Situationer: An avoidable death
Naseem Salahuddin Published September 28, 2017
KARACHI: It was a usual Infectious Diseases Clinic that day: complex referrals, difficult diagnoses and frequent power shutdowns. Many patients in the waiting area had been waiting for over two hours and were becoming agitated and quarrelsome. In the midst of all this, I got a phone call from the Emergency Department (ED): "I have this 12-year-old boy with rabies. What should I tell the parents?"
"Oh God," I thought. "This is the most difficult of today's work."
I left the clinic with the feeling of apprehension that the word "rabies" always evokes in my mind. The boy's uncle who sensed the danger of his nephew's symptoms but wanted to confirm the diagnosis met me at the ED. "I have to see the boy first," I said.
On the stretcher was this handsome boy, alert and observant; his face was flushed and he was breathing with difficulty. Interns, nurses and doctors in training were around him. I took permission from the boy and his uncle to make a video clip of my conversation with him on my mobile phone. I asked his name and the circumstances of his illness. "My name is Umar. I am 12 years old and am a student of class six in Hyderabad." He spoke fluently, but in short sentences as he was breathing heavily and fast.
"I was playing in the park; there were many children there, may be 40 of them. A bitch suddenly came from, I don't know where, and started running around the park and it bit many kids."
"Where did she bite you?"
"I tried to run, but I fell and she bit me here and here and here and here …." He pointed to his hands, upper arm, and thighs. He then lifted his shirt to show wounds on his chest and back. Do you know this happened more than two months ago?"
"What did your father do then?"
"I don't have a father. My uncle took me to a hospital. They washed me up and gave injections in both my arms."
I then put to him an important question: "Did they inject anything into the wounds?"
Umar looked perplexed. "No, but I went back at least three more times to get the shots, and they said I would be safe."
"Are you thirsty? Would you like to drink some water?"
"I have not had food or water for two days now. I can't swallow. But I can try."
A nurse brought him some water in a cup. Umar took the cup, hesitated, and then attempted to drink the water. Immediately, he began to choke and the water regurgitated through his mouth. "Please, please, no more. Doctor, I am frightened, please help me get better. I haven't slept and I don't know what will happen to me." His eyes were wide with fear and he took deep, heavy and fast breaths.
I stroked his forehead and said: "Everything will be fine; just close your eyes and relax." He gave me a faint smile and said, "Doctor, please send me the video on my email. It's umar@gmail.com."
My heart could take it no more. Some young nurses lowered their moist eyes, while others simply walked away to hide their tears. I composed myself and spoke to the uncle about the futility of further care. We could only give him terminal comfort and care, with heavy sedation, so that he would suffer no more. His mother would just be left with her eight-year-old son. The uncle was prepared for the worst. That night Umar was dead.
No one recovers from rabies once its symptoms set in. Treatment of dog bite, if begun immediately and correctly, can prevent rabies. The first step is to scrub all wounds thoroughly with soap and water, apply antiseptic and head for a centre of excellence (which, unfortunately, are few in Pakistan).
The trained healthcare worker should carefully examine all wounds, and if deep enough to cause bleeding, he should infiltrate each and every wound with Rabies Immunoglobulin (RIG), which neutralises the virus at the site of the bite, and then follow with a schedule of vaccine. Umar's treatment fell short of the correct management and led to the agonising death of the sweet child.
I have seen rabies in persons of all ages, though mostly in children, and each death touches me deeply.
Today being World Rabies Day, we should remind ourselves that it is preventable, if treated early and correctly.
The only effective way of eliminating the deadly disease is by Mass Dog Vaccination. Dog population can be controlled effectively only by Animal Birth Control, and not by killing.
This is doable only with collaborative efforts at all levels of health services, and bolstered by philanthropists from civil society. We must put an end to this horrific disease.
The writer is an Infectious Diseases specialist
Published in Dawn, September 28th, 2017
January 'deadliest' month since July 2018, says report
General polls not possible before Oct, says minister
Fawad granted bail, warned against repeating remarks
so sad! feel bad for wishing that something like this would happen to someone who matters..
Sadia Zahid
Please can you enlist or mention the medical institutions who take proper care of such diseases...I have two children and reading this...it just breaks my heart, how non diligence of one can caused such pain to others.
Well said! "The only effective way of eliminating the deadly disease is by Mass Dog Vaccination. Dog population can be controlled effectively only by Animal Birth Control, and not by killing." I appreciate the writer's wisdom, and compassion towards Animals.
Waqas Muhammad
https://www.wired.com/2012/07/ff_rabies/
Asif Kahsmiri
RIP - very sad news
khanm
Situationer: An avoidable death.. it could have been avoided. if everyone does what he or she is entrusted with. lack of civic amenities, lack of competent and honest people is the biggest problem. we can still deal with the rabid dogs far easier than to deal with rabid people, we have in our society.. they don't care about anyone but themselves...Folks.. the bottom line is ... We have been stabbed in the back by those we thought we needed them most. We have been lied by those we have been trusting. We have been left alone like nothing matters ...but the end of the day we have to learn our lesson that we are the only one who could help ourselves.. there is going to be nobody there for us...
Preventable deaths in a society where corruption reigns supreme.The innocent suffer while the perpetrators of injustice parade around demanding attention
such a sad story, my heart bleeds :(
Mujeeb
I will request the writer to communicate with the doctor and check the other children who were being infected that day so that some lives can be saved and the hospital where this child was being given treatment should be given necessary medicines and training to doctors for handling such patients. There must be proactive measure taken asap.
Castration is the only viable and humane option
Rahil Kidwai
May Umar's soul rest in peace. This is so sad, We believe in Almighty and this is his will but still a young soul departing kills us inside.
This broke my heart. Rest in peace, Umar. I just sent you a kitty video on umar@gmail.com I know you can still access your email and will enjoy it. Love
Rabies is one of the worst diseases to die from.
Amin Daha
this is just too sad.
Is it possible to run a mass campaign. Can be done via social media to spread awareness how to deal with a dog bite. Atleast people will know what to do. It's so heartbreaking to read this .
I was bite by a dog 10 years back. The hospital staff injected some vaccines not on my wounds.
Bikram
I couldn't bear this story of 12 years old Pakistani child, how people talk about an atomic war?
baldev
Very sad. Heart goes out to the lady who lost her young son to rabies. Extremely sad indeed. May Almighty bless his soul to rest in peace
Pakistan fastest growing apps market worldwide in 2022: report
Anchorperson Imran Riaz arrested for 'hate speech' against state institutions: FIA