Indonesia’s Intricacies: Rhinos, Lorises, and a Dab of Dengue

View along the way to International Animal Rescue – Bogor

When one thinks of Indonesia, picturesque scenes of Bali’s beaches or bold batik patterns might come to mind. Indonesia has an entirely different meaning to me, as this archipelago constitutes one of the most biodiverse regions on the planet. Amidst the dense rainforest foliage are fascinating endemic species, but given threats from habitat loss and poaching, the future of some Indonesian species remains uncertain. In particular, Javan and Sumatran rhinoceroses exist in a precarious state, being some of the most endangered mammals in the world. Last summer, I had the privilege of traveling to Indonesia with Carmen Smith (DVM 2021) and Montana Stone (BS 2019), under the guidance of Dr. Robin Radcliffe and support from Expanding Horizons and Engaged Cornell, to partake in a multi-faceted program centered around international conservation efforts.

Alex teaching children about the role sea birds play in the ecosystem

Building upon Dr. Radcliffe’s well-established relationships with partners in Indonesia, we were warmly welcomed by personnel from WWF-Indonesia, who had created a summer schedule with the goal of exposing us to different components of conservation work. First, we headed to the buffer zone of Ujung Kulon National Park, the last habitat of the Javan rhino. We assisted a group known as Sekala Petualang as they led conservation education programs for local school children where mainly Indonesian was spoken. It became quickly apparent that the weekly Indonesian classes we took during the spring semester before leaving were my only saving grace in that remote part of Indonesia (where cellular signals are nonexistent). Environmental stewardship was the underlying theme to the program, as educating children is an effective way to create a conservation-embracing culture. Despite living alongside a national park with Javan rhinos, a number of children were unaware that such an animal even existed in their “backyard”. It was heart-warming to see that the kids had open and receptive minds. One of Carmen’s presentations introduced veterinary medicine, yet another unfamiliarity that intrigued them. This segment of the summer underscored the importance of engaging with communities, walking in their shoes, and creating a space conducive for exchanging ideas bidirectionally. 

The next portion of the summer was spent at Institut Pertanian Bogor, a prominent university, which brought us back to the hustle and bustle of Indonesia’s urban scene. The crux of Carmen’s Expanding Horizon’s project was investigating rhino pathology as a means to better inform rhino conservation initiatives. The pathology faculty were very generous with their samples, taking us through both Javan and Sumatran rhino mortality cases. Despite my ineptitude with pathology, I was able to gain an appreciation for the challenges pathologists face working with wildlife species. I soon learned what the word “autolysis” meant as we scanned each image from the necropsy; imagine the difficulty of mobilizing a team of pathologists that must trek with their supplies to remote sites within the rainforest, finally laying their hands on the deceased rhino more than a day post-mortem, precious tissues vulnerable in the incessant Indonesian heat.

Carmen analyzing histology slides at IPB

Ultimately, Carmen and I were able to translate pathology reports into English to increase their accessibility, perform literature reviews, and identify topics worthy of discussion for a scientific publication. We realized that while individuals may have a species’ best interest in mind, other parties are bound to have conflicting interests or political underpinnings that ultimately jeopardize cohesive collaborations between various conservation organizations. We learned that any work of such nature, especially in a foreign country, must be done with exacting precision and respect. This chapter of the summer would be incomplete without mentioning my bout with dengue fever, which actually made me miss a portion of the pathology work. What started as a simple cough turned into body aches, fever, inappetence, and more. I figured an illness was inevitable in a novel tropical country, so I thought this was normal (despite running out of all of my pain medication trying to ease the symptoms). Soon thereafter, Montana also fell ill with dengue, at which point I was tested. Although no one heads off to international experiences with the intention of contracting a mosquito-borne disease, the experience was a lesson in resilience and preparedness. After all, despite being ill, I was unable to turn down a day trip to Taman Mini, a phenomenal bird park!

