Since no typed words will truly describe the goings on in Fez and the Fondouk, I can only recommend that anyone who gets the chance try and visit Morocco. Be forewarned that the culture is very different in all respects, and as an American you are a source of income for the people here. Moroccans can get pretty creative about getting tourists' money. There are a number of good travel references available, but the best situation is like the one I had at the Fondouk, where I lived with locals who could show me around and explain all of the ins and outs of functioning in this country, including how not to get ripped off. Speaking French was a tremendous advantage as well. Mohammed described it best today when he said "Morocco is always an adventure that starts the second you step off the plane." If you do decide to visit Fez, be sure to stop by the Fondouk and say "hi" to Dr. Frappier and meet the staff. The doors are open to the public weekdays from 7:30 a.m. until 1:00 p.m. Spending just an hour or two observing what goes on in the Fondouk is guaranteed to be an eye-opener.

While the working animals in Morocco have it hard, many of the people are suffering as well.

The political plight at the Fondouk seems direr every day. The depot of supplies and drugs are still sitting at the airport. Now the airport has been calling the Fondouk and threatening to return the shipment to the U.S. if the Fondouk does not pick it up. With no sign that Morocco is going to budge and grant the proper customs authorization for Dr. Frappier to pick up the supplies, the life blood of the Fondouk is trickling away. This is indescribably frustrating and has recently been a source of constant stress for the Fondouk's employees.

As a near-future equine veterinarian (assuming that pesky board exam goes alright later this year), my time in Morocco has renewed my passion for veterinary medicine and offered me a totally new perspective of the role of the veterinarian in society. I could barely communicate with the rural Moroccan farmers, yet I constantly felt displeasure in observing some of their practices. Regardless of how I feel things should be done, or the political battle between the Moroccan government and the American Fondouk, the bottom line is that these animals never asked to be thrown into their current situation. They just need people who will devote themselves now to alleviating animal suffering and try to educate the horse owners, even though the latter makes pulling wolf teeth seem a piece of cake. The work at the Fondouk must never stop.

Working at the Fondouk is as much an emotional journey as one of veterinary science. After just a month here, I would easily stay and continue to work tirelessly for these animals, without thought about my student loans, salary, or what kind of truck I want to drive. Now I understand why Dr. Frappier has stayed here all these years with no plans on leaving.

Thanks again to everyone who followed the blog and many thanks to The Horse for bringing this situation to the attention of horse enthusiasts everywhere. To learn more about the American Fondouk and/or to make a donation, you can find their Web site at http://www.americanfondouk.org/. 

I have been forever changed by this experience.

I am sitting in the train, which has just pulled out of the Fez station. I had no idea that I would have so much trouble leaving. I'm actually finding myself a bit choked up, after having made so many new friends and feeling so good about helping the region's horses. This experience has touched me in a way that's impossible to describe.

Left to right-- Back row: Garni, Mohammed, myself; Center row: Touria, Driss, Lyndsay (Western U), Dr. Frappier and his beloved Clara, Houria, Tamerin (Western U); Front: Azami. The donkey is Murphy!

Murphy looks a little confused... This is right before I left, so I got to enjoy the donkey smell on my clothes for the 5 hour train ride. It was worth it!

After a whole night of packing and preparing to depart, I stayed up to work this morning and enjoy the final moments of my Moroccan adventure. Working was a bit difficult because I was unwilling to get dirty, which would entail unpacking my bags for a change of clothes. I stayed surprisingly clean while passing a nasogastric tube for a fractious colicking mule that kept trying to go down, without so much as a few drops of mineral oil on my shorts.

The morning was bittersweet. I was sad to see that the neurologic mare had managed to rupture a hind flexor tendon over night, leaving her unable to bear weight on the right hind without the back of her fetlock touching the ground. The owner decided to sell her the butcher for 100 dirham (about $12). Moroccan people do not eat horse, but the meat will be used for dog food. The fact that the horse will go to slaughter before the proper withdrawal time for the medications she was administered really makes me appreciate our USDA and the strict regulations in the U.S. regarding drug use in food animals. There's no explaining such things to the Moroccan people. This mare's owner just sees the 100 dirham and would probably go so far as to walk into the Fondouk and take her away against doctor's orders.

