By Dr. Danielle Frey and Dr. Laurie Meythaler-Mullins
In rural Alaska, amid a pandemic that has reached even the smallest village, a team of veterinarians is connecting to people, bringing healthy solutions to remote regions, sharing knowledge among partners and clients, and building relationships that grow into friendships that last a lifetime.
The Hub Outpost Project, begun in 2017 in the Yukon-Kuskokwim Delta of southwest Alaska, proved invaluable this year, impacting the health of dogs and humans, and providing unique educational experiences for veterinary students.
The project is a collaboration between University of Alaska Fairbanks, Colorado State University and PetSmart Charities. Based in Bethel, a town off the Alaska road system, the program aims to provide an outpost of veterinary care to nearly 50 communities in the region, by traveling via plane, boat or snow machine with supplies to reach the isolated communities.
Working with tribal leaders and regional health providers for animals and humans, the project is a model for preventive veterinary care that can positively impact the health of the humans in those communities, each home to a federally recognized tribe. From spaying and neutering to help control the overpopulation of dogs, to vaccination and parasite treatments, the team supports animal health, and by extension, human health.
Veterinary students in the CSU/UAF program have the opportunity to participate in public health and to learn how they can create their own community programs after they graduate.
This concept played out during the pandemic when the team stepped in during the threat of a rabies exposure, a real-time demonstration of how building trust in communities through engagement and presence can lead to meaningful collaboration.
In January 2020, veterinary students Roxane Aflalo and Angela Molli joined Dr. Laurie Meythaler-Mullins in the community of Tuluksak, observing first-hand community members’ daily lives. From the low temperatures and isolation of this small community (estimated population 373), to the high costs of food and supplies, the in-person visit helped the students better understood how living in this region has affected the type of care that residents can give their pets.
We visited the local school, talking with children in Daphne Matz’s class about veterinary medicine and animal care. Matz welcomed us with lunch, and then dinner, and even a pie. This relationship proved important as Meythaler-Mullins was able to connect with her after the COVID-19 outbreak upon request from the State Emergency Response team.
Our visit to Tuluksak coincided with the annual Kuskokwim 300 sled dog race, a beloved community event in the Yukon-Kuskokwim Delta. We provided veterinary care to musher teams coming through the village and raised awareness of the importance of access to veterinary care across this region.
Later in January, Colorado State University veterinary student extern Keira Sztukowski joined Meythaler-Mullins in the community of Emmonak, which is dealing with an overpopulation of stray and wild dogs. We performed examinations, vaccinations, anti-parasite treatments and spay/neuter surgeries. Our project has brought hope that dog overpopulation control and public health can start to look different in these communities.
“It’s a testament to the human condition; how you can form a bond with those of such differing backgrounds by using a shared experience. I could tell the women of Emmonak were strong and resilient. With hardly any resources, they were managing huge families and doing the best they could manage for their animals. It brought me both happiness and great perspective to be able to spend time with them,” Sztukowski said after spaying and neutering their dogs. “I truly felt like I made a difference in both the animals’ and owners’ lives. But what is remarkable is that I felt like [they] made an even bigger impact on me.”
“What’s an animal doctor?”
In February, we flew with CSU veterinary student extern Amy Downey in a small bush plane to the community of Nunapitchuk. We made a snowy riverside landing, and used snow machines to haul ourselves and our gear across the frozen river.
As we began to set up our health clinic, we learned an astonishing fact: No veterinarian had ever been to Nunapitchuk. Many townspeople told us this during our stay, and when we visited the local school, questions from students confirmed this.
One of the teachers asked if we could speak to grades 7-12 about careers. After a brief classroom survey, most students reported they did not know there was such a job as an animal doctor. This led into a great opportunity to talk about learning veterinary medicine, and why veterinary care for their pet dogs is important.
The teacher also asked us to talk to the students about rabies. Roughly a quarter of the students knew what rabies was, so we had our next lesson on this deadly virus. As we taught the children of Nunapitchuk about what a virus is, and how it can be transmitted from an arctic fox to their dog and potentially to them, it sparked a lot of conversation.
