A RABIES CELL PHONE ADVISORY SYSTEM: A CULTURALLY TARGETED TOOL DESIGNED TO REDUCE HUMAN RABIES SUFFERING IN THE PHILIPPINES

1
A RABIES CELL PHONE ADVISORY SYSTEM A
CULTURALLY TARGETED TOOL DESIGNED TO REDUCE HUMAN
RABIES SUFFERING IN THE PHILIPPINES
E. Adriano1, M. Vinluan2 and S. J. Scholand3. 1.
ARF World Philippines, Quezon City,
Philippines 2. Department of Health, Manila,
Philippines 3. A Rabies Free World, Philadelphia,
United States of America.
www.rabiesfreeworld.net

• Introduction
• Rabies in the Philippines is endemic, with
  several hundred fatalities reported each year in
  the archipelago. Significant morbidity also
  exists from dog bite injuries, which often
  require rabies post-exposure prophylaxis (PEP).
• Rabies illness is virtually 100 preventable if
  appropriate and timely PEP is provided.
• Barriers responsible for the ongoing rabies
  problem in the Philippines and other developing
  countries include lack of knowledge regarding
  many aspects of the disease and its prevention.
  Information to empower a large segment of the
  population can be made available in a culturally
  appropriate format through the use of cell
  phone technology.

Abstract
Morbidity and mortality from human rabies in the
Philippines remains high. Major factors
responsible for the continued problem include
lack of knowledge regarding aspects of disease
prevention, perceived high cost of treatments,
cultural inhibitions to legitimate medical care,
as well as finite resources. In resource
constrained areas where rabies is endemic, low
cost technologies developed to address these
issues could reduce suffering by providing
information to make more intelligent
decisions. We sought to develop a cell phone tool
to disseminate information about rabies to the
people of the Philippines. We envisioned users
of the system to increase their understanding of
rabies so as to more appropriately access
existing health resources. We contracted a
private company to develop a cell phone
accessible information system designed to provide
basic information about rabies. Through text
messaging, users can download to their cell
phone information on rabies including rabies
prevention, rabies prevalence, disease basics,
appropriate treatment for potential rabies
exposures, and animal and dog information.
Additionally, the system provides the location of
Department of Health (DOH) approved Animal Bite
Treatment Centers and Bureau of Animal Industry
recognized veterinary diagnostic
laboratories. The three major telephone carriers
in the Philippines now support this tool, with
the potential to reach up to 20 million cell
phone users. Promotional efforts to make the
tool more widely known are ongoing. Future
studies to assess the impact of the rabies cell
phone advisory system in terms of health access
and utilization are planned.
Figure 1. Rabies Fatalities in the Philippines
2005

• We identified areas where lack of awareness
• lead directly to fatalities from rabies
• Exposure risk
• No medical care sought
• Delayed, inappropriate or absent PEP
• Medical care sought from local non-physicians
• (tandoks or faith healers)
• Perceived high cost of treatment
• Incomplete follow up

Materials and Methods
We designed rabies bullets of information that
could be accessed via cell phone following a
subscription to a rabies advisory system (see
Table 1). We included information on local
Department of Health (DOH) approved Animal Bite
Treatment Centers and Bureau of Animal Industry
(BAI) diagnostic labs. We contracted a private
company, DotEnable, to build this system,
vis-à-vis other cell phone informational systems
and manage it.
lt 1 1 19 20 29 30 39
Modified from original by Dr. E. Miranda
Results A rabies cell phone advisory system was
designed using existing technology. The system
was launched and implemented. Formal studies to
test efficacy as a learning tool are planned.
Figure 2. Fighting against the deadly virus
Table 1. Excerpted data from database
Rabies Tips
Animal Bite Treatment Centers
Rabies Approved Diagnostic Labs
Rabies is caused by animal bites or scratches. One in 100 dog bites is from a rabid animal. Signs and symptoms of rabies are fever, numbness at the bite site, agitation, fear of water, and paralysis. The victim might act crazy. Rabies does not develop right away. It can take weeks to months to develop. It is a must to consult an Animal Bite Treatment Center once exposed or bitten.



Manila City
Unciano Medical Center, Sta Mesa, Manila Manila Health Department, Division of Preventable Diseases, Manila City Hall
Research Institute for Tropical Medicine (RITM), Alabang Muntinlupa [phone] San Lazaro Hospital, Rizal Ave, Sta Cruz Manila
Manila City

• Bureau of Animal Industry, DA, Visayas Avenue,
  Quezon City
• Research Institute for Tropical Medicine (RITM)
  Alabang, Muntinlupa [phone]
• San Lazaro Hospital, Rizal Ave, Sta Cruz, Manila

• Conclusions
• Cell phones are widely available in the
  Philippines and other Asian countries where
  rabies is endemic
• Education about rabies disease and prevention
  saves lives
• A tool designed to provide valuable health
  information to the people of the Philippines
  supplements
  other anti-rabies efforts.

Maricar Dizon
References 1. Knobel DL, et al.,
Re-evaluating the burden of rabies in Africa and
Asia. Bull of the WHO. 83(5)360-8, 2005 May. 2.
Alera M, et al., Clinical and epidemiological
features of human rabies cases, San Lazaro
Hospital, Manila, Philippines, RITA, Brazil. Oct
2006.