This post continues from the series of posts regarding access to veterinary care that I have published earlier here and here.
One of the barriers for accessible veterinary surgery services, from the veterinarian’s point of view, is the available infrastructure and facilities and the perception of what facilities are required to provide basic care or to perform spay/neuter surgeries.
Questions such as “do you have a fully-fledged operating theatre (OT)?” are rather commonly asked in (and often the question comes from non-veterinarians), but what exactly is meant with a ‘fully-fledged OT’ remains a harder question to answer.
I often like to remind my audiences of Red Cross, or similar humanitarian organizations who are able to send highly skilled medical teams to set up temporary clinics and hospitals in disaster areas, using tents or any available halls or rooms. These medical teams are not looked down upon because they are not working inside custom-built hospitals. They are appreciated for their skills and ability to know when to improvise and when not to compromise.
Having a signboard stating ‘Operating theatre’ on the door to the room where you do spay/neuter surgeries, does not guarantee anything about the skills of the team working behind that door. To be able to create models and inspire and encourage more veterinarians, across India, to provide spay/neuter surgery services in small towns and in villages where people do not otherwise have access to veterinary spay/neuter surgeries, it is important to be able to understand what is really required and what are the externalities that do not influence the quality of care.
What matters are the sterile field and the skills of the surgeon. Sterile field is created by having the patient’s hair shaved off and surgical area aseptically prepared by scrubbing it with disinfectant scrub solution. This is then covered by sterile drapes (we use re-usable cotton cloth drapes that are washed and autoclaved after every use) and the surgeon wears sterile gloves after having his/her hands surgically scrubbed in preparation. Instruments are sterile, washed and autoclaved after every patient. Nothing non-sterile touches anything sterile.
That’s it. It is not rocket science.
Having good skills in surgery is a much more difficult task to achieve – though the aseptic preparation and sterile field are also integral to surgery skills – and requires good amount of practice and training under good guidance. However, sufficient confidence can be achieved in a relatively short period of time, if training is good, as recently shown by Emma Rayner at al (2023) in “Assessing the effect of a canine surgical-neutering educational programme on the knowledge and confidence of Indian veterinary participants”, published in the Frontiers of Veterinary Science.
According to Rayner et al., (2023)
“Veterinary participants’ knowledge of and confidence to undertake canine surgical neutering can be significantly increased through a targeted and practically focused, educational training programme, improving knowledge around key subject areas, and enhancing confidence in undertaking key skills required for canine surgical neutering. By demonstrating that a short, focused training programme has the capability to increase knowledge and confidence in a low-resource setting, this training programme provides an opportunity to build expertise amongst the veterinary community in India, as well as similar, global initiatives.
