Rabies has proven to us that aside

Rabies and Its
Danger in Poor Rural Area

Arranged
to complete the final task of Tahap Persiapan Bersama (TPB)

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Arranged by:

ZIAZAN BEVINA ATHALLAH

NPM   :
130210170045

 

 

 

 

 

VETERINARY
MEDICINE

FACULTY OF
MEDICINE

UNIVERSITAS
PADJADJARAN

2017/2018

TABLE OF CONTENTS

 

 

TABLE OF CONTENTS……………………………………………………………………………………    2

CHAPTER I : INTRODUCTION

1.      Background………………………………………………………………………………………….       3

2.      Importance and
Purpose…………………………………………………………………………      3

3.      Problem Formulation……………………………………………………………………………..,      3

CHAPTER II: DISCUSSION

1.      Definition…………………………………………………………………………………………….      4

2.      Symptoms……………………………………………………………………………………………      4

3.      Rabies in Poor Rural Area……………………………………………………………………..       4

4.      Pancasila’s perspective
towards this matter …………………………………………….      5

5.      Solutions……………………………………………………………………………………………..      6

CHAPTER III: CLOSING

1.      Conclusion……………………………………………………………………………………………     7

REFERENCES……………………………………………………………………………………………
……….            8

 

 

CHAPTER
I

INTRODUCTION

 

1.1  Background

Rabies is one of
the deadliest infectious disease that occurs in more than 150 countries in the
world. The disease is present on all continents with the exception of
Antarctica. Each year, 10.000 of people die from the infection it causes. Most
of the areas that are affected are in Asia and Africa, and account for over 95%
of human rabies deaths. The disease occurs mainly in remote rural communities.
Rabies outbreaks are rampant among impoverished and vulnerable populations. For
example, in India, rabies outbreaks occurs because of the high number of stray dogs
in the street around the settlement. This case has proven to us that aside from
the dog itself that could cause the infection, the condition of the living space
also plays a role in increasing the risk for people who lives in slums/poor rural
area to get infected by rabies.

 

1.2  Importance and Purpose

My
intention in raising this substance about rabies in rural area is because I
want to elaborate the 3rd point of Sustainable Development Goals
(SDGs) which is to ensure healthy lives and promote well-being for all at all
ages and the 11th goals which is to make cities and human
settlements inclusive, safe, resilient and sustainable. Both of these topics
tend to make a connection because in order to promote healthy live, people
needs to be safe, to have the access for adequate, safe and affordable housing
and basic services. By combining these two matters together, it would create a more
realistic cases in enhancing awareness of the importance of Sustainable
Development Goals (SDGs).

 

1.3  Problem Formulation

1.      What
is Rabies & its symptoms?

2.      Why
does it brings dangers the most towards rural area?

3.      How
is Pancasila perspective regarding to this matter?

4.      What
is the solution & contribution that we can offer to this matter?

 

CHAPTER II

DISCUSSION

2.1.  
Definition

According to
World Health Organization (WHO), Rabies 
is an infectious viral disease that is almost always fatal following the
onset of clinical symptoms, which could causes acute encephalitis (inflammation
of the brain). Rabies is a zoonotic disease, which means the disease could be transmitted
to human through the disease’s host, which is mammals, but more likely dogs. In
up to 99% of cases, domestic dogs are responsible for rabies virus transmission
to humans. Yet, rabies can affect both domestic and wild animals. It is spread
to people through bites, scratches, or usually via saliva.

 

2.2.  
Symptoms

The incubation
period for rabies is typically 1–3 months but may vary from 1 week to 1 year,
depend on the factors such as the location of virus entry and viral load. The main
symptoms of rabies include a fever with pain and unusual or unexplained
tingling, pricking, or burning sensation (paraesthesia) at the wound site. As
the virus spreads to the central nervous system, progressive and fatal
inflammation of the brain and spinal cord develops. There are two forms of the
disease:

·        
People with furious rabies exhibit signs
of hyperactivity, excitable behaviour, hydrophobia (fear of water) and
sometimes aerophobia (fear of drafts or of fresh air). Death occurs after a few
days due to cardio-respiratory arrest.

·        
Paralytic rabies accounts for about 30%
of the total number of human cases. This form of rabies runs a less dramatic
and usually longer course than the furious form. Muscles gradually become
paralyzed, starting at the site of the bite or scratch. A coma slowly develops,
and eventually death occurs. The paralytic form of rabies is often
misdiagnosed, contributing to the under-reporting of the disease.

 

2.3.  
Rabies
in Poor Rural Area

Rabies is one of
the neglected tropical diseases that mostly affects poor and vulnerable
populations who live in remote rural locations. Prevalence in the rural areas
is due to the lack of vaccinations. There is low vaccination coverage of dogs,
and inability to finance the costs of vaccination for humans. This often
happens because there is no sufficient number of health facility that could
handle the outbreak. Other factors include poor management of dogs, and in
particular the free movement of dogs, which increases their risk of contracting
rabies from wildlife.

