October 19, 2018

Vetter Software, Telemedicine and Veterinary care for dogs in a Mayan Village

Vetter Software, Telemedicine and Veterinary care for dogs in a Mayan Village

This story was contributed by the Global Alliance for Animals and People.

Tucked away in the Guatemalan highlands, Todos Santos is a small Mayan village that still embraces its ancient traditions; from their clothing style to their language. Todos Santos’ unique and revered culture has survived partly due to its relative isolation, but this has also had its share of negative effects on the community. In many ways, the people of Todos Santos are largely forgotten. They suffered immeasurably during the 36-year civil war and even today, racism is still prevalent, and they receive very little development assistance from the centralized federal government. As a result, many of their residents live in extreme poverty, with many homes still having dirt floors and latrines. Children are often required to leave school at 12-14 years of age to help with the household earnings to keep food on the table.

In these settings, although most families have dogs, cats, chickens, pigs and a horse or cow, their health and welfare is not even close to being on their radar. Animals simply serve a purpose as food, guardians, beasts of burden or pest control, but are required to fend for themselves.  The roaming dog problem in Todos Santos is just another of the many issues threatening the community’s wellbeing. Canine rabies is still a serious problem in these remote rural areas; cases are under-reported, prophylaxis is in short supply and the people are unaware of the benefits of vaccination.

This is how The Global Alliance for Animals and People (GAAP) started working in Todos Santos. In 2008, we were asked to come and help them deal with the rabies problem and offer veterinary services such as spay and neuter- all of which had never been offered before in the community. So, for the past decade, the GAAP along with partner organizations and volunteers from all over the world has been offering an annual veterinary and education campaign in this isolated community. The advantages have been many: we have seen a growing trend of interest by residents in caring for their pets; we have sterilized over a thousand cats and dogs, vaccinated over 3.300 pets over time, and have built an incredible trusting relationship with the community.

While we were happy to serve these pets and people once a year there were many concerns that surfaced for us as project directors such as the dependency this kind of “Foreign Aid” approach can create. Annual visits by foreigners have the advantage of building that initial trust with local residents and government, but it does not create any internal capacity nor does it empower community members in the long term. Furthermore, Guatemala is an extremely dangerous country, primarily due to narco-trafficking, and we felt we were potentially putting our foreign volunteers at risk. And lastly, the costs of running a campaign of this magnitude are prohibitively expensive limiting our visits to once a year. For spay, neuter and vaccination, an annual visit is fine, but for chronic conditions and emergencies, what are owners to do?  Given these drawbacks, we knew that someday we would not be able to go back, and what exactly would we leave behind after a decade of work? This is why we started looking for other ways to stay involved with the community.

Investigating other models for healthcare in remote regions of the world, we came up with a plan to develop a telemedicine project. To our knowledge this had never been done before for pets, so we used bits and pieces from other projects, and started building our program from scratch. Our veterinarians developed a Spanish textbook and reference manual along with the para-veterinarian training course. The book and accompanying materials are beautiful, using hand drawn illustrations of indigenous men and women from Guatemala to demonstrate restraint and sample collection for example. It covers everything from ethics, to diseases and parasites found in Guatemala, to euthanasia.

We selected a community member- Andres, who had already demonstrated a keen interest in animals and has worked with us for years. We also have a partner veterinary clinic in the nearest city of Huehuetenango that can take our emergencies. Andres completed the training program successfully and in July 2018, we launched the program. His responsibility is to serve as our eyes and ears on the ground and he has been trained to take a detailed history and to do a complete physical exam. How does he transmit the information to us located far away in Chile? Vetter Software of course!! He travels to the homes with his first aid kit and tablet, and all of his data are loaded into a medical record made especially for this project. From our office in Chile, we work through the cases, recording all of our conversations in Vetter, uploading photos and video, recording what samples were taken and what treatments were done. We can program his required follow-ups, send him reminders and assign tasks- all from our clinic in Chile!

On the very first day, we got our very first call! It was still the most difficult case we’ve had to date: a street dog in labor for over 24 hours and a dead pup stuck in her pelvis! Although our first choice would have been to evacuate this poor girl immediately to our partner veterinarian, of all the bad luck, Dr. Adriana just happened to be in Guatemala City, over 7 hours’ drive away from her clinic! So we had to think quickly. A crowd quickly formed around the dog so we had Andres carry the dog to his house to give her some food and water, subcutaneous fluids and some analgesia. Shortly after, she pushed the dead pup out. She was probably just exhausted! But we suspected she still had a belly full of pups and sure enough, about an hour later, she started pushing again. We supported her as best we could for the next 45 minutes, and then decided to evacuate as her contractions were becoming weaker and there was still no pup. Andres then travelled the 2 hour dangerous, steep and curvy mountainous road to the city where he awaited the return of the veterinarian. She removed two more dead pups and sterilized the bitch. Recovery was uneventful and Andres returned with her, to Todos Santos, the next day. Being his first case ever as a para-veterinarian, it was a big one to handle, and luckily all went well! Instead of returning the dog to the streets, his family decided to adopt her and so our first stray dog patient has a new home and a new name: Esperanza.

We learned an awful lot on that first case, and drastically improved our protocols and communications as a result. To date, we have treated over 50 dogs that would otherwise not have received any attention from a veterinarian. These include dogs that have been hit-by-cars, dogs with tumors, dermatitis, allergies and of course, those needing regular check-ups and vaccines.

The success of this story as we see it, is that through a fairly simple and cost-effective method, we are now able to treat animals all year round that are literally over 8,000 kms away as the crow flies. No longer do we worry about what to do when the campaign funding runs out. And the best part of all of this for us is to see the pride in this small community that has suffered so much in the last 50 years, when they talk about how they have finally taken control of something that is important to them, they have trained personnel, they have a viable and sustainable service, and in essence they have taken the responsibility for animal healthcare into their own hands.

If you would like more information about this or other projects, or would like to support our work, please visit our site: www.thegaap.org.

About Dr. Elena Garde

Elena Garde was born and raised in Canada, moving to Chile in 2009. She is a Doctor of veterinary medicine and has a master’s degree in international animal health. She began her career working with wildlife in Canada, and developed a keen interest in disease ecology, public health and interactions between human and animal communities. Working in Latin America, she became interested in the issues surrounding free-roaming domestic dogs and their impact on people and wildlife. As the Program Director and co-founder of the GAAP, her goals are to develop long term sustainable programs addressing these complex issues.