The Bohol Rabies Prevention and Elimination Project
Rabies is a fatal disease that is easily preventable. Yet, it still poses a significant public health problem in many countries in Asia and Africa. More than 99% of all global human rabies deaths occur as a result of being exposed to infected dogs.
In the Philippines, about 250 people die each year due to rabies because victims failed to seek immediate treatment or vaccination. About ten of those who die are reported in Bohol, which made the province rank 4th among the top ten provinces in the country for human rabies deaths. To correct the situation, the provincial LGU of Bohol developed its Rabies Prevention and Elimination Program (BRPEP) in March 2007, with the goal of eliminating rabies cases in the province by 2010.
Institutionalized through an ordinance, the BRPEP initially involved 124 government employees from the provincial down to the barangay level, who spearheaded a massive information drive. To hasten program implementation, community participation was enlisted in carrying out various aspects of the program. And to help defray the high program costs, the LGU developed partnerships with private sector organizations.
The results were dramatic. In the first half of 2008, the number of human rabies deaths decreased by 50%. More importantly, there have been no reports of death by rabies since October 8, 2008.
A Knowledge, Attitude, Practices (KAP) survey in 2009 revealed that 94% of local people already knew about rabies, 61% had knowledge about rabies transmission, and 89% were aware of the rabies elimination program. More people were also seeking medical assistance for dog bites. The number of potential rabies carriers was also reduced by 24% as the dog population in Bohol decreased from 100,572 in 2007 to 76,407 in 2009 as reflected in the barangay master list of dogs. About 70% of the dog population was also registered and vaccinated within that period.
Bohol’s LGU attributes the successful program implementation to the collaboration and cooperation of various stakeholders. Community participation was deemed crucial in various aspects of the program namely, dog population control, mass dog vaccination, dog bite management, veterinary quarantine, surveillance and monitoring.
At the provincial level, the program is managed by the Bohol Rabies Prevention and Eradication Council, which is chaired by the provincial governor and whose members represent various sectors and agencies. This multi-sectoral composition of the council is mirrored at the municipal (the Municipal Rabies Prevention and Elimination Council or MRPEC) and barangay (Bantay Rabies sa Barangay or BRB) levels.
The BRB organized Barangay Rabies Elimination Task Forces that compiled a master list of dogs and dog owners through house-to-house surveys and arranged mass vaccination in their areas. It was the responsibility of the BRBs to secure the registration of dogs, collect fees and facilitate the sharing of the collected fees with the provincial and municipal LGUs. They also helped settle disputes arising from dog bite incidents or other violations of the program.
Today, there are more than 15,000 people actively involved in implementing the program. The bulk are made up of community volunteers and teachers. Various organizations such as the Bohol Tri-Media Association and different government agencies such as the Department of Health and the Department of Education continue to work in concert to implement the program. This cooperation has effectively transformed the awareness campaign on rabies prevention and elimination from a government-led to a community or people-led program. The Philippine National Rabies Awareness Month in March and the World Rabies Day on September 28 are regularly observed by the province to continually remind people about the importance of eliminating rabies in Bohol.
Bohol has since become one of the first provinces in the country to integrate lessons on rabies and responsible pet ownership in the curriculum of all its elementary schools. Given that 25 percent of the rabies fatalities have been children below the age of 15, this innovation is very effective at increasing awareness on rabies prevention, especially among school-aged children. This also helps inculcate responsible pet ownership for the next generation.
International recognition of Bohol’s success is now evident as the provincial government has also been invited to share its experience in rabies elimination to an international audience. The LGU sent its program manager to present the program during the International Conference on Rabies in Vietnam in September 2009, in Indonesia in March 2010, and in Mexico in October 2010 during the 21st Conference on Rabies.
The Global Alliance of Rabies Control is helping replicate the Bohol Program in the Bicol Region and Palawan. Last July, international rabies experts met in Bohol to learn from the province’s experience and to explore the possibility of replication in other countries with high incidence of rabies.
Transforming the public’s attitude and cultural practices towards responsible pet ownership is perhaps Bohol’s longest lasting contribution to the global campaign to eliminate rabies. With rabies elimination and responsible pet ownership integrated into the public elementary school curriculum, the younger generation will surely grow up to be more aware about responsible pet ownership and help eradicate the disease altogether.