public clinic directional sign
Photo courtesy of Dr. Luis Alejandro Cruz Rivera
A colorful sign provides direction to a public veterinary clinic in Venustiano Carranza, a district of Mexico City.
At 7:30 a.m. on most days in Mexico City, people typically are already lined up around the block, hoping to get into Venustiano Carranza, a low-cost, government-run veterinary clinic. Doctors who work there say the day's slots usually are filled by noon.
The federal government, through a new law, is hoping to replicate clinics like this one throughout Mexico — ideally, without the long queues.
According to the country's 2021 National Survey of Self-Reported Well-Being, nearly 70% of Mexicans have at least one pet in their home. Seeking to make veterinary care more accessible, the federal government on Jan. 25, 2024, instituted a mandate that local governments across the nation establish public veterinary clinics that provide free sterilizations and affordable preventive care and emergency treatment.
One year since the law took effect, many veterinarians are still learning about its existence; some became aware of it only when asked by the VIN News Service to comment for this article.
Among those familiar with the mandate, some in private practice say it is too vague, including being unclear about enforcement. Critics also point to the lack of a funding provision in the law as an impediment to local governments in building and maintaining new clinics.
According to Humane Society International/Mexico, the country currently has about two dozen public veterinary clinics, about half of them in Mexico City, the capital. Mexico City Mayor Clara Brugada Molina announced last month, while presenting an "Integral Animal Welfare Plan for Mexico City," that the municipality intends to build a new public hospital and 20 more clinics.
Practitioners at existing clinics acknowledge that money for their operations is tight, in part because the local jurisdictions limit the prices set per service. At the same time, affordable care is desperately needed, they say.
The Mexican federal government didn't respond to requests for comment.
'More work needs to be done'
The text of the law — technically, an amendment to the General Law on Ecological Balance and Environmental Protection — states that the federal government must, "in coordination" with individual municipalities, "guarantee as far as possible" the free sterilization of animals and their "dignified and respectful treatment in animal control centers" or face "corresponding penalties."
The legislation states an intention to create public veterinary clinics "in order to provide animals with preventive medical attention and, in case of illness, provide prompt medical treatment endorsed by a veterinarian."
Local governments were given a deadline of July 22 to align their own laws with the mandate to promote and build the clinics. Four months after the deadline, three of eight private-sector veterinarians who spoke to VIN News weren't aware of the new law.
Dr. Juan Garcia Ripoll, who has practiced for 40 years, is among veterinarians in private practice who criticize the law for lacking specifics.
"It doesn't say if every government should have a clinic or just promote them. It's a big scope of action, full of ambiguities," said Garcia Ripoll. "It's unfinished, and more work needs to be done."
Among Garcia Ripoll's key concerns is that local governments aren't asked to adhere to a minimum expenditure. "If you leave it to the discretionary budget, obviously a public clinic will be among the last priorities," he said.
The federal government has been trying to improve animal welfare through sterilization campaigns going back to at least the early 2000s, according to Garcia Ripoll.
In the south central state of Morelos, where he lives and works, there are no public veterinary clinics. Rather, there are free sterilization events usually led by animal welfare organizations in partnership with local governments that lend the necessary space.
The campaigns, although seemingly well-intended, haven't led Garcia Ripoll to trust that the government is genuinely prioritizing animal welfare or well-being.
"The procedures are done in a big room, not a clinic. It's likely they don't reach an average standard of care," he said.
After being neutered, some patients are later brought to private practices with injuries they sustained while being treated or from inadequate care afterward, he said.
Garcia Ripoll said he would like to see new rules that more pointedly enhance the quality of public care, perhaps through the establishment of an accreditation system for public clinics. And the new law, he notes, lacks teeth because it contains no provisions for enforcement, such as penalties for noncompliance.
"This measure ... doesn't improve anything," he said.
A step too far?
Dr. Cesar Morales, founder of the Veterinary Conference of León and a leading figure in Mexico's veterinary community, agrees the law is vague. In his view, the law shouldn't exist at all. Mandating that taxpayer dollars be spent on pets is government overreach, he believes.
"Having dogs and cats is an individual decision, not an obligation," he said.
Morales thinks the mandate isn't well-known because it is part of an environmental protection law rather than a public health law. The latter would more likely be noted by the veterinary community, he said. Like Garcia Ripoll, Morales is skeptical that the law will have an impact, owing to its ambiguity.
Morales is critical of the performance of the few public clinics that exist, including one of the more ambitious state-backed projects, the Veterinary Hospital of Mexico City, which he deems a failure.
The hospital opened in 2016 offering free services such as sterilization, rabies vaccines and other services at low cost. In January 2024, veterinarians from the hospital spoke at a press conference to call attention to problems that began in 2019 with a change in leadership, according to a report in Diario Veterinario, a Spanish-language veterinary trade publication. Veterinarians' hours were reduced, and they were told their pay was too high, Clara Rodriguez, a representative of the Mexico City Public Servants Union, said at the press conference.
According to the account, the hospital stopped doing surgeries other than sterilizations. After a two-year closure due to Covid-19, it reopened without needed supplies, including anesthetics. Service prices doubled, even tripled, Giovanna Elizalde, the hospital's general coordinator, reportedly said.
Besides their labor rights, employees were speaking up for the rights of patients who "are the ones who have suffered the most," Elizalde was quoted as saying.
Morales said the hospital that had been "a gigantic project with first-class medicine and the best specialists" is now perceived as second-rate.
Still, he allowed, such public initiatives, although flawed, do provide some benefit to the profession by creating new sources of employment, especially for recent graduates.
