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BACK
ISSUES
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A
Memorable Patient - an Earthwatch Expedition
Elspeth
Pitt, an
Earthwatch volunteer tells an unusual story of her experience
on the Madagascar Lemur project |
I
think everyone would agree that going on an Earthwatch Expedition
is a memorable and worthwhile way to spend ones free time.
Last October, during the Team 1 visit to Madagascar's Ranomafana
National Park for the Madagascar's Lemurs trip we had an
unexpected and unique experience that none of us (not even
the Principal Investigator) had anticipated.
The Ranomafana National Park Project was set up in 1991
and now has four main components to its work: conservation
and research, community based sustainable development, education
and a health programme. We were privileged to assist Dr
Pat Wright and the very enthusiastic and experienced team
of research guides at the park in a long term study looking
at the behaviour and ecology of the Propithecus diadema
edwardsi lemur. This study has been ongoing for 14 years
and involves research on four groups of the Propithecus
that have been habituated in the park that Dr Wright helped
to set up. We also had the opportunity to see a number of
other species of Lemur as well as many other animals, plants
and birds on our numerous walks in the rainforest.
As I am sure is often the case we all got quite involved
in whichever of the four groups of Propithecus we were observing.
We would even get quite attached to the individuals, worrying
when one of the young males went missing (it was not long
until mating season) for a few hours or days. What none
of us anticipated was how we could get so involved in the
welfare of one of these gentle creatures to the degree we
did following an event during the second week of our stay.
We were out on our usual patch in the rainforest taking
notes on group 1 when one of the research guides came running
up the path with a hand-written note from Dr Wright. The
note appeared to ask that two of our team get back to the
research station immediately.
We learned that a Propithecus (not one from the groups)
had been found injured in one of the buffer zone villages
and he was not in a good way. He had probably been involved
in a fight with another lemur in his group and we surmised
that he had been thrown out/deposed from his group. As Dr
Wright explained, normally an injured wild animal is left
to its own devices (after all, that is the way of nature),
but the villagers had specifically come to Dr Wright for
help. In the past they may have eaten the animal but over
the years as the National Park Project had managed to educate
the people for the need for conservation and they had come
to realise how precious these animals are. It would have
been very difficult to refuse their request.
We got to the village to find the lemur in a very weak but
determined state clinging onto the roof of a shelter. He
had apparently been there for at least four hours with no
food or water. Richard, one of the research assistants,
had a blow gun and a sedative/anaesthetic which we used
in an effort to calm him and capture him without upsetting
him too much. The first two darts had no effect, in the
third we doubled the dose but still to no avail. The lemur
was completely unconcerned by the darts and they had no
effect whatsoever on his conscious level. We thought we
would need even more of the drug however Kevin, being a
professional animal handler at the Isle of Wight Zoo, managed
to net him without any difficulty, the lemur was quite docile.
In retrospect, I think that the animal was in such a shocked,
dehydrated state that it could not absorb the intramuscular
injection of the sedative from its muscle into its bloodstream.
Once we got back to the research station word had got around
and we were met by a number of concerned onlookers, the
research assistants, the American Study Abroad students,
as well as the rest of the Earthwatch team. At this point
I got a bit concerned at my potential role in these events.
My conversation with Dr Wright went something like this:
"I am a doctor not a vet ? I am not licensed to treat animals."
(Although vets, I believe, can treat humans!) "Yes, but
you are a surgeon - the nearest vet is at least two days
away if he is at all on the island. You are the lemur's
best chance." (Actually I am an Emergency doctor with a
surgical qualification.) At this point someone reassuringly
stated that if I screwed up they would take the lemur to
the U.S. and have me sued! I concluded that as lemurs
are primates and only a few chromosomes different to us
I would just have to imagine that I was treating a six month
old baby and it might not seem so strange.
So we got Murdo, as he came to be known, indoors and I started
the assessment: "Airway, clear. Breathing? Respiratory rate
rapid, air entry equal, chest movements equal. Circulation,
pulse 160, no haemorrhaging wounds. Disability? Responding
to painful stimuli, left pupil reactive to light, right
not visible due to local trauma. Exposure, obvious wound
to left side of abdomen."
Resuscitation was ongoing, he was clearly shocked, I couldn't
get a drip into his veins (too small) so I gave him a small
bolus injection of fluid and we sprayed him with cool water.
We only had limited resources, we were only on holiday in
the rainforest of Madagascar, not at work in the A &
E department of a hospital!
Onto secondary survey: "He has a penetrating injury to the
right eye, visual acuity is hard to ascertain. He has a
big laceration in the front of his mouth and a fractured
right upper canine. There is an incised wound to his left
flank, abdomen is soft, bowel sounds quiet but present.
