Green Mountain Bovine & Equine Clinic

The report that follows is an account and analysis of the VWB training session in Iganga, Uganda in September 2013.  The purpose of the training was to improve farm profitability and access to animal health and preventative veterinary medicine skills.  Through veterinary medicine we hope to support economic development, improve food safety, and control zoonotic disease.  The training was conducted at Sana Country Hotel in Iganga with follow-up visits to the farm sites of the trainees.  The project was a collaboration between Veterinarians Without Borders represented by Dr. Tom Graham and Dr. Stephen Major, MTCEA (Multipurpose Training and Community Empowerment Association), theIganga District Veterinary Office represented by Dr. Sam Kagoda and Dr. Balingeya Moses, and US Peace Corps represented by Pollaidh Major.   The success we achieved was due in large part to the selection by MTCEA of an enthusiastic and hardworking group of local community leaders as trainees.

I spent the week prior to the training meeting and making arrangements with US Peace Corps, Dr. Linda Nelson, MTCEA officials including Program Coordinator Peter Owor Minor, local community leaders, and Drs. Kagoda and Balingeya.  I also had the pleasure of making field visits to successful local farmers who would later come and address our group. 

The following is the daily account of the training follows by a summary of its results:

 Sept 4^th The first day of training – Wow did it go well.  The structure was first an extended session with participants, MTCEA staff, 2 – 3 government veterinarians, (Baligeya Moses absent), Dr. Joel, and Dr. Sam Kagoda all from the Iganga District Veterinary Office.  A government official Peter Muzee—Secretary for Planning, Investment and Training also attended and spoke briefly and well.  He waited through all the participants introducing their farms and concerns and responded to them, particularly to the concern that adulterated veterinary drugs are common.  The participants identified their prime concerns including ECF, tick fever, Ngana, mastitis, brucellosis (one participant had a brother sick from brucellosis from infected dairy cows, ectoparasites in pigs and cattle, lumpy skin disease, and abortion.

We had participants collaboratively identify the signs of sick animals both from a distance and with hands on.  They were enthusiastic and participated very well.  We then played a game to teach taking a history by me pretending to be an uneducated neighbor and they asking the important questions necessary to guide towards a diagnosis first of parasitism then of Anaplasmosis.   We broke for a good lunch and continued with a great practical on animal handling and physical exam on two oxen brought for the purpose.  They really loved learning how to tie a rope halter. Ayubu went and got rope so that they could each make a halter as home work. 

We finished with participants suggestion ways make farming profitable.  The answers were thoughtful and showed the progressive attitudes of the responders.  The ideas included pasture rotation, taking time to be with the animals, record keeping to improve accountability and credit-worthiness, proper treatment intervals, selective breeding, improving value of animals sold and remembering goals.  Other ideas included de-worming, shed construction, adopting a business attitude and interestingly, loving your farm and your work.   Participants noted many ways that a pride and love of one’s farm could improve your management which of course I see at home as well.

Sept.5^thDr. Linda Nelson  and her Ugandan Poultry expert friend Dan Kent  held participants  enthralled with a dynamic and detailed Poultry management presentation with power point slides.  He is currently underemployed and readily available for future presentations.  The 6^th we had superb presentations by successful farmers on dairy, goats and oxen.  I was awfully impressed that Moses, who lives in a small village far beyond electricity had a complete powerpoint presentation.  He is the one that deals with “jealousy” issues by providing breeding, tick spraying and deworming services for his neighbors.  The oxen farmer has worked his way up over 15 years from a small peasant farmer to a significant landowner plowing up to 30 acres a month with oxen and has recently purchased a $10,000 truck all with the proceeds of his oxen and fields.  