Prior to the next portion of the program, we briefly visited an illegal pet market, which unnerves me still to this day. I had a mental image of what such a market would entail, though nothing could have prepared me for the true horror I saw. Densely packed cages teeming with stressed birds (not to mention the dead birds littering the cage bottoms) were interrupted by cages of civets, flying foxes, macaques, and more. My heart ached for the bird that would not live to see another sunrise, for the listless civet lying motionless in its cage, and for the chained baby macaque tucked away in the shadows. I felt defeated, but I realized that such scenes are the very essence of what drives me and many other veterinary students to pursue careers that contribute to the conservation of wildlife. This experience solidified why educating the next generation on the importance of conservation and environmental stewardship is essential. 

Routine health assessment of a Javan slow loris at IAR

With the atrocities from the market still fresh on our minds, Carmen and I went to International Animal Rescue – Bogor, a site that primarily focuses on rescue, rehabilitation, and release of Javan and Sumatran slow lorises. Lorises are common in the wildlife trade, and in the markets, their canines are clipped, setting the stage for dental and subsequent metabolic disease. A number of the lorises we worked with were non-releasable, so the rescue exceeded twice its anticipated capacity. We engaged in loris husbandry, spent nights observing lorises (an experience unlike any other!), and helped with their veterinary care. Multiple patients illustrated the harsh reality of a fragmented habitat. The mere existence of a road bordered by uncoated electrical wires poses a great threat to unsuspecting lorises attempting to cross the road. The prognosis is often bleak for the few lorises that manage to survive electrocution. This experience solidified my understanding of the human/wildlife dynamic, which tragically tends to swing in favor of the former.

Carmen, Montana, and Alex at Kelian Sanctuary, Borneo

Habitat loss and fragmentation set the stage for the next experience that brought us to Kelian Sanctuary in Borneo. The previous year, a Sumatran rhino named Pahu was rescued from the wild and brought to the sanctuary. Pahu is possibly only one of three rhinos remaining of her subspecies, so it is of utmost importance to rescue these isolated animals and investigate breeding options. There are Sumatran rhinos (Sumatran subspecies) that reside at the Sumatran Rhino Sanctuary in Sumatra, so collaboration is anticipated in an attempt to save this species overall. As we landed in Borneo in a precarious propellor plane, the three of us were riddled with excitement. In the few days we had at Kelian, the team composed of individuals from WWF-Indonesia and ALeRT completely immersed us in the operations at the sanctuary. Before I knew it, I was hand feeding Pahu various plants, watching her veterinary examinations and procedures, and observing her in her paddock. It was at that moment that it was clear to me that megafauna like the Sumatran rhino simply cannot be lost from this planet—it is our duty to fight with all of our passion and intensity to save such species before they slip away. Even when I was out with the team collecting food for Pahu or planting trees in the rainforest, I embraced the physical and acoustic beauty of the surrounding rainforest. During patrols of Pahu’s paddock, I witnessed gibbons, macaques, hornbills, and even a clouded leopard. During this time, Montana was able to train personnel at the sanctuary to utilize a Cornell Lab of Ornithology Swift recorder to document Pahu’s vocalizations, as no bioacoustical analysis had previously been done on Sumatran rhinos. To this day, I treasure hearing a content Pahu wallowing in the mud, “humming” and producing kazoo-like sounds, and I hope that one day everyone will know of this rhino’s plight and hear their delightful vocalizations.

As I write, I wonder whether that was my first and last time working with a Sumatran rhino. Let me re-phrase that—will the next generation even learn of critically endangered species like the Indonesian rhinos or will the species’ names be relics of a bygone era? Questions like these serve as an impetus for my passion in conservation medicine. My time in Indonesia helped me grasp what international conservation work entails, exposed me to the associated difficulties, all while leaving me inspired. I met some of the most passionate individuals in Indonesia, so I have faith that my previous questions will have favorable responses decades from now.

Colonialism and Conservation: a look at Borneo, Indonesia

This past summer, I traveled to Indonesia as part of Engaged Cornell. Engaged Cornell is a program that pairs together a graduate veterinary student and an undergraduate student for a summer research project. The program provided funding for four pairs of students to travel to Indonesia, the Congo, and Uganda. As part of team Indonesia, I also took a semester long intensive language course as well as a Conservation in Communities elective course.

