What’s up doc? How Donkey therapy is easing Spain medics’ stress

Walking into a dusty paddock, a young nurse is quickly surrounded by a group of donkeys gently nudging her for attention as she strokes their soft noses and feeds them carrots.

What's up doc? How Donkey therapy is easing Spain medics' stress
Photos by Cristina Quicler / AFP

Walking into a dusty paddock, a young nurse is quickly surrounded by a group of donkeys gently nudging her for attention as she strokes their soft noses and feeds them carrots.   

When someone places a 10-day-old colt in her arms, Monica Morales squeals with delight, visibly relaxed after a few hours unwinding at El Burrito Feliz – “The Happy Little Donkey” –  an association offering free donkey therapy
sessions to medics fighting the virus.   

Known as animal-assisted therapy, such encounters can help with a range of physical and mental disorders, including stress, depression and anxiety.    

Although such therapy is more associated with horses, experts say donkeys are better suited to helping mental or emotional disorders given their gentle nature and intuitive respect for personal space.

“The situation is quite overwhelming, what we went through before is now happening again,” says Morales, 25, who spent months working in a Madrid hospital when the pandemic hit. She is now based in the south as Spain faces a
second wave.   

“There are more and more patients, and growing tensions among colleagues so being here with these donkeys is really helping.”   

Located by a sprawling forest on the edge of Andalusia's Donana National Park in southern Spain, El Burrito Feliz is a non profit association with 23 donkeys that have worked with Alzheimer's patients and children with problems.

The “Doctor Donkey” project began in late June as a way of offering respite to frontline workers battling a virus that has killed some 33,400 people, infected more than 900,000, and left medics traumatised and exhausted.

Japanese forest therapy

“The huge stress created through the daily struggle with Covid-19 exhausts them, so here they can be strengthened through therapy with the donkeys,” explains Luis Bejarano, 57, who runs El Burrito Feliz (Pictured above).

“They can recharge their batteries to keep fighting another day.”   

Bejarano says the idea came from a book about Japan's therapeutic forests where people spend time among trees to reduce stress and depression as an alternative to therapy.

“The situation generates a lot of anxiety and stress because of the risk of getting infected, or passing it on to colleagues, family members or other patients who are more fragile than usual,” says 31-year-old oncologist Mari Paz Lopez.

And the risk of falling ill is very real, with one in 10 of Spain's healthcare workers getting infected — twice that of the general population and one of the highest rates in the world.   

“We've not been offered any psychological help although I know it exists in other places,” says Lopez who works in the southern city of Jaen and heard about the donkey therapy through television.

After an hour wandering through the forest with a donkey called Magallanes, she admits to feeling a lot more relaxed.

“They're animals that inspire a lot of tenderness and that generates a lot of emotional well-being.. and you forget about the day-to-day. I'd definitely recommend it.”

Physiological changes

After befriending one of the donkeys, a visitor will go on a guided walk and when confident, they can go back into the forest alone with the donkey and stay as long as they like.

Back at base camp, they prepare food for the animals, and then there is the option of a “donkey bath” — entering the paddock for an immersive experience with the herd.

“Donkeys are very relatable animals and doing it in a natural environment increases the benefits,” says psychologist Maria Jesus Arque, who consulted on the project.

By being in a forest and having contact with an animal, “something happens that allows you to express yourself with another being that does not judge,” she told AFP.

Studies show that animal-assisted therapy triggers changes at a physiological level, activating oxytocin, conected to experiencing pleasure, increasing endorphins and reducing cortisol in the blood which is a product of stress, she said.

“And a 30-minute walk in a natural environment, like a forest, changes the mood.”

Painful memories

At her surgery in Madrid, Dr Nieves Dominguez Aguero, 49, has a pencil sketch of a nurse nuzzling up to a donkey by Cuban graphic artist Ramses Morales Izquierdo as a reminder of her visit in summer.

Talking about the horrific memories of spring still moves her to tears as she recalls patients left in the corridors because of the lack of beds and those who died without being able to see their loved ones.

“It's very hard, not only because of the pandemic and the infection itself, but because of people's situations. Unlike in hospital, when you're a family doctor, you know all about these people, their lives and families.”

Spending a few hours with the donkeys was surprisingly helpful.   

“It was wonderful, really great,” she laughs. “Being with the animals helps you relax a bit and the forest is spectacular. It's just a shame it's so far away.”

So far, 25 doctors and nurses have visited the project, although the pace has slowed as cases have spiralled and Spain's medics have found themselves battling one of the highest infection rates in the European Union.

