Mayhew International - Rabies prevention and dog population management afghanistan report web

Mayhew International WORKING TO ALLEVIATE THE SUFFERING OF ANIMALS ABROAD

Mayhew International in Afghanistan Rabies Prevention and Dog Population Management Prepared by: Dr. Abdul Jalil Mohammadzai (DVM) Mayhew International Project Manager, Afghanistan

Mayhew International is part of The Mayhew Animal Home, UK dr.jalil@mayhewanimalhome.org +44 (0) 20 8206 5879

Rabies Prevention and Dog Population Management

Mayhew International in Afghanistan Rabies Prevention & Dog Population Management Project Initiation Document Executive Summary The Mayhew Animal Home Mayhew International in Afghanistan Rabies – Global Overview Rabies – Afghanistan Overview Kabul – Current Dog Population Management

3 3 4 4 5 6

Proposed Project in Kabul  Trap, Neuter, Return Programmes (TNR)  Outline of Project Objectives  Initial Survey  Kabul Street Dog Survey, February – March 2015  Human Population Ratio to Dogs  Project Planning Post Survey  Scope Of Work  Staffing Requirements

8 9 10 10 20 37 38 38 42

Partnership Collaborations  In Afghanistan Current Connections Future Connections  Global Organisations Current Connections Future Connections

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Summary and Future Plans

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Appendix i) ii) iii) iv)

49 50 53 58

44 46 46 47

Case Studies of Successful Rabies Vaccination Programmes Identification Methods for Dogs Supplies Needed for Sterilisation Programmes References

Acknowledgements and Thanks

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Rabies Prevention and Dog Population Management

Executive Summary Mayhew International Rabies Mission in Afghanistan Rabies is a fatal disease posing a serious threat to human health worldwide and it is estimated that it causes between 40,000 to 100,000 deaths around the globe every year (1).

A further 15 million people are reported to receive post exposure prophylaxis treatment to prevent the disease; however this vaccine is costly which means poorer families are more likely to contract the disease (2).

Rabies remains a major public health concern in Afghanistan with an average of 2580 dog bites reported in Kabul City alone between 2003 – 2011, and 67 deaths reported in Kabul in 2012 (3). This proposal details the urgent need for rabies control in Kabul and Afghanistan and why Mayhew International is uniquely placed to tackle this issue.

This document aims to outline the proposed project Mayhew International wishes to implement in Kabul to control the dog population, with a clear primary objective to eliminate rabies in the city, outlining the proposed implementation of a mass vaccine and trap, neuter, return (TNR) programme. This will help to reduce human deaths, as well as reduce the need and cost for post exposure prophylaxis. We envisage taking the project countrywide with the support of the Afghan Government.

The Mayhew Animal Home The Mayhew Animal Home, registered UK charity no. 1077588, is an animal welfare organisation based in London that has been helping animals and their carers since 1886. In London, The Mayhew has a shelter facility for the rescue and re-homing of cats and dogs, the charity also works pro-actively in the community promoting responsible pet ownership and working to prevent animal welfare issues escalating to crisis point.

The Mayhew also has a Community Veterinary Clinic providing full veterinary provision for our onsite animals and free and/or low-cost preventative procedures (neutering, vaccinations, micro-chipping etc.) for the general public’s pets.

The Mayhew operates a TNR (Trap, Neuter, Release) programme for London’s feral cat population.

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Rabies Prevention and Dog Population Management

The Mayhew is a registered training practice for veterinary nurses and regularly welcomes vet students on EMS (extra mural studies) placements, as well as overseas vets on our International Vet Training Programme, who are working on street/stray population issues.

For further information please look at our websites: https://themayhew.org and https://themayhew.org/about/mayhew-international/.

Mayhew International in Afghanistan Mayhew International is a growing arm of our charity and has worked to help companion animals abroad since 2001 in countries as far afield as Russia, Georgia, India and Nepal.

Our work in Afghanistan started in 2002, when we responded to an appeal to help Kabul Zoo which had been destroyed during the conflicts there, and where the animals were starving and in desperate need. Mayhew International has supported Kabul Municipality with the restructure and redevelopment of Kabul Zoo providing advice and assistance until it was felt that responsibility could be transferred to Kabul City Municipality.

Mayhew International built on these foundations and has since provided assistance to Kabul University Vet Faculty and helped address the issue of stray and street animals in Kabul.

This has comprised practical training for vet students and the Vet Faculty and helping local NGOs working with companion animals on the ground. We continue to communicate regularly with government and city authorities on the issues of stray and street animal populations and rabies prevention, which overlap with public health issues for the country as a whole.

Rabies – Global Overview Rabies poses a substantial threat to human health: around 40,000 to 100,000 people die of rabies each year mostly in the developing nations of Asia and Africa and around 40% of the victims are children (1). A majority of animal bites and scratches go unreported, particularly in children where they are unrecognised, meaning that post exposure prophylaxis (PEP) is not administered. This, therefore, is likely to lead to a much higher number of young people contracting and dying from the disease than is reported in recorded figures. A further 15 million people receive post exposure treatment to prevent the disease (2).

WHO classes rabies as one of the 17 main neglected tropical diseases, and has a view of eradicating these diseases by 2020 (proposed in 2013). In more than 99% of human rabies

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Rabies Prevention and Dog Population Management

cases the virus is transmitted by dogs (2) and dog rabies potentially threatens over 3 billion people in Asia and Africa (4). People who live in rural areas are more at risk because human vaccines and immunoglobulin are not readily accessible. Rabies PEP (post-exposure prophylaxis) is costly, resulting in poorer people also being at a higher risk of death from the disease. Average PEP costs in Africa are US$40 and US$49 in Asia, where the average daily wage is around US$1-2 per person (5).

Canine rabies costs the world $124 billion annually, but could be eliminated within the next 30–40 years for as little as $6-$8 billion. Rabies has a huge financial impact alongside the well-known physical, social and psychological costs of the disease. Crucially, the economic impact affects not just the victims and those who require vaccination but the community as a whole (6).

Rabies – Afghanistan Overview Information provided from the Ministry of Public Health in Afghanistan shows that there is a high demand for rabies PEP due to the number of recorded dog bites.

Figure 1 shows the number of recorded dog bites for the capital city Kabul over 9 years from 2003 to 2011, averaging 2,580 reported bites per year (3).

