A bite away from death

A bite away from death

By Emmanuel Luciano
There is a killer on loose. Rabies is mercilessly decimating Malawians.
“Rabies is a very scary disease. Once signs have shown in a man it’s a death sentence. It is very dangerous unlike Aids which you can survive through ARVs. When you have signs you cannot live more than seven days. The maximum one has lived in history is 14 days. ”
That’s how the veterinary surgeon, Dr. Kholiwe Mkandawire, portrays the threat that rabies poses.
On a daily basis, dogs are biting more and more people in Malawi. The press statement from government, which Secretary for Health Chris Kang’ombe and secretary for Agriculture Patrick Kabambe signed, says “Blantyre ADD is leading in registering dog bites cases with an average of 125 dog bites cases per month.”
This staggering statistic translates into 1500 people being at risk of dying of rabies in a year in Blantyre ADD alone if they don’t access the anti rabies vaccine.
It appears all over sudden dogs are on the loose in the country as more people are dying of rabies.
The current rabies status, Dr. Mkandawire says, warrants calling it a crisis.
“One case of rabies in a dog is enough to call it an outbreak because that dog is likely bite another dog, a person and wildlife. One bite can cause 100 cases of rabies,” she says.
Of the reported deaths, Blantyre recently registered two deaths while Malawi News’ investigation revealed that seven people died of rabies in Mulanje alone.
Dr. Mkandawire believes there are many unreported deaths of rabies throughout the country. Many people, says Dr Mkandawire, who take dog bites as normal in villages and do not bother to seek medical attention.

“No where in the world are people are people dying of rabies at the rate Malawians are dying of it. Three to four people die of rabies in Viphya every month.”
But a report of the study done at Queens Elizabeth Hospital for three years beginning March 2002 and posted on the Centre for Disease Control and Prevention website, indicate that rabies encephalitis is an important cause of death among children in Malawi.
The study also showed that 14 of 133 children who died from suspected Central Nervous System infections had rabies.
The report of the study says since this was a hospital-based study, the number of rabies cases in the community was likely to be much higher.
According to the report, “in some parts of Africa, up to 100 rabies cases are estimated to occur for each 1 officially reported.”
The report further says lack of diagnostic facilities and difficulties with the system hinder national reporting of rabies in Malawi.
Dr. Mkandawire however says cases of rabies are supposed to be rare occurrences.
“I remember my university professor telling me that you will never see a rabies case because it is rare in Europe and America,” she says.
The cases of the Dowa and Dedza beasts, in the eyes of the veterinary surgeon, are a pure scenario of rabies that was transferred to wild animals.
“We don’t control rabies in the bush. The rabies virus perpetuates itself by causing the madness to attack but villagers don’t know how to explain these things,” she says.
The ministry of Agriculture’s department of Animal Health and Livestock Department has “introduced annual rabies week vaccination campaign whereby dogs across the country are vaccinated free of charge.”
But Dr. Mkandawire, says, the campaign is not effective.
“The vaccination campaign really is very cosmetic. For you to control rabies really you must have coverage of 80 to 90 per cent of the vaccination of all the population of dogs. You cannot cover that in two to three weeks.

“There are no enough funds to give the boys allowances for the two weeks that they would be vaccinating the dogs.
“Inside sources told me that those who were doing the campaign in Blantyre were only given allowances for three days. You can’t take for granted the allowances of the workers in this campaign,” she says.
The Department of Animal Health and Livestock Development hasn’t been conducting shooting campaign of stray dogs because, as Malawi News understands, of problems in procuring bullets since through decentralization, each assembly has to buy for itself bullets.
But director of animal Health and Livestock Development Dr. Wilfred Lipita told Malawi News recently that it was no longer easy to carry a shooting exercise of stray dogs.
“The dogs are being clever these days. During the day they are not seen around and probably come out at night,” he said.
Dr. Mkandawire says it is 150 times cheaper to prevent rabies than to cure it hence government should pull its resources together on vaccination of dogs.
“For instance anti rabies vaccine for dogs cost K100 while a brand of human anti rabies vaccine cost K3000 on average per dose and for one to be treated he needs five injections which translates into K15 000,” she says.
“We don’t need to wait. We can control rabies. Government needs to import veterinary surgeons from countries like Kenya, Zambia, Zimbabwe and Botswana while we are sending our young men to school. Imagine they are only four doctors in the whole Animal Health and Livestock Department,” she says.
The rabies crisis has prompted Kholiwe to hire a Kenyan veterinary surgeon to assist her in combating rabies.
“If Kholiwe can do it what can stop government from hiring veterinary surgeons? We also want sanity in the department of Animal Health and Livestock Development. This should be government’s priority,” she said.