After lunch Dr. Sam Kagoda delivered presentations on Foot and Mouth Disease and State Veterinary Services.  There is a full range of providers here from neighbors to graduate, usually district employed veterinarians who also do route rounds for private practice.  The government is transitioning from a state to a private practice model but the market does not yet support private practice models.   There seems to be a largely collaborative relationship now between the levels of care provision but little availability at the village level.  There are college of Ag degrees in Veterinary Science as well as University graduates.  Three young student types, tall Peter, Aggery, and Juliet (who is sweet and ambitious and therefore complemented as “stubborn.  She even drives a motorcycle.)  all want to learn some rectal palpation so I will run classes for them on my farm visits.  Dr. Kagoda felt it would be fine from the district point.  We will not charge for palpation and invite neighbors to bring animals over.  I gave groups of participants homework to design breeds and management systems to generate 1M shilling gross with broiler, goat beef, dairy and layer operations.  They will elaborate on them further later. 

Sept 7^th:  The participants outdid themselves on the homework with all five groups producing complete business plans with INPUT of 1M, costs deducted, loss figured in and all with net profits.  I have asked them to continue with modifications to show cost of money at 36% interest per year, land price stable, 50% depreciation on structures built and all animals sold at the end.  To follow these hypothetical examples I will ask them to use their own real farm plans to repeat the process.

In the morning we went to a local livestock market and slaughter house were they all identified animals that had health characteristics that increased or decreased their value.  On the way back we stopped to see a cow with lumpy skin disease and discussed the value of vaccinating the surrounding animals.  The cow’s value had decreased from 700,000 to 300,000 due to the disease according to the cattle dealer. 

In afternoon we reviewed ruminant physiology by discussing the many local crops that cows eat that humans do not and how to protect the hard working rumen bacteria from rapid change. Then we went on to breeding, and dystocia.  Long day and it will be good to have a break until Monday when we will review business plans, MTCEA services, and Save a Cow. 

Sunday – Pollaidh left for Peace Corp All Volunteer Conference, and I went to Noah’s church.  Noah is a jolly old man, not at all Old Testament who runs a Malaria/Aids health center and serves as the pastor.   It was very friendly and reminded me of Westminster West except for the vast majority being under 12.  They sang well and many verses so I could join in.  Noah’s aged mother was there, lovely old woman who would creep around on hands and knees and watched from her blanket at the back.  She wanted Noah to tell me that her other son was a veterinarian educated in Canada, but was killed in Uganda after condemning a carcass at slaughter.  That certainly adds to the challenge of meat inspection here. 

In the afternoon I went to a raucous and joyful college graduation ceremony with African dance, marching band and a neat ceremony where former University graduates welcomed the new by forming an arch for them to pass through. Education is very highly valued in Uganda.  School fees are the main thing that families save for. 

Monday 9^th.  Great work on the business plans by the participants and thorough analysis that took all morning.  In the afternoon a somewhat routine Send a Cow presentation, but I had to leave to focus on getting the ECF presenters to come and bring the vaccine for free.  Tom Graham arrived and we have had a pleasant evening chatting here. 

Tuesday we reviewed homework on individual business plans, I spoke on biosecurity, and Tom nicely covered infectious disease and necropsy with suitable pictures.  The participants seemed to glaze over after about 2 text slides, but certainly woke up for pictures and discussion.  They did feel honored and appreciate being given a veterinary college type presentation. 

Wednesday – The doctors from Eram came and we travelled north to vaccinate 40 animals for East Coast Fever.  It is an infect and treat vaccination so it must be done carefully to avoid infecting and not treating.  The procedure was new to everyone so I was little nervous and there were rather too many cooks directing the operation, but after overly long introduction we slogged through.  There were more than 40 animals there so I had to explain that the older animals were past the stage where they required ECF vaccination.  One animal we ended up vaccinating did have swollen lymphnodes already. But we did get the job done.  It did not seem that anyone was disgruntled by being left out as we tick sprayed all.  On the way home we did a roadside health check on an ox that had been doing poorly, was treated on veterinary recommendation and appeared fine now. 