My team went to East Kalimantan, the Indonesian province in Borneo. We were partnered with ALeRT (Aliansi Lestari Rimba Terpadu – The Alliance of Integrated Forest Conservation), a non-profit organization founded in 2009 by Dr. Marcellus Adi. ALeRT aims to protect the nature of Way Kambas National Park and encourage community development for sustainable living. In March 2017, ALeRT established a new office in Borneo to conduct disease surveillance and occupancy surveys of the Sumatran Rhinoceros found in East Kalimantan, in conjunction with WWF. The Sumatran Rhino is critically endangered, and was thought to be extinct in Borneo until it resurfaced between 2010-2013. There are an estimated 1-5 rhinos left in the region, and with continued habitat loss, the risk of death of these animals is high. WWF has been working in the region for a couple of years now, and plans to do a translocation of the rhino in the wild to the protected Kelian Forest. However, before the translocation can take place, a thorough evaluation of diseases in the current habitat and the protected forest is necessary to ensure that immunologically naïve rhinos are not exposed to new diseases in the protected Kelian Forest during the translocation.

We worked closely Dr. Aldino Yanuar, the ALeRT veterinarian at the field site in East Kalimantan. Our goal was to document the prevalence of gastrointestinal parasites and trypanosomes in cattle living in areas surrounding the potential habitat of the Sumatran rhinos. Because of the risk of cross-species transmission, establishing disease prevalence in cattle helps us to assess the risk to the rhinos. Since the ALeRT office was recently established, part of our job was to help Dr. Yanuar set up a small lab and help prepare sample collection protocol.

We spent a week at a time in remote villages that bordered the proposed habitat. Our partners had already begun choosing villages by sending members of the Social team to speak to villagers about whether they had seen any rhinos. Often, we didn’t have any prior information about how many cattle were found in each village. Some villages had just a few cattle, while others still maintained an abandoned government breeding program, and one village only kept swine. Because of this, it wasn’t always possible to anticipate what the day’s sample collection would be like.

We built temporary stalls using wood cut down and plastic wrap, or whatever else was on hand. Many of the cattle were not used to handling, so collecting samples and administering vitamins required a lot of patience. In one set of villages, each temporary stall resulted in cows jumping over or under the sides to escape. I was completely out of my element when one village did not have any cattle, but did have swine. I had utilize what little I had learned in my curriculum about swine to collect the samples we needed. I made a lot of mistakes, but I learned a lot about myself, as well. At times, you must use what you have. If you run out of gloves, you do what you must do to get the samples. Often the roads were almost impassable, taking hours toget from one village to the next. There was seldom cell service or electricity. Our curriculum gives us a base on which to build our experiences, but the rest, the creative problem-solving, is up to us. I also had to face the reality that, in Borneo as in many other places in the world, animal welfare regulations are not as strict as they are in the United States. The pigs are kept in small wooded enclosures 5 feet above the ground, because of the flooding, and are fed one to two times daily. Often the pigs did not even have access to water. Many animals are kept alive long periods of time when they should be culled, because cows are thought of as a symbol of wealth and are saved for ceremonies such as weddings and funerals.


While in the area, we attended a traditional Dayak Funeral ceremony for a woman who had passed away in her sleep just days before we arrived. We ate with her family, and then watched them make the first sacrifice to help the dead cross into the afterlife. The sacrificial cow was used for meat over the following days. The second and final sacrifice, 7 days after her death, involved tying a water buffalo to a carved tree in the center of the field and releasing the water buffalo as men in two teams surrounded it. Every drop of blood spilled was a step closer to the afterlife, so the men in teams had knives and would stab the water buffalo as it attempted to get away. We watched as this part of the ceremony took place. Before the life of the water buffalo could be ended, a fight broke out between the two teams, so we were whisked away. This funeral ceremony is quite rare, and it was extremely difficult to see. We learn in class about behaviors exhibited by animals when they fear for their lives, and this water buffalo was terrified. We talk about animal welfare, and the USDA would by no means approve of this ceremony. However, it is part of the Dayak Tribe’s culture, deeply rooted in their history and spiritual beliefs – and who was I to say that this ceremony was wrong? Without understanding, we lose pieces of human history and diversity.

