Field Report - The daily threat of rabies in Blantyre, Malawi

Post by
Frederic Lohr
April 1st 2015

Dr Dagmar Mayer, International Veterinary Manager of our sister charity Worldwide Veterinary Service (WVS) , arrived in Blantyre, Malawi in mid-March, working alongside local vets and preparing everything for our massive Mission Rabies vaccination drive and WVS's sterilisation programme in June. Follow her updates and experiences here and on the WVS page .

On Monday, Tarryn from the Blantyre SPCA and I visited the paediatric neurologist Dr Mac Mallewa at the Queen Elizabeth Children Hospital in Blantyre. Dr Mallewa has got a special interest in rabies in children and he has seen many of these sad cases in his life so far. To tell these parents that their child will not survive and in fact will be dead within the next week has to be the most difficult task anyone can imagine. 

We visited the paediatric ward where Dr Mallewa is working and the conditions we found there were just heartbreaking. The ward is full, even though the malaria season has not reached the peak yet. There are not enough beds and severely ill babies and small children have to share beds, often up to 4 children lying next to each other on bare mattresses.

Children with rabies tend to show the same symptoms of children with cerebral malaria and often these only get diagnosed after days in the hospital, after which they get isolated from the others. The isolation ward for children with rabies is just a room with two broken beds in, none of the patients who were admitted here left this ward alive. 

We will make sure that this ward will at least receive some desperately needed medical equipment and also an infusion pump. This is to ensure hat the terminally ill children can stay sedated during their last days.

Dr Mallewa is a great supporter of Mission Rabies and he will be part of a team to collect and publish data of rabies cases of children in Blantyre. Hopefully in the future we will see less and less of these unnecessary deaths. 

At the end of the week we got a phone call from Golden Maruwo, a veterinary technician from the Government Veterinary Lab concerning a rabid dog in one of the poorest areas with the highest human population density. Most dog bites are recorded from this part of the city. We were told that a bitch and her four puppies were attacked by a free roaming dog two weeks ago outside their owner’s hut. The mother dog ran away but at least two of the puppies were bitten. One of them turned aggressive two days ago and bit three children in the yard and then got killed by a family member. Today a second puppy showed obvious signs of rabies.

Tarryn (BSPCA), Golden and I went in torrential rain to see the family and confirmed their suspicion: the puppy was very aggressive, salivated and showed signs of disorientation. As the other two other puppies also showed bite wounds we took the hard decision to euthanise all three puppies. Diagnostic tests will be run at the government laboratory. 

The three children who got bitten all went to the Queen Elizabeth Hospital for treatment today. Their mother told us that their bus fare was more than 1200MK (£1.5) that is an incredible high sum for a Malawian family who often has to live on 20,000MK for the whole month. To be not at the risk of developing rabies these children have to go back for 4 more injections.

One of the children was bitten two weeks previously but has not suspected rabies as the cause of the aggressiveness. She didn’t feel well for 2 days now, had headaches and didn’t want to eat anything. We are very concerned that she might develop rabies and our thoughts are with her and her family and we will pray that this little girl will be fine.

Next week Tarryn and I will visit this family again, check up on the daughter and see how the mother of the puppies is doing. This dog had been vaccinated during our partner organisation’s, Blantyre SPCA, campaign last year and should hopefully be safe."

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