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A teaching opportunity to jump at…

by
01 March 2015, at 12:00am

Dr DAVID WILLIAMS has been to Sudan to help with training in ophthalmology and is captivated by the place and its livestock such as camels and cattle – but could have done without the rats

AS we flew out of Cairo the green triangle that showed the lush productivity of the Nile delta soon disappeared to be replaced by the arid brown of the desert. There was nothing to break the monotony until two hours later a green snake appeared below us, soon to be transformed into the brilliant emerald which was Khartoum, my destination.

Why on earth Khartoum, you might ask! What would entice me to fly out to Sudan, a country of which we only hear negative reports, civil unrest in the south, drought and famine in Darfur? It all started about three years ago with an e-mail from a new graduate from the veterinary school in Khartoum. She was interested in ophthalmology but couldn’t find anyone in Sudan with an expertise in it – her vet school didn’t even have an ophthalmoscope! Could she come and spend two or three months with me to learn more about the subject?

Well that is the sort of international teaching opportunity I just jump at! And so I arranged for Reem to visit, stay in college accommodation here at St John’s and work with me. She learned, as I had done with Keith Barnett 25 years earlier, by examining every animal that was presented to me and building up an understanding of the pathological patterns we see in eyes as I’ve talked about before.

Over three months we managed to see about 500 cases which gave her, as Bamber Gascoigne would have said, a starter for 10!

My goodness, how rapidly Reem picked up what was needed. With the additional help of my good friend Dominic Alexander who could give her the West Country exposure to cattle ophthalmology I just couldn’t in the near barren desert, at least ruminant wise, of East Anglia, Reem had enough eyes under her belt, if you will excuse the phrase, to return to Khartoum as the eye expert of the area.

And she didn’t just sit on the knowledge she had acquired. Soon she was organising a Masters degree by thesis on ophthalmic disease in cattle and horses in North Sudan. All well and good.

I gave her what help I could by e-mail, answering questions on the cases for which she sent me jpeg images. And it didn’t seem more than a blink of a bovine eyelid (though it was actually two years) before she had finished the thesis.

The question was, who would examine her dissertation? I was delighted to be asked, yet the political and military situation in Sudan meant that as soon as we came to organise the flights the civil unrest on the ground precluded my visit.

Again and again we tried to sort out a visit but again and again we were thwarted. Eventually, the powers that be in Khartoum arranged the flight and I obtained my visa from some rather gruff fellows with rather large guns at the Sudanese embassy in London. And so here I was flying across north-west Africa wondering what on earth would meet me in Khartoum.

How would I cope with an average temperature of 38 to 40 degrees and would I get blown to bits in the civil unrest that still seemed to be going on?

How wrong could I be?! Waiting for me at the arrivals gate was Professor Elmalik. I had been in contact with her by e-mail for that year of travel planning but just didn’t expect this huge African mamma standing there with arms open wide ready to welcome me to her wonderful country.

I had been required to send my CV and reading through it she had picked up my comment on being a committed Christian. “How good,” she had written in her last e-mail, “I am a committed Muslim. I am sure we will have some interesting conversations.”

What was I to make of that?! I couldn’t have met a more loving, welcoming lady and indeed within the first few hours we had talked about our faiths and how similar they are in many ways. Let’s face it, we both have the same God – the God of Adam and Noah and Abraham, but just rather a different way of approaching him!

She knew that when she had done something wrong she needed to rely on Allah’s acceptance of her apology and I could tell her that God was able to forgive her because Jesus had died in her and my place on the cross to pay the price for our rebellion against him.

How tragic that what we discussed in such a friendly manner over cups of Sudanese coffee had resulted in the Crusades all those years ago and still ends up in bloodshed today. Sudan was a key centre for Christianity in the first 300 years after Christ’s death as shown by the amazing frescos in the national museum.

But much as this introduction was a sheer delight, I had work to do – farms to visit, the vet school to lecture at and Reem’s thesis to examine. I needed some sleep and settled down in the university’s guest accommodation just a hundred yards from the Nile. How wonderful to open the door in the morning and look out over the gleaming golden minarets of the mosques on the far side.

Not quite so wonderful each morning to find a little faecal offering on my pillow from the rats that infested the hostel, being so close to the river.

The whole reason Khartoum was that gleaming emerald of green on our flight in is the phenomenal agriculture arising from the use of the water from the Nile, or rather the two Niles, since Khartoum is the point at which the blue Nile coursing from the Ethiopian highlands with its blue rocks meets the white Nile running from Uganda.

The dairy industry around the city is remarkable – numerous farms milking native cattle by hand but also modern Western-style, more industrial farms milking Holstein-Friesian cattle specially flown in by jumbo jet from Holland.

You’ll understand that these animals just can’t cope with the heat out there. Thankfully for me, I had come in the relatively cool autumn and without the rain that would have made the heat unbearable. But in the middle of the summer when the temperature was at least 45 degrees in the shade, how did these high-yielding cattle manage?

They had a lovely modern rotary parlour and shed with huge fans at one end and a mister that blew cool water over the cattle. Later that day I was taken to an up-market coffee shop outdoors in downtown Khartoum and what was there to cool us? Just a smaller version of the cows’ mister fans. I could see how they were quite content there.

But what I hadn’t reckoned on finding were camel dairies! Rather a different kettle of fish, it must be said, with 10 or so animals each with a nearly weaned camel calf by their side. A calf was prevented from continually suckling by a leather pouch secured around the udder, this being taken off a few minutes before milking to allow the calf some mouthfuls of milk and give a natural milk let-down before the milker came to strip the udder with a thick creamy liquid gushing into a plastic pail.

Offered some there and then, I couldn’t refuse could I, though I must say I did wonder for a moment whether Mycobacterium bovis or tuberculosis affected camels. I was sure it did but a quick forage through “Google Scholar” on my return home told me that old world camelids are not considered particularly susceptible.

I did have my BCG vaccination at school though another trawl through the literature was not quite so reassuring with data on BCG efficacy not available for longer than 15 years. Such are the joys of travel, hey!

You’ll be glad to know that Reem passed with flying colours and is now about to start a PhD with me as one supervisor, this hopefully allowing me many more visits to a country that has completely captivated me.