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The Bark MagazineView original article here.

Over the past decade, as Christine Crawford has been developing her unique animal welfare model and rolling it out across Costa Rica, she has noticed some significant changes. For starters, these days, it’s rare to see a dog lying dead along the highway, and the dogs she encounters are generally much healthier than they used to be. At the same time, she’s seen a host of new veterinary clinics open up in almost every neighborhood of San Jose, Costa Rica’s capital city — something she interprets as a clear sign of the growing value being placed on companion animals. But what really caught her attention was the recent arrival of upscale doggie boutiques and the introduction of canine couture.

“We went from a culture where people would kick and starve their animals to a place where you can now buy dresses for your dog in shops in San Jose,” says Crawford, who moved to Costa Rica from her native California in the mid-1990s. “Never in my life would I have thought it possible. It’s like night and day.”

Acknowledging these positive developments in Costa Rica is about as effusive as Crawford will get in describing the impact that the McKee Project ( — the animal welfare organization that she founded in honor of her “second” mother, Mary Ann McKee, in 1997 — has been having on the lives of animals. While legions of animal advocates are unflinching in their praise for what she and her dedicated staff are accomplishing, Crawford isn’t likely to view McKee as a success until every village in every country in Latin America and the Caribbean has its own well-trained vet with a long line of clients eager to have their dogs and cats spayed or neutered.

Crawford herself was just such an eager client in search of just such a well-trained (or even competent) vet when she first settled into life in San Jose and realized the deplorable conditions companion animals faced. From emaciated dogs hunting for scraps to abandoned pregnant females and newborn puppies tossed on the trash heap: she couldn’t escape the daily parade of misery. Her first response was to carry dog food with her at all times. Her second was to reach out to People for the Ethical Treatment of Animals (PETA). PETA told her that the only sure way to improve the lives of animals was to stop the cycle of procreation. They sent her literature on spay/neuter and suggested she find a local vet who would help her launch a sterilization campaign.

Crawford followed that advice, scouring the city of some 4 million people for vets to enlist in her cause. She found just 10 who even treated small animals. (Because Costa Rica’s economy is primarily agricultural, most vets focus on large animals.) Of these 10, only five seemed competent, and even those five tended to approach a spay surgery as though it were a heart transplant. A typical incision ran the length of the animal’s rib cage all the way to the pelvic bone in a brutally invasive procedure that required an array of equipment, supplies and personnel, and took about 45 minutes to complete. Even worse, the trauma was so severe that mortality rates were shockingly high. The whole thing was barely tolerable for an individual animal, let alone a viable model for a large-scale campaign.

That’s when she first approached the Veterinary Licensing Board of Costa Rica and met its president, Dr. Yayo Vicente. A former official in the Ministries of Health and Agriculture who also ran his own veterinary clinic, Vicente is a pro at navigating the tricky waters of business and government bureaucracy. Most importantly, he shares Crawford’s vision of spay/neuter as key to improving the lives of animals. Soon enough, with the assistance of some of Crawford’s animal-welfare contacts in the United States, they were able to send a few Costa Rican vets north for advanced surgical training in high-volume spay/neuter techniques.

Fast-forward a few years, and the growing McKee team had mastered and then surpassed these techniques, developing their own surgical method that today may well be the most efficient on the planet. For starters, using their technique, the incision on females is very small — less than one inch — and its location can be easily and precisely determined by measuring against some stationary physical “landmarks.” This dramatic reduction in incision length correlates to similar reductions in every other aspect of the procedure. The surgery itself is so much faster — a well-trained vet can spay a dog or cat in less than 10 minutes — that much less sedation is required.

Rather than an inhaled anesthesia, which is used to keep an animal under longer, the vet can now administer an injection that lasts 20 minutes. Without the need for an inhalant, there is no need for a $20,000 anesthesia machine, and without that machine, there are no power requirements, which means that the whole thing is portable. In fact, McKee teams can go to even the remotest areas, packing their tables into boats to reach destinations only accessible by water.

