KARACHI: Reacting to a recent statement of the Sindh health minister in the provincial assembly in which she favoured culling as a method to control population of stray dogs and prevent deaths from rabies, experts on Saturday shared that the remarks reflected absolute confusion on part of the government as it had already released huge sums for vaccinating and neutering dogs under its rabies control programme.

The statement, they said, also demonstrated that government officials didn’t understand the whole dynamics of the problem as it’s not just a matter of uncontrolled population of the animal but also pertained to an acute lack of training of doctors handling cases of dog bites.

The media reports suggested, they pointed out, that a significant number of dog-bite patients across the province were contracting the deadly infection despite getting treatment at government hospitals including the Civil Hospital Karachi (CHK).

Experts say dog culling should be carried out as per WHO recommendations and not as a permanent strategy

“We want to ask why innocent people are dying of rabies if proper treatment is available at government hospitals. The fact is that doctors handling such cases don’t have the required training,” said Dr Mirza Ali Azhar, president of Pakistan Medical Association-Sindh chapter.

He added that media reports suggested that doctors particularly in rural Sindh weren’t even diagnosing patients with rabies.

He emphasised that it’s the state responsibility to train doctors and provide them with adequate doses of anti-rabies vaccines and rabies immunoglobulin, a life-saving medicine needed in cases of deep dog-bite wounds.

Govt should opt for one-time dog culling

About how to tackle the recent surge in dog population, he said that the government should opt for one-time culling of stray dogs but it shouldn’t be used as a permanent strategy.

“The government must put in place a system to vaccinate and neuter stray dogs, as is being done in the rest of the world, once their population comes under control through culling.

“Second, it’s prolonged official indifference towards civic issues that has led to an increase in dog population to an extent that the poor animal has now become a threat to human life and there is no sympathy for it except hate in the community,” he said.

Studies, he said, had linked the increase in dog population to heaps of solid waste and how efficient the government was in waste management is no secret.

Advocate Tariq Mansoor, who is pursuing a public-interest litigation against the government over its failure in preventing deaths from rabies and controlling dog population since 2019, criticised what he described as indecisiveness and confusion on part of the government.

Call for training in dog-bite case management

Sharing her comments, Dr Naseem Salahuddin, senior infectious diseases expert at the Indus Hospital where she also heads the Rabies Free Pakistan Project, regretted a persistent delay on part of the government to tackle the issue that had claimed so many lives over the years.

“I personally went to the health minister’s office two years back and presented a plan to train doctors for dog-bite case management and control dog population. But, there has been no response from the government,” she said.

The Jinnah Postgraduate Medical Centre, the National Institute of Child Health and the Indus Hospital equipped with trained staff and having required medicines had been running dog-bite prevention clinics for many years successfully, she added.

“The government needs to think why patients are dying of rabies despite seeing a general practitioner or getting treatment at public sector hospitals including Civil Hospital Karachi. This is happening because the medical staff haven’t been trained in dog-bite case management and non-availability of rabies immunoglobulin at government hospitals,” she said.

On dog population control, she said one should understand the difference between mass killing and culling.

“Contrary to mass killing, which is indiscriminate, culling is selective and targets only diseased animals. We only endorse this method as recommended by the WHO.”

She called for public awareness on how to manage an injury after a dog bite and vaccination in the dog population to eliminate virus transmission.

“The public should be told to wash the wound thoroughly for 15 minutes with soap at home before medical help is sought. This crucial first step significantly reduces chances of rabies.”

Utilisation of Rs350m fund questioned

“Why the rabies control programme was launched if the government wanted to cull all dogs? Second, the government has already released a sum of Rs350 million out of the Rs1.25 billion amount allocated for the programme that was launched on the court’s intervention. One wants to know where that amount was utilized,” Mr Mansoor said, adding that one major hitch in setting up a mechanism for controlling dog population was absence of bye-laws on this subject.

“The government hasn’t formulated bye-laws on how to control the population of stray animals for the past eight years under the Sindh Local Government Act, 2013. On the court’s intervention again, a draft of the bye-laws has been submitted finally this year but it hasn’t been notified,” he said.

The bye-laws were important to assign responsibilities at the union and taluka level to government officials and make them accountable, he emphasised.

Advocate Mansoor, who is a human rights activist and member of the International Bar Association Human Rights Committee, UK, also mentioned that the helpline specifically launched for dog-bite complaints on court’s orders had been turned into a facility for general complaints by the government.

Published in Dawn, May 30th, 2021