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Charlie Matthias highlights the difficulties and ethical issues he encountered on his placement in  Sri Lanka. He speaks of the differences between veterinary practice in the UK and  less economically developed countries.

I have recently returned from a 3 week extra-mural studies (EMS) placement in Sri Lanka, where I was involved in a sterilisation and rabies vaccination programme, as well as working at a local private vet practice.

I cannot praise too highly the dedication and passion that the vets and vet assistants displayed, often working under difficult conditions, with limited medical supplies and equipment.

The vets involved in the sterilisation programme not only help to control stray dog and cat population size – crucial in a country with such a large stray problem – but also have contributed to a reduction in the incidence of rabies in both humans and animals.

In addition, they provide essential veterinary care to the stray dogs and cats of the island, which would otherwise be left to suffer treatable medical conditions without any form of help.

A vet student performing a castrate on a stray cat

Having said this, I thought I would share a number of ethical issues I encountered on my trip that you may not have thought about.

The first involves the reluctance to use humane euthanasia in animals caught for routine sterilisation but found to have other serious medical problems. In the UK euthanasia may be deemed the appropriate course of action for these problems.

The reasons I could see for this reluctance were two-fold. Firstly, with a large Buddhist population in Sri Lanka, the concept of deliberately ending an animal’s life, regardless of the circumstances, is simply not acceptable to some Buddhists.

In addition, if stray animals caught by the catching team are not returned to where they were found after the sterilisation operation, the community will often notice their absence, leading to complaints that animals taken by the vets are not returned.

Despite these animals being ‘strays’, communities are often protective of ‘their’ strays, leading to resentment when they are not seen again.

The problem is that the clinical reason for euthanasia is often not understood or accepted by the often impoverished and poorly educated local communities, since these animals may not obviously require euthanasia to the untrained eye.

A good example of this reluctance was a cat with suspected feline infectious peritonitis. Nothing useful could be done to save this cat’s life, and it would undoubtedly have been more humane to euthanize this animal to prevent further suffering.

However, with the above concerns in mind, it was in fact given supportive treatment, and then returned to the street.

The van used as a mobile surgery. The van contains operating equipment and is driven from place to place so surgeries can be performed in different parts of the island.

Another problem I believe is the relatively high level of antibiotic use. There were many situations, during the sterilisation programme and at the private vet practice, where antibiotics were given without anything to indicate they would be effective.

This is the result of the ingrained practice of giving antibiotics as a standard first line treatment in many situations. This practice occurs in the UK as well and we must all work towards changing it.

It was clear to me whilst working at the vet practice that there was a lack of affordable diagnostic tests for many Sri Lankan pet owners, meaning that antibiotics were often used in place of a definitive diagnosis, as this was the cheaper option.

There were, however, situations in which the use of antibiotics where they might not have been used in the UK could be justified. For example, whilst working as part of the sterilisation programme, a stray dog that was caught to be sterilised was also found to be suffering from diarrhoea.

She was given a dose of antibiotics on the off chance that it was bacterial in origin, even though this would rarely be a first line treatment in the UK. However, this animal, and many like her, may not ever be seen by a vet again and the one valuable chance to treat them is when they have been caught for sterilisation.

In these circumstances, antibiotic therapy, along with the fluids and absorbents also given, suddenly seems much more acceptable.

It is also worth pointing out that, due to the relatively low level of animals with owners or animals receiving veterinary care in Sri Lanka, the amount of antibiotics given to pets is still probably proportionally less than in other countries such as the UK.

The focus therefore must still be on more economically developed countries leading the way on responsible antibiotic use.

The author performing a spay (ovariohysterectomy) on a stray dog

A further ethical issue I encountered concerns post-operative infection in animals treated in the sterilisation programme. Although every effort is made to achieve excellent sterility, this is not always possible given the challenges of the working environment.

This problem is compounded by the fact that once these animals are returned to the streets, they may not be seen again, resulting in a situation where a previously healthy animal may die as a result of veterinary intervention.

However, in my view, the benefits to both human and animal health of population and rabies control in the animal community far outweighs this ethical issue.

Furthermore, as the animal catchers follow similar routes each day, they do occasionally notice previously neutered animals looking unwell, and these can be picked up for treatment.

Finally, it is important to appreciate that despite the ethical issues I have discussed, the vets and vet assistants do a great job, doing their utmost to improve animal welfare in often challenging conditions.

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