#EndRabies
End Rabies Together
##WorldRabiesDay
Guidance manual for World Rabies Day 2015
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www.ifmsa.org
www.ivsa.org
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End Rabies Together
This year the IVSA, IFMSA and GARC are partnering again to encourage students to do something to help prevent rabies!
#EndRabies
World Rabies Day is on September 28th
How can you make a difference? Organise a World Rabies Day event – we have lots of ideas in this guide Get your colleagues in the health sector involved And as a bonus – your event could be selected for the IVSA or IFMSA’s project fair For more information –
#WorldRabiesDay
Contact: IFMSA scophd@ifmsa.org IVSA publichealth@ivsa.org
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www.ivsa.org
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#EndRabies #WorldRabiesDay
Contents 1. Rabies – the facts 2. World Rabies Day 3. History of World Rabies Day 4. World Rabies Day 2015 #EndRabiesTogether 5. Medical and veterinary students and World Rabies Day 6. Why students should take the lead 7. Participating in World Rabies Day 8. Step by step 9. Setting up your event 10. Ideas for World Rabies Day activitie 11. Sharing your activities 12. Relevant Links
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www.ivsa.org
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II Rabies – the facts
Rabies has been terrorising humans and animals for 4,000 years. It is transmitted between animals and humans (a zoonotic disease), usually via a bite wound inflicted by an infected animal, although licks on open sores and scratches may also pose a risk to developing rabies. While many mammals are capable of transmitting rabies, more than 99% of the 59,000 people that die from rabies each year are the result of exposure to a rabid dog.
In addition to the thousands of human deaths, millions of dogs die each year due to rabies and indiscriminate culling due to fear of rabies, an ineffective preventive measure. Annual economic losses because of the disease are around 8.6 billion US dollars, mostly due to premature deaths, but also because of the cost of human post-exposure vaccines, lost income for victims of animal bites, livestock losses, and other costs. Prognosis
Following exposure to the virus, symptoms can appear anywhere from a few days to more than a year afterwards; however, the average time to symptom onset is 3 to 12 weeks after exposure.
The first symptoms of rabies are similar to those of the flu. As the disease progresses over just a few days, a person can experience delirium, abnormal behaviour and hallucinations, as well as the famed hydrophobia(fear of water) and foaming at the mouth (related to the paralysis of swallowing muscles and hyperventilation, which produces froth).
Once symptoms manifest, rabies is 99.9% fatal. Only a handful of people have survived rabies, and most of them have permanent neurological disabilities. However, if people are given a course of vaccinations and boosters to their immune systems shortly after exposure to a rabid animal and before symptoms become evident, the disease can be prevented.
Prevention
Rabies is preventable. The tools and science to halt the extensive suffering, loss of life, and financial burden of rabies already exist. Primary interventions against rabies involve vaccination of dogs and responsible, humane canine population management. When these tools fail to prevent rabies at its source, secondary prevention methods must be used, such as human vaccination after 29/9/2 015 exposure.
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Geography
Although the rabies virus is distributed globally, with only Antarctica and a few island territories considered rabies virus free, canine rabies is well controlled or even eliminated in many countries. Today over 95% of human victims live in Africa and Asia, most in marginalised and impoverished rural communities. While rabies is the most deadly of all known zoonotic diseases, it is still labelled by the World Health Organization as one of 17 Neglected Tropical Diseases.
A neglected disease that perpetuates poverty
Rabies is a preventable disease that afflicts the poor most, both in terms of its death toll as well as the financial burden associated with the disease. With a survival rate of less than 0.1%, those exposed to the virus face a stark choice: go in search of post-exposure prophylaxis (PEP, the series of vaccines and immunoglobulin that prevent the onset of the disease) or die. In some cases, PEP costs more than the monthly household income and families are known to either go into debt to pay for PEP, or sell livestock on which they depend for income; both are options that negatively affect families’ future prospects. Dogs
Countless animals die after suffering the horrific clinical symptoms of rabies. Dogs also suffer from a second tragedy: fear of rabies transmission from dogs regularly prompts mass dog killing in which animals are killed indiscriminately, often in brutal ways. Eliminating most dogs from an area creates a territorial vacuum and encourages new, likely unvaccinated, dogs to move in, and the entire process begins again. World experts agree that dog culling does not stop rabies, and in fact can make the situation severely worse. Preventing canine rabies is the key to saving human lives
Canine vaccination is the key to preventing the disease in humans because it stops the disease at its source. The immunity of vaccinated dogs (and other domestic animals) also forms a protective barrier between potentially rabid dogs and wild animals, and people.
