During my second year of MSc studies, I was introduced to the "Zero by 30" campaign to eradicate canine rabies worldwide. As part of this effort, the United States Centers for Disease Control and Prevention (CDC) is currently supporting an intensive mass vaccination campaign for dogs in Haiti. I was fortunate enough to meet with Dr Ryan Wallace, a CDC epidemiologist, at a conference in the summer of 2017. Dr Wallace suggested a collaborative study investigating dog bite injury to vaccination workers in Haiti that could fulfil the dissertation portion of my masters degree. Although the majority of my dissertation work was survey preparation and data analysis, I was keen to also visit the study area to observe the vaccination campaign and get a better perspective on the issues involved. Haiti is a beautiful yet highly impoverished Caribbean island nation that is struggling to rise above the oppression of colonialism and political strife. Its location also makes it tragically prone to natural disasters (earthquakes and tropical storms). While the Dominican Republic (the country that Haiti shares an island with) has achieved good canine rabies control, it is estimated that rabies still causes up to 130 human, and 18% of canine deaths each year in Haiti. International assistance is proving invaluable in working towards rabies eradication in dogs within the envisioned timeframe. Thanks in part to a small travel bursary from the Deanery of Biomedical Sciences, I flew to Haiti in March 2018 to observe the mass vaccination campaign in progress. I spent 3 days with the vaccination workers in both city (Port au Prince) and rural (Le Sud department) settings. Image Preparing for the day's vaccination efforts at the Department of Agriculture, Le Sud branch. Image On the road, heading to the day's designated vaccination area. Working as a vaccination worker is a relatively physical endeavour. On the day I spent with a vaccination team around Les Cayes in Le Sud department, we walked around 6 miles, in high temperatures and over rugged terrain. Much of Haiti shares this mountainous topography. Image Landscape typical of Le Sud department. Most dogs in Haiti are "loosely owned", meaning they are owned but roam relatively freely around their owner's property, and are not regularly handled. Issues encountered by vaccination workers include the dangers of restraining and vaccinating this type of dog, a general lack of safety equipment, long distances between dog-owning properties, and reluctance of dog owners to participate in government-led campaigns. Image Dog owners collecting and restraining their animals for rabies vaccination by workers. Image Rudy Kirkhope While in Haiti, I was also able to visit with some of the key individuals responsible for implementing the vaccination project from the Haitian department of agriculture (MARNDR). I learned about dog vaccination efforts prior to CDC involvement, protocols for pre-exposure prophylactic rabies vaccination of workers, and the organisational structure of government-led veterinary services. Preparation of my written survey, and translation of the survey into the Creole language was enabled by direct input from these individuals. At the conclusion of my visit I had made some valuable contacts, and felt more informed and confident in my ability to write knowledgeably about mass canine rabies vaccination from a Haitian perspective. At the time of writing, my study has found a significant increase in likelihood of experiencing a dog bite in a certain population of vaccination workers, and we are currently investigating this trend for causative factors and potential remedial measures. Many thanks go to Dr Ewan MacLeod and the University of Edinburgh Biomedical Teaching Organisation for their assistance in organising this trip, Dr Ryan Wallace for facilitating contact with the Haitian ground team, and to Dr Kelly Crowdis, Dr Pierre Dillius, Rosedanie Cadet and Frantzlet Estime for their hospitality, travel assistance and insight during my visit. This article was published on 2024-08-05