Although
effective human vaccines exist for rabies, they are not readily available or
accessible to those in need. Globally, rabies deaths are rarely reported and
children between the ages of 5–14 years are frequent victims. Treating a rabies
exposure, where the average cost of rabies post-exposure prophylaxis (PEP) is
US$ 40 in Africa, and US$ 49 in Asia, can be a catastrophic financial burden on
affected families whose average daily income is around US$ 1–2 per person.

Beside that,
there are also many gaps in the knowledge and practices of the respondents
regarding rabies. This may be the result of the reduced participation of public
health agents in the transfer of details about the disease. The lack of
knowledge may be a direct determinant in the occurrence of new outbreaks.

 

2.4.  
Pancasila’s
perspective towards this matter

Pancasila is a
fundamental and ideal life perspective that guides the Indonesian people in
carrying out their life activities. It contains five basic values that form the
basis and reference in the nation and state life. Five of them pancasila are
the norms that must be used as a foundation in Indonesia’s national development
so that nations and countries in its development process have a strong national
identity and are not easily influenced by other ideologies contrary to
Pancasila. Ideologies contrary to Pancasila along with development in the era
of globalization, has invade and affect the life of the Indonesian nation. One
of the development sectors secured by pancasila is health development. The
second phrase  “fair and civilized
humanity” and the fifth phrase “Justice for all Indonesian
people”. Fair and civilized humanity means everyone should have the same
opportunity to gain their rights as human beings with their human nature. Social
justice for all Indonesian people implies that all Indonesians should have
equal opportunity to have access to all sectors of development (social,
economic, health, environment, etc.) with the principle of equality in decent
living. Everyone means everyone, despite their ages, gender, skin color, race, ethnic,
religion, and last but not least, their living spaces, either in urban or rural.
People who lives in poor rural area must have the same chances to get the same healthcare
service when it comes to handling infectious and dangerous disease such as rabies.
They deserve to have a decent health facility in order to support the services,
and they deserve to live in a living spaces that is safe for them; a place where
they could stay comfortably, without having to worry all the time because of what
threatens them, in this case, stray dogs which didn’t get vaccinated because no
one owns them.

 

2.5.  
Solution

Rabies is a vaccine-preventable viral disease. Each
year over 14 million people receive a post-exposure vaccination to prevent the
disease. This vaccination prevents hundreds of thousands of rabies deaths.
Other strategies to control the disease consist of controlling the dog
population, vaccinating domesticated animals and education about prevention to
reduce the number of animal bites. After a bite, immediately cleaning the
wound, and immunization within a few hours after contact with the animal can
prevent the onset of rabies. But, due to the cost it takes for the vaccination
is considerably high, there is a clear need for specific educational
initiatives involving the local population and the public health entities, with
the primary aim of contributing to the prevention of rabies, especially in poor
rural areas. Also, WHO has come with a strategy, which called ‘Zero by 30’. ‘Zero
by 30’ focuses on improving access to post-exposure prophylaxis (PEP) for bite
victims; providing education on bite prevention; and, expanding dog vaccination
coverage to reduce human exposure risk. If this strategy could achieve zero by
2030, then it could possibly help the SDGs goals number 3 which is to ensure healthy
lives and promote well-being for all at all ages by eliminating rabies as one
of the major infectious disease in this world.

 

 

 

 

 

CHAPTER III

CLOSING

 

3.1
Conclusion

Rabies
is a deadly zoonotic disease most often transmitted to humans through a dog
bite. Human mortality from endemic canine rabies is estimated by WHO to be
around 55,000 deaths annually, with over 31,000 deaths in Asia alone, mostly
children. Most of these deaths could be prevented through post-exposure
prophylaxis (PEP), including immediate wound washing, rabies immunoglobulin
administration and vaccination. Unfortunately, at-risk populations are not
well-informed of the risk of rabies and what to do in the event of an animal
bite,
especially in poor rural areas. The lack of sufficient facility to handle
rabies makes it harder for the citizen to get treatment. Based on that, I can
conclude that there is a
necessity to apply appropriate wound care and to consult the nearest rabies
prevention centre as soon as possible, and to add more
facility and creates a safer environment for rural areas so that the
possibility of the inhabitant in the poor rural area infected by rabies could
be decreased, and it will help the strategy ‘Zero by 30’ to become successful.        

REFERENCES

Universitas Jember.
(2015, Desember). Pancasila Dalam Perspektif Kesehatan Lingkungan. Retrieved
from: http://repository.unej.ac.id/bitstream/handle/123456789/77358/Khoiron_Buku_ISBN_%20978-602-229-651-5_PANCASILA%20DALAM%20PERSPEKTIF%20KESEHATAN%20LINGKUNGAN_%28FKM%29.pdf?sequence=1  

WHO.
 (2017, September). Rabies. Retrieved from : http://www.who.int/topics/infectious_diseases/factsheets/en/

The Borgen Project. (
2015, September 28).  Rabies Outbreaks in Poor Rural Areas. Retrieved
from: https://borgenproject.org/rabies-outbreaks-poor-rural-areas/