Interview with Orangutan Doc: David Irons
Source: The Times Online
David Irons works both at the Borneo Orangutan Survival Foundation’s centre and Galloway Community Hospital
Gillian Bowditch
For those who like their wildlife tame, BBC2’s new series Orangutan Diary is a tellyfest of sentimentalised furriness. There’s Nobby, the “bad boy” of the nursery class who is graduating to “forest school” where a team of teachers will teach him how to live in the wild. There are the “irresistible orphans” Peanut and Pickles. In fact, the entire cast sounds as if it has come from a five year-old’s soft toy box. It helps that in the cuteness stakes, orangutans are at the top of the evolutionary tree.
The mancubs come in the form of presenters Steve Leonard, the television vet, and Michaela Strachan. But the strangest creature in the cast has to be David Irons, a 46-year-old doctor who, when he isn’t tending to the apes in the Borneo Orangutan Survival Foundation’s (BOS) centre at Nyaru Menteng, is patching up Scots in the accident and emergency department of the Galloway Community Hospital in Stranraer. For those who believe wildlife is in danger of becoming Disneyfied to an unnatural degree, Irons, who gives a whole new meaning to the term going ape, represents the ultimate in anthropomorphism.
The GP, who also tutors seafarers in medicine for the Maritime and Coastguard Agency, is an accidental pioneer in the medical treatment of great apes. He has crossed the species barrier and is now using the skills he has developed in the NHS to save orangutans under threat from poachers and the loss of their habitat to palm oil plantations. Irons believes the medical diagnosis and treatment of animals and humans is part of a continuum and that doctors are better placed than vets to treat great apes.
“Orangutans have 97% of their DNA in common with us, their anatomy is very similar and their systems work, in most cases, practically the same as ours,” he says, speaking from Borneo. “They are prone to the same diseases as we are and respond to similar treatments. Where great apes are concerned, there is a significant overlap between veterinary and human medicine.”
It’s a controversial view, particularly in a Muslim country where medical resources for humans are scarce, as Irons knows only too well. Last October he fell dangerously sick and ended up battling failing consciousness to self-administer a treatment that almost certainly saved his life.
“When something happens, it feels very remote here,” he says. “It is scary when you realise there is nobody else to rely on. My illness came on very suddenly. I was well in the morning. I felt a bit light-headed at lunchtime. Four hours later I was starting to become uncoordinated. I couldn’t stay upright on my bicycle.
“By the time I got home I was hallucinating and losing it very rapidly. I was developing sceptic shock and I couldn’t get through to anyone on the phone. I had to give myself an intramuscular injection of antibiotics. I work in an emergency department and I don’t usually panic but when you are rapidly losing consciousness, which was what was happening to me, it is frightening.”
The BOS centre, founded 19 years ago by an extraordinary Danish naturalist, Lone Dröscher-Nielson, is far from the jungle paradise BBC viewers might believe. Dröscher-Nielsen, who gave up a career as an air hostess to work with the orangutans and has run it almost single-handedly for years, originally built the sanctuary to take 150 orphaned or maltreated apes. There are now about 700, and up to 20 animals arrive every month. It costs $1.5m (£1.05m) a year to keep the place going.
“It’s an amazing sight to see a couple of hundred orangutans just playing together as if they were in a school playing field,” says Irons. “It is very uplifting. At the same time you know they are here because their mothers have been hacked to death. It’s a bittersweet experience. You can’t help your heart going out to them but you also wish they weren’t here because of how they got here. It is a wonderful experience in many ways but when you see what Lone has been through in the past 15 years you realise it is not a paradise. It can be very stressful. There are real ups and downs. It is daunting.”
Irons who has previously volunteered in Argentina, working with disadvantaged children, and in Thailand working with animals, ended up at BOS almost by chance. Two years ago he saw a BOS appeal for £3,000 to help rehabilitate 15 orang-utans rescued from kick-boxing tournaments in Thailand. He knew that if he worked medical shifts over Christmas and New Year, he could raise the money.
“It’s a little bit clichéd but I felt I had to put something back into the equation,” he says.
He raised the money and also offered his services as a volunteer, not expecting to hear anything more. Then an invitation arrived to a BOS fundraiser in London, but because Irons had moved house, he did not receive it until the day before the event. He managed to get there and met Dröscher-Nielsen. They hit it off and she decided she could use his help, although initially Irons, who arrived 18 months ago, had no plans to treat the apes medically.