All dogs should regularly be vaccinated against rabies, and in many countries it is required by law. 29/9/2 015
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What to do for an animal when it bites someone:
A dog or cat that bites a person needs to be examined by a veterinarian immediately.
The animal may require monitoring for 10 days to make sure it doesn’t develop rabies.
Report any illness or unusual behavior by the animal to a veterinarian immediately.
What to do when your animal has been bitten by another animal:
Consult your veterinarian immediately and have your veterinarian examine your animal and assess your animal’s vaccination needs.
Contact the relevant local authority (such as animal control) if the bite was from a stray or wild animal.
Monitor your animal for a specified time period by state law or local ordinance (usually at least 45 days) if an unvaccinated or wild animal bit your pet.
What to do if a person is bitten by an animal: Following human exposure to rabies, time is of the essence.
The wound needs to be washed thoroughly with soap and running water for at least 15 minutes.
The victim then needs to seek urgent medical care and exposure assessment.
Prompt and appropriate post-exposure prophylaxis (PEP) after being bitten and before the disease develops can stop rabies infection and prevent the disease.
PEP consists of a series of rabies vaccinations, and, where available, immunoglobulin injections into the wound (these are antibodies against the rabies virus). The number of vaccine doses and the days on which you receive them may follow a different regimen, but 1 dose on each of days 0 (the day of the exposure, 3, 7, 14 and 28 is the most common.
For PEP to be effective, the victim needs both the vaccination and the immunoglobulin treatment.
In some cases, particularly for people who are considered at high risk of exposure, pre-exposure vaccinations (PrEP) are given. If subsequently exposed to rabies, the patient still needs two additional doses of vaccine, on day 0 and 3 but does not need immunoglobulin injections. 29/9/2
PrEP is particularly important for people who are at risk of encountering rabid animals and who are, or will be, far away from medical services.
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Some key challenges to rabies prevention
Lack of awareness – this is a problem at all levels of society, from those most at risk to governments.
Lack of coordination – as a zoonotic disease, prevention often falls under the remit of various agencies. It is essential that these agencies are joinedup in their approach the problem.
Lack of data – Accurate surveillance (or monitoring) of rabies incidence is critical to a true understanding of the actual burden.
Lack of capacity – this includes knowledge, the sufficient availability of quality vaccines and immunoglobulin (at a price people can afford), and networks to support supply.
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III. World Rabies Day
On World Rabies Day, September 28 every year, the world unites in the fight against rabies and the suffering it causes. It is a day of activism and awareness. You can join this global movement by organizing or taking part in a World Rabies Day event.
3a. History of World Rabies Day
World Rabies Day was launched in 2007, with the goal of engaging 55,000 people to do something to increase awareness on this day. The number 55,000 was chosen as a goal because this was the estimated number of people who died of rabies each year.
World Rabies Day is held on September 28. This day commemorates the death of Louis Pasteur who, as the creator of the first rabies vaccine, laid the foundations to prevent this tragic disease.
World Rabies Day is the first global advocacy, education and awareness campaign for rabies, reaching over 150 million people with rabies prevention messages, and it has reinitiated rabies prevention in many parts of the world. Global participation continues to grow each year - to date at least 150 countries have supported World Rabies Day by hosting events and over 300,000 visitors have logged onto the website to download free educational material and toolkits for their events. Over 150 participating schools of public health, veterinary and medical colleges have hosted rabies awareness events, and in 2014, every continent had at least 1 World Rabies Day event, with 260 events registered on the Global Alliance for Rabies Control website from 48 countries.
