Rabies kills but can be controlled

"As we talk now, we have one classical case of rabies (in the ward). Unfortunately, we cannot save the life of this young lady at this stage" said a health worker from a health unit in Kotido on June 4, 2015. This statement has nothing to do with the competence of the professionals but all to do with the nature of the disease and its prevention measures. The health worker was briefing a multidisciplinary and multinational team of professionals (veterinary and biomedical laboratory) from Tanzania, Kenya, Rwanda, Ethiopia, Uganda and the United States of America. They were on a study trip in Karamoja, among other places, to understand animal production systems, animal diseases, zoonoses (diseases that affect both humans and animals) and their impact on community livelihoods.

Rabies, a viral disease that affects both animals and humans, is a killer disease that has unfortunately received insufficient attention globally. It reportedly kills up to 55,000 humans every year (one person every ten minutes) in Africa and Asia alone where 95% of the cases occur! Uganda contributes to this statistic although we believe that due to poor reporting, misdiagnosis and other challenges, the entire magnitude of the burden is not documented.

Rabies is largely transmitted to humans through dog bites and kills mainly children in the rural areas of the country due to various reasons. Children tend to interact with the dogs more closely than adults and are also prone to attack due to their naivety and failure to flee quickly from dangerous dogs. Rabies is sadly 100% fatal when clinical signs show - the disease is irreversible by any known human intervention once clinical signs of the disease show. Usually at this stage the virus has found its way to the brain initially entering through the nerves at the bite wound. However, if a bitten person accesses post-exposure treatment soon after being bitten, the virus is arrested before it advances far from the point of entry hence significantly increasing the chances of survival.

In Kotido, up to twenty (20) dog bite cases have been reportedly seen in one day! This is alarming but the consolation is that not all dogs that bite humans are rabid. The good news about this killer disease is that it is controllable through a multifaceted intervention approaches: vaccination of dogs and cats, population control of stray dogs and cats, and community education. A responsible member of the community should therefore contact their area veterinarian for guidance on when to vaccinate theirs and other dogs in the community. All humans at risk should also be vaccinated and given boosters regularly e.g. veterinary professionals; animal handlers in security organisations, zoos, animal clinics and veterinary and animal science students.

Community members should also report any animals behaving unusually to the nearest animal health worker for checking and follow-up. When bitten by a suspected rabid animal or indeed by any dog or cat, one is advised to get as much information as possible about the animal and its vaccination record and volunteer it to the authorities or animal and human health workers. They should also clean the wound with clean water and soap or antiseptic besides other first aid measures and immediately report to the nearest health unit for appropriate medical attention. Obtaining animal vaccination record is important for guiding the medical worker's choice of treatment protocol so as to save the life of a dog bite victim. Such information is also useful to support the veterinarian’s follow-up protocol for the dog in question.

The embarrassing thing about Rabies is that it can be controlled and yet it still ranks high on the list of globally neglected killer zoonotic diseases! It is known that controlling it at the animal level eliminates cases in humans.

This article was published in the New Vision Newspaper of 8th July 2015.

Professionals are often a forgotten and neglected constituency in a national electoral campaigns

As Presidential, Parliamentary and Local Council campaigns get heated in Uganda, the nature of campaign promises progressively exposes the little attention given to issues concerning the reliable and faithful professional workforce. Candidates do not seem to remember that these professionals who run most of government (local and central) and private sector technical programmes also have unique professional needs that ought to be attended to. They have votes too; and they can influence a few more. They need an enabling environment; appropriate and sufficient resources to work with and easy access to reliable ICT support facilities. These would empower them to “do their thing” as the leaders harness credit and political mileage for the guaranteed resultant positive achievements.

The required environment should be composed of, among others, good regulatory frameworks and associated enforcement strategies. Professions world over are regulated. A person should go through a given form of initial training and subsequent periodic re-training (continuous professional development) to acquire and maintain specific knowledge and skills sets, and must practice within specified ethical bounds in order to qualify to be categorized as a member of a profession. The mandate and guidelines for regulation of professional practice, including composition of the body of regulators, is usually defined in an Act of Parliament. Such laws must be kept up to date to match needs of the era and for global compliance. Membership to professional regulatory bodies should therefore be appropriately constituted and must be given independence to do their work within defined professional and legal bounds without unnecessary interference. Such interference happens either directly through refusal to appoint; meddling with and into the affairs of the regulatory bodies or indirectly through appointing incompetent people into the regulatory authority. Furthermore, deliberate unnecessary delays in the processes of reviewing and updating the related (parent) law passes for negative interference.

Professional regulatory authorities are intended to and will usually protect the consumers of professional services and associated goods from being duped to settle for less or fake services from dishonest professionals and masqueraders (quacks). This way, they would avoid suffering great losses through paying for services that would not meet their demands and moreover could result in horrible consequences! Failure of government to provide an appropriate and supportive environment or empowerment of these regulatory bodies and the professionals to excel is, subtle though it is, very harmful to medium and long term national development agenda. As part of the regulatory legal framework, all other laws governing and guiding practice in the trade of a given profession also ought to be updated regularly and effectively enforced.

The professional, whether in public or private sector, should be appropriately supported, protected and facilitated to carryout their technical functions. These could be provided through, among others, commensurate remuneration; reliable, easy to access ICT services; appropriate technical equipment; adequate staffing; respect of professional opinion and support for continuous professional development. Professionals are extremely useful in guiding policy direction, budgetary prioritisation and implementation strategies of government and private sector plans if appropriately involved. It is therefore my considered opinion that every professional regulatory body should be supported to create a think tank arm that will periodically provide evidence-based, professionally-crafted guidance to government and the public on local, regional and global matters related to their profession. Such a team could also propose and/or vet special national awards to professionals thus eliminating politically influenced, non-professional and undeserved praises.

A national leadership that will work to promote the professionals and support them to be high global performers will surely experience a high quality service delivery and a positive trade balance, as direct contributions by the professionals. Such leaders would most likely cover good grounds towards delivering the promises made in their campaign manifestos.

This piece was published in the opinion column of the New Vision Newspaper of Wednesday 3 February 2016 under the title, “Professionals are a forgotten and neglected constituency”. Ugandans will go to the polls on 18 February 2016 to elect a President and Members of Parliament. On 24 February 2016 they will elect the local council leaders.