Learning from the cruel death of Fatima

A schoolgoing child named Fatima who was in class three, died of rabies in August 2, 2016. The father of Fatima went to Upazilla Health Complex; the authority ordered them to leave the facility because this was an infectious ailment and told them that there was no treatment for it. The Infectious Disease Hospital (IDH), Fouzderhat referred her to Infectious Disease Hospital, Dhaka for better treatment. The poor father tried his best to save his girl from the vicious disease. He could not afford the cost of the treatment. So he was supported by his fellow villagers and resorted to 'taking out the poison' from her body. They invited 'Batuni Baidya', a village quack who believes in spiritual power to heal, tried to take the poison out from Fatima's body. The quack tried many harmful practices and ultimately Fatima surrendered to death.

The digital age has not been able to teach us the things what we have to do in this situation. If the people of the village were aware about rabies and its symptoms, Fatima would not have to leave us so early. Fatima is a recent example but thousands of people are passing away in silence.

Rabies is a preventable viral disease. The rabies virus infects the central nervous system and causes disease in the brain. There is no effective treatment and once symptoms start, death is inevitable. The rabies virus is transmitted from infected animals to humans through scratches, bites or licks on mucous membranes of the lips or eyes. The virus cannot be transmitted through intact skin so touching, petting or being close to the animals is not a risk. In addition to dogs, many other animals can transmit rabies.

If preventative treatment is sought promptly, rabies need not be fatal. Immunisation is almost always effective if started within two days of the bite. Chance of effectiveness declines, however, the longer the vaccination is put off. It is important to start immunisation even if it has been weeks or months following a suspected rabid animal bite, because the vaccine can be effective even in these cases. If immunisation does not prove effective or are not received, rabies is nearly always fatal within few days of the onset of symptoms.

According to IDH, the annual number of rabies related death was 167 in 2006 coming down to only 72 until September, 2014. However there is a large number of rabies death unreported.

A national rabies prevention and control center, established at IDH, receives about 350 to 450 patients with dog bites daily. Anti-rabies vaccines are distributed free of charge from this center. In addition there are 65 rabies prevention and control centers at the district level in Bangladesh.

However, there are many challenges facing the total eradication of rabies. Mass vaccination of 1.2 million dogs has remained as one of them, because massive killing of stray dogs is banned by the Supreme Court in Bangladesh in 2011. Before the writ, the government used to have plan to massive killing the stray dog but it is stopped.

On this issue Dr. Abu Jamil Faisel, Country Representative of EngenderHealth, Bangladesh recommends the following steps.

Vaccinate the pets: one should ensure that one's pets are regularly vaccinated against rabies — it is a legal requirement. Dogs and cats should be given vaccine at 3 months of age, a booster within the following 9 months, and every 3 years thereafter. In high risk areas, yearly vaccinations are recommended. If you are not sure whether your pet has been vaccinated, or if overdue for a vaccine then visit your local veterinarian immediately.

Avoid being bitten: Not every bite poses a risk of rabies, but a bite or scratch from a stray animal, sick animal and an animal that is behaving strangely or an unprovoked attack would suggest a rabies risk. Never handle stray animals or animals that appear sick.

Sterilisation of pets: Vasectomy is an accepted way to sterilise stray male dogs without impacting hormonal changes. It will prevent the ever growing population of stray dogs. After vasectomy the stray dog should be vaccinated.

If the government takes proper steps to control rabies with the above mentioned steps then unwanted death will decrease, thousands of Fatimas will not face such premature and cruel death and the parents and villagers will not burst into tears.

The writer works at Health21. E-mail: alam229pearl@gmail.com