The afternoon was a productive and more relaxed discussion of the vaccine. Fortuitously Eram is looking to recruit more people to train in the vaccine administration so our youngest three or four expressed keen interest.  Aggery has actually made arrangements to interview in Kampala for the training in Kenya.  Dr. Baligeya Moses came in at the end to lend his appreciation of this collaborative event and to emphasize the importance of all working together collaboratively, which does seem a real blessing of this area. 

Sept 13^th, Thursday.  A pleasant walk to Sana Hotel with Pollaidh, then a presentation by me of the business model analysis of ECF vaccination, first using Galvmed’s number and then inserting reasonable skepticism to give a more careful analysis still showing a 2 fold advantage to using the vaccine even at 30,000 per dose and with a more modest figure for disease impact under routine acaricide spray.  Then Dan Kent came back for poultry feed mixing and Dr. Balamdemu presented on drug and vaccine availability. 

Dr. Sam, talked on Trypanosomiasis control included messages like prophylactic treatment yearly with diminizine and quarterly with Samorin, insecticide nets around zero grazing units, brush clearing, tsetse traps.  Samorin is preventive, Imidocarb (diminizine ) is treatment. 

Friday – A mixed day.  The morning was great with Dr. Denis Mugizi from Makarere University presenting on Brucellosis with a very complete presentation of the disease, how it is spread and the human health risks.  He even had an impressive study from 2005 by a Dr. Mwele showing a 23% incidence of Brucellosis in Iganga (seroprevalance).  He also demonstrated the Brucellosis agglutination test which is cheap and quick to do on serum. The Peace Corps came this morning to check on Pollaidh’s site and were cheerfully greeted by the participants and NaigagaPollaidh’s contribution was pointed out by several including her proud father.

The down side of the day was the long Launch ceremony and the surprise request for vet kit packages for 26 when we only had 20.  Tom was wise to bring extra hats and not to emphasize gifts at all.  The Ugandan’s attitude towards gifts is very demanding a consequence of the hand-out culture left over from the big 1980s aid distribution efforts.  It gets annoying when you have just arranged nice packages for the supposed 20 participants and are told that the MTCEA officials need theirs as well even if they may not have agricultural projects.  There were no extra of course so they were petulant with Pollaidh.  I guess I would recommend only symbolic gifts (hats), or major projects to set up a regional lab, but not attempting to equip traineees  with supplies that may be wasted on some participants or resented by those who did not receive them since they are peripheral to the project.  Oh well – cultural clash.  It is also astonishing how cell phones are used here in a way that would appear extremely rude in the United States.  It did seem quite over the top when the district leader sitting at the speakers table immediately next to the Chairman, who was speaking, answered his phone and commenced a long and loud conversation during the Chairman’s presentation.

After the Launch a Stanbic Bank rep came to talk about agricultural loans.  It was good to hear that with reasonable business plans farms can get loans at 16% instead of 36%.  Then Dr. Kagoda and I graded each participants ‘business plans and reviewed them prior to tomorrows presentations.

Saturday 9/14 Last day of training!  We reviewed and tabulated business plans and it is truly amazing that they almost all showed close to 100% return on investment with the two season species like goats and pigs getting above 200%.  They built in risks and management expenses and even so had the ability to seriously improve their equity in one year.  They also handed in course evaluations and scheduled vet consult visits.  It will interesting to read the evaluations, but I feel great that we all learned so much and new career opportunities have opened up in farming or in related services like working for ERAM on East Coast Fever Eradication .  

The evaluations are quite positive.  They all liked the Sana Hotel and the food and most said that the training could have lasted even longer or asked that we run another module.  Only one asked if possible for a ‘sitting fee’.  There were no complaints that I noticed in a quick read through.

