ISLAMABAD: Twin cities residents who have been bitten by dogs are only being provided one-time rabies vaccine injections by public sectors hospitals instead of a full course amid an alleged shortage of the vaccine.

Public sector hospitals in Islamabad have been administering a single injection to dog bite victims, telling them to buy the rest themselves from the market where the vaccine is not available either.

The Ministry of National Health Services (NHS) said there was no shortage of the rabies vaccine in Islamabad’s public sector hospitals. Rawalpindi Medical University Vice Chancellor Dr Mohammad Umer said the rabies vaccine was being provided to patients according to the provincial health department’s standard operating procedure.

Omair Badar told Dawn that his two-year-old son Badarur Rehan was bitten by a dog in G-15 Markaz on Nov 19.

“I took him to the Pakistan Institute of Medical Sciences (Pims), where he received a free injection. But the staff told me they were only allowed to administer one dose, and I should arrange the second from the market,” he said.

Residents of twin cities claim hospitals are only providing single dose and telling victims to buy the rest themselves; officials deny shortage of vaccine

“I went to a pharmacy to buy a dose of the vaccine on Thursday but I was told it was not available. I went to a number of medical stores and got the same response. I used all of my sources to get the medicine and a private hospital finally agreed to arrange the vaccine through a reference.

“I was told I would have to pay a registration fee of more than Rs500, and then I would be able to buy the vaccine for more than Rs800 for a single dose,” Mr Badar said.

Mohammad Arshad, who lives on Rawalpindi’s Chaudhry Bostan Khan Road, said his daughter was bitten by a stray dog on her way home from college. He said there were groups of stray dogs roaming around the area.

“My neighbour’s son was also bitten by stray dogs at night,” he said.

Mr Arshad said the rabies vaccine was not available in the open market while Benazir Bhutto Hospital only provided one dose. He said they bought the vaccine from Bohar Bazaar for Rs900.

Arya Mohallah resident Majid Khan was bitten by a dog while he was at the mosque for morning prayers. He went to the District Headquarters Hospital, where they vaccinated him immediately and asked him to buy another dose on the open market after three days.

But the vaccine was not available in the market, Mr Khan said. He managed to buy some from a wholesale dealer in Bohar Bazaar, who charged extra for it.

According to Khayaban-i-Sir Syed resident Sajid Raza, local residents have complained to the Rawalpindi Metropolitan Corporation, who turned a blind eye to the issue. Mr Raza said it was strange that the civic body was not controlling stray dogs while hospitals had a vaccine shortage.

In developed countries, stray dogs are vaccinated and neutered. In Pakistan, poison is used to kill dogs which leads not only to a painful death for the animals but also affects the environment. Poisoned animals seek out water after they have been poisoned because their thirst increases, and if they die in the water marine life is affected as well.

The rabies vaccine disappeared from the market almost a year ago, Furqan Raza, who runs a medical store in Islamabad, told Dawn. He said the vaccine used to be available in the market; medical scores would buy it for Rs300 and sell it for Rs500.

“Now it is only available in public sector hospitals. The private sector has stopped selling it due to a price issue with the Drug Regulatory Authority of Pakistan (Drap), or some dealers sell it on the black market,” he claimed.

Young Doctors Association (YDA) Rawalpindi chapter president Dr Rana Azeem claimed that the provincial government had not provided hospitals with a sufficient amount of the vaccine, which was why doctors provided a single dose.

However, Drap CEO Dr Asim Rauf said as far as he knew the vaccine was available in the market.

“But I will look into the issue and take it up with a committee that deals with unavailable medicines and has representation from the Pharma Bureau, Pakistan Pharmaceutical Manufacturers Association and other stakeholders,” he said.

Dr Rauf said the rabies vaccine was manufactured at the National Institute of Health (NIH) and imported from China and India.

NHS Secretary Dr Allah Bakhsh Malik said 212,000 doses were produced at the NIH in a year.

“Punjab gave the largest order, 150,000 doses, and paid in advance. So the doses were supplied to Punjab and the rest to the other provinces,” he said.

Dr Malik said a single dose of the rabies vaccine was required in most dog-bite cases and additional doses were provided to patients in some cases.

However, University of Health Sciences Vice Chancellor Dr Javed Akram said depending on the circumstances of the dog bite, the victim can require five to seven doses of the vaccine.

RMU Vice Chancellor Dr Umer said the rabies vaccine was purchased from the NIH and all three government hospitals had enough stock according to the SOPs issued by the Punjab government.

Hospitals have been asked to vaccinate all those in need immediately and not to delay the vaccination, he said, adding there were fewer dog and snake bite cases in Rawalpindi compared to other parts of the province.

He said hospitals do not refer cases to private clinics or ask them to bring medicines from outside.

Published in Dawn, November 22nd, 2019