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| Tuesday, 19 October 2004 |
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There was a lot of reporting in the past several weeks in the newspapers about rabies and stray dogs and the spiralling costs of providing the anti-rabies vaccine to dog-bite victims: those who are quoted in these reports are subtly hinting that reverting to killing dogs is the solution to the problems, states the Kandy Association for Community Protection Through Animal Welfare (KACPAW) in a press release. Unfortunately these reports highlight only a few aspects of a complex problem made worse by non-application of certain effective measures such as provision of rabies vaccination to over 70% of the dog population, despite it being made available free of charge by the government. It is pertinent to note that the suggestion to kill dogs as a solution to the problem is made by a few individuals at a time when there is significant consensus in the country amongst almost all concerned that humane methods (primarily sterilisation of dogs to prevent unwanted dogs) to control stray dogs should replace the inhumane methods (strychnine/cyanide poisoning, gassing, etc.) that have been used up to now. "It is all the more significant that such a suggestion is being made at a time when no less a person than the Minister of Health, Nutrition and Uva Wellassa Development,. Nimal Siripala de Silva said that killing dogs as a solution to the problem has failed addressing a meeting he had convened for all strakeholders at his ministry on September 21 to share views on this matter and come up with a solution. This is a very progressive step on the Minister's part, which the public should appreciate. He also said that the probable solution to this would be islandwide sterilisation of dogs, coupled with widescale rabies vaccination, registration, and public awareness on responsible pet ownership and stressed the need for a practical, balanced, long-term solution to the problem of rabies. He also stressed that the need is to eradicate rabies and not merely to control it, a view put forward by the Director General of Health, Dr. Kahandaliyanage. At the end of the meeting the Minister appointed Mrs. Siva Obeysekera as the Chairperson to a committee and invited anyone of the participants who wished to serve in this committee to sign up and asked the committee to come up within two weeks' time a plan of action that can be applied by January 2005. Dr. Pal Harischandra, Director, Public Health Veterinary Services was asked to serve as the convenor of these committee meetings. This committee is yet to meet. In the above context the public ought to know the following facts related to stray dogs, incidence of human and dog rabies and the spiralling cost of providing the anti-rabies vaccine to dog bite victims etc. In general stray dogs are not in a habit of biting people (they may be, however, considered a public nuisance by some) without some sort of provocation. In fact they are either very friendly or want to be left alone. If they do bite, then they are either provoked or perhaps rabid. According to a study by Dr. R. M. U. K. Rathnayake, Medical Officer, General Hospital, Matara published in the Journal of the Ruhunu Clinical Society (pp. 3-5, Vol.9, No. 1, 2002) of the post-exposure treatment in the Matara Hospital in 2002 the majority of the bites were by domestic animals - i.e. 72% (61% dogs and 12% cats). A great proportion of the injuries was due to 'provoke bites' and the majority were children. Among the 72% of the animals only 14% were vaccinated against rabies. Dr. Rathnayake says that if we had a high animal vaccination rate, unnecessary vaccination of humans could have been avoided (repeated exposure to rabies vaccination, like most other vaccinations, could have detrimental health effects). He also says that the majority of the wounds belonged to 'minor category' according to WHO classification and proceeds to say that "all this clearly shows that correct animal vaccination seems to be the single-most important factor which needs attention if we are to reduce hospital vaccination rates." Dr. Rathnayake says that "when compared, the cost of a single animal vaccination which is only Rs. 13 to the government with that of ART (Anti-rabies treatment) which is Rs. 1,200 for the full course per adult patient, it is clear that animal vaccination is cost - effective." Children being bitten indicates irresponsible pet ownership by the pet owners. The cost of anti-rabies treatment per person is now calculated at Rs. 1,500. Dr. Pal Harischandra, corroborates Dr. Rathnayake's findings when he says that 84% percent of the bites for which the anti-rabies vaccine is given are by domestic animals. The high rabies vaccination rate of dogs (domestic, community, and stray dogs) in the Puttalam district by Dr. Harischandra in 2004 has resulted in reducing drastically the human rabies incidence in that district bringing it to nil so far this year. The Puttalam district could be declared rabies-free if the trend continues indicating the clear advantage of animal vaccination. It is obvious then this practice should be applied countrywide. Dr. Omala Wimalaratne, Consultant Medical Virologist and Vaccinologist of the Medical Research Institute is of the view that if the doctors follow the instructions given to them on administering the anti-rabies vaccine to dog bite victims unnecessary vaccination could be minimised and as a result the costs would be reduced. There is no cause for argument that even one human being should die of rabies (rabies is a preventable disease). It is extremely sad to note that recently a child died (actually euthanised according to a newspaper report on October 10, 2004 at the Lady Ridgeway Hospital when the doctor realised that she had contracted rabies: the veracity of this bizarre accusation will have to be dealt by the hospital authorities) of rabies. However there are unconfirmed reports that some parents do not follow the full vaccination course for the victim or resort to alternative treatment such as mantra gurukam (black magic). All these factors contribute to the problem of rabies in our country and fortunately the relevant Health Ministry authorities on rabies in the country are aware of the se facts. The time is right for all of us then to solve this problem in a civilised, effective way. The Hon. Minister of Health has given us an opportunity to come up with a practical solution to the problem and the onus is now on the committee appointed by him to do so without delay. So many discussions have been had on this issue over the past two to three years and a vast majority of Sri Lankans opt for a civilised, practical approach to the problem of stray dogs and rabies. Hence it's time for implementation of actions that would bring about visible results. |
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