Monday , 16^th My first motorcycle ride ever, with Ajab driving quite conservatively to visit two farms a long distance into the countryside.  Paul had a lovely farm that he has built over 30 years with oxen (through MTCEA) goats, chickens (which he will improve with his farm business plan and enclose with a chicken house.  Currently he has to tether the chickens to keep them out of neighbors’ crops) pigs and rabbits.  He has a dog to protect the chickens and rabbits which get snatched by a wild cat.   He urged us to stay for tea then promptly grabbed one of his seven rabbits and a chicken, delivered them to the kitchen and chatted with us until a lovely roasted lunch appeared with meat and his own g-nuts. Other members of the farm group attended. Paul is a progressive community leader who, despite his remote location, attends training sessions and serves as a resource and guide for area farmers.  He already vaccinated his chickens for Newcastle and is able to obtain the vaccine on ice at the local trading center and arrange to vaccinate others.

In the afternoon we took another, now hot and dusty, but still pretty road to Kiigo’s.  He is a young farmer, half Paul’s age, with a young family having just moved 3 years ago from his parents.  He is building his house and operation with MTCEA oxen—2 mature and paid off, 2 young in training and being paid for.   His plan is to double his goats to 16 and build a new raised goat house.  He also farms with a group who collectively work the oxen. 

Sad news – Adrienne called. Lana puppy died this morning. She was behind the car when Adrienne backed up.  She is so sad.  Daddy helped bury Lana and Jess made Adrienne tea.  Marion will call her and Kim will be around. I felt so sad that I could not hug her from here.  No Lana for coffee on the porch, No Lana to curl up on the bed.  I am a long long way away.

Tuesday, September 17, 2013

A busy day of farm visits, delayed a bit by running out of gas on the way from Nampilika to Iganga and the need to confirm in the budget that there was enough money in the budget to pay for travel to these sites.  I bought for Abudu the missing syringe that needed to be in his package.  While visiting with Dr. Balandemu at BAM veterinary supplies he thanked me and VWB for the training and the opportunity to introduce products to the participants.   Charles had already been in that morning to price out vaccines for his 500 layer operation to complete and accurate business plan.  We headed out on the road to  Ibulanku region.

The first stop was Kakuba Joshua who planned to expand his Boer goat to 4 goats.  He first needs to sell his one female who had mastitis and only one teat.  He has a good raised shelter and works with a farmer group with oxen.  There was one animal with lumpy skin in the group of group tethered cattle and I advised him to spray weekly, not monthly, and to arrange for a group vaccination for Lumpy Skin Disease to protect the two oxen pairs.  One nursing cow had ear ticks so I also emphasized the great importance of tick control to prevent East Coast Fever.

The second stop was Joshua Kiakuba whose plan is for an expansion and improvement of his swine operation.  He has it set well back in this garden so the pigs should be safe from infectious disease if he can acquire healthy animals and quarantine them.  He will deworm regularly and will work with neighbors to establish regional deworming program.  All participants seemed well prepared to work together with neighbors and spread veterinary management skills to their farming groups. 

KasangoYusif works collectively with his large group of about twenty on communal gardens and a future large broiler plan.  He will arrange community vaccinations for Newcastle Disease, Fowl Pox, and coccidiosis treatment.  This group also enthusiastically showed off their savings and loan box and introduced all the membership.  The savings and loan is a new product of Pollaidh’s training for which they are very grateful.  The savings will not be enough to be the lender for a 500 bird broiler project the first year, but might be able to finance significant projects in a later year. 

Kasango Charles has a single cow dairy with a big healthy exotic cow right in the village of Idudi.  It will graze in a back lot and come into a brick house at night.  I advised him about the importance of extremely good sanitation and adding a raised level of sand in the cow’s stable to control mastitis.  His animals have been vaccinated against lumpy skin disease.  He plans to advise neighbors to spray for ticks.

Sarah was last and quite delightful.  She lives with her lovely children and grandchildren who were all dressed up for the visit.  Her plan is for a modest poultry operation which will be an expansion of her existing flock.  She has recently arrived oxen (bulls) which she already had to get the sub-county vet to treat for apparent Ngana (Tryps).  Sarah has already mobilized 200 cattle in the subcounty for FMD vaccination in the few days since the training.  She will spray tomorrow as there are ticks.  I preg checked her cow which was supposed to be 6 months pregnant but was open.  However both of her oxen are bulls so they should get the job done.  I also had forgotten to get her the sleeves but luckily had some in my coveralls pocket. 

