The Equitarian Initiative: Help for Horses in Need

The Equitarian Initiative is a new nonprofit organization with a mission to provide care for the world's hard-working animals and education for their caretakers.

Jay Merriam, DVM, and Adrienne Otto, DVM, freeze a sarcoid off a horse’s ear as part of the Equitarian Initiative to provide care to animals in rural, developing nations. © Courtesy, Julie Wilson, DVM

When you travel in many parts of the world, it’s striking how many horses, mules and donkeys you’ll see toiling in the same traditional jobs that have existed for centuries: pulling plows, tending herds, hauling produce to markets and in many cases providing the only transportation their owners have. Most are working side by side with people in impoverished conditions.

If you love horses, as I have since I was a small child, scenes like these fill you with a mixture of emotions. It is gratifying to see how much people care about the horses, donkeys and mules they rely on so heavily. Losing an animal to injury is a significant setback; it can mean the difference between earning enough to live on, or not, and even a one-day lay-up for an animal could mean a catastrophic loss of income. And yet it also stings to notice animals with open sores, swollen joints or?overgrown, cracking hooves who must continue to toil so that their owners?can survive.

I first witnessed scenes like these as a 6-year-old, when my father worked at the American embassy in Madrid and we traveled through rural regions of Spain. As I grew older we spent more years abroad in places like Thailand and the Philippines. The cross-cultural experiences there brought more glimpses of the plight of people, and their animals, living in severe poverty.

As a high school student in the Philippines, I participated in community service projects in remote areas, one of which delivered medical care to indigenous people. After watching human surgery in a cinderblock schoolhouse with no roof, I knew I could stomach surgery on animals and become a veterinarian.

These experiences also nurtured a dream I’d had since those early years in Spain. Just as groups like Doctors Without Borders organize doctors and nurses to hold health clinics in underserved areas, I wanted to bring veterinarians to similar clinics to aid hard-working animals in places like these. These clinics would not just address the horses’ and donkeys’ immediate needs, they would also teach owners better techniques for ongoing care and nutrition. Not only would the animals’ daily lives get better, but they’d be able to work longer and more efficiently, which would improve the people’s lives as well.

But it takes an overwhelming amount of time, organization and commitment to bring about programs like these. I continued to nurture the thought as I went to school. Once I’d received my veterinary degree and specialty training in internal medicine, I was fortunate to be invited to lecture in many countries. The travel reinforced my interest in providing equine education and health care internationally. Wherever I went in Asia, Africa or Latin America, I saw horses, donkeys, mules and people in need.

Finally, a few years ago, after years of looking for a viable way forward to act on my dream, I found a large group of like-minded veterinarians, and together we created Equitarian Initiative. This nonprofit group trains veterinarians to provide health services and owner education in very poor areas, and in 2010 we launched our first successful workshop, where we treated more than 800 animals in Veracruz, Mexico. Here’s how it came about.

From idea to reality
My dream of building an organization like Equitarian Initiative finally began to take root in 2007, during the annual convention of the American Association of Equine Practitioners (AAEP), when Joe Bertone, DVM, DACVIM, of Western University of Health Sciences organized an informal meeting of veterinarians who had worked with international nonprofit?organizations. We talked about our experiences and discussed the challenges of providing sustainable help to these very deserving horses, donkeys and mules. We all shared the goal of creating a new vehicle for action.

We had people present who could describe their work with several groups worthy of emulation:
? The Mongolia V.E.T. Net, a non-governmental organization that grew out of the Christian Veterinary Mission’s work to educate equine veterinarians?in Mongolia.
? Project Samana, a group sponsored by the Massachusetts Veterinary Medical Association that cares for?large and small animals and provides ongoing owner education in the Dominican Republic.
? Heifer International, a leading?charity that provides livestock and education to impoverished families around the world to help them improve their nutrition and generate a sustainable income. I served on the board of directors for this group, and I also shared experiences from my teaching efforts in Latin America.

All of these groups are doing transformative work, but the need for more help is still so great in so many places around the globe. We all wanted to do more. Jay Merriam, DVM, of Project Samana coined the word “equitarian” to define the spirit of veterinarians and others interested in humanitarian work that benefits working equines: An equitarian is one who serves horses, donkeys and mules with compassion and whose only reward is their improved health and welfare.

Our next step was to catch the interest of the AAEP leadership and other members.?At the 2008 AAEP?convention, Merriam and I led ourfirst Table Topic on equitarian work.?To our delight, it was standing room only, and a follow-up half-day program at the 2009 AAEP convention drew another large audience. Clearly, many North American veterinarians were?interested in this kind of work, and more than a few were eager to find a way to get started.

So we had plenty of volunteers lining up. Now what? One of the speakers at the 2009 meeting was Mariano Hernandez Gil, DVM, an amazing young Mexican veterinarian who spoke about a program caring for the equines who haul garbage and recycling at the huge dump in Mexico City. This program partners students from the veterinary college in Mexico City (Universidad Nacional Autonoma de Mexico, UNAM) with support from The Donkey Sanctuary (DS), a British charity, to provide much needed health care and owner education. The veterinary students gain valuable skills, both in social service and in hands-on training with the animals.

At the time of his presentation, Hernandez Gil was expanding that outreach program to serve poor villages in the state of Veracruz on the Gulf Coast of Mexico. UNAM’s agricultural research station has dormitories there and routinely houses students from the veterinary college. Mobile teams of veterinary students and faculty members come to each participating village for one day of work every six months.