This campaign has the support of all international health organizations and major stakeholders such as the WHO, OIE and FAO. It inspires and supports rabies champions to take action in their own communities on World Rabies Day. As future leaders in the fight to prevent rabies, veterinary and medical students can start helping their communities by participating in World Rabies Day.
The World Rabies Day logo is known worldwide, and is available online in over 40 languages for anyone to download and use with their events. There are also many awareness resources available online for different 29/9/2at their events and for audiences and languages, which people can use 015 other activities around rabies.
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3b. World Rabies Day 2015 - #EndRabies Together
Organizations and individuals across the world hold events in their communities and promote World Rabies Day every year, and each year a different theme is selected to help everyone to spread the message.
The themes over the last eight years all emphasized the need to work together in order to end this disease, and this year’s theme is no exception - #EndRabies Together
This theme can work in many ways, for example:
National governments working together on the international stage – as rabies goes beyond country borders
Government departments working together at the national and local levels, as collaboration is needed between public health, animal husbandry, education and possibly other departments, as different elements of rabies control usually come under different departments
Professionals from the human and animal health sectors working together, with educators, legislators, community workers and others, to prevent rabies at the community level, and to influence the authorities
Communities working together to improve access to vaccines and ensure that dogs are vaccinated
Families living together with their vaccinated animals, safe from rabies
3c. Medical and veterinary students and World Rabies Day
World Rabies Day is an opportunity for medical students and veterinary students to work together, to encourage intersectoral collaboration in rabies prevention. Physicians and veterinarians are major stakeholder groups in tackling rabies.
Every year on World Rabies Day, September 28, thousands of individuals and organizations conduct events to raise awareness about rabies and the need for pre-exposure canine vaccination and postexposure human vaccination. Students have always been an active part 29/9/2 of World Rabies Day, with past activities including veterinary schools 015 across the US competing to host a rabies symposium at their universities, and individual students raising funds and awareness through sponsored activities such as marathons and mountain climbing.
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Involvement of the IVSA and IFMSA
In 2013, the IVSA promoted and organized World Rabies Day events across different chapters globally.
The IVSA and IFMSA both have a strong focus on the One Health concept, which is defined as:
A collaborative effort of multiple disciplines -
working locally, nationally, and globally -
to attain optimal health for
people,
animals and
the environment
As part of this commitment, both organizations have set up One Health Committees. Rabies is one of the diseases that falls very clearly under the One Health approach if it is to be tackled effectively, and this is why the IVSA and IFMSA have joined GARC to increase awareness around World Rabies Day among veterinary and medical students.
In 2014 the IVSA/IFMSA/GARC partnership held the Global One Health Challenge competition focused on future health professionals this World Rabies Day, asking them to work together against rabies. Teams from all over the world participated in this competition, and all the events were compiled in this booklet, which we hope will inspire you to participate this year in World Rabies Day.
3d.Why students should take the lead
As students of the healing professions, you have probably already realized that you have great potential to make a difference in the field of disease prevention beyond the clinical setting. In the case of rabies, for example, you can educate people about what to do when they get bitten, encourage them to vaccinate their dogs and take care of their animals responsibly, influence local authorities to implement existing rabies laws, and work with local charities to help people and animals who could be affected by this deadly disease.
Above this, you also have the power to add your voice to the international fight against rabies through social media, professional 29/9/2 networks and associations such 015 as the IVSA and IFMSA.
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4. Participating in World Rabies Day 2015
Being part of the World Rabies Day partnership is really simple – 4a. Step by step
1. Create and register your event online at http://rabiesalliance.org/world-rabies-day/events/report-event Don’t forget to check the IVSA/IFMSA member box on the registration form
Above all, we encourage cooperation between medical and veterinary students. 2. Organize an event in your community around World Rabies Day – up to October 31st 2015.