I stood dejected in front of the mare's stall only to turn around and see a beautiful Arabian weanling. I talked to his proud owner for a while, who told me that the colt is destined to be a Fantasia horse. I didn't get to attend a Fantasia event this trip, but that's just one more reason for me to come back. The colt had a two-finger umbilical hernia. Doc referred him to a private practitioner for the repair.

In the last few minutes before I headed to the train station this afternoon, we managed to round everyone up for a great group photo. Then it was time for me to pose with our favorite pet/mascot at the Fondouk, Murphy.

Murphy is an orphaned yearling donkey that was dropped off at the Fondouk because his owner felt he would never be able to work. The farmer was right: Murphy has every major problem in the book. He is tiny (I estimated about 140 lbs), with hooves about as big around as my thumbs. The hooves don't hold him back as much as his hind legs--his hocks rub together and periodically catch on each other as he tries to walk. Thankfully he's also cryptorchid so we won't be expecting any baby Murphys any time soon!

The greatest part about Murphy is that he's the most friendly and happiest donkey I've ever seen. He acts like a dog. We let him out to graze in the concrete courtyard in the afternoons. He keeps the place clean, eating every little sprout pushing up through cracks and in the dirt around the Fondouk's trees. I laugh out loud every time I see the little guy. Doc said they will be relocating Murphy to a farm where he will not be expected to do any work. If I had even a quarter acre back home I would have taken him with me!

Sadly, this concludes the day to day journal. I had a great time sharing my experiences with all of you, and I truly appreciate the encouraging e-mails that so many have sent. I hope that the articles have been informative and entertaining. I'll write one more post to highlight some final thoughts before I get on the plane.

• Next Post: Reflection

Well, the end of my stint here is approaching. I spent little time in the hospital today in order to get some last minute things done before heading back across the Atlantic. I finally got a chance to see the Medina! The Medina in Fez is the largest in Morocco, comprised of a maze of narrow alleys packed full of small shops, cafes, etc. The most impressive part was the tannery, where leather is processed the old fashioned way into all sorts of attractive merchandise.

I finally got to see the hard working animals that I've been helping to treat for the last four weeks in their usual milieu. They are essential for transporting the heaviest of loads through the streets of the Medina, where no autos are allowed or would even fit. Surprisingly, most of the animals I saw on active duty looked pretty well cared for. Alas, the rubber shoes were rampant but actually did seem to prevent the donkeys from slipping on the slick stone walkways, which tend to be sharply inclined. Our visit to the Medina was cut short when the "tourist brigade" stopped Azami (the farrier), asking him what he was doing touring four Americans around the Medina. They are trying to cut down on fake guides who charge tourists too much money to show them around the Medina, engaging in all sorts of shady business. Even after we explained to the officer that Azami was our friend and co-worker, Azami was ordered to leave the Medina. Ridiculous considering that the Medina is where Azami lived for 36 years. That incident left a bit of a bad taste in my mouth.

The evening ended on a terrible note. The other students and I returned from dinner to find that someone had left a dying dog propped against the doors of the Fondouk. He was old and in rough shape, and he looked lifeless except for his continued attempts at difficult breathing. We immediately woke up Doc to get the euthanasia solution and put the dog down.

I will be taking the train out of Fez tomorrow afternoon. I'll be staying overnight in Casablanca because of my early morning flight on Friday. Not much left to do but get packing and reflect on all that I've seen and learned here. I'm looking forward to posting the most important lessons and the general impressions I've gained. I'm not, however, looking forward to leaving and I have promised the staff at the Fondouk that I will return the next chance I get.

• Next Post: Time to Go

Today was exciting and fast-paced. Since it wasn’t nearly as busy as yesterday, I enjoyed taking a little more time with the patients.

