As I sit to write this article, I know this will be an emotional one. I know it, because it has been my vision and my passion to see Cambodia rabies free; to never hear of another case of a child that died playing with a neighbourhood puppy. I know it will be an emotional article because the past 2 years I worked so hard in developing the Rabies Free Cambodia comprehensive campaign and implementing it as a pilot; and yet, in the wake of recent tragedies, it seems as if it has never mattered.
As I sit down to write this, I ask myself: how is it that in such a small country I have called home for almost a decade, we are still losing lives, and still unable to control and eliminate this fatal, yet absolutely preventable disease?
Rabies panic took over Cambodia rather suddenly few days ago. The public paranoia ensued after the news of a death of a young girl from the bite of a rabies-infected cat surfaced on social media. The post of her funeral received thousands of shares and in matter of few days, hundreds of people flocked to the only place they knew where the protection is available – both pre- and post-bite: Pastuer Institute.
The huge crowds of people, scared and desperate to get the magic “injection” from the disease took over the streets near the entrance of the Institute. Many of the those lining up were told to leave, if they were not bitten by any animal in the last 10 days. Most of the people are completely unaware what injections are required anyway, how many of injections do they need to get the necessary immunisation levels; what are the differences between pre- and post-bite injections and how to protect themselves and their family from the certain death, in case the bite does happen. Most of those with whom I have spoken personally wanted only one thing: “the injection from crazy animal disease.”
What’s even worse is that the public paranoia led to mass killing of animals on the streets; brutal beating of dogs and cats to death with metal sticks. Clubbing and culling is a sight one cannot forget. The videos of people attacking and savagely killing peacefully sleeping community dogs are flooding social media these days. It is sickening, but not surprising: this is what the combination of ignorance and a mass fear does to people: irrational actions towards any object – living or not – that in their minds represent the cause of their suffering or demise. Of course, none of them realised that most mammals can be rabies carriers, that even if they killed all the dogs and cats, rabies will still exist and thrive and people will continue to die of it… but all this information has fallen to deaf ears now as mass panic takes over rational thoughts and actions.
The problem of rabies, its long history in Cambodia is so complex, I am not sure where to start. To me, the most obvious dilemma is the fact that rabies has been a huge public health issue in Cambodia for many years and yet only now we are talking about it loudly, but only because social media created public outrage and a crisis. It has never been a secret that between 800-1,000 people – mostly children below 15 years of age die annually of rabies after being bitten by an infected animal. The figures, provided by Pastuer Institute are officially recorded deaths, I assume. And if so, the annual death toll may be much higher, considering that provincial health care is rather basic, most cases go undiagnosed or unreported, villages have no access to post-bite vaccine and in most cases, even when it is identified, it is just too late to vaccinate or too far to travel to the nearest clinic that has the post-bite immunizations.
In addition, I have always been bewildered with the way the rabies problem has been handled so far. First of all, I do not understand why in the developing country with high rabies fatalities, the people at risk – those who live or work in close proximity with animals and wildlife – are not mandatorily vaccinated. It is especially shocking that the employees are not held responsible for their workforce, specifically when their work is in close proximity or potential of this unnecessary risk. Most employees will go unimmunised – farmers or wildlife workers – since they are unable to afford the pre-bite immunisations costs. I would think, in the country where rural population is still living in poverty and is at high risk, rabies shots would be provided free of charge to people before any other projects are carried out. But even that is not the saddest part of it all.
The one issue that bothers me personally to the core is complete disinterest of the public health agencies who work in rabies prevention to address the heart of the problem: the mass vaccination and population control campaigns of community animals to battle rabies. While another human clinic for post-bite vaccinations is opened, no interest is expressed (even when offered without any strings attached) in collaboration with animal agencies to tackle the heart of the problem – vaccinations of the animal rabies carriers, namely community, pagoda and rural dogs and cats. As human post-bite clinics pop up, there are no comprehensive and intensive campaigns about animals being mandatorily vaccinated to prevent and finally eliminate the disease from the country. Why is it still something completely ignored in the discussion of an emergency response to the rabies epidemic?
There is just no excuse for this. Rabies is well studied and prevention is easy. Government officials have rightly stated that animal vaccination is the key. We see a sharp increase of pet owners vaccinating their pets. But what about those community animals? It is clear that without cooperation between human and animal health agencies, such as WHO, Pastuer, Animal Mama, Rabies Free Cambodia Project and others – rabies will continue to be an epidemic and will continue to take lives.
As a founder of the animal health charity, I have always advocated for the one health approach which considers interdependence of human and animal well-being as a basic paradigm of our existence. One World – One Health paradigm coined by the international community advocates for recognition of how human health is deeply connected to the animals and environment.
Just a small group of us were able to develop and implement on a small scale a comprehensive response to rabies through our Rabies Free Cambodia Project. In a short span of 17 months, we have been able to vaccinate, spay/neuter and treat for parasites over 5,000 animals, 1,654 of them since September 2018. I know it is possible because we did it, on our own, with small group of dedicated people and no outside funding.
Now, imagine what we can do if we have active cooperation with human health agencies working on rabies elimination, partnering with other animal welfare-based agencies to rid Cambodia of this completely needless disease. We tried it, we piloted it and we saw results. It is inexpensive, it is effective and it is absolutely possible. I know how to do it, because we did it. We have a formula that works.
Who is going to join us?
Animal Mama® Animal Clinic & Welfare Centre provides a wide range of services for animals & pets: vet care, boarding, daycare, pet food & supplies, hydrotherapy, grooming and doggy play dates.
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