There is a closed transverse fracture of the right ring
finger and possible fractures of the little finger and right
hand. He also has numerous small incised superficial wounds
to his legs and arms."
Gratifyingly his pulse came down to 132 and his respiratory
rate and level of consciousness were also improving with
the external cooling and intravenous fluid (we only had
500mls of Dextrose/Saline but it was helping). He even became
alert enough to take fluids orally (this is unusual for
this species who normally get all the fluid they need from
their food, indicating how dehydrated and sick he was).
I then proceeded to explore, clean and stitch his flank
wound, which on examination did not penetrate through the
abdominal wall. Finally we took some baseline observations
- weight, height, canine length and number of teeth as well
as testicular size!
At this stage as Murdo began to recover from the sedative
and we had to make arrangements for his accommodation. So
whilst Kevin, Richard and I finished treating him the other
members of the group were industriously trying to construct
a cage from any materials they could find near the station.
Hence the "Hilton Propithecus" was designed and constructed
successfully, yet another truly team effort.
We were unsure at this stage if Murdo would survive his
severe injuries or the stress of captivity and we all felt
quite concerned for his well being. For the rest of the
day he was constantly nursed by very caring attendants from
the Study Abroad Group, Earthwatch and finally, of course,
Dr Wright who kept him warm in her own tent overnight. The
next morning Murdo was moved into his new home which was
complete with branches for sitting on and clinging to and
all the best leaves for eating. Lemurs are known to be quick
to recover from illness and injury but do not do well in
captivity and are notoriously fussy eaters. Murdo was not
impressed with his new abode and just sat on the floor not
even looking at the food or climbing onto the branches,
he was still very weak and sick.
As he was neither eating nor taking the water we placed
on the leaves, we constructed a rig from the drip set and
bag of dextrose/saline that we had. We set it up so that
we could hold the end of the drip close to his mouth in
the cage and open the drip outside the cage. He lapped up
the water from this delivery system even getting enough
courage to hold our hand steady if we got too shaky for
him. Shortly after we found him some tasty robary fruits
(their favourite) and offered him these. He wouldn't take
them unless we crushed each fruit and held them up individually
to his mouth. What he started doing, like he did with the
water dispenser, was hold the feeder's thumb to steady their
hand while he munched on a fruit in their palm. Propithecus'
hands are soft, like very soft leather, and even when he
sucked on our fingers looking for fruit he was so gentle
- I was surprised that the toothcomb and tongue were so
smooth and soft.
Murdo's flank wound had completely healed in two days but
he required hand feeding with the best and freshest fruits
we could find in the forest on a very regular basis as he
recuperated. By the fourth day he was beginning to take
food off an offered branch and was starting to climb in
his makeshift cage and his pule rate was down to 72.
After much discussion and consideration between the entire
group including Dr Wright, the research assistants, the
Earthwatchers, and the students we decided that it was best
that Murdo was taken back to the area where he had been
found. Even if he was never taken back into his own
group or if he was beaten up again by the lemur who attacked
him, it was agreed that this was still the best option.
It was quite an entourage that scrambled up the bare deforested
hill into the rainforest to see him released. We found a
suitable site and opened up the bag in which Tim had been
carefully carrying him. To our complete surprise he just
sat in his sack looking at us as if to say, "You feed and
water me, smother me with attention and keep me safe and
warm and you want me to leap out into this harsh forest
where they beat me up!" Eventually, with some encouragement,
he suddenly leaped into the trees and disappeared into the
rainforest. He was followed for the rest of the day and
he seemed contented. I have to confess that even I, the
hardened A & E doctor, had a tear in my eye as he leaped
back fit and well into the forest.
What did I learn from this unexpected and unusual patient?
Well first of all, compared to most A & E patients who
have been in a fight, he was much better behaved! Also the
anatomy and physiology of our primate relatives is amazingly
similar to ours (well at least similar to that of a six-month-old
baby). The "ABC" principles of trauma care
(Airways - Breathing - Circulation)
can be applied to primates as well as humans (after all
they are only a few chromosomes away from us - maybe even
closer in some cases!).
The whole experience was very much a team effort from the
rescue, initial
treatment, nursing care and cage construction, to the feeding
and general care of Murdo. It was an amazing privilege to
have handled, treated, cared for and even hand-fed this
gentle and rare animal. We may even have been the first
to document the resting pulse rate of a Milne-Edwards Sifaka
- it is 72 beats per minute, similar to that of an adult
human.
Further Information
If you would like to take part in an Earthwatch project,
you can contact them on +44 1865 318831 or visit their website
at www.earthwatch.org/europe |
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