the cities and a few government-salaried vets, but overall, we're the only professionals in the region whose job it is to look after sick or injured wild animals. So we do what can when we're not in the field with the gorillas.
In the past six months, we've treated or collected samples from a variety of species: a chimp with meningitis, a baboon with a snare injury, two golden monkeys caught by farmers for stealing potatoes, a half-dozen parrots, numerous wild forest buffalo (several of which were killed by the local community for meat), and several dozen dogs whose owners requested a spay or neuter. I even paid a call to check on a downed cow belonging to the chief park warden of the Parc Nationaux des Volcans in Rwanda. Just as I was deciding she must be suffering from low calcium or magnesium, the district vet appeared and administered the treatment for both problems. She was up in an hour.
So when my cell phone rang the other day about a new non-gorilla problem, I took a deep breath. Luckily, we had no active wild gorilla patients because this case was going to be a big one — a giraffe with a snare around its leg in Rwanda's southernmost park, Akagera, a four-hour drive from here.
The park system vet, Dr. Tony Mudakikwa, was calling to ask if I had a particular type of anesthetic and if so, could he get a supply from me? My answer was no, but I had something similar. I wanted to help, but reminded him — and myself — that giraffe anesthesia is very risky and should be attempted only if absolutely necessary. I'd have to call or e-mail for advice from my zoo and wildlife vet friends about the dosage. Meanwhile, could he find out more about the giraffe, or maybe even go see it?
I'd anesthetized several giraffes in a zoo setting years earlier and knew how difficult it was to do this procedure safely — for the people and the animal. But I also felt we should try if the problem was confirmed and there were no other options, like flying in experts from South Africa who do this sort of thing routinely. I called each of our field vets and our director, Mike. All agreed: we should help and we’d work together as a team.
The subject line in my e-mail query read, "It's a giraffe with a snare, not a gorilla!" I figured they might wonder why I was asking them about giraffe anesthesia when they know I work in the mountains and not the savanna. The word "snare" would explain. This is an awful injury no matter what the species — all the more distressing to a vet because it's caused by human hunters.
Two days later, armed with expert advice and all of the equipment we could think of to bring, our entire MGVP field vet team gathered in Ruhengeri at 4 a.m. — myself, David, Jacques and Eddy from the DRC, Benard from Uganda and Jean Felix from Rwanda. We picked up Tony, the park system vet, in Kigali — he hadn't yet managed to get to the park to see the patient — and arrived at Akagera National Park by 7:45 a.m.
Akagera's warden, Robert, and one of the lead rangers, Roger, were happy to see us. They explained that the giraffe, a nearly full-grown male, had become unable to keep up with the herd. Worse, he was so lame that he was barely eating and hadn't found his way down to the watering hole in days. We set off to take a look at him, driving into the park and then following him on foot. Tony felt this would be best, though I'd never gotten close to any hoofed animal without remaining hidden in a vehicle. We scrambled through the thorny acacia, but could get no more than a distant glimpse of our patient.
We switched back to the truck. An hour later, after driving slowly through the bush with the thorns screeching against the metal sides of the car, we finally got a good look at the giraffe and were able to take pictures. The young bull had a dark wound encircling his lower left front leg above the hoof and the entire leg was swollen to twice its normal size.
He also looked thin. The problem was not new, we learned; nor were we sure we were seeing a snare. If we decided to try anesthesia, the difficulties would be even greater than I'd envisioned. Darting alone would be a challenge, since this was not open savanna. I urged Tony to call the South African experts. Two hours later we heard that they couldn't get to Rwanda any time soon.
I thought to myself, "Do I do this?" It's true that I'm the only one in all of Rwanda who knows how to anesthetize a giraffe; on the other hand, since I've never worked on a wild giraffe, some of the experience will be new to me, too. The recommended anesthesia involves a three-drug combination that has only been recently studied in this species. Plus, these anesthetics are dangerous to handle and our team members will be speaking different languages — English, French and Kinyarwanda. But if we don't act, the giraffe will continue to suffer — veterinarians take an oath to help animals in need.
I decided the right thing to do was try. But by then, the day was mostly gone; we'd have to stay the night and make the attempt first thing in the morning.
Despite a night of little sleep, my mind occupied with all the things that could go wrong with giraffe anesthesia, I felt calm the next morning. We drove slowly through the thick bush up to the lame giraffe. I'd decided to give the anesthetic all in one large volume dart, which meant using a CO2-powered pistol (our powerful and more accurate rifle takes only small darts). This meant we had to get close.
The giraffe was calm but kept his distance. I had to aim high and lob the dart in. It stuck, but not hard enough to inject. I made another dart and lobbed it in. It went off just fine. The giraffe went down smoothly 14 minutes later. He lay on his side and breathed well.
We'd assigned everyone a duty and those working on anesthesia with me, including Eddy and Benard, helped to get his head and neck properly positioned — outstretched on a board.
The snare-removal team started in on their job. They confirmed what our pictures had told us: there was no longer a snare embedded in the leg. Jean Felix, Elisabeth, David and Tony worked rapidly to cut away the ring of scar tissue and clean the wound, following the track down to the bone.
I briefly examined the leg with them. We couldn't find any foreign material, but hoped that by cutting away the old diseased tissue and aggressively cleaning the wound we could reduce the tremendous swelling. Meanwhile, Benard got blood samples and Jacques snapped pictures.
I focused nearly all of my attention on the giraffe's breathing, determined that he survive the anesthesia (even in a zoo setting, one out of three giraffes do not survive). When his breathing rate dropped, I asked everyone to finish quickly so that we could wake up the animal. Jean Felix gave our patient a huge injection of penicillin, many times the volume of antibiotic needed for even the largest gorilla.
As soon as I gave the anesthetic reversal, I knew we'd be OK. The giraffe had gone down well and we'd worked quickly — the actual procedure had taken just 30 minutes. Now we needed to wait with him patiently and not encourage him to get up too quickly. I could see my team was a bit anxious, not knowing what to expect. We’d gathered around the backside of the giraffe, gently holding his shoulder, neck and head down on the board.
Sure enough, he began to blink and flap his ears under the blindfold after 10 minutes. I waited another five and pulled off the towel, but kept my hands under his jaw and asked everyone to back away. With a little push upward, the giraffe lifted his great head and neck off out of our arms, rolled back on his sternum and put his front knees down on the ground. He rocked back, pulling his rear legs under his body, then lifted his upper body and flipped his front legs under him. He stood up on all fours just seconds later and then walked quickly away from us.
I slapped Tony on the shoulder. "Yessss!! We did it!" Everyone was all smiles. David jumped up on the roof of the truck to keep an eye on the giraffe while everyone else packed up the gear. "He's walking slowly. Can't see him now behind the bush. There he is, still moving, looks normal, neck looks fine, perfectly straight. Gone now. There he is again. Seems fine."
The next day the giraffe was seen eating, though still limping and alone. Two days later he was back with his herd. Five days later the lameness had all but resolved. The combination of antibiotics and wound treatment seemed to have done the job. I suppose there could have been tiny fibers of an old rope snare embedded in that scar tissue, though the rangers say people use only metal snares around the park. Though we may never know exactly what caused the giraffe’s injury, we do know our teamwork probably saved his life. That's a good feeling.
[Rwanda, July 10, 2007. Pictures: Lucy Spelman/MGVP]
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