Dog bites cases administered ARV* Kabul (2003 2011) 3500 3017

3060

Number of cases

3000 2500

2217

2217

2000

1921

1839

1985

Male 1500

Female

1130

1000 500

874

200

0

223

351

500

630 400

614 430

415

Year

2003

2004 2005 2006 2007 2008 2009 2010 2011

Figure 1: Dog bites recorded in Kabul from 2003 – 2011 (*ARV = anti-rabies vaccine) The number of reported deaths is also very high with an average of 37 deaths per year over the period 2010 to 2012.

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Rabies Prevention and Dog Population Management

Figure 2: Reported deaths due to Rabies in Kabul over the period 2010 – 2012

Kabul - Current Dog Population Management The current programme in Kabul to control the street dog population is setting up locations with baited poisoned meat that the dogs will seek out and ingest. The poison used is strychnine which causes convulsions and impaired breathing, sometimes taking an hour or longer to kill the animal depending on how much poison has been ingested. The poison may not work immediately and the animals may experience extreme pain whilst conscious until they die (2).

In modern society this method of controlling dog populations and rabies is seen as impractical, cruel and culturally unacceptable. Other animals will also be exposed to the poisoned meat meaning that this method of culling dogs could contribute to the loss of other species. Of particular concern are the endangered species in Afghanistan such as the Afghan Hound (known as Tasi), the Striped Hyena (Hyena hyena), the Greater Spotted Eagle (Aquila clanga), the White Rumped Vulture (Gyps bengalensis) and many more.

Mayhew International would collaborate with NEPA (National Environment Protection Agency) to ensure that proposed programmes would not affect endangered species, including the indigenous Tasi (Afghan Hound) population, which is not allowed to be exported presently due to a severe drop in numbers.

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Number of dogs poisoned 25000 Number of dogs poisoned

21241

22460

18920

20000

17220 15460

15000 10000 5000 0 1 2008

2 2009

3 2010

4 2011

5 2012

Figure 3: Showing numbers of dogs culled over past 5 years. Methods and quantities used have remained constant over the 5 year period showing that culling is not helping with population numbers.

In Kabul the carcasses of poisoned dogs are collected by municipality workers and disposed of by burying them in the ground. This method poses its own problems; the methods of transportation used to move the carcasses can increase the spread of the virus due to lack of hygiene and lack of Health & Safety protocols. The burial sites may become contaminated as well and there is the possibility of other carnivores digging up the carcasses and eating them, thus increasing the spread of the virus. Prior to pick up, the carcasses could also be preyed upon by other animals again contributing to the spreading of the rabies virus. The virus can potentially also be spread by bat bites.

The current programme in Kabul is carried out through the belief that it will help control the spread of rabies in dogs and control street dog population numbers. Obviously, Mayhew International does not support these inhumane methods of controlling dog populations and the rabies virus and believes that the mass culling of animals, simply to remove them from the streets, is cruel, ineffective and not sustainable. Mass culling may increase the spread of rabies; dog territories can act as a natural control mechanism to prevent the movement of street dogs and thus prevent the spread of the rabies virus from one area to another.

Culling through poisoning is a waste of government funds which could be better put towards more sustainable and humane methods of control. This, in turn would benefit both human and animal populations and more effectively control rabies and the street dog population.

There have already been many rabies vaccination programmes around the world which have significantly reduced, or eliminated rabies within dogs and reduced rabies related deaths in

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Rabies Prevention and Dog Population Management

the human population (See Appendix for case studies). Alongside these examples, there has been a lot of research into the management of street dog populations with successful programmes documented in several countries. These illustrate that there needs to be a sustained strategy benefitting from the input of a variety of stakeholders, including national and local government, local residents, veterinary professionals and animal welfare groups, working together to provide a comprehensive system of mass neutering, vaccination and education and awareness programmes.

Mayhew International has experience with such programmes, in particular working in Ranchi, the capital of Jharkhand state in north India. There, Mayhew International is funding an ABC (Animal Birth Control) programme and the training and development of community outreach initiatives for the non-profit organisation, HOPE & Animal Trust (http://www.hopeandanimal.org). The ABC programme includes mandatory rabies vaccination. We provide veterinary training and assist in lobbying the local authorities on the importance of using humane methods to address the problems of the overpopulation of street dogs and the spread of rabies. In addition, Mayhew International funds an Education Officer and promotes initiatives for schools and community groups to raise awareness about the benefits of neutering the street dogs, rabies prevention and how to behave around dogs.

Mayhew International is also a member of the group of charities funding and supporting the Mission Rabies project (www.missionrabies.com). Ranchi is one of the focal points for Mission Rabies in northern India for the delivery of the project in part by veterinary staff and dog handlers from both The Mayhew and Hope & Animal Trust.

Through combined efforts Ranchi is proposing to be rabies free by 2017.

Proposed Project in Kabul Recent scientific studies show that the spread of rabies in very low density dog populations is very similar to that in very high density dog populations (7). Therefore the spread of rabies does not depend on the number of dogs. Reducing numbers through inhumane methods of culling will not help lower the risk of rabies in humans.

Neighbouring dog populations will migrate to new territories post cull and consequently, due to the lack of competition with other dogs for food and space, are able to reproduce easily, adding to population numbers. An example of how ineffective culling to control rabies is, is that of the Indonesian island of Flores which was rabies free until a canine rabies outbreak in 1997 resulted in 113 human deaths. Local authorities tackled the situation by initiating mass

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killings in 1998, culling around 70% of the street dog population; however rabies was still present in 2004 despite the street dog population being reduced to around half (8).

Mayhew International believes that vaccination programmes are the most effective, as well as being the more efficient method to control rabies. This method is also more humane for the animals and presents fewer health concerns for local communities and the natural environment. Vaccination helps by producing a barrier to the disease. Vaccinating at least 70% of the population in one area helps to create immunity to the virus, slowing down the spread of rabies until it eventually dies out (7). This method is also much more cost-effective than culling dog populations; as more dogs are vaccinated fewer humans are exposed to potentially rabid animals thereby reducing the demand for costly human PEP treatment.

A recent investigation into a rabies outbreak in the Kapisa province of Afghanistan in March 2014 found 30 suspected rabies cases in humans from the attack of one potentially rabid street dog. These 30 cases were treated with an anti-rabies vaccine (one rabies vaccine costs about $25 in a private clinic) (8).

With the removal of the threat of rabies through a mass vaccination campaign, Afghan people would not need to fear such possible attacks and there would be no great need for provision of the expensive vaccines.

A Rabies vaccination programme of the dog population tackles the virus issue, however, to work on managing the population numbers there are several studies which suggest that neutering a minimum of 70% of the dog population can stabilise or gradually reduce population sizes over a number of years (10).