Although the project was only supposed to run until November, Bejarano is extending it and even considering installing lodgings so people can stay overnight.

“It might go on for years. Let's hope not but if that's what's coming, we must accept it.”

By AFP's Hazel Ward and Jorge Guerrero

READ ALSO: Free holidays in Ibiza offered to healthcare heroes across Europe

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How Spain could stamp out smoking

A fifth of Spain's population smokes on a daily basis. With such high numbers, here's how the country's pulmonologists propose to get smokers to quit.

Spain plans to get people to quit smoking
How Spain plans to get people to stop smoking. Photo: Khalil MAZRAAWI / AFP

For many outsiders, Spain is a nation of smokers. 

The stats from Spain’s Ministry of Health show that 23.3 percent of men smoke every day in Spain, compared with 16.4 percent of women.

For both males and females, the highest number of smokers are aged between 25 and 34, meaning that it’s the younger population who are smoking slightly more than the older generations. 

Spain’s pulmonologists are now pushing for the country’s tobacco laws to be tightened, claiming that reform is needed after the last legislation was approved a decade ago.

READ ALSO: Spain warns against smoking and vaping in public to avoid Covid infections

Why is smoking such a problem in Spain and what is being done about it?

The latest stats from the Spanish Ministry of Health show that lung cancer, often caused by smoking, is the third most frequently diagnosed cancer in Spain, with 29,549 cases diagnosed so far in 2021.

Given these high figures Spain’s Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) has proposed five measures to help get people to stop smoking.

SEPAR points out that every time anti-smoking legislation is reformed and things for smokers made more difficult, the prevalence of smoking decreases.  

Smoking on terraces was banned in some regions during the pandemic. Photo: CRISTINA QUICLER / AFP
  • Price of tobacco to rise in 2022

The first point on their list is to raise the price of tobacco, which must cover all forms, from cigarettes to cigars, through to rolling tobacco, and electronic cigarettes.  

This first measure may soon become a reality as the Spanish government has already predicted that the price of tobacco will rise in 2022, after several years of stagnation.  

It is expected that tobacco will be responsible for almost a third of all special taxes received in 2022, equating to €21.8 billion.

According to the World Health Organization (WHO), “cheap tobacco” in Spain guarantees “a percentage of smokers above 30 percent”.

In Spain, the price of a pack of tobacco is around €5, which is much cheaper than in other countries. In Australia for example, a pack of tobacco costs around €22, and in the United Kingdom and France, each pack of tobacco costs around €12.4 and €10.5, respectively.

According to Dr. Carlos A. Jiménez Ruiz, pulmonologist and president of the society, the current anti-smoking law has “some deficiencies” that need to be addressed in order to develop legislation that is more effective and efficient, especially with regard to the prevention of tobacco consumption in young people, but also in helping smokers to stop smoking and in protecting the health of non-smokers. 

READ ALSO – Maps: Which beaches in Spain have banned smoking?

Besides increasing the cost of tobacco SEPAR proposes four other measures to get Spain to quit smoking. These include:

  • Banning the consumption of tobacco in public spaces, even outdoors
    During the pandemic, several regions approved a regulation to prohibit smoking on terraces. SEPAR proposes that smoking be prohibited not only in spaces such as terraces but also in sports stadiums, beaches, parks and bullrings, and that fines should be imposed for those who do not comply.

  • Establish generic packaging
    SEPAR also wants Spain to introduce generic packaging, which means no logos and images of the tobacco companies. This measure has also proven to lower the sales of tobacco in countries where it has been implemented, such as Australia and New Zealand. According to the latest statistics from the Australian National Drug Strategy Household Survey around 11.6 percent of adults in Australia smoke daily. 

  • The regulation of other smoking devices
    Despite the fact that all products that burn tobacco such as cigarettes are already regulated, SEPAR believes that it is also necessary to regulate the sale, consumption and advertising of electronic cigarettes. This is because e-cigarettes have become particularly popular among young people. 

  • Promote help for those seeking to quit smoking
    The last proposal is the creation and development of special units in public health departments to help people to stop smoking and to put more funds towards these programmes. 

How does Spain compare with other European countries when it comes to smoking?

According to the Organisation for Economic Cooperation and Development (OECD), while Spain does have a high number of smokers there are still several European countries that have more. The European countries with the highest number of smokers are Greece, Bulgaria and Hungary.

The latest European survey from 2020 shows that 42 percent of Greeks claim to be smokers, which is only slightly above Spain. 

On the other side, the European countries with the lowest number of smokers are mainly Nordic countries, such as Sweden, Finland, Iceland and Norway.