Wednesday, September 18, 2013.  Another big day with farm tours for nine hours down to the lovely hill country in Jinja, Mayuge and Luuka districts.  It is a less well-off district dominated by sugarcane production which is a guaranteed market but low profitability.  Farmers feel that they can do better with gardens and animal agriculture.  Peter was first and there we focused on his great enthusiasm for teaching his farm group to write complete business plans with all veterinary health issues included.  Aggery was next with his sister Juliet nearby.   He farms with his brother and a large farmers group who operate together with dairy, goats, and a piggery as well as crops.  They have a strong semi-political focus aimed at changing sugarcane production back into crops for regional consumption to promote a greater profit and improved local economy.  I gave him and Juliet lessons in rectal palpation.  They have both had an introduction at veterinary ‘college’ and enjoyed the chance to practice.  I advised Aggery to regularly move the tie up and feed trough area to control mastitis by giving the cows a clean lying area. He will also need to develop transport and market for his pigs as the depressed small trading center nearby would not consume it. 

At the end of the day we visited Awaza Charles who is planning for a new dairy cow and the Beatrice who is planning for an expansion of her existing goat operation.  She also will conduct regular community tick spraying and also gather animals for vaccination.  She has a zero grazing cow and goat dairy and layers and works very hard as a single mother of four kids trying to pay for school fees.  She has had no mastitis for 7 years and seems to manage her very productive   (16 liter/day) cow well.  Overall I was very impressed how the trainees were dedicated to bringing their organizational and veterinary skills back to the village. 

Thursday, September 19, 2013, Mubuutu farm visits.  Another day with a mix of success and sadness.  I rode with Ajab on the motorcycle in pleasant weather through nice country that lifted up to bold granite outcrops.  Again the trading centers are gray and dusty but the villages and countryside had small thatch and mud huts, tidy crops and mostly healthy animals.  We had a tire puncture as we left the first farm and we brought the motorcycle to a local expert who removed the inner tube with 2 tools and used my leatherman to extract the wire.  Then he sanded the inner tube with a brick and left to tap a rubber tree for latex to attach the rubber patch.  He came back from the fields with a leaf containing milky white latex rubber which dried on the inner tube to adhere the patch.  I am glad it was the right season for patching tires and that the sun was shining to dry the latex.

I am looking now for ways to evaluate the success of the training.  Clearly the success or lack of it can be determined on several levels.  The basic level is to see if farmers are making progress on their business plans for their own operations.  Another measure could be to determine what additional skills or services they have brought back to their villages.  Some, like Peter, are teaching business planning for farm operations, others, like Sarah have already started or completed group preventative health measures like vaccination.  Others are eager to help neighbors as first responders on animal health with referral to the district veterinarian as needed.  Finally some, like Aggery, may use the training for a professional stepping stone to make contacts to be trained to give the ECF vaccine, preg check cows, or enroll in an AI course.  It is not possible to get a single measure of success although the central theme could be increased access to preventative health services. 

Our first visit was Buyinza James, a relatively young farmer with a passel of kids who has a business plan for a pig operation.  He has already bought the bricks for his pig shed and has confirmed his market with NAADS program.  Before the training he did not spray or vaccinate his animals but he will now make arrangements to do so for his neighbors.  All of the participants will check up on the ECF vaccinated animals in their groups to confirm ID and check for reactors.  So far I saw or heard of no adverse reaction other than mild swelling from tetracycline injection. 

The second participant, Festo, was away getting medicine for his daughter.  We saw her briefly and noted her yellow eyes and swollen abdomen.  Ajab suggested she be taken to the hospital and suspected yellow fever.  Unfortunately she died soon thereafter.  She was the third infant to die in the area in 24 hours including Ayubu’s nephew.  Clearly animal health is not the only issue of importance here.  The mood was of course subdued due to the impending funerals in the area. 