The simpler, shorter procedure also means that little additional manpower is needed. These cascading reductions translate into a cost per procedure that is about one-third to one-fourth the cost of traditional methods. (The main innovation comes in the spay; neutering procedures are fairly standard the world over. However, the use of an injectable anesthesia likewise reduces the costs of a neuter.)

For the patient, of course, the faster, less invasive technique means significantly less trauma, less risk of postoperative complications and an all-around speedier recovery. The only element that isn’t reduced is safety. “Even when they set up in a tent rather than an operating room, their technique is extremely safe,” says Patrick O’Marr, regional director of Mexico, Central America and the Caribbean for the World Society for the Protection of Animals (WSPA). WSPA sponsored a McKee project in Guatemala in 2007.

“And that’s been the challenge — how to provide the highest standards on a shoestring budget so we can reach as many animals as possible. I think it’s the best model out there.”

So does Aldo Wilson. A veterinarian who specialized in birds in his native Peru, Wilson now works on the emergency response team at Best Friends Animal Sanctuary in Utah. Best Friends sent him to Costa Rica in 2011 to learn from McKee’s chief of surgery training, Dr. Blas Rivas. Wilson practiced for a week on assorted sizes, sexes and ages of dogs and cats and became so adept that, during one session, he performed 118 procedures in 11 hours — an average of one every six minutes. A highly efficient vet in the United States might need 20 minutes for each operation (39 hours) to achieve the same result. (This rate is recommended only for extraordinarily proficient vets.)

“You probably know about Jehovah’s Witnesses — they are so committed to their cause that they go door to door and try to convert people, and it’s all they ever talk about,” Wilson said by cell phone en route to help animal flood victims in Tennessee. “Well, I’m a McKee witness.”

Wilson is one of more than 500 vets who have received training in the McKee Advanced Spay and Neuter Surgery Protocol. They hail from Argentina, Belize, Curacao, Guatemala, Mexico, Nicaragua, Panama and Peru.

In some cases, they flew to Costa Rica for the training; in others, McKee vets traveled to the trainees’ home countries. Any vet who agrees to offer regular low-cost spay/neuter clinics in his or her own neighborhood may attend the McKee training at no charge. During training, the student vet performs at least 10 surgeries and may also assist in a mass-sterilization event, in which he or she may operate on dozens more animals. The training costs of $150 per vet are typically paid through private funding, or with the support of international organizations like WSPA and Best Friends.

Dr. Miguel de León Regil, who works with Mayan families in the town of Panajachel on the shores of Guatemala’s Lake Atitlan, received McKee protocol training in 2007. He was motivated by a desire to end the weekly killing of strays being perpetuated by local authorities.

They agreed to stop the carnage if he could come up with a more humane way to address the problem. He knew that spay/neuter was the answer, but he typically performed only four or five sterilizations a month and, given the invasive technique he was using, felt the procedure was very risky for the animal. Today, he does more than 50 procedures a month.

“We just didn’t have any education about sterilizations, so we hardly ever did them,” he writes in an email. “The new technique changed everything radically — it’s much safer and more efficient, and my costs have been reduced by 60 to 80 percent.” Regil reports that the population of stray dogs and cats is considerably diminished in his community, and he hopes to expand the program into neighboring areas.

As important as the spay/neuter program is, it is only part of the McKee model; equally critical is broader community training. As Crawford likes to say, the project “trains vets and people.” For this, McKee brings together various factions — from government officials and local authorities to representatives of nonprofits and business leaders — as well as local vets and educators in a series of meetings to frame animal welfare in terms of public safety, health and economics. Many communities recognize that for many reasons, large populations of abandoned animals are undesirable, and seek to reduce their numbers. But, with few resources and limited knowledge of alternatives, they often resort to mass killings, using cruel methods like poisoning. In the meetings, Vicente explains that culling is both inhumane and ineffective. Killing an area’s stray dogs simply leaves territories open to be claimed by new roamers, and the cycle continues.