Mayhew International plans to work with the Kabul authorities to implement a mass rabies vaccination programme as a priority, with a trap, neuter, return programme (TNR) running concurrently, subject to resource availability, in order to aid stabilisation of the roaming dog population.

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Trap, Neuter, Return Programmes (TNR)

This part of the project will involve collecting dogs and bringing them to a veterinary clinic.

Healthy dogs will be neutered; males will be castrated and females will be sterilised.

All dogs will receive a rabies vaccination as well as treatment for parasite control. When it is established that the dogs are healthy, fit and do not present any other zoonoses they will be released back into the same area from where they were caught. The dogs will be marked to

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indicate they have been neutered and vaccinated, (see appendix) (11). Any unhealthy or potentially rabid dogs will be euthanised humanely and carcasses disposed of correctly.

It is important that the dogs are released back into the same area as this is their territory where they will live in a pack with other dogs. These dogs will defend this particular area ensuring that no other dogs migrate into it thus preventing any spread of diseases such as rabies. The benefits of this programme include a dog population that is not reproducing, which is vaccinated and healthy, and of greatest importance the dogs do not pose a threat to humans. See appendix for details on supplies that are needed for sterilisation programmes.

For both a rabies vaccination campaign and a TNR project, full cooperation of the authorities and local communities are required. There needs to be a simultaneous awareness raising campaign for local residents on the why and wherefores of the programmes, and what the benefits will be for the public as a whole.

•



Outline of Project Objectives -

Free Kabul city of the threat of rabies gradually expanding to the whole of Afghanistan;

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Creation and maintenance of a rabies immune or rabies free dog population;

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Improve health and welfare of both the owned and the stray dog population;

-

Reduce risk of the spread of zoonotic diseases other than rabies;

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Reduce numbers of stray dogs to acceptable levels;

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Promote responsible pet ownership and education of the local communities;

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Prevent harm to the environment and other animals.

Initial Survey

The successful elimination of canine rabies depends on having a strong evidence base of the current situation: accurate data on dog populations and demographics, as well as disease prevalence are required (12). Studies have shown that for effective rabies control at least 70% of the dog population must be targeted for vaccination (8).

Therefore figures for the estimated dog population in the control area need to be determined before the vaccination programme is implemented, to ensure that a significant number of dogs are vaccinated during the control effort. Data on the initial dog population will allow for

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ongoing monitoring and evaluation, determining the progress and impact of the intervention and will enable the cost-effectiveness of control efforts to be calculated.

Mayhew International, therefore, conducted an initial survey to calculate a street dog population estimate in Kabul. This estimate was made by counting the number of dogs in a random sample of the city’s sub regions, and then extrapolating this count to the whole city.

This survey, using the same methodology, can be repeated over several years, enabling us to observe any changes in the numbers of roaming dogs. Additionally, surveyed animals can also be categorised in the following sub groups to enable a more detailed estimate of the population demographics: -

Age – pups and adults

-

Sex – males, females and unknowns

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Reproductive status – may also be recorded depending on any current methods of neutering or marking

-

Body Condition Score – an additional category that can be added to reflect the welfare status of the animal if there is time to record this information.

Note: As it was the first survey in Kabul, and the surveyors didn’t have enough experience on body scoring, to avoid false reporting we decided to avoid noting down body condition score. We will consider gathering this information in the next survey carried out.

-

Dogs seen walked by the owner – As a cultural or religious belief, in some Islamic countries people are cautious about touching or getting close to the dogs and in different parts of Kabul people have different opinions about being in contact with dogs. It was interesting, therefore to find out how many people were actually walking their dogs in the morning between 6am and 8am.

The information below outlines the details of how the survey was conducted. This has been adapted from World Animal Protection’s (formerly WSPA) guidelines on surveying dog populations (12).

First the city was divided into sub regions; this was initially achieved by dividing the city into its already defined 22 districts. These districts were then further divided into smaller blocks that did not necessarily need to be exactly the same size. The size of these blocks meant that they took no more than 2 hours for the surveyors to cover.

We carried out the survey in 16 districts (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 15, 16 and 17), which are more central, and excluded districts 14, 18, 19, 20, 21 and 22 due to

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Rabies Prevention and Dog Population Management

insufficient information about the human population, possible risks to the safety of our surveyors and the distance from the centre of Kabul.



Selecting sample of blocks

The number of blocks selected for the estimate depended on the time and resources that were available. The more blocks that could be covered, the more accurate the estimate was likely to be.

Figure 4: This example shows district 2, central Kabul city from a Google map. For the survey proper, divisions will be made according to district.

1. Once all the blocks were established and outlined on a map, from the 22 different districts, four letters (eg. A, B, C and D) or four colours (eg. blue, red, green and yellow) were selected and assigned to the blocks, ensuring that no adjacent blocks are the same letter or colour.

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Rabies Prevention and Dog Population Management

Figure 5: Blocks assigned one of the four letters, ensuring adjacent blocks are not the same letter

2. Once complete, one of the four colours or letters was chosen at random and provided a random sample across the city to survey i.e. provided a quarter of the total population estimate.

3. If, once the letter or colour was selected, the sample size was still too large, then the selected colour blocks were numbered from left to right and top to bottom.

4. Once completed the number of blocks were picked depending on the time available to carry out the survey, for example every third block starting from a random number generated between 1 and 3.

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Figure 6: One letter chosen at random to provide sample of blocks to be surveyed



Counting within a selected block

Counts took place early in the mornings between 6am and 8am (before 6am in February it is dark in Kabul), ensuring that a maximum number of dogs were seen before the streets become too busy. Surveyors could move with more ease through the blocks at this time.

Detailed street maps of the selected blocks were required to ensure that every street was covered. The method of counting was standardised amongst all surveyors, as well as an agreed protocol for including dogs at block boundaries.

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Rabies Prevention and Dog Population Management

The red lines show the streets that have been traversed. From the image above, we can determine that the sub-district has been comprehensively surveyed, as the smaller streets can be clearly viewed from the main roads.

The Mission Rabies app is a very sophisticated system supported by GPS. With this technology the surveyor can see their current location and with the Path Tracker option showing their route, they can see which areas have been covered. From this, it is possible to determine the accuracy of the area covered as demonstrated in the image above.



Calculating the number of roaming dogs from the count

Once the count has been completed within the selected blocks, it is possible to calculate an estimate of the number of roaming dogs in Kabul. This is achieved by dividing the number of dogs counted, by the sampling fraction of sub-districts, and then multiplying this average figure by the total number of sub-districts in the whole district (i.e. the number of blocks counted, over the total number of blocks). This figure is not going to give an exact estimate of the dog population, however a 95% confidence interval of the estimate can be calculated. This will indicate with a 95% certainty that the true number of roaming dogs lie within these limits.