We’re looking in particular for events that show:
strong partnerships that demonstrate the One Health approach, particularly those that show partnerships between medical and veterinary students, although other partnerships will also be considered.
effective outreach activities in the community - the number of people reached by the event
Your event could be anything from mass dog vaccinations to school education to street theatre, anything that helps to increase awareness about rabies (see next section for more details)
Get inspiration from last year’s events
3. Share and submit your event
Share your event with others around the world – invite the media to your event, create and post videos online, spread the message through Facebook and other social media, or any other way you like, using the hashtags#EndRabies
Submit full details of your event by November 30, 2015 using the report form that will be sent to you after you register your event. If you’re a medical student, please submit your report to the IFMSA at scophd@ifmsa.org. If you’re a veterinary student, please submit your report to the IVSA at publichealth@ivsa.org. 29/9/2
015 4. Your event may be selected for an IVSA or IFMSA project fair, or for a joint project fair at the WHSS.
Please email us at campaigns@rabiesalliance.org if you have any technical queries about the competition.
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4b. Setting up your event
There are 15 steps that will help you to organise your event, right from the beginning until you’ve completed the event and reporting - and please don’t forget to have a good time in the process!
Team
Set up a team to help with your event – we encourage veterinary and medical collaboration. Democratic decision-making and nourishing of the team spirit are important, but it should be clear who is responsible for each part of the plan and what each team member expects from the event.
Ideas
Brainstorm ideas and possibilities. There are some examples of other events in 3c Ideas for World Rabies Events in this manual
Your activity
Once you’ve decided on your activity, as a team you need to determine the scope of the event, the targeted beneficiaries, your budget and possible partners.
Set up a detailed action plan, strategy and budget
Initial meeting: At a convenient time and place for all of you, discuss your event – you may find the event checklist (appendix 2) useful for this – and create a detailed list of actions, a timeline and clearly identify who is responsible for what. Prepare work tables/sheets with specific tasks and go through the plan one step at the time. Be clear about what you expect each team member to do. To avoid misunderstandings and possible resentments, make sure you all understand what others are doing too. Repeat the most important things more than once – people tend to forget. Continue to be transparent in your work and communicate updates among yourselves on a regular basis (at least once a week), so that you all stay in the loop. Organize other meetings according to need.
Fundraising
Before you start fundraising carefully consider exactly what you need. Then determine who can help you and how they can help you. Make sure you clearly ask for specific things.
The kind of fundraising you do obviously depends on what is acceptable in your country but some examples are given below:
holding a cake (or bake) sale,
asking for sponsorship to complete a task – e.g. a 29/9/2 sponsored run, bike ride 015 or swim,
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Extra volunteers
If you need extra volunteers for your event, start with a general call among students at your university – it helps (but is not essential) if they are from different sectors, particularly if they are going to be part of the team. Advertise in places that students gather (mess hall, dormitory, library, computer room, departmental notice boards, favourite café or bar), as well on the university email network or website, if one is available to you. If you find it difficult to recruit volunteers, try approaching local NGOs or youth centres.
Externals
Whether you’re coordinating a World Rabies Day event locally or nationally, do some research on institutions, services, governmental and non-governmental organizations or special programs that deal with rabies – these are called externals.
They can support your event by providing other contacts, writing letters of support, sharing their publications and materials, providing additional volunteers, facilities, equipment or professionals (lecturers, designers, etc.) and financial support.
Businesses, in particular, may support you by either by directly donating to your project (sometimes in return for advertising at your event) or by providing services in kind (e.g. providing refreshments for your volunteers, covering printing costs, helping with sterile waste services, etc.)
Training
It is always best to set aside at least 2 hours to discuss rabies (see Rabies – the facts, above, and http://rabiesalliance.org/rabies/what-is-rabies-and-frequentlyasked-questions/), how to best approach people or answer questions when approached, and How to handle the media (appendix 3). This session will make your group more cohesive, and give you the time and opportunity to express your concerns or ask questions.
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Media
Work with the media to maximise the reach and impact of your activity. Issue a press release. You could even consider organizing a press conference! Again, this is covered in How to handle the media (appendix 3).
