Going to the dogs By Jeff Richardson

Photo caption: Hub Outpost Project veterinarian Dr. Laurie Meythaler-Mullins with a patient during a visit to Holy Cross in October 2019. Photo courtesy of Laurie Meythaler-Mullins.

When Laurie Meythaler-Mullins arrived in the village of Holy Cross for the first time last October, she wasn’t quite prepared for her reception in the Southwest Alaska community.

Meythaler-Mullins, a veterinarian for more than a dozen years, stopped by the village’s K-12 school to talk about her job. She was met by a room full of blank stares, which led her to ask how many of the kids knew what a veterinarian did.

Nobody raised their hand.

“It’s so humbling to me,” she said. “Instead of saying, ‘Do you want to become a veterinarian?’ I’m explaining what a veterinarian is.”

Photo caption: Tobias London of Bethel tries checking for a patient's vitals next to his mom, Shirleen, and Dr. Laurie Meythaler-Mullins. Photo by John Conn, Stage 2 Studios.

The experience was part of a year of firsts for both area residents and Meythaler-Mullins. She moved from Iowa to Bethel last spring to serve as the community outreach and public health veterinarian for the Hub Outpost Project. The endeavor provides free basic veterinary care to nine villages in the region that have had almost no access to animal medicine. The University of Alaska Fairbanks, Colorado State University and the Yukon-Kuskokwim Health Corp. launched the project with a $450,000 grant from PetSmart Charities.

The program is designed to address a problem shared by much of rural Alaska: There are far more dogs than veterinarians.

Photo caption: UAF veterinary medicine student Roxane Aflalo visits with a dog during a field visit to Tuluksak, Alaska in January 2020. Photo by Laurie Meythaler-Mullins.

That reality has contributed to some big challenges for both the people and the animals that live with them. Dogs that haven’t been fixed lead to to overpopulation and stray animals, which results in a rate of dog-bite injuries seven times the national average. A lack of vaccinations is linked to rabies cases in both dogs and humans. The region’s vast size and lack of infrastructure are ongoing barriers to even basic vet care.

To remedy that, Meythaler-Mullins has spent the past year traveling by bush plane from her home in Bethel to surrounding villages. Four large plastic totes contain her mobile office, which transforms a local bingo hall or spare classroom into a temporary clinic.

The response, she said, has been remarkable. During a busy first visit to the community of Aniak, Meythaler-Mullins joked, residents asked when she’d be back before she’d even left. In the year since, she said, residents have been consistently thrilled at the prospect of receiving animal care for their pets.

Map illustration by Kari Halverson.

“I’ve been met with open arms,” she said. “It’s very geographically isolated, but I’ve never felt alone.”

The highlight of her visit to Holy Cross came the day after she met the puzzled group of elementary school students. An 11-year-old girl in the class visited the clinic with her father and their puppy, asking if the animal could be spayed and vaccinated.

“You could tell she thought that was pretty darn cool,” Meythaler-Mullins said. “It was a really exciting thing that she went from not even knowing what a vet was to bringing her dog in to us.”

‘Just a phenomenal experience’

The mobile clinic also provides a unique teaching opportunity for UAF and CSU, which have jointly offered a veterinary medicine degree since 2015. Students in the program, who split their time between Alaska and Colorado, can get a profound contrast to their classroom work by volunteering in rural Alaska.

Photo caption: UAF veterinary medicine students Roxane Aflalo (top left) and Angela Molli (top right), and Dr. Laurie Meythaler-Mullins provided veterinary support during the Kuskokwim 300 sled dog race in Tuluksak, Alaska. Photo courtesy of Laurie Meythaler-Mullins.

Angela Molli, a second-year UAF veterinary medicine student, found herself standing on a frozen river outside the village of Tuluksak during her visit in January. It was the middle of the night, and temperatures hovered just below zero. Occasionally a team of sled dogs would stop in the darkness, requiring a quick checkup for their joints or muscles.

Weeks after volunteering at the Kuskokwim 300 Sled Dog Race, Molli was still amazed by her experiences under that starry sky. It wasn’t what she’d expected — it was much better.

“It was so fun,” she said. “It was just a phenomenal experience. I had a really, really great time.”