Every country will have its own challenges when conducting a dog survey. In Kabul over 70% of the streets have no names, so in some areas it was difficult for the surveyor to ascertain their location. Restrictions in some areas, e.g. the NATO Military bases, Afghan National

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Rabies Prevention and Dog Population Management

Army (ANA), Afghan Police Force, Kabul Airport (which covers a large area in district 15), and other government buildings could affect the accuracy of the survey results, as total access into these districts is difficult. However, with the methodology and technology we have used, we are likely to gain the greatest accuracy possible in our results.



Using the Mission Rabies or Rabies App

WVS (Worldwide Veterinary Services) has supported us during our Kabul dog survey , for which we used their Mission Rabies (MR) app or Rabies app. Their technical teams were in close contact with us while we were surveying the dogs in Kabul and assisted us in loading the maps of the areas that we wanted to survey into “My Map” app.

The red dot is the surveyor location and the black line is showing the surveyor route path. On a road such as this it would be difficult to ascertain where the surveyor is without the help of the Mission Rabies App and My Maps App.

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Rabies Prevention and Dog Population Management

The blue dot shows the start point and surveyor location - District 8, block C10.

The blue dot shows the surveyor location and the grey area needing to be surveyed-District 8, Block C9.

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Once the survey of an area was complete and the entries synchronised, it was possible to see the location of the dogs on the screen along the route taken. From a practical point of view, the MR app also worked as a useful tool to ascertain the most crowded areas where we would start the future vaccination and TNR projects.

Each red mark indicates a dog within the district.

A team of volunteer students from Kabul University Vet Faculty played a major role in this survey. They were young, passionate, dedicated and determined to complete it. It is worth mentioning that 194 students came forward to work voluntarily in counting dogs for us, but only about 15 of them got the opportunity to actually take part in this interesting programme.

One teacher from the vet faculty, and a Mayhew International representative were also involved in running this survey.



Detectability:

For a population size estimate to be as accurate as possible, it is important that the counts need to be corrected for both coverage proportion (i.e. sampling fraction), and “detectability�.

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

Expert views about estimated dog counts:

To clarify things, detectability is very different from coverage issues. Imperfect detectability occurs even if you survey along every single road within a plot and then routinely correct both for coverage (if it is less than 100%), AND then correct separately for the estimate of detectability. We can (probably) safely ignore considerations about animals moving into or out of the plot, as it will all balance out when taking the district as a whole.

However, some experts argue that from all the evidence they have, it would suggest that when we walk down every road in a plot counting street dogs, you would only see about half (maybe less) of the dogs that are primarily associated with that plot. This would be the case even if you were to survey during the most active times of the day. Of course the detectability for surveys done during the more active times are a lot higher than surveys done during the times of the day when dogs are resting, but the detectability never seems to approach 100%, regardless.

We understand that one of the main issues of every survey is the detectability ratio, which is dependent on the methodology and techniques that are used.

The survey Mayhew International carried out was the first dog survey in Afghanistan.

Mayhew International, as part of The Mayhew Animal Home, is the first organisation planning to implement a comprehensive Rabies vaccination programme and dog population management programme in a humane way in the country. Consequently, there was no evidence or previous information to start from and for that reason we could not necessarily rely on research and figures from other countries. The experience and the information we have subsequently gained will help us to start the programmes with a broad and strong foundation.

When we start the vaccination programme, a detectability survey will be run in the same areas already analysed, so that we can find out how many dogs were missed using the methodology described above. The methodology for the detectability survey will be chosen according to well-known guidelines. In this way we will be able to compare the results from the ‘per district’ survey against the ‘Detectability’ analysis and calculate the percentage difference between the two methods. This will give us an offset that we can apply across future surveys to help make them more accurate.

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Kabul Street Dog Survey February – March 2015

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Rabies Prevention and Dog Population Management

Human Population Ratio to Dogs

District

Human Population in District

Assumed stray dog population in District

Ratio of Humans to stray dogs in District

Area (sq km)

People per sq km

12

45,900

431

106 :1

34.6

1327

17

92,800

777

119 :1

52.3

1774

13

210,700

356

592 :1

39.5

5334

16

147,900

810

183 :1

25.2

5869

6

301,800

665

454 :1

50.9

5929

8

300,100

1089

276 :1

49.3

6087

5

272,600

593

460 :1

29

9400

9

259,600

618

420 :1

24.8

10468

15

340,900

719

474 :1

31.8

10720

7

361,000

687

525 :1

33.5

10776

11

249,200

590

422 :1

17.3

14405

3

138,800

503

276 :1

9.02

15388

2

114,600

266

431 :1

6.91

16585

10

318,400

582

547 :1

13

24492

1

94,100

431

218 :1

3.77

24960

4

295,300

508

581 :1

11.6

25457

14

No data for this District

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Rabies Prevention and Dog Population Management

2

The R of the trend line is reasonably strong (at 0.5574) and it is the same negative trend we see in other surveys around the world (the higher the human density, the fewer dogs/100 humans).



Project Planning Post Survey

Now that the initial survey of the dog population has been completed we have an estimate of the total number of roaming dogs within Kabul. From this information we are better able to plan the vaccination and TNR programme phase of the project. This figure has enabled us to predict the scale of the project, how much rabies vaccine will be needed and how long this stage of the project will take.

Scope of Work 1. Vaccination Programme: According to the results of Mayhew International’s dog population survey carried out Feb-Mar 2015, we are expecting the total number of dogs to be ca. 10,280 in the 16 districts of Kabul City. Based on detectability survey guidelines, we need to then add a further 50% onto this total to give a more accurate estimate of the number of dogs.

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Rabies Prevention and Dog Population Management

By adding a further 5,140 dogs (50% of dog population), we would expect to target 15,420 dogs for vaccination in the 16 districts of Kabul.

To effectively control rabies at least 70% of the dog population must be vaccinated (8).

ďƒ˜ Year 1 Vaccination Plan: We will target 100% of the dog population in 16 districts for the first year, due to insufficient information on detectability and to avoid being under budget for the project.

During the vaccination programme, the team will work 6 days a week, 312 days/year. If we deduct 15 days for public holidays, a total of 297 days will be the duration of a one year vaccination programme.

According to this schedule, 50 dogs a day in this first year will need to be vaccinated to achieve our goal. We will extend our project to the following year and will monitor the number of Rabies cases and dog bites with the help of the Ministry of Public Health. When the number of Rabies case reports in Kabul City is at zero for three consecutive years, we will then be able to start creating a buffer zone around Kabul City. Our vaccination programme will be on-going in the buffer zone area for a time yet to be determined.

