Day 5: Vulvoplasties and a Trip to the Grocery Store

So, I was not expecting to get a new post in today, but our travel plans changed unexpectedly, so here I am. Anna and I were supposed to leave for Tangier early this afternoon but when we went to get our train tickets, we were informed that all trains to Tangier had been cancelled due to flooding of the train tracks. We looked into other ways to possibly get there but the 7-hr bus ride and the $200/5-hr cab ride made that sub-ideal given that we were only going to be there for the weekend. So, we're staying in Fez for the weekend. 
Today marked the end of our first week of work at the Fondouk. We know the drill and are much more efficient about getting things done. At least 20-25 horses, donkeys and mules passed through the Fondouk gates today, a significant increase over the last few days. Apparently, the waxing and waning of patients seen is fairly predictable. For example, right before we arrived, the Muslim world celebrated Eid al-Adha, a festival commemorating when Abraham offered to sacrifice his son, Ishmael, as an act of God. As the story goes, God intervened and offered him a ram to sacrifice instead. In the weeks leading up to Eid al-Adha, Moroccan Muslims fatten up their lambs to be slaughtered for the festival. This is done by excessive feeding which, unfortunately, results in the formation of urinary stones. Thus, for the couple of weeks before the holiday, the Fondouk sees blocked lamb after blocked lamb after blocked lamb. In the weeks immediately after the holiday, the Fondouk is inexplicably quiet.
Because of the increased volume of equines seen today, we were all torn in different directions. Anna was put in charge of making sure everyone got dewormed while waiting to be examined. I got to spend a fair bit of time tending to a mule with a large fluctuant swelling in her hind end, certainly the result of a kick from another mule. As many of you know that I love sticking needles into things and draining them, you can imagine how much pleasure I got from this case. I pulled off a huge volume of serum, injected some steroids and antibiotics and sent her on her way.
One of the other interesting cases  I saw today was a ewe who was dragged in with her uterus dragging on the ground behind her. A prolapsed uterus in a ewe is something that we do see in the States, and although I hadn't actually ever fixed one myself before today, I wasn't too surprised when Houssine whipped out a jar of honey. Honey, like granulated sugar, has the power to reduce inflammation quickly. After washing the uterus and dousing it in honey for 15 minutes, Houssine was able to return the uterus to it's normal position inside the mule. I then placed an intra-uterine antibiotic tablet and set out to restore her anatomy and ensure that the uterus could not re-prolapse. Houssine told us that this ewe had already had the prolapse repaired once by a Moroccan veterinarian, but that her sutures had been way too tight and now a large portion of the uterus and vulva was necrotic. I spent the first 15-20 minutes of the surgery basically doing plastic surgery on her vulva, piecing her back together one stitch at a time. Finally, Houssine showed me a purse-string-like suture pattern to hopefully keep the uterus in place. We gave her pain medication and antibiotics. Houssine also introduced me to the concept of using a commonly-used bronchodilator (Ventipulmin, just in cars you were wondering) to stop uterine contractions. We asked the ewe's owner to bring her back early next week for a re-check exam. Hopefully he will.
Since we didn't have any surgeries for the afternoon, Dr. Frappier arranged for Anna and some of the vet students to go for a ride at a nice nearby stable. He is a pretty popular guy in Morocco, as you might imagine, and people appear to bend over backwards to accommodate him and those who are associated with him. Every policeman we passed on the street waved at him while we were en route to the stable. Although the stable was only 6 miles from the Fondouk, it took 30 minutes to get there and even longer to get back. The traffic in Fez in crazy and, as I learned from Dr. Frappier today, Morocco has more car accidents than any other country. That is a pretty scary statistic but a totally believable one nonetheless. Lanes appear to be optional as is listening to the policeman directing traffic. The roundabouts are definitely a free for all with some roundabouts giving cross-traffic the right of way and others giving cars already in the roundabout the right of way. The pedestrians are fearless and there are people and motorbikes meandering through the cars every time traffic slows down. However, we made it there and back and the girls apparently had a nice ride through the olive tree groves.
We made a stop at a big grocery store on the way back from the stables. It actually reminds me of a Super Target we see at home. You can buy cheese, a dishwasher, clothes and vegetables all under the same huge roof. It is very modern and clean. Anna and I have been eating breakfast and lunch at the Fondouk and our dinners have been either out or cooked in our living quarters. We have taken endless amusement by the names of some of our food, most of which is labeled in French and Arabic. Our favorite so far is definitely our breakfast cereal, "Tropical Crunchy."
For those of you wondering about "Rolex," our rockstar mule from earlier in the week, I'm pleased to report that his owner came to take him home just minutes before we returned from the market. That's a good thing, not only because it is a happy ending, but because I had fallen in love with him and was already pondering ways to bring him back to New York with me. 
Now that we're back at the Fondouk for the evening, I'm sure we'll buckle down and come up with a plan for tomorrow. For now, good night.