Over the summer, I spent 2 weeks in Rarotonga, Cook Islands, externing at the Esther Honey Foundation. Esther Honey is the only veterinary clinic in the Cook Islands, consisting of 15 islands spotting the South Pacific Ocean. During the month that I volunteered, they treated a total of 243 patients, all free-of-charge. With the exception of the clinic director who lives on location, the clinic is run solely by a constant influx of volunteers and generous donations, including the occasional bunch of bananas.
Most of our clinic days were spent outside in the heat and humidity, unless in the single surgery “suite” or seeing a patient in the consult room. For the volunteers, this meant that shorts, flip-flops, and an Esther Honey scrub top were the acceptable attire. Cat and dog kennels were both set up outside, under the shade of roofs made of palm leaves. Some of these animals were inpatients, some being boarded, and still others were strays up for adoption. Adoptable cats had the luxury of the “monkey cage”, where they all could spend time socializing. I was pleasantly surprised by how friendly the animals on the island were; I never encountered a single fractious cat!
The clinic was open Monday through Sunday and work began at 8am sharp every morning. For an hour, we were all expected to help with the daily chore of “feed and clean”, which included dispensing medications to all inpatients who needed them. After that, we moved on to our assignments for the day -- surgeon, anesthetist, or consulting. The job of surgeon was left to the veterinarians, although this is not to say that I did not participate in surgery as well. With supervision from the veterinarian on duty, I performed one canine spay, one canine neuter, one feline spay, and two feline neuters. What the student volunteers were able to do was completely at the discretion of the veterinary at the time. I also observed leg amputations (including a goat!), femoral head ostectomies, a shot gun wound debridement, a bladder repair in a dog that had been hit by a car, removal of a mass from the third eyelid, and several tooth extractions. As anesthetist, I was solely responsible for monitoring patients in surgery, and when consulting, I saw common things like flea problems and ear infections, in addition to fish poisoning cases. Consults were often difficult given the very few diagnostic tools that we had -- running a minimum database was unheard of. But perhaps what we missed the most was an x-ray machine, given that lameness was one of the most common presenting complaints. Our days ended with another “feed and clean” at 3pm, although work continued for those staying in the clinic when called on for emergencies late at night -- most commonly dogs that had been hit by cars.
My time in Rarotonga was not entirely spent working. Every week, volunteers were given one weekday and one day of the weekend to explore. I spent the majority of my days off going on breathtaking hikes, one of which went straight across the island. Another day, I rode a bike around the island, 20 miles in circumference. I enjoyed time on several isolated beaches and ate some incredible food and fresh fruit smoothies. I also spent a day at the end of my trip and flew to a nearby island called Aitutaki -- in a word, paradise. And of course, there were several evenings where the volunteers would wander down to the beach to have a cocktail and enjoy the beautiful sunsets.
Overall, it was a rewarding experience. I have participated in numerous programs in which I have traveled abroad to work in struggling communities, but never one where I worked at a hospital that saw such a variety of cases and did so many exploratory surgeries. It truly re-iterated the importance of the basics -- taking a good history and performing an excellent physical exam when little else is available.