Mayhew International will use only one vaccination team throughout the first year. During this time, we will organise some short term campaigns with the support of foreign volunteers and in this way achieve results that will take us over the target amount.

ď ś Training of the Dogcatchers: Mayhew International will organise a team of 6 dogcatchers to come from India. UK charity WVS and Indian charity HOPE & Animal Trust, with whom Mayhew International already works, will support us in this regard. We will plan to keep the Indian team for two weeks in Kabul to train our dogcatchers.

12 - 20 candidates will participate in this two-week intensive training course; we will choose only 6 of the best dogcatchers who show particular talent during this programme.

In the short term, we will ask the Indian team to bring 20 catching poles with them, but for the future, we will source this item from the local market.

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Rabies Prevention and Dog Population Management

We will also investigate the possibility of making these catching nets with PARSA (the US charity based in Kabul that helps Afghan Widows and Orphans), so that we can support a local charity and the local residents by buying these items from them.

Apart from the vaccines, all other materials will be sourced locally. In this way we will be helping to improve the economy of the country rather than relying on importation from abroad.

ďƒ˜ Years 2 & 3 Vaccination Plan: Mayhew International will perform a second survey by the end of the first year’s vaccination drive. Based on the information gathered, we will be able to look ahead towards future targets and plans.

Mayhew International’s strategy will be to continue the vaccination programme and cover all 16 districts. This is regardless of whether those districts have zero Rabies cases reported in the hospitals. By the end of the third year, Mayhew International will be able to consider future plans and decide whether the best course of action is to create a buffer zone around Kabul City or to continue with the vaccination programme within the remaining 16 districts.

2. Dog Population Management: Mayhew International believes the best solution to humanely control and contain the dog population is to instigate a Trap Neuter and Return (TNR) programme. This is likely to be a long-term (8-12 years) project for Kabul City. Due to related but differing factors and involvement of various government sectors in dealing with the situation, it will be an on-going but necessary challenge to control the dog population in the city.

Access to food on the streets, from waste products or from people actively feeding the dogs, naturally improves the fertility of the dogs. In some cases, dog owners will release their unwanted, entire and/or pregnant female dogs onto the street, thereby potentially adding to the street population.

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Rabies Prevention and Dog Population Management

ďƒ˜ TNR Programme for Year 1: We will ask Kabul Municipality to start the TNR project in 5 districts (1, 2, 3, 4 and 10) with the possibility of more being considered, resources allowing.

We expect the total number of dogs in these five districts to be in the region of 2,290. By adding an additional 50% for detectability reasons (1,142 dogs) we are assuming that we will have to control and contain 3,435 dogs in these five districts.

Within these 5 districts, Mayhew International will target 80% of the dog population, which equates to 2,748 dogs. If we work 260 days in one year, we are aiming to neuter 11 dogs per day to reach our target.

The first year TNR programme within the five districts will be a trial project. We will conduct a detectability survey to find out how many dogs have been missed or crossed into the zone that we are operating in (Green Zone).

ďƒ˜ TNR Programme for the Second Year: If the neutering programme functions successfully and we achieve the neutering target set, we will take over one or more districts from Kabul Municipality and will expand the work area according to our funding availability.

In this case we will create two dog-catching teams for the second year: Team one will focus on the five districts to maintain the number of neutered dogs to the same number that was achieved in Year 1.

Team two will work in the new districts; the new districts will be those neighbouring districts so that the original ring is expanded.

Finalising the budget for Year 2 of the TNR programme will be dependent on results and outcomes from Year 1.

After establishing the percentage of dogs we covered in the first year, the remaining number will be added onto the budget for the next year. The Mission Rabies mobile app will help give an indication as to where the most of the dogs are situated and indicate where to start the next phase of the TNR programme.

Importantly, before any TNR programme can take place in Kabul City, the Municipality culling programme has to stop. Both programmes (TNR & Culling) cannot run at the same time.

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Rabies Prevention and Dog Population Management

We need to have the facility to keep ca. 25 dogs at a clinic. After neutering all dogs will be released back to the same street where he/she was taken from. A full health check should be given at point of entry and again before releasing them back.

We plan to sign a contract with the University Vet faculty clinic to use their facilities for the neutering programme. The vet students will then get practical training in small animal reproductive surgery as well as building up their surveying & monitoring skills.

Challenges: Mayhew International is aware of challenges that could impact on our work on the ground.

1.

With the current culling programme run by the Kabul Municipality there is presently a

low number of dogs on the street. By stopping their programme the number of dogs could increase in five districts until we control the dog population using the TNR programme. As a result of that we could face some complaints from the local people regarding the increase of dog numbers on the street.

2. While we are carrying out the TNR programme in five districts, the Kabul Municipality is carrying out culling programmes in the neighbouring districts. As a result of this some of the dogs we neuter might roam into other areas and get poisoned by Kabul Municipality.

3. Because of the uncertainty of borderlines between districts, the Municipality might enter into parts of the Green Zone and poison the healthy dogs that have been neutered and vaccinated. Poisoning the neutered dogs around the borderline between districts can open the gate for the unneutered dogs to enter into the green zone.

However, Mayhew International is fully aware of all these issues and is planning to address and minimise these challenges by co-operation and teamwork with Kabul Municipality, MAIL and the Ministry of Public Health.

Staffing Requirements International Project Manager – Afghanistan – Dr Abdul Jalil Mohammadzai DVM, The Mayhew Animal Home.

Dr Jalil qualified as a Doctor of Veterinary Medicine from Kabul University, Faculty of Veterinary Science, in 1995 and started working at The Mayhew in February 2002. During

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Rabies Prevention and Dog Population Management

his time with The Mayhew he has gained extensive experience in small animal surgery and shelter management. Dr Jalil has been involved in the training of vets overseas, teaching surgical procedures in Universities and to vets working for other charities, as well as teaching about TNR programmes in Romania, Russia, India, Georgia and Afghanistan. In November 2014 he visited India to work with the Mission Rabies programme in Ranchi, which was sponsored by The Mayhew, with the aim of vaccinating 5000 dogs against rabies in two weeks and assisting with the TNR project.

Dr Jalil has also extensively advised on Mayhew International projects within Afghanistan, using his understanding of the culture and local languages to create positive results for the animals within the country. Based on his experience at The Mayhew he has been recruited as the International Project Manager for Afghanistan to implement this Rabies Prevention and Dog Population Management Programme. Dr Jalil believes that the implementation of this project will help save thousands of human and animal lives and will help to improve the welfare issues currently faced in Afghanistan.