Kasiko James was already digging holes for the poles of his broiler shed as specified in his plan.  He also said that he had not used vaccine or spray before but would now do so for his group and had already bought the spray. 

Nalwemya James, a young man still living at home has started his own Animal Traction Business and had already purchased a 2 year old ox to go with the one he has.   He is planning to castrate them to make training easier.  He will call the district vet for a Burdizzio castration.  

WaiswaAusman is converting his loose local poultry to a confined operation and has fired the bricks this weekend.  Both he and Lukobala plan to arrange community deworming and spraying.  I reminded them to charge more for the spray than it cost so they will get enough to buy it again.   Ausman plans to teach others “so it can still be done when I am sick.”  

Friday, September 20^th, Last day of field visits.  I travelled with Abudu on Peter’s motorcycle with our start delayed by heavy rain with slick and muddy roads.  We travelled first to Swaya’s place to see his magnificent 3 story palace for layers that he has almost finished.  Swaga has only ¼ acre in a trading center so every bit is utilized for growing or chicken housing.  His chicken house is well constructed of straight, tightly spaced poles, with the floors also made of poles with grass mats under the chickens so that manure can be swept to the drop slot.  The program has benefited him by allowing him to polish his business plan so that he can get a bank loan to purchase the 700 chicks at a reasonable interest rate.  I encouraged him as well to organize the vaccination of other poultry in the trading center to provide a service to neighbors and to protect his own operation from infectious disease like Newcastle Disease.  

Abudu brought me next to his home farm that he shares with his brother.  This farm has plenty of land, but most of it has not been tilled for a long time so the soil is hard.  His plan is to buy a 2 year old bull on Saturday to train with his own bull.  Having seen his rather aggressive bull, I urged him to sell that one and buy a good young pair, get Dr. Kagoda to castrate them as they leave the auction, then have a nice easily trained pair of oxen to get ready for the next planting season.  Abudu’s family has few resources but lots of fertile land that has been fallow for years so they could easily improve their position with animal traction.  I did enjoy the ½ kilometer walk down through his long thin lot past the witch doctors’ hedge surrounded ancient tree, to view his garden plot and cows.

From his place we took a slippery single track path to Winnie’s place to view her plans for a broiler operation right in a trading center.  She has just started the foundation.  Her primary business in which she is quite successful is animal traction.  She has 4 teams, two work on any given day, and they work primarily at planting seasons about 6 months a year.  She also said that they effectively last 5 years before it makes most sense to sell them for meat and train another pair.  This means any animal traction business should count on income generated from oxen 4 days a week for 6 months a year or about 96 days a year.  Furthermore money needs to be saved to purchase a new pair every five years and train them for three months or more before selling the older pair.  Over the five years enough needs to be saved for cash to be available for that purchase and time to train. 

Henry Wandira was the last farm visit.  He has a lovely pastured dairy operation with cross bred cows that are predominately exotic – they actually look much like Holstein Friesians and seem so much more friendly then the native cows.  It was nice to be with cows that actually appreciated being handled.  He has 4 cows and a couple of heifers.  One calf had diarrhea and a fever and I recommended he give it tetracycline which he has available.  Henry sprays weekly on a steady schedule.  His father, who we met, started with exotic cows in the 1980s and they all died without spray.  His father has lovely expansive pastures for 25 or so head.  He has lost only one calf this year.  They has a recent severe outbreak of Lumpy Skin Disease, but limited the damage by getting vaccine done quickly.  Henry has a well to do family with better access to veterinary services, but his father is looking forward to having his expertise available.  This farm is ready to make the transition to machine milking and refrigeration although Henry and his dad thought that was rather exotic. I realized as we were viewing his cows that Henry is the Chairman’s brother because the both have the same big jolly laugh.  I understand their sister is a recent, and first women, vice-president of Uganda.  The family has less need of assistance in farm management, although it was pleasant to visit the gentle cows and beautiful pastures.   