Review
How are things going? Do you need to make adjustments to your plan?
Conduct the event
Use the checklist (appendix 2) – or your modified version –to stay on track and make sure nothing is overlooked. Make one person responsible for taking pictures, video and comments from attendees. Otherwise this is easily forgotten and you need it for the report and your own social media efforts. Remember also to collect any press clippings.
Debrief
Have a final meeting after the activity to evaluate how it went. What went well? What could have been better? This is valuable feedback for organizing events in the future.
Remember to thank each other – you will all be promoted on the partners’ website and social media - and if your team wins, they could be participating in a project fair!
‘Thank you’
Remember to thank those who supported the activity, especially if they donated money or materials–a nice thank you note goes a long way! It may make people more willing to support you in the future.
Report
Send in your World Rabies Day report using the report form that will be sent to you after you register your event (preferably within 2 weeks after the event, while all the details are still fresh in your memory and supporting evidence is more readily available).
Financial - your sponsors, if you have any, may want a financial report which records how the money was used.
Next year
Have a follow up meeting when planning next year’s World Rabies Day event! 29/9/2 015
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TROUBLESHOOTING
All of the steps above can be used anywhere in the world for a World Rabies Day event, with modifications according to your local/national situation.
Some steps can be done in parallel, while others really need to wait until the previous step is successfully completed. If you find things aren’t going to plan, adapt and change them a bit to make it work.
It would be wise to start preparing for your World Rabies Day event at least a few weeks in advance, Plan activities according to your time, money and resources. Some ideas – like organizing community education workshops, having an information stand at the university with educational materials and posters from http://rabiesalliance.org/resources/, or organising a theme party – can be done with relatively few resources. Something can always be done; be creative!
4c. Ideas for World Rabies Day activities
Organize World Rabies Day information stands at a community event or centre
Mobile team units / outreach – distributing materials in places where you don’t have a information stand, or holding workshops in remote communities
Indoor stands in pharmacies or drug stores
Art performance / installations – in the street or following other organized events
Play or skits – by peer educators or actors
Posters, photographs or drawing exhibits
Graffiti, creative writing or art contests – for young people
Video airing – with or without facilitated discussions afterwards
Joint efforts – candlelight walk, ringing bells, holding hands
Together Against Rabies theme parties or concerts
National sport events – have a short speech about rabies and hand out leaflets
Local sport events – organize a football or basketball End Rabies Together tournament
Peer education workshops – for students from other fields to increase awareness about the need for rabies vaccinations
Organize interactive lectures or round table discussions with externals
Organise a mass dog vaccination event with your local clinic or animal welfare group
Organise sessions in schools for children to learn about dog bite prevention, 29/9/2 015 rabies and responsible pet care - we have a lot of resources you can use for children - http://rabiesalliance.org/resources/teaching-children/
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4d. Sharing your activities
Remember to share your wonderful work with everyone – put it on your website, if you have one, post it on your Facebook page, send emails to your friends, families and supporters (if you’re part of an organisation), add it to your newsletter, put it on the community notice boards, ask journalists to cover the event in your local newspaper or magazines, speak on a radio show, write an article for a student magazine, hold a press conference – these are just examples – there are many other ways to share your work with your community and beyond.
See How To handle the media and Using social media (appendices 3 and 4) for guidance.
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Relevant links
Global Alliance for Rabies Control
www.rabiesalliance.org
International Veterinary Students’ Association
www.ivsa.org
International Federation of Medical Students’ Associations
www.ifmsa.org
World Health Organisation
http://www.who.int/rabies/en/
World Organisation for Animal Health
http://www.oie.int/animal-health-in-the-world/rabies-portal/
One Health Initiative
http://www.onehealthinitiative.com
World Medical Association
www.wma.net
World Veterinary Association
http://www.worldvet.org
How to plan an event on Rabies day
https://rabiesalliance.org/world-rabies-day/eventresources/organizers-toolkits
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