The following resources will be required per team during the vaccination and TNR phase of the project. 1 team will be required for dog catching purposes to begin the rabies prevention and dog population management project.

Additional Staffing Requirements Field Teams comprise of: -

2 x Veterinarian - total 6 x Dog Catchers 2 x Driver/Catching Assistant 1 x Vaccination Data Officer / Catching Assistant 1 x Post Vaccination Surveyor 1 x Painter (carries paint & vaccine box)

Base Team comprised of: -

1 x Supervisor 1 x Data Officer 1 x Accountant (Office Manager / Book Keeper) 1 x Cleaner 1 x Cook to prepare canteen style food

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Rabies Prevention and Dog Population Management

Partnership Collaborations In Afghanistan Current connections • Department of Public Health, Ministry of Agriculture and Farming, and Kabul Municipality - These are three of the main bodies tasked with controlling rabies and the dog populations in Kabul. The Mayhew has a good longstanding relationship with these governmental departments and they are already involved with the initial stages of the project.

• Kabul Municipality, Sanitation Department – The oversight of Kabul Zoo comes under Kabul Municipality. Our work with Kabul Municipality started in 2002 when the animals were dying from starvation at Kabul Zoo following the collapse of the Taliban regime and the new government had no budget for staff salaries or animal feed.

Dog population management is the responsibility of the city’s Sanitation department. We have been advising them over the past few years to stop culling dogs through poisoning and encouraging them to start a TNR programme that is a more effective and humane way of dealing with the issue. Kabul Municipality is very keen to work with us and to start a Rabies vaccination and then TNR programme in Kabul.

• Kabul Zoo – The Mayhew proposes to work with Kabul Zoo with their current education programme that currently reaches around 40,000 students. Through collaboration we can teach about the importance of managing street dog populations in particular to help with reducing rabies in the human population.

• National Environmental Protection Agency (NEPA) – The Mayhew has a long-standing relationship with NEPA and we will work with them to ensure that the programme does not affect any endangered species and to make certain that rabies does not spread to the wildlife population of Afghanistan.

• Kabul University and Herat University Veterinary Faculties - We have been supporting the Faculty of Veterinary Science at Kabul University since 2002. The Mayhew helped, in 2005, to rebuild the clinic for the vet faculty that had been destroyed during the conflict in Afghanistan. We bought a gas anaesthetic machine and some other equipment for the clinic and we are still involved in the training of their staff and students. Recently, we managed to connect them with the University of Edinburgh and the Jeanne Marchig

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Rabies Prevention and Dog Population Management

International Centre for Animal Welfare Education and we are sure Kabul Vet Faculty will benefit from their expertise.

Recently we have made contact with Herat University Vet Faculty in Herat province, northwest Afghanistan and we are aiming to support them in the same way.

We believe our long-standing relationship with both Faculties will enable us to extend our programme throughout the country and with this long term education programme we will be able to improve animal welfare, rabies control and dog population management issues in a humane way.

• PARSA - Founded in 1996, PARSA is a private non-governmental organisation working directly with the disadvantaged people of Afghanistan. PARSA supports communities as they make their own development solutions, focusing on promoting social change and a healthy and fair society for all people, but especially women and children. The Mayhew has supported this charity for several years by selling products made by local Afghan woman at UK events and on our website. PARSA currently has its own educational programme and The Mayhew will work with them to expand this to incorporate education about rabies and responsible dog ownership, good animal welfare and issues around refuse collection and the environment (http://afghanistan-parsa.org).

• Nowzad - The aim of the charity is to improve the welfare of the animals of Afghanistan; which includes humanely reducing the stray dog population which in turn will reduce the incidents of canine rabies, provide animal welfare education for the Afghan people and develop training programmes to improve the lives of working animals. The Mayhew was involved with assisting the founder of Nowzad with the original set up and has been working with Nowzad for several years with both financial and practical support: assisting with the training of their vets, visiting the facility twice a year to support them etc. The Mayhew proposes to work with Nowzad during the dog population management programme and use their clinic facilities to help with the TNR programme (www.nowzad.com/projects/vet-training).

• Embassy of Afghanistan in UK - The Mayhew Animal Home has a good relationship with the Embassy of Afghanistan in the UK; we always keep the Ambassador and relevant Embassy staff informed about our project in Afghanistan.

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Rabies Prevention and Dog Population Management

Mr Dawood Yar (H.E. Ambassador in UK) visited The Mayhew Animal Home twice last year and through sponsorship by the Embassy one 20 ft. container of supplies (veterinary equipment, drugs etc) will be transported to Afghanistan.

The Embassy will support us to register our organisation in Afghanistan, so The Mayhew can work as a legal entity/NGO in Afghanistan.

Future Connections • Afghan Army and Police – The many police checkpoints and army bases have numerous dogs in their area and could be a useful resource to aid with the trapping of dogs and also performing counts of the numbers of dogs.

Global Organisations Current Connections • Worldwide Veterinary Services (WVS) – The WVS launched Mission Rabies in India in 2013 with the overall goal of ridding the world of rabies by 2030. The Mayhew has contributed with some funding from the beginning and has provided vets and dog handling staff for the vaccination drive in Ranchi, where we already support Hope & Animal Trust.

In 2014, The Mayhew sponsored the ABC training and Mass Rabies Vaccination drive for Mission Rabies in Ranchi in November. The Mayhew’s vet team lead on the surgery training and also provided vets and handlers for the vaccination drive. (http://www.missionrabies.com/) • World Animal Protection – (formerly WSPA) is calling on governments to stop killing dogs, and instead run effective dog vaccination programmes, they offer guidance documents and support for these programmes. The Mayhew has been collaborating with Alistair Findlay, Middle East Programme Manager at WAP, who has been advising on survey methodology.

•

Humane Society International (HSI) - The HSI have knowledge and experience with rabies eradication projects around the globe; their knowledge and experience with rabies will aid us with the fight to rid Kabul of rabies. HSI have collaborated with vet training by Dr Jalil for ASAL (Afghan Stray Animal League) in Kabul.

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Rabies Prevention and Dog Population Management

Future Connections • Dutch Committee for Afghanistan – Veterinary Programme (DCA) - DCA-VET is a non-governmental organisation helping to rebuild Afghanistan. Being a veterinary oriented organisation, DCA-VET commits itself to improve the health and productivity of the Afghan livestock. Mayhew International proposes to work with DCA-VET ensuring livestock including horses and donkeys are vaccinated against rabies to aid with the elimination of the disease throughout Afghanistan through providing vaccines to be distributed around the region.