At each village we visited, I was astonished by the villagers’ kindness and willingness to share – gifts, food, and knowledge. The quote “Sometimes, those who give the most are the ones with the least to share” came to mind quite often. In one village, they started up the generator for us each night, and when we ran out of water to bathe in, rushed to the river to get us more water. I was gifted a handmade Dayak purse by one woman after spending the evening teaching English to the kids in the village. These amazing people had so little to give, and yet gave so much. At one point a farmer asked us, “why do doctors only come to check the animals and not us?” This statement still haunts me. The healthcare system in Indonesia is riddled with corruption. Much of the money is invested in Java and Jakarta for the roads. Though this is changing for the people in East Kalimantan, I wonder if it is changing fast enough. And as the needs of people continue to increase, it only means that the forest will get smaller. Many people still rely on the forest. Some villagers see the forest as an endless possibility. Other are afraid of the creatures it holds, and still others are unconcerned about the forest, because it is palm oil and rubber that provide for their families. Conservation of animals is so closely intertwined with the people surrounding these flagship species like the rhinoceros. I remember riding the motorcycle from one village to the next, seeing many people with guns going hunting. Even in the protected Kelian forest, there was evidence of people. A bearded pig had a distal limb amputation from a snare. We ate monitor lizard in a village close to the Kelian forest, after a villager offered us some of his prized meal. The question is, how can we really get people involved in protecting the forest and animals, while at the same time maintaining a sustainable economy?

To explain the relationship between America and Indonesia, you must understand the complex history between the two nations. Indonesia was originally a Dutch colony for hundreds of years. The Dutch established a caste system and controlled all portions of the government. In 1945, after a complex role in World War II and a period of Japanese occupation, Indonesia proclaimed its independence. America brokered the deal: for their independence, Indonesia would pay the Dutch what would be about 150 billion dollars today. The country was left poor, with its natural resources exploited. In the 1960s, communism began to take hold of Indonesia. At the height of the Cold War, the United States intervened, and the CIA effectively ran a shadow government. With the backing of the United States, Indonesian General Suharto took control, and murdered high-ranking members of the military, blaming it on communists. The subsequent anti-communist purge led to the genocide of 300,000-400,000 people. Indonesia continued to grow and develop economically, but Suharto’s administration was widely suspected of corruption. In 1998, Suharto resigned, and Indonesia became a democracy. In 2010, the net worth Indonesia’s vast oil and mineral reserves was over 95 billion dollars, yet the government only operated on 19 billion dollars that year. The remaining 66 billion dollars in revenue from Indonesia’s natural resources went to American, Australian and Singaporean companies.

So with this history of colonialization and even more recent neo-colonialism, what is our role as conservationists? That is a question I still struggle to answer. The clear majority of Americans will never know what it is like to grow up in a developing country. We might have preconceived notions about how easy it would be for someone to just stop poaching, or to build a better road. To just simply stop the hunting of prized animals such as elephants, even though it can provide some income to poor villages. To see an elephant in chains and proclaim that such treatment is inhumane. To judge someone who traps a pangolin, despite not even knowing the laws preventing it. To say that a farmer needs to provide his cows with more calcium, while the farmers must prioritize their children’s needs for the same mineral. Even as veterinarians, we are taught that when an animal presents with a problem, we fix that problem. Practice is rarely so simple. We will learn later in our careers how complicated that can be, based upon the client and their financial needs. We live a sheltered life in veterinary school, but programs like Engaged Cornell and Expanding Horizons give us glimpses of the “real world.” My experience taught me how the world really operates, and left me with more questions than answers when it comes to the realities of conservation, and how to implement change. Even now, words don’t do my experience and the people I met any justice.

Eden and Dr. Marcel

Working with ALeRT helped me to see that my role, and maybe our roles, are not to march in as crusaders, to try to get people to stop what they have been doing for years. ALeRT was run entirely by Indonesians, and they employed people with connections to the Dayak tribe. Our role is to empower and educate people who can utilize that knowledge, along with their understanding of the culture, to make long lasting impacts for people, the rhinos, and the environment. I am proud and humbled to be a part of Engaged Cornell because it is a program that augments the work that Indonesians such as the illustrious Dr. Marcel Adi and Dr. Yanuar are doing to protect the environment.

