Feb
19
2013

Learning to do more with less is a challenge that Dr. Susan Chadima has gladly accepted in her efforts to improve the state of veterinary medicine in Kabul, Afghanistan.

The veterinarian from Maine - with much support from the Maine Veterinary Medicine Association - has made more than 10 trips to Afghanistan since 2005. According to Chadima, strict cultural views, high poverty levels, lack of training for local veterinary professionals, and a war-torn environment have helped to create a situation where animals endure treatment ranging from severe neglect to deadly abuse. 

Chadima highlighted some of the challenges she and other veterinarians in Afghanistan are facing as they attempt to educate the Afghan public about the value of both animals and the veterinarians who care for them.

Doing more with less

Practicing veterinary medicine in modest, poorly equipped clinics in Afghanistan is worlds apart from fully stocked, state-of-the art hospitals in America, Chadima said.

The university clinic, for example, is currently operating within two metal shipping containers for at least the next two years while they attempt to find better accommodations, she said. Many clinics are severely in need of diagnostic technology, monitoring equipment, gas anesthesia, medications, and vaccinations.

In addition, veterinary students in Kabul don’t receive nearly enough hands-on clinical experience, and many of them are more interested in getting a university degree than being veterinarians, Chadima said.

“You do find a few who are interested and want to work with animals and are committed to their career and really trying to do their best, and the thing that’s very difficult there is they don’t have any idea that they are getting a substandard education compared to the rest of the world, and that’s really sad,” she said.

It doesn’t help that veterinarians are often the subject of scorn within the Afghan culture.

“I have found Afghan veterinarians, paravets, and staff to be committed to their jobs, but especially those who work with small animals frequently have to endure scorn and denigration by their family and friends. Being called a ‘dog washer’ is a very derogatory comment,” Chadima said.

For the general public to change their perceptions about veterinarians, Chadima said the public needs better education about the true value of the services veterinarians provide.

Facing economic and cultural challenges 

Chadima said she envisions improved conditions for dogs and cats in Afghanistan, but the economy needs to strengthen before substantial changes can take effect.

“It has to happen in concert with all kinds of other things, and it can’t happen when people are starving, either,” she said. “Literally, sometimes the dogs and people are competing for the same food.”

The rampant dog overpopulation has led people to fear dogs based on the potential for bites or disease. It has even become all too common for children to stone puppies or dogs to death on the streets, Chadima said.

Although dogs are in a precarious situation at the moment, Chadima said she thinks things can improve when Afghans are able to find a comfortable middle ground between the extreme poverty and extreme wealth that currently divides the country.

In that middle ground, Chadima said veterinarians can “start teaching humanity, compassion about dogs - how to live with them safely, that they can be companions, how do you interact with them, how do you treat them, how to build those relationships.”

Keeping a low profile

Although Chadima said she feels relatively safe in Kabul, which is a big city without as many military and insurgency threats as some villages in the country, there are still occasional reminders that danger can appear at any time.

For example, Chadima said a bomb exploded about a year ago on the major road leading to the clinic where she was scheduled to be part of a surgery. Fortunately, the surgery was re-scheduled that day because of equipment malfunction, so she wasn’t around when the bomb went off.

The students at the university clinic also were lucky, as they had left about 10 minutes before the explosion.

"Otherwise, there probably would have been a lot of fatalities," Chadima said.

Living in Kabul has taught Chadima that protecting her safety requires keeping a low profile, including driving around in “an old, beat-up Toyota Corolla with an Afghan driver.” She also said it’s best to avoid being anywhere near military vehicles or convoys, as well as big, white SUVs with UN logos on the sides, because those vehicles draw the attention of would-be attackers.

Recognizing the power of vaccinations

Chadima is very familiar with the vaccination debate in the United States, surrounded by questions of whether animals should or shouldn’t be vaccinated, or whether they’re being over-vaccinated. After spending time in Afghanistan, any reservations about vaccinations in Chadima’s mind have been resolved, she said.

“When you see a country without any vaccines compared to one where everything’s vaccinated, the difference is striking,” she said.

According to Chadima, she has seen many diseases and parasites in Afghanistan that have been largely eradicated in the United States because of vaccinations, including canine distemper, leishmania, rabies, and dirofilaria repens.

“I wish we had truckloads of vaccine, and I would give it to every dog and cat I saw because these fatal diseases that we so rarely see are rampant and devastating, and it answers this whole question of why vaccine is so important and how it has revolutionized health care for animals,” she said.

Editor’s note: This is the first part of a two-part series. The second part will be published next week.

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