Flaws aside, rule has support
Some private-sector veterinarians welcome the new federal law, citing a need for affordable care. "Laws like that are necessary," said Dr. Beatriz Coyoy, who owns a private clinic in Mexico City.
Coyoy isn't afraid public clinics might take business from her. To some degree, she hopes they will.
"Where I work, it's not a high-income area, and a lot of patients come and ask for a favor," she said. "Sometimes, you give a cheaper price."
In other words, Coyoy forgoes profit so she doesn't have to turn a pet away. She would rather be able to recommend a cheaper alternative.
Coyoy is among veterinarians who hadn't heard of the new law until being approached for an interview. She speculated that it's not well-known because it hasn't led to tangible and noticeable change so far.
For their part, doctors working at public clinics were more hopeful the amendment will lead to change. They emphasized that while government-led public veterinary care is not perfect, it is needed by many pet owners.
How public clinics work
Dr. Luis Alejandro Cruz Rivera is head of the animal protection and health department of Venustiano Carranza, a district of Mexico City with roughly half a million residents. He leads a public veterinary clinic that's open from 9 a.m. to 3 p.m. Monday through Saturday.
The center originated in 1979 as a dog and wildlife control center providing euthanasia and rabies vaccinations. It changed its name to "clinic" in 2016 to reflect its expanding services, including sterilizations and more types of vaccinations.
Three years later, the local government funded more equipment and outreach. The Mexico City government also standardized prices for each service, a schedule that's updated each year.
The clinic's head of surgery, Dr. Fernando Martínez Galindo, said there are 11 such clinics in Mexico City, though some remain control centers and not clinics as defined by the new law.
No listing of public clinics in the country exists, but VIN News identified nine other clinics outside of the capital. Several public universities also offer low-cost veterinary services. (Mexico has 2,477 municipalities, according to the National Institute of Statistics and Geography.)
Not only are public clinic prices much lower than those charged in private practice, Cruz Rivera said, prices at Venustiano Carranza's clinic are lower than required by the city.
He provided this comparison rundown: For a consultation, the clinic charges 58 pesos ($2.80), compared with 200 pesos ($9.65) in private practice. Rabies vaccinations are free, and other vaccinations cost a flat 210 pesos ($10.13). Private practices charge 400 pesos ($19.30) or more, depending on how many illnesses a given vaccine protects against. Sterilizations cost 233 to 883 pesos ($11.24 to $42.60) at the public clinic, depending on the patient's weight, sex and type of anesthesia used.
The low prices draw high demand, with clients sometimes lining up two to three hours before opening for a chance at an appointment. Similar scenes occur in Mexico's public human health care system, Cruz Rivera noted.
Of the approximately 600 service requests fielded by the public veterinary clinic each month, the most common are for consultations, vaccinations, deworming and sterilizations, Cruz Rivera said. Working within the given budget is difficult, he added. Some medicines are simply out of reach — like painkillers and potassium citrate, which is used to, for example, counteract the formation of urinary tract stones — and the clinic hasn't replaced a broken X-ray machine since 2020.
When clients can't afford medicine needed by their pet, doctors get creative.
"We give [the medication] to a patient during the visit and schedule follow-up visits for a second dose," Cruz Rivera said. The clinic can buy drugs at a discount and will sometimes sell them to clients at cost.
Cruz Rivera wasn't aware of the law aimed at establishing more public veterinary clinics but he did know the Venustiano Carranza district has another clinic project in the works. He looks forward to having a second facility share the workload.
He also hopes other districts in Mexico City will open clinics, since a significant percentage of clients travel from outside Venustiano Carranza — a challenge in a huge city with a complex transportation system, he said.
"I understand that the current government of Mexico City is very attentive, and with important initiatives on the issue of animal welfare, hopefully many projects will continue and, in the end, be able to expand and facilitate veterinary care in general," he said.
A new hospital on the horizon
In León, the fourth most populous city of Mexico, where there is no public clinic, Mayor Alejandra Gutiérrez Campos put the option of a veterinary hospital to a vote. Significantly more expansive than a clinic, a hospital includes specialist veterinarians and more equipment.
León has participatory budgeting, in which residents vote on how part of the municipal budget is spent. In 2022, 25% of nearly 9,000 votes cast favored the hospital, making it the most popular project on a list of many. (Turnout was low, with only 0.52% of León residents voting.)
Since then, construction delays have caused the hospital's opening to be pushed back repeatedly, from June 2024 to October 2024 and now April of this year.
Reportedly, also the cost has ballooned, from 46.9 million pesos ($2.3 million) to 78 million pesos ($3.8 million).
The prices the hospital will charge pet owners have yet to be determined but will be comparable to other public veterinary centers, according to Juan Luis Guzmán Ruedas, a physician and director of León's epidemiology and health. He estimates prices will be about 50% lower than that charged by private practices.
The center will offer basic consultations, surgeries, emergencies, diagnostics, radiology and ultrasound. It will employ 100 to 120 people, with a goal of providing 120 consultations a day. Initially, it will serve only dogs and cats, but might later expand to other species.
While the decision to build the new public veterinary hospital predates the new law, Guzmán Ruedas thinks the legislation will spark real change.
"This national decree is very positive because, at the end of the day, we are going to guarantee veterinary medical attention to sentient beings," Guzmán Ruedas said. "Because they are part of our home and they are part of our family — and because they also have the right to be attended and to have their health cared for, and to be given dignified and quality attention."
All interviews were conducted in Spanish and translated into English by the author.