Today Bali faces a new threat, one that presents a clear and present danger to the health of its population and its economic well-being. That threat is rabies, a disease that is easily treatable but invariably fatal to humans once symptoms occur. Unless the disease is eradicated or quickly contained, the problem may quickly spin out of control with severe economic consequences. None more so than for the travel industry. It is perhaps time then, that leaders from tourism and others in the private sector step up to the plate to assist government and NGOs in their efforts to combat the disease.
Quite apart from educating people about the disease (most importantly to complete the post-bite vaccination course) we need to make up our collective mind to one overriding fact - Bali needs to regain its Rabies Free status as soon as possible. Anything less than the total eradication of rabies, which is both practically, humanely and financially relatively easy to achieve, is a potential disaster waiting to happen. Without being cynical, lesser options, meaning containment and a low death count, may be an acceptable if imperfect solution for the powers that be elsewhere in Indonesia, but it should not be in Bali. Before God, their families and all people of goodwill an Indonesian life has the exactly the same value as a tourist’s. We would be deluding ourselves, however, if we believed economics does not enter into it. Sooner or later tourists are going to be bitten by rabid dogs or monkeys, and some of them will die back in their own countries. When that day comes, in let us say Australia or Japan, what do you think will happen? It will be open season on Bali, which already faces considerable challenges, as a tourist destination, in the national press of those countries, as well as hot news throughout the international travel trade press. New and specific rabies advisory warnings will result.
Bali cannot afford to let that happen. That is why government, animal welfare NGOs and the private sector, particularly the travel industry, need to act in concert to do whatever it takes to make Bali rabies free again. Much is already being done by way of mitigation, some of it to good effect, but for Bali to be officially declared rabies free in 3 years, which is what it takes, the correct steps need to taken now.
And that means the vaccination of three quarters of the entire dog population in Bali. Nothing less will eradicate the disease.
Once that decision has been taken and the political will clearly demonstrated, then Bali will find much, if not all, the expertise and financial support to do the job from the WHO and other international sources.
In November 2008 rabies came to Bali for the first time and in the five months since the first case was diagnosed from dog bite in South Kuta in the Badung regency nine people have died from the disease, which has already spread as far afield as Denpasar. The provincial and various local authorities have acted to restrict the spread of the disease and further deaths in the manner local authorities have traditionally adopted elsewhere, which is primarily killing dogs, vaccinating some of them, stocking human anti-rabies vaccines, and seeking to enforce existing by-laws restricting dog importation and domestic transportation. Further by-laws and education programs are in the offing governing the control and restriction of dogs by owners, who can face legal sanction if they ignore the new rules.
The problem with such an approach is that it does not work and has never done so, according to the World Heath Organisation and other international health authorities.
Killing an entire dog population might work in theory, but it is not an option. It is an impossible task and has never ever been achieved, anywhere. The only thing known to have worked is the mass vaccination of at least 70% of a dog population with a modern vaccine effective over a 12-month period and repeated for a further two years. Even more effective and economic are 3-year vaccines. The vaccine currently in use in Bali I’m told, is effective for three months only. All other methods serve as mitigation only and will, make no mistake, mean rabies is in Bali to stay. Are we really on for that?
The truth of this hard fact is demonstrated most clearly throughout South America, where human deaths from rabies have now been effectively eliminated through mass vaccination programs. In India and Africa (the countries where rabies is most prevalent), in Vietnam, Thailand, the Philippines and China, cases and deaths from rabies still occur. As for Indonesia, it has a rabies problem that straddles the archipelago. In West Sumatra ten people died from the disease last year with three already dead by this February, nearly 200 rabid animals were destroyed in a wealthy residential district of Jakarta last month, six people died recently in Sulawesi, with recent deaths reported also in Kalimantan, the Moluccas and East Nusa Tenggara, most notably Flores, where 165 people have died over the past decade.
In fact Flores, an island in the same latitudes as Bali, is an excellent example how anything less than mass vaccination won’t work. In East Flores over 10 years they killed 70% of an estimated 600,000 dogs. They still have people dying from rabies, which has since spread throughout the island. In the period 1998 -2009 165 people died from rabies, six of them last year. The Flores provincial government elected to follow exactly the approach that is now being adopted here in Bali. The course of the rabies epidemic 1998-2004 has been documented by the WHO, who advised all along that a major vaccination of the majority of dogs was the only thing that would work. Despite this, the authorities chose to follow an incremental program of massive dog culls and spot vaccinations in the hope they could contain the problem. It didn’t. Rabies is now endemic to the entire island and people continue to die there to this day.
There is one chilling statistic to consider, where Flores differs markedly from Bali. Last year almost 2 million overseas visitors came to Bali. I don’t know what the comparative figure was for Flores, but in 2007 just 2,800 tourists visited East Nusa Tenggara province, which includes Sumba and West Timor. Bali has a dog population variously reported being somewhere between 400,000 to 600,000, a resident population of some 3.1 million people, plus the 2 million odd visitors.
Flores comprises a territory of 14,300 sq. km and a population of 1.5 million. With one third the size, well over twice the population and a similar size of dog population, you figure it out. It does not bode well.
Clearly the message about mass vaccination needs to be got across fast and the necessary action taken by government and relevant sections of the community to do whatever it takes for that to happen. The cost is an estimated US$3.0m, considerably less than the cost of one hotel development in an island that already has too many.
At the moment the only people who seem to be taking this aboard are local animal welfare organisations, such as BAWA. These folk are not just fluffy dog lovers. They know a thing or two about dogs and rabies. In touch with the WHO and other international organisations, they are an invaluable resource for Bali in attracting necessary funding and expertise. And, let’s be clear here, these are not people who are against killing dogs to protect the community. Objecting to the sight of dogs being agonisingly and unnecessarily killed by strychnine or bludgeoned to death (nobody wants to see that, least of all tourists), does not negate the essential point re. mass vaccination. These NGOs understand why indiscriminate killing of what may broadly be termed “owned” dogs, is NOT a good idea. Wild, possibly rabid dogs, precisely the ones who are hard to catch and kill, will simply move into the territories vacated by non-rabid and/or vaccinated dogs that have been destroyed.
It is well known that dogs quickly repopulate to the level the habitat supports. Another question NGOs have is, why it’s currently illegal to vaccinate dogs in areas outside infected areas? Bali dogs also perform many useful services, not least killing rats, the ones too big for kitty. What the NGOs and the WHO are telling us is, it makes no sense to try to kill all or cull healthy dogs, when it only leads to more, not less rabies. Knowing this and killing healthy dogs for political expedience is simply wrong on any count.
Surely the smart thing to do is for everyone to sit down now, establish the facts about mass vaccination beyond all doubt and go about seeing how the money can be raised to regain Bali’s Rabies Free status?