Many of my questions remained unanswered, swirled in the reality that I am just one person. With clinical rotations looming in my immediate future, I feel the frustration of being faced with these questions and not being able to do much right now. However, I have learned that the integration of multidisciplinary roles is essential to effectively enact long-lasting change. I believe that One Health is going to change the world, but it will be a long and arduous road to creatively solve major issues facing the planet, and asking the right questions is just the beginning. One area I would like to see improve is the sharing of information. There was a lot of prior research conducted in Indonesia that I could not access without knowing some of the language. Speaking with the head of WWF Indonesia, I know he and other people are working hard to translate what they know, to make it available to people in English-speaking countries. Indonesian researchers would benefit from translations, as well. It is just a slow process, and many species don’t have that time.

For more information on neocolonialism in Indonesia, check out this article.



Eden Stark is a third year veterinary student.

Chimpanzee Medicine in the Republic of Congo

During the summer leading up to my third year of veterinary school, I worked with the Jane Goodall Institute (JGI) in the Republic of Congo. As part of the college’s commitment to wildlife health and international medicine, Cornell has established a partnership with JGI through the Engaged Cornell Program. Engaged Cornell gives veterinary and undergraduate students the opportunity to apply concepts learned in the classroom to field sites in developing nations across the globe. Students can elect to take an on-campus course during the spring term and apply for the opportunity to continue their studies abroad during the summer. Upon return, they take a follow-up course in the style of a seminar series, to share their work with faculty and peers, and to learn about their classmates’ experiences. Thanks to Engaged Cornell, I was able to work at Africa’s largest chimpanzee sanctuary alongside one of the world’s leading experts in the field, Dr. Rebeca Atencia.

Tchimpounga Chimpanzee Rehabilitation Center is currently home to over 130 chimpanzees, most of which fell victim to the illegal bush meat and pet trades early on in life. Through the efforts of Dr. Atencia and her team of nurses and caregivers, these animals are being given a second chance. JGI is currently working to prepare a number of these chimpanzees for release back into the forest, where they will have the opportunity to live as wild apes once again. Before that can happen, however, they need to be both physically and psychologically fit to survive the harsh realities of life in the rainforest. My efforts this summer were put towards ensuring the capability of these chimps to thrive outside of the confines of the sanctuary.

Some of my time in Congo was spent performing routine “health checks,” or comprehensive physical exams, on animals under the care of JGI. I participated in the anesthesia, general examination, cardiac evaluation, and abdominal ultrasonography of over thirty chimpanzees. I learned basic skills such as taking blood pressure measurements, giving injections, and drawing blood, and more advanced skills such as abdominal ultrasound, echocardiography, and designing anesthesia regimes. I gained invaluable hands-on veterinary experience that I truly could not have gotten anywhere else.

Melissa Hanson describes the results of a chimpanzee electrocardiogram at the Tropical Biology and Conservation Symposium, October 2017.

In addition to medicine, I spent much of my time analyzing behavior and social interactions of the chimpanzees. I became versed in their verbal and non-verbal language, watched alliances form, and saw individuals rise to power and dominance within their community. A chimpanzee’s well-being relies heavily on its sense of security in its social group, and the health of a chimpanzee community depends on the degree of harmony amongst its members. The knowledge base I formed through careful observation was pivotal for my participation in data collection during the integration of new chimpanzees into established social groups. During an integration, JGI caregivers and veterinarians carefully record behaviors, to ascertain whether a chimp will be accepted by its conspecifics or not. Things happen very fast, so it is imperative that observers be well-acquainted with the chimps’ social cues. In time, I was confident enough with my skills to participate in this data collection, and even had the chance to make recommendations as to which individuals to introduce to the group.

