Nobody has to die of rabies. Annually, at least 200 to 300 Filipinos succumb to rabies, despite the fact that there are available vaccines (pre-and-post exposure) for animals and humans.
As of the week of March 2018, according to Dr. Ferdinand S. De Guzman, MD, MHA, DrPH(IP)
Fpafp, fpafp-tm, fpsvi, fps, FpsmS, Medical Specialist IV, and
Chairman of the Department of Family Medicine Infectious Disease and Tropical Medicine of the San Lazaro Hospital they had already recorded 12 deaths, and the last victim who filled the 12th spot was a 6-year-old girl. The victim got the rabies when a rabid dog licked her and, unknowingly, she has an open wound, which became the entry point of rabies.
Who would like to imagine a young boy or girl suffering from the effects of rabies virus during his or her last minute? Witnessing a dying person or a loved one is already hard to bear, but seeing someone dying from rabies is one of the saddest, most painful and terrifying ordeals you will ever see.
Every day, at least 500 to 1500 people—children, adults and elderly, men and women—line up at the grounds of this government hospital to avail themselves of rabies vaccines. According to de Guzman, most of these people, who brave the scorching heat of the sun or the stormy weather, come from different parts of the country that do not have access to rabies vaccines.
This situation is already a herculean task—physically and mentally taxing, but the real challenge is when the patients are already showing the symptoms of rabies infection.
De Guzman, who has been serving the Filipino people at the San Lazaro Hospital for 22 years, had seen the torment and agony of both the patients and their loved ones. Going back to the times he witnessed how a patient suffered and died of rabies, according to him, takes a lot of courage and emotional strength, especially when dealing with the family members of the rabies victims.
The good doctor said when a patient manifested the signs of rabies, what they do in the emergency room is to prepare and advise the family members on how to bring the cadaver back to their homes.
This sounds so callous, but if the victims do not recover from rabies, they will eventually die.
The horrifying fact about rabies infection is you will die like a different person, losing all your mental and physical control. The infected person will have episodes of irrational excitement, agitation, convulsion is also common, severe and extremely painful throat spasms suffered by the person when trying to swallow—or even upon seeing—liquids.
Sharing some of the cases that Dr. de Guzman can’t forget, he said that rabies virus is mightier than any bullet of World War II. He recalled the oldest recorded patient of rabies in the country was an 88-year-old war veteran who told him that he was able to evade the bullets of WWII, and a small wound can’t harm him.
However, the war veteran eventually succumbed to rabies.
Another case he recalled was of the 36-year-old lawyer from Pampanga who manifested unusual symptoms of rabies. De Guzman commended the doctor in Pampanga who attended to the lawyer. Though he can’t clearly explain what was happening to the lawyer, he immediately advised the family to send the lawyer to the San Lazaro Hospital because he had a history of dog bite
De Guzman said the lawyer felt very weak in his lower extremities, almost paralyzed, so the family members thought the lawyer suffered from stroke. Upon receiving him in the ER of San Lazaro Hospital, they knew it’s rabies. And the lawyer who was bitten by a dog many years ago, eventually died of rabies.
He also shared that one patient got the rabies virus though ingestion. A male victim prepared kinilaw na utak ng aso, unaware of the dangers of rabies virus, which is found in the brain of dogs, the male patient ate the kinilaw. He died of rabies.
Out of the 200 to 300 recorded deaths annually, the San Lazaro Hospital handled at least 25 percent of the cases, and the victims were from outside Manila. Most of them were males who were bitten or scratched by rabid dogs.
There were cases not involving animal bites but open wounds or scratches on the skin that were licked by a rabid dog or cat. These cases were the saddest to know because they could have been prevented had they not been ignored or had the dogs and cats been immunized.
One painful fact I have learned from my interview with de Guzman was most patients die of rabies because there were no vaccines available in many provinces, and if there are available vaccines the patients cannot afford the cost so they have to travel to Manila. And during the time of travel symptoms of rabies will show up and upon reaching San Lazaro, they will just hear the verdict that it’s the end of the line for them.
However, over the years, the number of animal bite centers have increased. The DOH through its animal bite treatment centers are now giving human rabies vaccines for free. Other private hospitals now also have included animal bite management in their services.
Last week I witnessed and experienced the step by step process in getting a rabies vaccine shot and I must admit I admire the patience and attitude of the staff of San Lazaro Hospital who were attending to the patients.
Enduring the noise from crying children, irritated patients, conversations of people from all directions and even the noise of the nurses who are trying to pacify kids and parents, is already a challenging task they have to face from Monday to Sunday as early as 8 a.m until the last patient of the day is attended to.
I can only nod my head and whispered to myself, “This situation can be changed. We can be better than this.”
With the incredible advancements in medicine and technology, most of the countries around the world are already rabies-free but the Philippines is still trying to achieve one of its targets stipulated in the Millennium Development Goal—to be rabies-free by 2020. However this goal seems to be elusive as long as the laws regarding pet ownership, animal immunization are not properly and fully implemented. The year 2020 is less than two years away and until this very moment, thousands of dogs, cats and other animals are not immunized.
The Bureau of Animals should be really involved in animal immunizations to totally eradicate the disease brought by animals. Cutting off the source of infections through vaccination is the key to prevention and disease elimination.
However, the sad truth, in the country today, instead of animal vaccination the people are more encouraged to get the vaccines. It is not bad to get ourselves protected but if we are really eyeing for rabies-free Philippines, vaccination of animals should be the focus and not the other way around. As long as there are rabid animals roaming in our streets, we are not free from the dangers of rabies. We need stricter laws for pet ownership because we have a responsibility to, first protect ourselves, the people around us and to the animals we call as pets.
Owning a pet is not just about feeding and giving them shelter, it is also protecting them from harm and from harming other animals and people. And those who can’t feed and provide home to these animals, do not attempt to get one.
Rabies is not only fatal, it is also scary. The mode of transmission is not just though animal bites, it can be transferred to you without even noticing it, especially those who are exposed to animals.
The goal to rid off rabies by 2020 can be achieved if everyone in the community will participate in reporting all the stray animals to their barangays, sending their pets to immunization centers and also getting ourselves protected.