Today’s funny moment was during another teeth floating. This mule had a mouth full of stalactites and stalagmites that warranted the power float. And since we weren’t too busy, I enjoyed the luxury of having the time to do a thorough job. The mule’s owner obviously (even though I couldn’t understand a word he was saying to me) needed to get back to work pretty soon. Every time I turned around to grab a light or rinse the float, he tried to take off the mouth speculum and open the stocks as if he had an important rendezvous to get to. I was laughing as I finished the floating; this owner reminded me of a few of the more demanding horse owners I’ve met back home.

COURTESY DR. FRAPPIER

This is the cart injury horse. We knocked her down to put the pieces back together. Please disregard the split in Azami's coveralls; I know that drives all of the ladies here pretty crazy!

I was keeping busy when I heard Azami exclaim “wow…look what just walked in.” The horse was spurting arterial blood all over the courtyard from beneath her hind legs. The story went that this mare spooks easily, and she did so while pulling a cart today. It must have been a sight to behold as the cart broke apart and a piece of the wreckage penetrated the inside of her thigh, severing some large vessels and severely damaging the muscles and other soft tissues. While unfortunate for the horse, I was excited that we would get to treat a fresh wound, since most of the traumatic injuries we see are weeks old and infected. This wound repair went well. We were a bit worried about putting her under general anesthesia considering the blood loss, but she did fine and recovered uneventfully. We’ll keep her as long as possible to manage the wound healing.

The neurologic mare from yesterday is doing much better. She is still showing the neuro signs, but seems more comfortable and has been eating and drinking. We have to pass a urinary catheter several times daily since she still cannot urinate on her own. I have high hopes that she will pull through.

• Next Post: Last Glance

Today was the busiest day in the clinic since I arrived. It’s just our luck that Houssine, the large animal technician is on vacation this week, magnifying the craziness. An overwhelming number of mules and donkeys came in because "he’s losing weight and food falls out of his mouth," so I got to spend lots of time sweating it out with a hand float. The majority of the patients, though, were of the small animal type. At one point, I looked over to see a group of about 20 people getting loud and impatient because some were being seen before others. People were walking up to me, trying to hand me their animals, obviously distressed and wanting some attention. Trying to restore some order and prevent a riot, Azami and I frantically began tearing little pieces of paper and scribbling numbers on them. Thankfully the "please take a number" system was successful! Everyone waited much more patiently and we were able to see all of the patients before the doors closed for lunch.

Azami spent a lot of time translating Arabic for me today so that I could communicate directly with the animal owners and help things move along more quickly. I was staring at a gray horse that was showing signs of advanced neurological disease. When I went through the usual "please tell me what the problem is," I couldn’t help but laugh when Azami relayed the message that the mare hadn’t urinated in three days. I couldn’t believe that the owner didn’t seem to mind the fact that the poor animal could hardly stand! I suppose he would have figured it out sooner or later when she just fell over in the street. Forgive my sarcasm, but some of this stuff gets pretty hard to swallow at times. We hospitalized the mare for further observation and treatment. Indeed she has a raging urinary infection in addition to the generalized ataxia and some cranial nerve deficits. Our working diagnosis right now is equine herpesvirus-1 infection.

Unfortunately, we will not be able to confirm such a diagnosis because confirmatory testing such as antibody titers is generally unavailable and not cost effective for the Fondouk. The prognosis is guarded, but we are treating her and monitoring her condition closely.

I talked to Dr. Frappier today about another aspect of the situation that makes diagnosing diseases almost impossible. The owners seldom answer questions truthfully, or they just do not know the medical history because they don’t see the animal every day. A great deal of veterinary medicine depends on acquiring an accurate and detailed history of the problem at hand and any past problems. Since that information is completely unavailable, we are blindfolded in a sense when it comes to prescribing an appropriate treatment. It makes things very difficult, but Doc seems to have learned to accept the fact and do the best he can under these circumstances.

• Next Post: Fresh Wound