My experience did not stop there, however. While in Congo, I also had the chance to work with a variety of unique native species, such as Mandrills, a Tree Pangolin, and African Grey Parrots. During time spent with JGI’s education and public health teams, I visited local villages to discuss conservation and sustainable agriculture with their people, as well as provide parasite preventatives for their pets. I also gained a lot of experience in the laboratory analyzing blood and fecal samples and screening for infectious disease among the chimps. Additionally, I participated in several ongoing research projects at Tchimpounga and even could explore some of my own interests and questions. One endeavor I am most proud of contributing to is the establishment of a preliminary body condition score (BCS) system for chimpanzees that will allow caregivers to monitor nutrition and well-being in a non-invasive manner. Hopefully, this scoring scheme will be used when the chimpanzees are being evaluated for their success in the forest after their release.

I am incredibly fortunate to have experienced all that I did this summer, and cannot thank the partners of JGI or Engaged Cornell enough for allowing me to pursue some of my greatest aspirations while still in veterinary school. Participating in chimpanzee medicine and rehabilitation allowed me to be a part of something much bigger than myself and to learn about a species with which I had never worked, but had always dreamed of. My time in Congo made me a better student, a better person, and will undoubtedly make me a better veterinarian in the years to come.


Melissa is a third-year veterinary student from Cortlandt Manor, New York. She received her Bachelor of Science degree from Duquesne University where she majored in biology and minored in biochemistry and history. Her interests are in clinical zoo and wildlife medicine and particularly rescue, rehabilitation, and release. She works as student technician at the Janet L. Swanson Wildlife Health Center, a service of the Cornell University Hospital for Animals.

Buffalo Trypanosomiasis, A One Health Approach

In Indonesia, we traveled to a remote village, Cegog, the most remote village in Java and the buffer village closest to the protected Ujung Kulon National Park. To give some perspective on what it means to be a “buffer village”, the Rhino Protection Unit took a video recording of a large, adult male Javan Rhino just 4 km from where we were staying.

This trip was not originally planned as part of our internship. However, alarming results from a serological analysis done on the water buffalo in Cegog months earlier prompted an emergency response from WWF. The serological analysis was done on the entire 101 water buffalo by WWF veterinarians, Drs. Kurnia, Gita and Zulfiqri. The results yielded a 91% seroprevalence of trypanosomiasis in the herd. This is contradictory to the normal endemic prevalence of around 10% to 20%. Thus, this was an outbreak that required immediate action.

In mid-June, during our first field sampling trial in Sumur buffer village, we received the news. Dr. Nia and Dr. Gita asked me to help with the outbreak by first drafting a one page Emergency Outbreak Response Protocol for Trypanosomiasis in Water Buffalo. This legislation was to be sent to WWF headquarters in the United Kingdom, to grant us funding to address this outbreak and future outbreaks. It also was translated in Bahasa Indonesia to be distributed to government officials for approval to work in Cegog. This was the first time I have been involved with writing legislation, especially in the context of conservation. I thoroughly enjoyed the process and learned immensely from it.

From the literature and having a basic understanding about the bureaucracy behind Javan Rhino conservation, I tailored the document towards the economic benefits of addressing trypanosome outbreaks.  Money talks, when it comes to conservation.  I structured the protocol into four components. First, the treatments proven to be most effective in mitigating parasite loads in water buffalo: Diminazene Aceturate (DA) at 7 mg/kg intramuscular injection to a seropositive animal maximizes efficacy (often curative) and decreases the risk of parasite resistance. Next, I addressed the importance in creating good relationships between veterinarians and farmers. Farmer education of the life cycle, clinical signs, health impact, and economic loss accrued from chronic trypanosomiasis in their herd builds trust and incentive for a long term veterinary care. Additionally, informed farmers allow earlier detection of outbreaks and rapid response. The third component was diagnostic testing. Antibody Detection ELISA on blood samples from every buffalo during a suspected outbreak is the recommended method, with simultaneous trapping of Tabanid flies – the vector of trypanosomiasis – and PCR on fly blood meals for presence of trypanosomes. The fourth component was on prevention. Prevention requires creating a more proactive and structured approach towards dealing with trypanosomiasis. Yearly testing and physical assessment, along with farmer education and subsequent treatment of herds twice a year with effective drugs, are the most cost- and time-effective ways to reduce prevalence of trypanosomiasis. My conclusion reiterated that it is paramount to address these emergencies early and effectively, to not only reduce the economic burden on farmers and the Javan economy, but also to protect one of the most endangered and praised species to Indonesia: the Javan Rhino.

