Systemic Change or Baby (Puppy) Steps

A few weeks ago, a small puppy curled up on the steps in front of our office. Shivering, breathing irregularly, and hardly eating or drinking – it was clearly not in good shape. Every tourist guide book that has ever been written warns visitors to India not to touch street dogs, and so far I had done a fairly good job abiding by this rule. But how could I possibly ignore this poor thing?  

I knelt down next to the puppy, and whispered, “I’m going to take you to the vet tonight, okay? That’s the plan, Stan.” I took Stan, now officially Stanley, back to my apartment, gave him a bath, found out he was a she, and took her to the vet with a coworker. 

Stanley, a puppy, curled up in a shoe box
The first day Stanley came to our office – curled up in a shoebox and still shivering.

The vet told us that Stanley was suffering from acute cellulitis. Her severe limp was caused by a bacteria, introduced by a dog bite which had pierced her skin, which was liquifying her hind leg/hip muscles. What I had initially expected to be a fairly quick (maybe a few days?) “nurse her back to health and release her” situation was quickly turning into a long term care situation right before my eyes. I did what I could to ignore the sense of overwhelming responsibility that was washing over me in increasingly powerful waves, and attempted to focus on the present. 

When he punctured and drained the abscess, the muscle tissue and pus just kept coming and coming. For such a small puppy, it was a significant portion of her muscle mass. I helped him hold her down as he drained, flushed, packed, and wrapped the wound. The only thing that kept me from throwing up was my pre-med background. In college, I had shadowed many a doctor and observed many surgeries as I was preparing to go to medical school. 

Stanley at the vet
Waiting room pictures at the veterinarian’s office. Left: Me and a napping Stanley. Right: Stanley with Shivani, my coworker who also took responsibility for the care of Stanley.

Sometime in my junior year, though, I changed my mind about medical school and pursuing direct patient care. I was excited by the political stir around Universal Healthcare/Medicare For All in the U.S. (If I’m being honest, the awful-ness of organic chemistry also played some part in the decision.) 

Regardless, I shifted focus from thinking about individual health to the larger, structural forces that lead some to sickness. I became attracted to systems-level work in health policy and governance. Along with previous experience in India, this is what led me to the “development sector” and the AIF Clinton Fellowship. 

I’m a firm believer in the idea that development goals are only going to be realized through a large-scale overhaul of significant, deep-rooted institutions and systems of inequality. The United Nation’s ambitious Sustainable Development Goals are a picture of a more equitable world – and it will take a major redistribution of power for them to be achieved. 

The 17 UN Sustainable Development Goals
The 17 Sustainable Development Goals set by the UN. Photo credit:

As Oren Harari once said, “Electric light didn’t come from the continuous improvement of candles.” With this in mind, I get frustrated when my work operates quietly within these big structures or societal power dynamics in which I want to see change. 

For a minute, take India’s homeless dog problem as an example. Stanley is on the road to recovery now, but thousands of other Lucknow dogs still roam the streets. When I took Stanley back to the vet every night to get her wounds re-drained, re-flushed, re-packed, and re-wrapped, I looked out the window and thought about the stories of all the puppies we drove past. 

dogs on the street of Delhi
A house had put out food for street dogs in Delhi. A coworker and I both remarked that in general, Delhi street dogs look remarkably well-fed compared to dogs in Lucknow!

With the time and energy I invested in Stanley, I probably could’ve helped a hundred less-sick dogs. I also have a full-time commitment with an organization that helps improve human lives. Should I divert this time and energy to that effort? Every puppy sighting throws my thoughts into a spiral of ethical dilemmas. It’s a recipe for the phenomenon known as ‘compassion fatigue.’ 

India’s animal welfare problem is much bigger than the one puppy who was lucky enough to end up on the right office steps a few months ago. I think of Stanley’s case as a microcosm of other issues I care about. Helping Stanley lights a mere candle in a system that needs electricity. Saving Stanley’s life won’t bring about the metaphorical lightbulb that would alleviate the suffering of all the homeless dogs out there. However, my belief in animal rights still drives me to help Stanley.  

A human rights approach to the Sustainable Development Goals considers both the structural level and the individual level. Which level should be prioritized? Medicine and health care (for humans, but also for animals) are perhaps the most striking examples of this predicament. 

Reflecting on my journey with Stanley, I know that effective equity work requires both top-down and bottom-up fixes: both giant leaps and baby steps. Or in this case, puppy steps. 

Stanley chilling in a bean bag.
Stanley chilling out on a beanbag in the Medha office.

McKenna is serving as an American India Foundation (AIF) Clinton Fellow with Medha in Lucknow, Uttar Pradesh. For her Fellowship project, she is expanding partnerships with educational institutions to scale up an existing 21st-century career skills training center designed to improve employment outcomes for youth. McKenna graduated with a degree in nutritional sciences. During her undergraduate years, she participated in research on the iron fortificants and protein quality of different fortified blended food products used by the U.S. Agency for International Development to address malnutrition and iron-deficient anemia in developing countries. After several years of nutrition research, she began questioning the underlying causes of malnutrition and poverty in the developing world. She diversified her work to investigate the social and economic factors that impact health outcomes, such as a community advocacy group for affordable housing in Manhattan, Kansas, and eventually to Split, Croatia, in 2017 to learn more about socialized healthcare systems. A childhood exposure to Indian culture left McKenna with a lifelong passion for the country, which led her to spend four months studying abroad in Bangalore at Christ University. She is excited to return to India in a professional capacity as an AIF Clinton Fellow. During her year of service, McKenna is looking forward to evolving professionally, engaging with the cohort, and gaining new perspectives on the development sector.

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