Animal Health Development Programme (AHDP II) Susan Chadima DVM Afghanistan Ministry of Agriculture, Irrigation and Livestock (MAIL) Landell Mills Development Consultants Susan Chadima qualified as a doctor of veterinary medicine in the US and has been working in Afghanistan in the past few years. She previously worked with DCA (Dutch Committee for Afghanistan) in Kabul and is currently working as the team leader for the Animal Health Development Programme with the Ministry of Agriculture in Afghanistan.

Susan’s knowledge of the Afghan culture and working with foreign organisations in Afghanistan is very good. In the past Susan has collaborated with the Mayhew on projects in Afghanistan, and with other organisations working in Kabul in the animal field.

Susan is a very trustworthy colleague and a professional vet with whom Dr Mohammadzai has carried out a variety of small animal surgeries whilst working in Kabul.

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Rabies Prevention and Dog Population Management

Summary and Future Plans The Mayhew has a good, longstanding relationship with Kabul Municipality, Kabul Zoo, the Ministry of Agriculture and Farming, NEPA (National Environment Protection Agency), Kabul Vet University, AVA (Afghan Veterinary Association) and some local MPs, plus we have direct contact with several Afghan Ministers and politicians. These connections, coupled with Mayhew International’s experience on dog population management initiatives and working on mass rabies vaccination programmes, means that we are in an excellent position to embark upon the elimination of rabies in Kabul and nationwide in Afghanistan.

Our long term goal is to remove the threat of rabies, enabling Afghan communities to live without fear of contracting this terrible disease. During this long term project we also envisage educating veterinary professionals and local people about responsible dog ownership as well as working to maintain a healthy, neutered street dog population.

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Appendix i)

Case Studies of Successful Rabies Vaccination Programmes

Case Study 1 - KwaZulu Natal, South Africa This area of South Africa was reported to have 79% of reported human cases of rabies in the whole country between 1983 and 2007. A dog vaccination programme began in 2009 and 1.5 million dogs were vaccinated with the occurrence of animal rabies halving over a three year period. Between 2010 and 2011 the KwaZulu Natal authorities reported a continuous 12 month period without a reported human case of rabies showing the success of the programme which is now being extended across southern Africa (4).

Case Study 2 - Visayas, Philippines The regional programme to eliminate rabies in the Visayas has involved the vaccination of more than 3 million dogs in a 5 year period. The number of human deaths from rabies has decreased significantly, from 48 cases in 2008 to 13 in 2012, a 70% reduction (4).

Case Study 3 - Latin America In 1983, Latin America committed to mass dog vaccination to eliminate cases of human rabies transmitted by dogs. Adopting this humane approach has paid off: dog rabies cases in the region declined from a peak of 25,000 in 1977 to just 196 in 2011 – a decrease of over 99%. Similarly, human rabies cases fell by 96% to only 15 across the whole continent.

The effectiveness of vaccination is clear: dog rabies cases were reduced to zero from close to 5,000 per year in Buenos Aires, Argentina; 1,000 in Lima, Peru and 1,200 in Sao Paulo, Brazil (14).

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Rabies Prevention and Dog Population Management

ii)

Identification Methods for Dogs

(as outlined in WSPA’s guidance document [11]) The following are methods of identification for stray animals as part of an intervention.

Visible identification methods such as ear notches or collars are widely used to distinguish animals that have been neutered, vaccinated or treated as part of a dog population management programme. This can have the additional benefit of indicating to the community that these animals are being cared for as part of a management programme, raising awareness of the organisation or authority carrying out the intervention and potentially enhancing public cooperation.

Methods include the following: Permanent – Tattoo; Microchip; Ear Tip/Notch; Freeze Brand Semi-permanent – ID Collar; Ear Tag Temporary – Paint/Dye; Radio Transmitter The identification method chosen should be the most humane and efficient of the available options taking into account the target population, resources available and local conditions.

For population management programmes, the method chosen should be guaranteed to remain effective at least until the objectives of the programme are completed, and the animal should suffer no adverse effects on its immediate or long-term health or behaviour. The welfare implications of identification methods differ according to each situation, but the following factors should be assessed: Capture, restraint and handling -

For nearly all methods of identification, some level of physical restraint will be required.

-

Distress should be minimised by using techniques appropriate to the species, and bearing in mind the huge variety in size and shape of (dog) breeds.

The procedure -

The operator must be suitably trained (some methods require significant training).

-

The time taken for the application should be minimised, but not at the expense of safety.

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Rabies Prevention and Dog Population Management

-

Some methods can only be used on animals under general anaesthesia. Wherever possible therefore, these methods should coincide with surgery (e.g. neutering), to minimise the time, cost and risk associated with performing general anaesthesia.

-

Precautions must be taken to prevent the spread of infectious disease (either between animals or from animals to people).

Potential long-term implications -

Risk of infection or abcessation from skin damage or puncturing.

-

Chafing from collars and injury caused by snagging or pulling of collars or tags.

-

Toxicity e.g. from dye or ink.

-

Ecological implications of increased visibility/altered appearance. Prolonged pain following procedure (e.g. due to growth restriction).

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Rabies Prevention and Dog Population Management

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Rabies Prevention and Dog Population Management

iii)

Supplies Needed for Sterilisation Programmes

The basic supplies needed to set up a sterilisation clinic, and the equipment required to perform 100 female sterilisations are provided in this section.

Items for static clinic Equipment

Cost

Registration area - Tables and chairs Waiting/recovery area -

Poles / tresses to tie leashes to

-

Extra cages for small dogs and cats

-

Newspaper, towels, mats

-

Heating pads (particularly in regions with cold weather conditions if the clinic is outside)

Prep room / store room / laundry -

Tables (ideally stainless steel tops, otherwise tables with easy to disinfect surfaces)

-

Autoclave ideally, otherwise a steriliser or cold sterilisation equipment that will render the equipment aseptic

-

A storage cabinet with a lock (for storage of drugs)

-

Weighing scales

-

Refrigerator (to store vaccines and drugs)

-

Electric clipper with blade size 40 (alternatively, disposable shaving blades)

-

Spray bottles for prep solutions

-

Waste bins

-

Restraining devices for dogs and cats (e.g. muzzles, leashes, nets, crush cages, towels etc.)