To be effective, the program requires cooperation with the village leaders, who are responsible for encouraging the local animal owners to participate and letting them know when and where the veterinary team would be working. The DS/UNAM team also works in conjunction with a second British charity, World Horse Welfare, which trains local people to become farriers and harness makers, to provide these services to the animals at each village.

As he concluded his talk, Hernandez Gil offered a brilliant suggestion: Perhaps interested American veterinarians could spend a week with his program in Veracruz. The experience could serve as a training ground for starting other international programs. This was a terrific opportunity, and we immediately began investigating how we could make it happen.

Now we just had to raise funds.?We put together a grant proposal to the AAEP Foundation to help subsidize the cost of ground transportation in Mexico. We were incredibly excited when we learned we had gotten the funding. More help came from the Humane Society Veterinary Medical Association, which offered to provide five travel stipends for recently graduated veterinarians. We then had just?a few short months to spread the?news to veterinarians about the opportunity, coordinate volunteers and organize the trip.

Then we kept our fingers crossed that this area of Mexico would remain safe and that we would attract the number of veterinarians we needed to make the trip worthwhile.

Hands-on help
Finally, everything came together, and in October of 2010, 27 equine veterinarians from the United States and Canada arrived in Veracruz, Mexico, for the first Equitarian workshop. There, we joined a team of Mexican veterinarians, veterinary students, farriers, harness makers and social workers to learn about both structuring community assistance projects and delivering basic equine health care in rural villages.

Each day began with classroom discussions to learn how to provide veterinary care effectively under field conditions. Once in each village, we’d have to practice a fast and targeted form of veterinary care, with no x-rays, no blood tests, no running water and no chance for follow-up visits anytime soon. We also had some discussions on cultural sensitivity: Understandably, many of the owners could be persuaded to spend time and money on ongoing care only if the treatments would increase the animal’s utility.

After class, we piled into vans and continued the discussions on the way to that day’s clinic. We would visit four villages in four days, and each location was in a different ecological and agricultural zone, ranging from the coastal plain to mountainous coffee farms. Each region presented unique medical challenges, and the animals’ work ranged from hauling coffee beans or milk cans to herding cattle.

When we arrived at our first clinic, my colleagues and I were dumbstruck at the huge number of animals assembled. Already villagers and local farmers had lined up with more than 100 donkeys, mules and horses, and others were still coming.

The veterinary students, who had arrived before us, had set up eight different aid stations on the village soccer field. One station served as an intake site, where each animal was briefly assessed to determine his needs, and the owner was given a list of the other stations he needed to visit to receive appropriate care. The services provided included: surgery, lameness care, farriery, harness fitting and repair, internal medicine/reproduction, parasitology/nutrition and dentistry. A horse trailer served as the supply center/pharmacy.

After the initial chaos as we got started, the clinic settled into a pattern of steady work. Many of the animals needed dental work and hoof trimming. Too many were thin and had saddle sores. Some were absolutely loaded with ticks.

I was the lead veterinarian for the internal medicine station along with my Mexican friend, Maria Masri, DVM, PhD. At our station, we saw dozens of cases each day, with a wide range of medical issues, including vampire bat bites, pasture-associated heaves, sand midge skin disease, bursitis due to parasitic infections, sarcoids, moon blindness and weight loss due to poor nutrition, poor dentition and parasites. The surgery station performed castrations, hernia repairs, wound debridements, sarcoid removals and more. All of our participants rotated among stations, spending half a day at each over the four days.

All in all, the workshop was a?rousing success. Over the four days,?we saw a total of 835 animals. What’s more, we’d all learned a lot, and we were buzzing with ideas on how to improve the process in the future.

A number of the Equitarian workshop participants began thinking about planning projects in other areas with horses, donkeys or mules in need. Could local contacts, community support and funding for travel and supplies be identified? Were veterinarians and horsemen in other areas interested in both education and improving the health care of the working animals?

Looking forward
Additional positive results of our workshop came quickly. Two veterinarians, Adrienne Otto, DVM, from Sullivans Island, South Carolina, and Mario Lopez, DVM, from Toronto, Ontario, successfully began a second project in an area of Costa Rica that Otto was familiar with.

One participant, Angela Gebhart, had been an undergraduate at the time of the workshop, and when she returned home, she inspired her faculty and classmates at South Dakota State University to begin similar projects on the Native American reservations in the Dakotas. Following through on one of our suggestions for improvement—to better engage all of the curious children who inevitably gathered to watch us—Gebhart created a donkey and horse health coloring book in Spanish with the help of her local 4-H group. Then she persuaded her former Girl Scout troop to both bind the coloring books and donate crayons for the planned 2011 Equitarian workshop.

Elated by the workshop’s success and continuing impact, Merriam and I reported back to our pleased AAEP supporters. We applied to the AAEP Foundation for funding to hold a second workshop in Veracruz. This time, however, we offered to become an independent nonprofit organization that would handle registration and all the logistics for our work. The leadership of the AAEP and AAEP Foundation concurred and again generously provided a grant.

And so Equitarian Initiative was born as a nonprofit organization in October 2011. The second workshop in Veracruz went even better. This time, more than 80 veterinarians, students and educators made the trip, and more than 1,000 animals were treated. Since then, a second successful trip to Costa Rica was completed as well as a new project for cart horses in Honduras. We recently completed our third workshop, this time in Santa Cruz, Tlaxcala, Mexico, and we’ve begun planning new projects in Guatemala and South Africa.

Our dream to find a way for American veterinarians to learn how to provide education and service to the very needy working equines in the world is coming true. Together we’re creating a network of veterinarians with a common goal and spirit of sharing experiences with others that will only grow in the years to come.

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