Moreover, mass spay/neuter campaigns play an integral role in bringing about noticeable declines in the incidence of rabies.

Once these societal issues have been explained, Vicente reveals the pièce de résistance: not only will his program address animal overpopulation, but it will also provide local vets with a new way to make money. That’s right.

There is now a financial incentive for vets to address the problem of animal overpopulation. To die-hard animal activists everywhere, this amazing development is like hearing a lock’s tumblers fall into place after spending years searching for the right key.

As Crawford and others know, any serious animal-welfare effort must involve spay/neuter. Those procedures can either be done by sending in foreign vets, which is usually an expensive, one-off event, or by using local vets. And here’s where it gets tricky.

Regil, Wilson and other notables aside, most vets don’t choose their profession in order to be agents for social change; they simply want to make a living. The idea of offering low-cost sterilization services has seemed like unaffordable charity as well as a direct threat to their own businesses. Veterinary licensing boards have been known to stop such efforts in their tracks, much to the dismay of the animal-welfare community.

“This is a common barrier, but it’s not insurmountable,” says O’Marr, referring to the standoff between vets and animal-welfare activists. “Rather than pointing fingers at each other and creating a hostile relationship, McKee has been able to get these two groups to the same table.”

A McKee-method spay costs a pet owner as little as $10 to $12 while still earning the vet a profit, which means that a whole new socioeconomic market can now afford to have their animals altered. Moreover, that initial procedure often leads to a long-term relationship between vet and pet owner.

Crawford says that about one-quarter of the people who have had their animals sterilized by a McKee-trained vet return for additional services, such as vaccines and emergency care, and to buy products. In Dr. Rivas’s own practice, for example, he has expanded his regular client base by 900 during the time he has been using the McKee protocol.

This conversion from one-off to regular customer represents another critical element of the McKee approach. When a pet owner — even one who would be considered lax by U.S. standards — makes even a small financial investment in an animal, that animal’s perceived value grows accordingly. And the more valuable the animal becomes, the better he or she will be treated.

“We have seen that going to a vet really changes the dynamic between animal and owner, between owner and vet, and between vet and community,” says Crawford. “It happens as people

meet a vet for the first time during the course of this procedure, and then as they begin to see the impact that the procedure has on their animal — the change in her behavior, the improvement in her coat, and the fact that they no longer have to figure out what to do with multiple litters. It’s a complete cultural shift.”

Of course, in most of these communities, there are stray dog and cat populations. Even in this case, the low sterilization cost makes it much more likely that local animal nonprofits or even municipal authorities will underwrite the costs. And most of the McKee-trained vets make a habit of conducting at least one low-cost clinic per month targeted to this population.

Orchestrating and conducting these training sessions, as well as meeting with diverse community members, raising awareness, conducting outreach to new areas and providing follow-up, falls to a remarkably small crew of dedicated staffers. Yet, with each training session, the number of supporters and advocates grows. “McKee is a collaborative effort, and it’s much like a table — without one leg, it tips over,” says Crawford. “McKee truly comprises hundreds, if not thousands, of selfless and committed community veterinarians, community leaders and animal lovers.” One thing the McKee program does not endorse is the creation and maintenance of traditional animal shelters.

Without the cultural predisposition toward adoption, such shelters fill up immediately with unwanted cats and dogs who have virtually no hope of ever finding homes. Living in cramped conditions, the animals suffer terribly, and most are euthanized. Euthanasia rates of 99 percent throughout Latin America and the Caribbean are not uncommon.

In fact, shelters in these areas may actually perpetuate the problem of animal overpopulation by removing the incentive for spay or neuter. If someone has a place to dump successive litters of unwanted puppies, why bother to get the mother fixed?

“The thing is, if you have a shelter, people will treat it like a dumpster and they won’t fix the problem in the long term,” says Wilson. “If you take the limited resources that these countries have and invest them in more strategic areas like spay/neuter and education, then you won’t fill up shelters in the first place.”

As a “McKee witness,” Wilson probably has a pretty good idea where he would like to see those limited resources directed.