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Rabies Prevention and Dog Population Management

Equipment

Cost

Surgery room -

Surgical tables (ideally stainless steel tops, otherwise tables with easy to disinfect surfaces)

-

IV stand

-

Instrument stand

-

Provision of clean water supply (bottled if necessary)

-

Surgical lamps (optional if vets feel there is adequate light)

Items for mobile clinic Equipment

Cost

General - Provision of clean water supply (bottled if necessary) -

Items for registration/education materials

-

Registration forms

-

Post-operative care instructions

-

RPO materials

Medical/surgical equipment needed (1-2 of each unless otherwise stated) -

Kidney bowl

-

Thermometer

-

Gauze container

-

Scissors

-

Haemostat

-

Suture-removal scissors

-

Nail clippers

-

Stethoscope

-

Pen light

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Rabies Prevention and Dog Population Management

-

Storage jar

-

Laryngoscope

-

Various sizes of endotracheal tubes (ideally used only once daily – minimum 15-20 required)

-

Spay sets (depending on daily capacity - preferably a minimum of 10 sets)

-

Towel clamps

-

Haemostats

-

Needle holder

-

Allis forceps

-

Tissue forceps

-

Backhaus clamps

-

Carmalt forceps

-

Scissors

-

Spay hook

-

Items for a crash box (emergency)

-

Resuscitation bag

-

Endotracheal tubes and laryngoscopes

-

Needles and syringes

-

Gauze

-

Emergency drugs (adrenalin, atropine, dexamethasone, antihistamine, morphine, doxapram, reversal agents etc.)

-

Medical/surgical consumables (for 100 dogs)

-

Gauze 1,500 pieces (for prep – minimum 10-15 per dog)

-

Cotton (for injection - 1-2 rolls)

-

Needles (one needle per injection – estimate at least 600700 pieces)

-

Syringes (minimum 100 pieces ). Note: syringes can be reused for same drugs unless contaminated. Preferably changed daily.

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Rabies Prevention and Dog Population Management

-

Lubricating jelly (to take temperature) – 1 tube

-

Examination gloves – minimum 100 pieces

-

Scrub brushes – 4-5 pieces

-

Disposable drapes, 100 pieces, one per dog and washed daily (can be replaced with cloth drapes)

-

Surgical gloves – 100 pieces (plus 10 extra)

-

Surgical blades – 100 pieces

-

Sutures

-

Chromic catgut – 40 metres

-

Vicryl/Safil (synthetic absorbable) – 50 metres (if used for intradermal sutures, or 30 m without)

-

Nylon – 40 metres (for skin sutures, but needs to be removed)

-

Suture needles – 10-20 pieces (if needles not sewed on to sutures)

-

IV infusion set – 25 pieces (can be re-used if using the same bottle; ideally changed daily)

-

IV catheters – 100 pieces (plus 20 extra)

-

Autoclave tape/indicators – 1 roll

-

Autoclave envelopes – 100 pieces or 30 metres (can be replaced with cloth), one per spay set (can be reused)

-

Surgical tapes – 30 metres

Drugs/medicine -

Premeds

-

Anaesthesia

-

Antibiotics

-

Analgesic

-

Chlorohexidene solution – 1.5 litres

-

Alcohol – 5 litres

-

Tincture iodine – 0.5 litre

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Rabies Prevention and Dog Population Management

-

Eye ointment – 5 tubes

-

IV drip (lactated ringers or normal saline) – 25 litres

Items for cleaning up -

Basin – 2-3

-

Brush – 2

-

Detergent – 1 bottle

-

Towels

-

Broom/mop and bucket

-

For identification of dogs – there are a number of alternatives

-

For collaring – 100 collars

-

For tattoo – tattoo equipment with ink

-

For ear notching – curved haemostats, cauteriser, 100 blades

-

For microchipping – 100 microchips, scanner, 100 alcohol swabs

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iv) References 1.

Knobel DL, Cleaveland S, Coleman PG, et al. 2005. Re-evaluating the burden

of rabies in Africa and Asia. Bull World Health Organisation. 83:360-368.

2.

World Society for the Protection of Animals (WSPA). (2013). Controlling

Rabies: One humane solution, three reasons why.

3.

Dr Marofi & Dr Shahab. Islamic Republic of Afghanistan Ministry of Public

Health. (2014) Rabies control in Afghanistan.

4.

World Health Organisation (WHO), Regional Office for South-East Asia.

2013. Strategic Framework for Elimination of Human Rabies Transmitted by Dogs in the South-East Asia Region.

5.

World Health Organisation (WHO), 2010. Rabies Fact Sheet 99.

6.

Global Alliance for Rabies Control, September 2013. World Rabies Day:

Rabies elimination could save the world $124 billion annually 7.

Hampson, K., Dushoff, J., Cleaveland, S., Haydon, D.T., Kaare, M., Packer,

C. & Dobson, A. 2009. Transmission dynamics and prospects for the elimination of canine rabies. PLoS Biology, 7, 462–471.

8.

World Society for the Protection of Animals (WSPA). Mass vaccination

against rabies; the only solution saving humans and animals.

10.

Jackson, E. et al. 2013. Rabies: Scientific Basis of the Disease and its

Management, 3rd Edition. Elsevier Publishing.

11.

World Society for the Protection of Animals (WSPA). Identification methods for

dogs and cats; Guidance for WSPA staff and members societies.

12.

International Companion Animal Management Coalition. 2007. Humane dog

population management guidance.

All references accessed January 2015

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Acknowledgements and Thanks Andy Gibson, MRCVS – Worldwide Veterinary Services (WVS). Thank you for the technical support whilst surveying in Afghanistan and using the Mission Rabies App. Michelle Mortors, Ph.D. – Cambridge University. Thank you for the advice given to Mayhew International with regards to Rabies vaccination and dog population management, and the best strategies to use.

Alistair Findlay – Middle East Programme Manager, WAP. Advised Mayhew International regarding the best survey methodology guidelines.

John D Boone, Ph.D. – Research Coordinator, Great Basin Bird Observatory (GBBO) was a great help in explaining survey detectability guidelines and methodology.

Caroline Yates – CEO, The Mayhew. Guidance on the rules and structure of the proposal Kate Saunders and Lorea Hoye – Mayhew International administration Graham Hilling – creating the map layout used in the survey of Kabul.

Kabul University Teachers and Students – for taking part in the survey and counting dogs on the street. Thanks go to Professor Amanullah Aziz, A.Bassat, Alidad, Beheshta, Hussain Ali, Jawid, M.Ali, M.Ehsan, M.Ismail, M.Sadiq, M.Sulaiman, Omid, Rahmatullah, Samoon and Sulaiman Omarzai.

59

www.themayhew.org/international The Mayhew Animal Home, Trenmar Gardens, Kensal Green, London, NW10 6BJ Registered charity no. 1077588