After leaving the Waindiras’ we stopped by Ruth’s place (Pollaidh’s counterpart and assistant with the village savings program).  Happily she was home. We had a pleasant visit and she fed us lunch which was very much appreciated by that time. 

SUMMARY OF TRAINING:

This initial Veterinarians Without Borders training program has been a remarkable success as viewed from this preliminary level.  Uganda has high comparative food prices and a strong demand for animal agriculture products.  Farms can make remarkably high returns on investment here and there are some very talented, hard working farmers.  Planning is often too short term to realize the great potential here.  Preventative veterinary health services are available but not used appropriately due to a lack knowledge about their real value in minimizing risk and securing profitability.  Zoonotic diseases like Brucellosis are also common and present a threat to food safety and human health.

The training program addressed these challenges by teaching farm business planning skills and by introducing participants to veterinary disease prevention and management.  The quality and enthusiasm of the participants made for a great interactive and learning environment so that I felt many of them went home with meaningful new skills.

The follow up visits allowed us to reinforce the lessons and also appreciate the speed with which the participants went to work on their own farm businesses or instituted community preventative veterinary health measures like spraying and vaccination. 

The success of this program can continue to be monitored by rechecking with participants in 4 to 6 months to see both how they have developed their farm business plans and what veterinary services they have provided to their farm groups and communities.  The communities could also be interviewed to see what benefits they have gained as well. 

Future efforts by Veterinarians Without Borders can be continued on a several fronts.  At a meeting with MTCEA leaders and the local district vets Drs. Baligeya and Kigoda Sam on Sept 23^rd we discussed ways forward:

1. A study of disease prevalence leading to a future establishment of southeastern Ugandan veterinary diagnostic lab would clearly assist in controlling animal diseases that affect agricultural production or human health.  I visited the district veterinary office where they have a nice large bright room for a diagnostic lab.  They have a sink with running water, a lab bench, a large working refrigerator, fairly stable power, a hematocrit centrifuge, giemsa stain, slides, and a good model, but partially functioning microscope.   The office would be happy to have the space well used. There is a preference for low tech but skilled laboratory capacity (slide agglutination, blood smear stains, fecals) over high tech high maintenance machines like ELISA.  Participants like Juliet were identified as enthusiastic and trainable for laboratory skills.   In addition those trainees and future ones can be recruited to learn the techniques of blood or other sample collection to assist in studying and controlling zoonotic disease.
2. Use the current participants to collect some baseline data of diseases encountered, treatments  and preventative steps taken.  Obtain this data during the February follow up visits to evaluate farm business plan progress.
3. More training sessions similar to this one but in additional subcounty areas to continue the expansion of both access to veterinary services and demand for veterinary consulting services.  A new session should include training in blood collection to start creating a trained group to assist with disease prevalence sampling
4. Consider working with Makere University students to provide skills like rectal palpation for pregnancy diagnosis and other skills not fully taught to new graduates.  These skills are starting to be in demand as Artificial Insemination becomes more widely used. 

 Overall there is excellent potential for significant improvement in food production, farm profitability, and zoonotic disease control by continuing and spreading this model of food animal health management. 

I owe thanks to Dr. Tom Graham for inviting me to represent Veterinarians Without Border on this mission and for his assistance in the program itself.  I also want to acknowledge Dr. Sam Kagoda’s tireless and cheerful translation of our efforts into Lusoga, his effective work as a facilitator and his local veterinary knowledge.  Peter Owor’s  coordination kept our focus on the broad community benefit.  Ruth Namasulo ably opened and closed our sessions as well as translated both language and culture.  AyubaMusolu kindly hosted Dr. Graham and I as well as drove me around.  Special thanks to “Nygaga” Pollaidh , of whom I am very proud for her able job coordinating this whole effort.