We learned that while most students did know that if a fox bit their dog, an adult would have to shoot the dog, they did not understand why. This discussion brought up many stories of “dogs who turned mean after a fox bite” and aggressive foxes charging people; and it became an opportunity to help the community and the children understand the dangerous impact of the disease and connect to programs to prevent and report these situations.
The HOP veterinary clinic in Nunapitchuk was very busy, providing care for 49 dogs. The tribal council president thanked us for working in their community, and the elders and youth of the community shared their time, food and culture with us during the clinic. We enjoyed dried salmon strips while community members played drums, sang and danced. The kids taught Downey a traditional Yup’ik culture dance, and we could palpably feel how impactful our time there had been.
“In veterinary medicine we are constantly adapting and changing to accommodate our patients’ and clients’ needs,” said Downey after the trip, reflecting on the strength of the human-animal bond in a different culture from her own. “We recognize that bond might be different from our own experience, but a bond is a bond nonetheless.”
Building relationships improves public health
The pandemic has highlighted the integral role that access to veterinary care plays in public health, and the importance of building trust with people in the region. In response to COVID-19, a majority of villages in the Yukon-Kuskokwim Delta, including Quinhagak, have banned travel and visitors, in an effort to protect their vulnerable populations from the novel coronavirus.
But in April, Meythaler-Mullins worked with the village of Quinhagak to determine that a rabid coyote had threatened dogs and people in the area. Because of the trust she had established with tribal leaders, and the serious threat to public health, the Quinhagak Tribal Council felt comfortable to invite Meythaler-Mullins to travel to their community to rabies vaccinate every animal.
Masked and with the support of the village tribal police officers, she visited every single home in the community of 650, deworming and vaccinating 131 dogs for Rabies, Distemper/Parvovirus. The deworming is an important protective step as certain parasites, like Echinococcus, are prevalent in the region, and can cause illness in people as well as animals.
Because the region has not previously had consistent access to veterinary care, we learned during the visit that roughly 85% of the animals in Quinhagak had never been vaccinated, which poses very significant human health concerns.
Meythaler-Mullins examined the two dogs who had been attacked by the coyote, and fortunately, they had both previously received rabies vaccinations. She was able to follow the recommended health protocols and immediately re-vaccinated these dogs with instructions to the owners to confine the dogs for 45 days and contact her if they showed any signs of illness.
In May, Meythaler-Mullins responded to an eerily similar situation in the village of Napakiak, when a fox came into the community and fought with a 100-pound dog and charged its owner. After the incident, the tribal council president invited Meythaler-Mullins into their community of 350 to ensure all animals were vaccinated.
Meythaler-Mullins vaccinated and dewormed 93 dogs, many of which had never received any sort of veterinary care. Before her bush plane left, she was also able to perform a few spay and neuter surgeries, and made plans to return after the travel restrictions are lifted.
Back in Bethel, looking ahead
As the pandemic continues to impact every corner of the world, including tiny Alaskan villages, Meythaler-Mullins has been able to adapt processes to safely provide essential veterinary services in southwestern Alaska. In addition to calling on villages by plane, Meythaler-Mullins continues to offer spay/neuter sterilization surgeries, anti-parasitic treatments, and vaccinations.
As we move forward into 2021, we plan to return to consistent services for Bethel and the outlying villages. We are working with our partners to ensure the sustainability of the plan for this region to develop similar models in other geographically isolated regions. And we will continue offering unique hands-on experiences in Bethel for our veterinary students.
In her time getting to know the people and the animals of Emmonak, student Keira Sztukowski learned that education goes both ways: “You can greet people with a smile, engage in conversation, and form a connection with those you meet. And by doing so, you can change a person’s whole perspective. These sisters taught me that these small acts can make the biggest difference in the world.”
Dr. Laurie Meythaler-Mullins is the community outreach and public health veterinarian for the UAF/CSU Hub Outpost Program. Dr. Danielle Frey is director of international student experiences for the CSU Doctor of Veterinary Medicine Program.