Dr. Nia and Dr. Gita really liked the approach I took towards addressing the outbreak, and distributed the document to be reviewed. Several weeks later, we received word that the request was approved.  We were going to Cegog to address the current outbreak and put what I had written into practice. I was then asked to create an abbreviated physical exam checklist to specifically address trypanosomiasis.

I used the same method we are taught in veterinary school to address a disease process. First, I tailored my history-taking questions towards identifying factors that may indicate the presence of chronic trypanosomiasis.  I asked farmers about the presence of abortion and about any decrease in market value in their herd, specifically regarding decreased weight and meat quality. Another important consideration is the function of the water buffalo outside the context of meat or extra revenue. These water buffalo are the organic machines that till their rice paddies and make work on the paddy much more efficient. This decreases the time it takes to farm and the number of personnel required to work on the farm, which allows other members of the family to work additional jobs or go to school. Chronic trypanosomiasis leads to chronic anemia, consequently causing cachexia (muscle wasting) and lethargy – decreasing the productive lifespan of the buffalo and the overall working interval for each buffalo.  This directly correlates to a less productive farm, and mitigates the listed benefits of owning buffalo.  Buffalo are sold earlier into slaughter, further decreasing the productive value of each buffalo and the number of birthing intervals possible. In order to assess the impact of trypanosomiasis on farm productivity, I tailored my questions towards these consequences.  From just an economic standpoint, it is clear that this disease has a complex net of negative impacts that further perpetuate the socioeconomic problems these remote villages face.

My next step was to customize the physical assessment to specifically look for trypanosomiasis, by looking for key clinical signs and establishing a diagnostic protocol to rule out other disease.  Thankfully, much of the diagnostic rule-outs have been established in this herd. The veterinary work done on this herd earlier in the spring ruled out many of the diseases that look like Trypanosoma evansi, such as hemorrhagic septicemia and anthrax (all diseases that were proposed to be a cause of mortality in the Javan Rhino). Using what I have learned from the physical exam of the cow in veterinary school, I created a checklist of clinical signs to look for the manifestations of chronic trypanosomiasis in water buffalo: TPR, clinical signs of surra (cachexia, lethargy, weakness, recumbency, CNS signs, conjunctivitis, edema, inappetence, dyspnea, diarrhea), and signs of anemia (pale mucous membranes, cold extremities from poor peripheral perfusion, lameness, tachycardia and bounding peripheral pulses).

With the checklist (also translated in Bahasa for Dr. Zulfiqri and Dr. Gita), we conducted physical exams on the entire water buffalo herd in three days. First, with mediation from Dr. Zulfiqri and Dr. Gita, we met with all of the farmers to educate them on the common disease of water buffalo, including trypanosomiasis, hemorrhagic septicemia and anthrax. We reiterated the negative impact these diseases have on their buffalo’s health, and thus the economic benefit of establishing veterinary care for the buffalo. We also brought multivitamin tablets, oral de-wormers and an intramuscular ATP and B-vitamin supplement. To promote good veterinary-farmer relations, it is paramount that our interventions do not end at simply coming to the village, assessing the buffalo, and then leaving. WWF made sure to give the buffalo medicine that would help promote immune system function, RBC and muscle regeneration and de-wormers to combat trypanosomiasis and secondary infection. This would hopefully show the farmers observable improvement in their buffalo which would reflect the benefits of continuing to allow veterinarians to assess the health of their herds in the future. Also, if we find clinical evidence of trypanosomiasis, establishing respect between veterinarian and farmer is critical in allowing WWF to later return and treat directly for trypanosomiasis.

Next, with approval from the farmers, we spent the three days working two hours in the morning and two hours in the afternoon to work with the herd of buffalo (101 individuals). During the day, the buffalo were led into the forest (the national park) to pasture. It is likely that buffalo walk the same paths the Javan Rhinos uses for browsing and foraging, which goes to show the urgency of a trypanosomiasis outbreak in this buffalo herd and the potential implications of disease transmission to the rhinos.

