PESHAWAR, May 26: Non-availability of anti-rabies vaccines in public-sector hospitals has increased the death risk from dog-bite, especially in the rural areas of the province, doctors told Dawn.

The doctors said one or two people died of dog-bite every day, especially in the rural and mountainous areas. On average, about a dozen people, mostly children, are bitten by dogs.

The victims, however, do not get proper treatment at the state-run hospitals because these institutions are not provided with any vaccines owing to paucity of funds.

The anti-rabies vaccines manufactured by multinational companies are available at Rs4,000-5,000 in open market. Due to their high cost poor patients cannot afford them. Many of them end up developing hydrophobia that ultimately leads to a painful death. Most of such horrendous cases go unreported.

Unfortunately, the number of stray dogs is on the rise due to the negligence of the municipal authorities. There are people whose job is to eliminate rabid dogs, but the population of rabid dogs is swelling without any check.

Strychnine, the poison used by civic bodies to kill stray dogs, is very expensive and the process is risky as well. Also, dumping the dead dogs is not an easy task for the municipal authorities or for the public.

ARV, the vaccine being manufactured by the National Institute of Health, Islamabad, is provided free of cost. But the vaccine is stated to have hazardous side-effects. The vaccine, according to doctors, destroys the central nervous system (CNS).

A single dose of the vaccine consists of 14 injections which are administered around the umbilicus. Its mode of administration is painful. The provincial government has set up vaccination centres at the offices of the Executive District Officer (EDO) health to facilitate patients.

EDO, Peshawar, Dr Mosam Khan said his office had been treating 300 rabies patients for some time, while 200 new cases were reported every month. The district government, he said, provided Rs70,000 against the requirement of Rs300,000.

A source at the directorate of health said most of the EDO offices owed money to the NIH, which had stopped the supply of vaccines because of non-payment of dues.

Due to shortage of vaccines, doctors at other hospitals of the city had started referring patients to the EDO office, but the stock at the EDO office was not sufficient enough to meet the demand, he added.

In D.I. Khan, Dir, Charsadda, Mardan, Swabi, Kohat, Bannu, Swat and tribal areas, the non-availability of vaccines adds to the miseries of dog-bite victims.

The only vaccine manufactured under the universally-accepted safe formula called human diploid cell (HDC) is too expensive for a common man to afford. Two multinational pharmaceutical firms manufacture the vaccine under the HDC formula which is available at Rs4,500 and Rs3,500, respectively, an amount many people are unable to afford.

It is because of the high cost of the vaccines that even the teaching hospitals - Lady Reading Hospital, Khyber Teaching Hospital and Hayatabad Medical Complex - are unable to provide free-of-cost treatment.

The problem of high cost of vaccines and their non-availability is more acute in the rural areas where people are seen running from pillar to post to find them. Doctors say that the cost of rabies treatment has almost gone out of the reach of the common people.

The small plant at the National Institute of Health is unable to produce vaccines in the required quantity, while their availability is also limited. According to experts, dog-bite victims need to be administered two kinds of injections, one for providing immediate treatment and the other for future protection as the incubation period of rabies virus can vary from nine days to even months.