“I was happy to do what was needed, clean, build things,” he says. “But I soon got involved in the care of the orangutans. In many zoos great apes are usually treated by doctors. The medicine is a tiny step sideways from human medicine but quite a leap from veterinary medicine. They get colds, flu and other diseases such as typhoid and malaria.”
There is, however, no textbook for treating apes. The centre has just lost 10 orangutans to cerebral malaria in a horrific outbreak and Irons is experimenting with the use of prophylactics. The Convention on International Trade in Endangered Species of Wild Fauna and Flora (Cites) prevents the vaccination of the apes against diseases such as typhoid.
“If orangutans get cerebral malaria, they can be dead within 10 hours,” he says. “Our staff did everything they could do. We had to do something radical and we now think we have stemmed this outbreak.”
Few vets or doctors have experience of treating such a large colony of apes. Irons, who returns to the UK intermittently to work as a doctor in order to raise enough money to keep himself, is setting up protocols to allow the 200 Indonesian workers at the centre to care for the orang-utans medically when he is away.
“My hypothesis is that, until proved otherwise, treat them as you would humans because the anatomy is so similar,” he says. “If you listen to an ape’s chest, it is exactly the same as a human chest.”
The orangutans appear grateful for the treatment. Recently, a four-year-old ape called Delphi who had been kept cage-bound was brought to the centre unable to walk.
“It took a while but now she’s climbing trees,” says Irons. “She was very withdrawn when she arrived but as soon as she realised there was some love and attention she became one of the most loving orangutans. She loves to come and have a cuddle. Most of them are very affectionate.”
Apes have similar psychological conditions to humans and Irons treats them with psychiatric drugs when necessary. Viewers of Orangutan Diary will meet Ruthie, a maltreated orangutan who self-harms.
“When Ruthie arrived, she wasn’t too bad but she went off the rails — tearing her hair out and biting herself. It’s not about superimposing human traits on them. They are just very similar to humans.
“I worked in paediatrics and I can’t help seeing the similarities. When children are maltreated they withdraw in exactly the same way. You don’t need any imagination to spot depression in an orangutan. They are usually the most joyous of animals and respond to love and attention in the same way as humans do. I don’t use antidepressants on them but I do use some human-based medications to help them if they are very stressed, just to give them time to heal.”
It’s not all one-way traffic. Working with orangutans is teaching Irons skills he can utilise on human patients back in Scotland. As a GP he would not normally encounter such complex and life threatening conditions. As well as adding a new dimension to his experience, he is having to return to branches of medicine he hasn’t studied since he was a student at Sheffield University in the 1980s. With no specialist laboratories available, he has to do all his own microbiology and haematology.
“It’s fascinating. There is so much to relearn or learn from scratch,” he says. “My medicine was good before-hand but it is much better now. The fact that the orangutans can’t tell you what is wrong improves your observational skills.”
The orangutans are eventually released back into the wild. Irons admits that staying emotionally detached from his patients can be difficult. When three apes became very sick recently with an intermittent mystery illness, he battled to save their lives.
“They were all lovely and I spent a lot of time around them,” he says. “I used to have little wrestling matches with one of them. You can’t help getting attached. In the end, I worked it out a little too late. They had a rare kind of aggressive bacterial infection and this particular orangutan was brought in to me and collapsed and died in my arms. I did CPR on him but couldn’t revive him. But what we learnt from his death helped us to save the other two.
“You can’t let the sadness get to you or you won’t do your job properly. He was like a friend but you can’t think like that or you’ll go nuts. You have to stay as objective as possible.”
Irons who has written a medical book for human travellers, the Travel Anywhere Medical Guide, is keeping notes on the apes to help others who work medically with them. He denies the suggestion that his medical expertise should be reserved wholly for humans.
“I love working in the Galloway Community Hospital,” he says. “The staff are great and I love working with the patients. But there are a lot of species in the world and many won’t survive without human help. Humans as a species don’t really have that much of a problem surviving. I don’t have any real culture clash working with humans and apes. In medicine generally you have to think on your feet and stay calm and that is true for both species. I like the mixture of work and I think they complement each other.”