The PE success was variable on the buffalo. The buffalo are only tied by rope to a small piece of bamboo in the ground. There are no squeeze cages. The buffalo were also wild compared to their docile bovine cousins. Quite often, I would have to duck and dodge out of the way of their huge horns. I often had to rodeo with them to get temperatures or access a mucous membrane to look for pallor and CRT.  Overall, I produced about 20 thorough physical exams out of the 101. The rest were observational, relying more on the history, looking for key historical information such as abortion, lethargy and decreased productivity and wholesale value. For some, this may have seemed like a nightmare. But, I loved every second of it – diving out of the way from buffalo, rodeoing them to get any meaningful information.

What did we find from the work we did in Cegog? Results were highly variable between farmers. Some herds were in better condition than others. All herds had very high ectoparasite loads , and consequently had very poor skin condition and hair coat. Most herds had emaciated individuals and evidence of muscle wasting. Most farmer histories included decreased overall whole sale market price, lethargy and decreased productivity. Most herds had evidence of anemia (pallid mucous membranes, poor peripheral perfusion, prolonged CRT). Most animals were mildly dehydrated (5%). There were several herds with abortion storms, as well.

There were some hurdles that limited our ability to maximize the efficiency of our work. The buffalo were difficult to work with, and don’t like veterinarians – especially tall, white, hairy ones with Cornell scrubs. There was variable physical exam data, most being observational. Farmers were inherently wary of outsiders. We were the first foreigners this village had ever met. Dr. Zulfiqri and Dr. Gita were very helpful in mediating my questions on history. However, Dr. Zulfiqri and Dr. Gita seemed to think the farmers may have provided false information on history with regards to the presence of abortions and of illness and poor herd productivity. It is likely the conditions of these animals are far worse than I described.

So, what should we do next? Firstly, a more thorough PE survey must be done on every buffalo. I likely missed many individuals with fever and anemia due to lack of physical exam accessibility. Also, a more thorough diagnostic work-up, such as a CBC/chemistry and QATS, should be conducted on the most clinically sick buffalo. Finally, a more efficient system to developing the clinical history for individual buffalo, such as a number system for each farmer’s buffalo, though ear tattoos.

After I completed the summarized physical exam assessment of what I found in Cegog, I presented my findings to the WWF Ujung Kulon team. I think the information I gathered will be a great foundation and resource for when they return to Cegog for future work. After my presentation, the team discussed what they thought (all in Bahasa). Dr. Nia translated, reiterating that they had liked the way I presented in the context of One Health, especially regarding the economic benefit of establishing a better veterinary-farmer relationship. She told me that the work I did on the original one page emergency response protocol had prompted WWF to organize a group to go once a year to villages like Cegog to establish the treatment, education, diagnostic and prevention protocols I helped create. They also planned to make the missions One Health-focused, by including environmental scientists and human physicians to address public and environmental health problems.

All in all, there is a lot I learned from this experience about the complexity and bureaucracy in addressing conservation issues in Indonesia. I learned a lot about conducting veterinary work in a developing country. I also became more knowledgeable about the vector biology and clinical manifestations of trypanosomiasis in water buffalo. Additionally, regarding veterinary work in a developing country, I concluded that developing good veterinarian-farmer relations is paramount. Establishing preexisting trust is the only way to successfully educate farmers on the human, environmental, and animal health benefits for instituting long term veterinary care for their buffalo. Veterinary care for these buffalo not only enhances the economic gain for these villages, but reduces the risk of zoonosis between human and buffalo and reduces trans-species transmission of disease to the Javan Rhino and Banteng.

By utilizing the tools of One Health, we can address a vast array of conservation issues – from tackling problems locally, such as this example, to addressing national, international and global conservation issues. It is very clear to me now how complex these issues are. Not one person, nor one profession can fix all the complex problems involved in conservation. Confronting human, animal and environmental health requires collaboration between institutions, disciplines, cultures, and countries. I am beyond fortunate to have had this realization at the start of my veterinary career. I cannot wait to see what is in store for our profession and myself in the field of One Health.