Rabies dispatch from Malaysia

Just a few days ago, I arrived here in the heart of Malaysia. 

The capital, Kuala Lumpur, is a clean, orderly and modern city. KL, as it is affectionately known, is a thriving gateway to Southeast Asia. 

Shiny sky scrapers are clustered about the city center, motorcycles and cars pulse through the streets, banyan trees and thickets of bamboo offer oases of shade, while thick humid air enshrouds everything in unbearable heat.  At night, the Petronas towers shine like crystal. Wow!

I came here for the 13th annual International Congress on Infectious Diseases.  Doctors and scientists from all of the world met to review the latest drugs, emerging diseases, HIV/AIDS, parasitic infections and tropical medicines - it was an exciting time. 

Luckily, there is no rabies here.  Decades ago, the government resolved to eliminate that threat.  Dog control with vaccination and round-up of street animals was authoritarian but effective.  Rabies had no place to hide.  The WHO officially recognizes Malaysia as rabies-free.   Occasional rabies cases may cross over from border countries, but are quickly stamped out.

Many countries in Asia still struggle with rabies. Depending on resources and commitment, the situation varies. In Thailand, for example, the government curbed human rabies by providing free anti-rabies vaccines to anyone exposed. Expensive, but effective, human rabies cases number only a dozen or so per year. In the Philippines, reductions in rabies suffering are anticipated with the passage of the “Anti-Rabies Act of 2007″ (Republic Act No. 9482).  This law commits to wiping out rabies by 2020 from those islands.  Hopefully it will occur sooner, and with more resources it certainly could. 

RFW is gearing up to support more dog vaccination projects in the Philippines through our click2vaccinate program.  Dispatching rabies from the Philippines remains our primary goal.  We have alot of work ahead of us!

Travelers to Malaysia should check out the CDC website and confer with a travel medicine specialist before their trip.

RW

Doctor Sunshine

My dad always wanted to be a doctor. He grew up, the eldest of three brothers, in upstate New York. His father worked in the factories of Rochester, his mother Coletta did her best to provide. She suffered from primary biliary cirrhosis, an autoimmune disease that slowly destroys the liver. My Dad recalled that she was always sick.

Joe delivered newspapers and studied hard in school. He was driven and lucky to be gifted. He received a scholarship to St. John Fisher college. Then, he applied to Harvard Medical School and by some small miracle was accepted. Before he could graduate, Coletta passed away from liver failure. I can only imagine how awful that must have been. It fueled my dad’s passion. He would try to heal what could not be healed.

My dad was the kind of person I think of as a ‘natural doctor’. He cared about his patients beyond ‘professional’ obligations. He was like family to them. He loved them. He wasn’t afraid. Once another doctor warned him that he shouldn’t drive his patients home from the hospital – ‘You might get sued!’ he exclaimed. My dad just smiled, knowing how impossible that was.

His patients, friends and colleges came to know him as ‘Doctor Sunshine’. He always had a ready smile. Everyone was equal – everyone had a name. From the janitor on the 4th floor, to the new radiology tech, to the E.R. nurse’s mom. For almost thirty years my dad took care of people in small town Connecticut. He was their doctor. That was my dad.

Cancer took him too early. I remember I first heard the news while traveling in the Philippines. He didn’t want me to come home, but to finish my work there at San Lazaro hospital. That was typical of my dad, he always put others first.

I had hoped one day to show my dad the Philippines. There was so much work to do, so many to take care of. He would have to see it through my eyes and hear it through my stories. The Philippines was such a far away place.

For some reason, my dad never had pain during the weeks his health declined. That was another miracle. As the cancer spread, he slipped into a long sleep without suffering.

It’s hard to believe it’s been five years already since he left. I know I’ve got big shoes to fill.

RW

“March Madness” - Rabies awareness month

Rabies.  The sound of the word sends a chill down
my spine. I have seen what this virus can do, and it’s very very frightening:  Hydrophobia, ‘foaming at the mouth’, psychotic screaming, savage agression, immunity to pain.  These are symptoms of a dark, terrifying Force - a Fury unleashed.

It astounds me to know that in this 21st century, such an ancient, Evil disease can flourish in so many parts of the world.  It truly is ’madness’.

Rabies is one of the ‘neglected’ diseases of our time.  It is 100% vaccine preventable, yet 100% fatal once symptoms are present.  No other infectious disease has such an unforgiving mortality rate.  Ebola, by comparison, carries at least a 10% chance of survival. 

Miracles do occur (see Jeanna Giese) but certainly not enough of them.  We need more miracles out there, especially for the 55,000+ people who die from rabies every year according to the World Health Organization (WHO).  The fear, the terror I’ve seen in children’s faces suffering from rabies haunts me.  I wish somebody would do something…

My first rabies mentor

When I first came to the Philippines, I was introduced to many of the doctors at San Lazaro Hospital.

My first rotation was with Dr. Camino. He must have been in this early fifties. He, like many Filipinos, was rather small. He sat behind a small old wooden desk, which was stacked with papers on each corner. He wore a wry smile and joked in Tagalog with the other doctors and patients which frequented his office. His office door would swing open, and a patient and family members would pour in, sometimes bearing gifts of sticky coconut cake or other ‘merienda’.

He wore a white polyester blazer and black polyester pants, with polished red-brown leather shoes. A stethescope hung over his shoulders, its chromium frame glinting under the fluorescent strip lights. The strong smell of nicotine washed over me as he laughed, all too perfect bright white teeth flashing behind a peppered mustache.

Dr. Camino had an infectious flamboyance, encouraging others to laugh at his silly jokes. He was a brilliant man, sharp of mind, but seeming unabsorbed with his genius. Laughing was his preoccupation. Caring for the patients on the ward seemed to be done automatically.

It was Dr. Camino that gave me the idea and the means to film the rabies patients I was seeing every week. I never even thought to bring a video camera on this rotation, but he lent me his – a solid Sony Hi-8 camcorder. I remember him telling me ‘They’ll never believe this’ – referring to the incredible disease manifestations of human rabies. He was right.