She’s among the veterinary students who traveled to Southwest Alaska this school year to help Meythaler-Mullins with animal care. Some provided help with services like spay and neuter surgeries, vaccinations and anti-parasite treatments. Others, like Molli, provided spot checks of teams competing in Bethel’s high-profile sled dog race.

Meythaler-Mullins said such opportunities don’t just offer a look at animal medicine beyond farms and veterinary clinics. They also provide students with a real-world contrast to their classroom work.

“We tell students all the time that there’s so much you can do with your degree, but showing them what that looks like is so important,” she said. “This project shows them that there are different options out there, teaching them to have an open mind and be creative.”

That lesson resonates with Meythaler-Mullins. After spending more than a decade in private practice in Iowa, she began to feel an itch to do something more. Along with her husband, Dan, and their three kids, she took the opportunity to begin a new adventure in Bethel last spring.

“One thing I can tell students is you can change what you can do,” she said. “Don’t feel stuck in your job.”

Photo caption: Veterinary medicine student Sam Kessler gives a thumbs-up before traveling to Holy Cross, Alaska, to help with a veterinary mobile outpost clinic. Photo courtesy of Laurie Meythaler-Mullins.

Sam Kessler, a fourth-year CSU vet student who helped Meythaler-Mullins in Holy Cross last October, said her visit provided a valuable perspective. It was striking how much could be accomplished with hard work and basic veterinary equipment in an underserved community, she said.

“We still offer the highest quality possible, but this is where theory meets practice,” she said. “I was really seeing that side of it — you can do so much to help animals with so much less than we’re taught in vet school.”

Linking animal, human health

The Hub Outpost Project is also a real-life illustration of UAF and CSU’s commitment to the One Health concept, an approach to research and public policy that examines how environmental, animal and human health are interconnected.

The lack of veterinary care in Southwest Alaska affects more than the region’s animal population. Rabid foxes on the outskirts of villages can spread the disease to dogs, which in turn endangers humans. In some villages, populations of aggressive stray dogs have become so worrisome that people are afraid to walk outside.

Bethel, Alaska

Photo by John Conn, Stage 2 Studios.

“I think a very important part of this is the public health, not just animal health,” said Arleigh Reynolds, a veterinarian and the director of UAF’s Center for One Health Research.

Although the project’s focus is largely on dog care, it requires a broader approach to meet its goal of helping both animals and people. Meythaler-Mullins said her village visits always include conversations about what people see in local wildlife, from lesions found on caribou to changes in salmon migrations. Those details could provide information about diseases and environmental changes that may affect the region.

“A major portion of my work is communication — I talk with youth in schools, I set up these clinics, I listen,” she said. “Getting out in the communities and learning how to do that is a big part of this.”

Taking a broader approach is the only way to make a lasting difference in the region, Reynolds said. The initial grant will pay for two years of veterinary care in the region, a critical period for building community relationships and infrastructure.

After that grant expires, Reynolds hopes the project will live on through other funding sources. Other communities, such as Nome and Utqiaġvik, are also being considered as areas that could benefit from a program like the Hub Outpost Project.

Sled dogs run during the Kobuk 440 near Kotzebue. UAF photo by Todd Paris.

Brian Berube, environmental health manager for the Alaska Native Tribal Health Consortium in Bethel, said the Hub Outpost Project is off to a promising start. He believes its approach of delivering care directly to villages in the region could help provide residents with the tools they need to address ongoing problems like rabies, dog bites and dog overpopulation.

“If they can go back to places regularly and continue that level of service for years, that’s really when you can make a difference,” Berube said. “That’s when it starts to show that this can be a public health service.”

An important part of the effort is collecting public health data to quantify the benefits of the Hub Outpost Project. Ultimately, Reynolds believes the numbers will show that basic veterinary care costs less than the health implications of doing without it.

“We don’t want this to be two-and-done — we’re trying to build a sustainable program here,” Reynolds said. “We feel like we have a huge commitment to make this a long-lasting program.”

Hub Outpost project veterinarian Dr. Laurie Meythaler-Mullins attended the Alaska Federation of Natives convention in Fairbanks in 2019. UAF photo by JR Ancheta.

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