Every time an animal died at the Calgary Zoo under bizarre circumstances over the last few years, critics pounced on the incident as another sign of systemic problems and zoo officials would insist it was nothing more than a regrettable accident.

But now, a scathing independent report concludes that an increasing number of animal deaths at the zoo "is not just a series of unfortunate events" but a symptom of numerous underlying woes.

Staffing and training is inadequate, says the report by the Canadian Association of Zoos and Aquariums and the Washington-based Association of Zoos and Aquariums.

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So, too, is security and safety. Planning of animal collections is weak. Funding to upgrade aging infrastructure is lacking. And there's poor communication throughout the chain of command, according to the report.

Six months ago, Dr. Clément Lanthier, the zoo's president and chief executive officer, pledged to bring in outside experts to look through the facility's operations to prove to the public that there were no broad-based troubles.

Forced to make an about-face, Calgary Zoo officials will now spend the next 12 months implementing a 36-point action plan to address the myriad concerns raised in the report released Thursday.

"We will not let the animals down," Dr. Lanthier pledged.

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The zoo asked the two groups to launch the investigation after a capybara, the world's largest rodent, was was crushed to death after being pinned by a hydraulic door being operated by worker.

Previously, a knife was accidentally left in the western lowland gorilla enclosure. A Turkmenian markhor, a type of goat, hanged itself on a toy. "Human error" was blamed in the deaths of dozens of cownose stingrays. Two baby elephants have died. So have a number of gorillas. A hippopotamus died after suffering circulatory complications when it was shipped from the Denver Zoo.

Since the investigation was launched, there were near-escapes of two snakes and a gorilla.

The organizations that conducted the review maintain standards for the industry and accredit facilities, including the Calgary Zoo. Animal welfare advocates had complained that their report would be clubby, not independent.

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The report does highlight dedicated staff, top-notch veterinary care with "healthy and well-cared for" animals, beautiful grounds and state-of-the-art facilities.

"Overall, the Calgary Zoo is a community asset of which the citizens of Calgary should be proud," it said.

But the report also describes a "troubling trend of increasing problems related to human error" and animal deaths "significantly greater" than at similar facilities in North America.

It points to deficiencies in exhibit designs, in part in an attempt to provide "enhanced visitor experience." Piano wire hanging in the bat display so patrons could get a better view ended up wiping out colonies.

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Before the report was made public, the bat display was shut down and a long-time senior director quit.

Concerns about financing were also raised since the city cancelled its $1-million in annual funding. But Grahame Newton, the zoo's chief financial officer, said the facility is "financially sound" and plans to spend about $2-million this year on infrastructure.

The zoo has maintained a profitable balance sheet while it continues to attract 1.2 million visitors annually and membership numbers grow.

"The community support has never wavered in the last few years," Mr. Newton said.

Indeed, even as the rain poured Thursday, the zoo was bustling with students and seniors. Randy Lamirante, visiting from Brooks, Alta. with his son's school group, hopes the report turns things around.

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"It makes me feel sad that this has happened to all the animals," he said, adding that even a negative report won't stop people from visiting, "The kids still want to come."

The report is bittersweet vindication for Julie Woodyer of Zoocheck Canada, who said Dr. Lanthier should resign, that the zoo's accreditation should be stripped and a truly independent report should be commissioned.

"If your own industry association is saying that [things are bad]and your peers are saying that, things must be really bad," she said.