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Mission Rabies Tanzania 13th to 24th January 2018 Contents Page Background…………………………………………………………………………………………………………………………. 2 Partnership and staffing….…………………………………………………………………………………………………… 3 Location………………………………………………………………………………………………………………………………. 3 Program………………………………………………………………………………………………………………………………. 4 Data…………………………………………………………………………………………………………………………………….. 6 Experiences on the ground………………………………………………………………………………………………….. 8 Health and Safety………………………………………………………………………………………………………………… 11 International guests…………………………………………………………………………………………………………….. 12 Financials…………………………………………………………………………………………………………………………….. 13 Future work…………………………………………………………………………………………………………………………. 14 References………………………………………………………………………………………………………………………….. 1 Background Rabies is one of the deadliest viruses in the world, with an estimated 59,000 human deaths each year 1. Despite this it is 100% preventable through vaccination. As over 98% of human rabies cases are a result of exposure through dog bites2 vaccinating dogs against rabies will significantly reduce the number of human rabies deaths. Vaccinating at least 70% of the canine population creates herd immunity against rabies and effectively eliminates it from the canine population3; this has a knock on effect improving the welfare of both dogs and people. Mission Rabies was set up in 2012 to help eliminate canine rabies from the world. With support from several organisations including the Dogs Trust, MSD, the Marchig Trust and Worldwide Veterinary Services it is hoped that this goal can be achieved by 2030. After the success and great results from working in India since 2013 Mission Rabies has expanded its work to other parts of Asia and Africa. Mission Rabies conducts yearlong vaccination campaigns in Goa, India; Ranchi, India; and Blantyre, Malawi. There are smaller campaigns in Zomba and Chiradzulu, Malawi and annual vaccination campaigns in TanZania, Uganda and Sri Lanka. In January 2016 the first Mission Rabies – Mbwa wa Africa partnered vaccination drive was conducted in regions within Meru District, TanZania. Initially 2 wards within Meru District were covered during a 2 week pilot vaccination campaign in Maji ya Chai and Usa River. This drive was repeated in 2017 and included an additional ward, Songoro. During the remainder of 2016 Mbwa wa Africa continued vaccinating following the Mission Rabies protocol within Meru District covering 3 additional wards, Nkoaranga, Nkoanekoli and Kin’gori. The 2017 campaign was opened up to International Guests (volunteers). This report details the 2017 vaccination campaign. Mission Rabies employs four concepts in its work to reduce human rabies cases 1) Mass Canine Vaccination, targeting at least 70% of the dog population 2) Humane Canine Population Control 3) Community Rabies Education and Awareness 4) Canine Rabies Surveillance Prior to and during the vaccination drive, Maureen from Mbwa wa Africa went into local schools to educate children about rabies and to encourage participation in the vaccination campaign. The education work is not detailed in this report. Mbwa wa Africa, in partnership with WVS, ran a spay- neuter campaign alongside the vaccination campaign as well as treating sick and injured dogs highlighted by the Mission Rabies vaccination teams. Since the first vaccination drive there was one suspected rabid dog in an unvaccinated ward in Meru District only and there are reports of human rabies vaccine sales drastically reducing in the locale. The Mission Rabies core staff responded to a suspected rabid dog at Nkoaranga hospital during the vaccination drive. This was on the edge of our Songoro vaccination Zone, an area covered by Mbwa wa Africa in their July campaign. Unfortunately after 3 visits to the hospital, he dog was unable to be captured for quarantine and observation and was not reported to have been re-sighted by hospital staff. 2 Partnerships and Staffing Mission Rabies has partnered with Mbwa wa Africa to work in several wards in Meru District, TanZania, where Mbwa wa Africa are based. Mbwa wa Africa was established by Jens Fissenebert and Sandra Kliegelhoefer in 2013, initially providing animal adoption, veterinary care and preventive care to animals in the region. In 2015 Mbwa wa Africa expanded into spay-neuter clinics, initially with the help of WVS, before partnering with Mission Rabies in mass vaccination campaigns. A pilot vaccination campaign was held in January 2016 to demonstrate the effectiveness of Mission Rabies’ working protocols and to how effective these would be in TanZania. A total of 3,924 dogs were vaccinated over 11days of static point and mobile door-to-door vaccinations. This was estimated to be approximately 68% of the canine population in these regions. In 2017, Maji ya Chai and Usa River regions were vaccinated for the second time with an additional ward added in Songoro. The total vaccination count was 4575 over 11 working days. Mbwa wa Africa undertook most of the in country preparatory work for the 2018 vaccination campaign, under the guidance of the Mission Rabies team in the UK. Local TanZanian volunteers were recruited to be part of the vaccination drive in addition to 2 Mission Rabies staff members, the Mbwa wa Africa coordinator and 10 international Mission Rabies volunteers. Location Vaccinations took place in 3 of the 17 wards of Meru District, which is close to the city of Arusha. Arusha is a tourist destination between Mt Kilimanjaro and several National Parks, including Serengeti and Ngorongoro crater. This area was selected as a result of a human rabies death in 2015 and several suspected canine rabies cases around the same time. 3 Image 1. TanZania 1a, Location of Meru Disrict in TanZania. 