Powerless to save lives

Doctors dedicate themselves to one thing: saving lives.

They undergo years of study and training to be able to treat and care for their patients. And in most instance, they have the power to give people the best life possible. But when facing a victim of rabies, they're utterly powerless.

Rabies is completely vaccine-preventable, but it still kills a child around the world every 22 minutes. And there's nothing medical practitioners can do about it. Because once the child is symptomatic – even just the slight tingling of the hands or disorientation – death is inevitable.

Tupechele, a three-year-old girl from Malawi, one was one of those children.

Powerless to save lives
Queen Elizabeth Hospital in Blantyre

Her grandmother was in the house when the young girl came running in shouting, "Grandma, a dog has bitten me." They didn't know it at the time, but that young dog was rabid.

Tupechele's family helped calm her down, and then cleaned and bandaged the wound with what little they had. But for an infected bite wound, this wasn't enough.

Sometime later, Tupechele's behaviour started to change. She was irritable and unhappy, acting nothing like the young village girl everyone doted on. When she started to refuse food and had difficulty swallowing water, her parents grew concerned and took her to the hospital.

Dr Neil Kennedy examined Tupechele at the Queen Elizabeth Hospital in Blantyre, an institution that recorded the highest number of child rabies deaths from any single institution across the whole of Africa in 2012. Working here, he was no stranger to rabies – and the unimaginable suffering it brought upon young people.

When Tupechele was first admitted, she didn't even seem that unwell. But as the family explained what had happened, along with her symptoms, Dr Kennedy knew it was more serious than it appeared. He tested Tupechele by blowing gently in her face. She startled and grimaced in a way that people do with rabies, and Dr Kennedy's heart sank. All of Tupechele's changes in behaviour were symptoms of rabies; restlessness, sensitivity and fear of water and fresh air. It meant certain death for the three-year-old.

Doctors like Dr Kennedy see both adults and children die all the time, and it's always distressing. But it's even more so when the cause is entirely preventable. Vaccinating dogs and administered post-exposure vaccines to people who've been bitten, can save both people and animals from rabies. However, in places like Malawi, both are lacking, resulting in children Tupechele dying unnecessarily – by one of the worst deaths imaginable.

In the hospital ward, the team made young Tupechele as comfortable as possible, but the disease quickly took over her tiny body. In the end, she was agitated, combative, and gasping for air. Her brain activity had deteriorated, and within three days, she was dead.

Doctors do all they can, but they are often powerless to save patients from the oldest and deadliest virus on the planet. But we can stop children ever being infected by rabies, removing this terrible burden from doctors and communities.

Dr Kennedy

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