1b, wards of Meru District. The wards covered in this vaccination drive are: Maji ya Chai, Usa river and Songoro. Both Maji ya Chai and Usa River are areas which were covered for the third time this year, whereas it was our second year in Songoro. A 2012 census gives the human population at approximately 64,069 for the 3 wards covered in this vaccination campaign4. Maji ya Chai consists of predominantly flat rural land at an elevation of 1400m above sea level with spaced out houses. Usa river is more densely populated with an urban core. Songoro is on the side of mount Meru and is very difficult terrain, more time was allowed for the coverage of Songoro region due to this. Since the first vaccination campaign in this area of Meru District there have been no suspect rabies cases reported within these wards, though other cases have been suspected outside of this working area. Program The dog population estimate of Maji ya Chai, Usa river and Songoro wards was calculated to be 6,179 after the vaccination drive in 2017. To achieve 70% vaccination coverage of the canine population we would need to vaccinate approximately 4,300 dogs. Mission Rabies’ Research and Programmes Intern, Amy, and Mission Rabies Project Coordinator, Paul were present for the duration of the vaccination campaign. All staff and volunteers were briefed before the start of the vaccination campaign. The briefing contained information about the history of Mission Rabies; the pathophysiology and epidemiology of rabies; exposure and post exposure protocols; how the vaccination campaign would run so that all team members were fully aware of their roles and responsibilities; and health and safety. All participants signed to say they had been present and understood the briefing. This was followed up with a practical brief introducing all volunteers to the WVS App. To help with the briefing, vaccination protocols, clinic protocols, English versions of the education material, an example complete vaccination certificate and App FAQ sheet was provided to the volunteers. These were made available for reference in each volunteer field kit. 4 The programme ran from 11th to 24th January for 10 working days. Image 2. Static point vaccination sites in Meru District. Different colours represent the different days for static point locations. Yellow areas were vaccination points for the first Saturday, Green the first Sunday, Red the second Saturday and blue the second Sunday. The volunteers made up 8 teams of predominantly 3 but occasionally 2 people. On Saturdays and Sundays static point vaccination clinics were held at strategic points across the 3 wards (Image 2). They were chosen according to population siZe and density in the area as well as having suitable locations for hosting a static point vaccination site. Data from 2017 was analysed and this helped to identify areas where static point vaccination sites were successful. Monday to Wednesday the teams walked door to door in these wards recording dogs previously vaccinated and vaccinating and recording those that were vaccinated at that time. On day 1 of the static points, 2 teams did half day clinics followed by half days of door to door work. On the second Saturday, 1 team spent the whole day going door to door and 1 team had a half day static point followed by door to door. As there were only 6 static points on the final Sunday, 1 team did 2 half day static point in the morning and afternoon, leaving 3 teams to do door-to-door work. For the door to door days’ teams were allocated specific regions of the wards to cover on the Mission Rabies App. 40 wards were covered door to door by the teams over 10 working days. These regions were mostly bordered by roads to make navigation easier and were of a size thought to be sufficient for a day’s work. Some locations took longer than a day to complete and so the teams returned to those regions to complete the area before moving onto their next area. Towards the end of the project, teams worked together to compete wards 5 Image 3: Showing wards covered by teams over the 2 weeks Alongside the vaccination programme Mbwa wa Africa, in partnership with WVS, held a spay neuter campaign. Owners were asked if they would like their dog to be sterilised by the vaccination teams and their telephone numbers collected where applicable. This data was used to contact owners for the sterilisation campaign. As well as sterilising dogs this team also provided medical care for any sick or injured dogs encountered by the vaccination team.

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