Bangalore: Even as hospitals and health centres in the city are stocking up anti-rabies vaccine (ARV) to combat the perceived increase in the number of dog bites, the crux of the issue seems to be of lack of access to prompt medical care to the poor and those on the streets rather than non-availability of the vaccine.

Voluntary organisations working with the marginalised say this is more of a social issue than a medical one, as the street children are the most vulnerable to dog bites.

Around three months ago, a four-year-old boy from a lower economic background was bitten by a dog, but was refused treatment at a Primary Health Centre (PHC) because he did not have a BPL card.

"Health workers at the PHC in K.R. Puram refused to administer the vaccine to the child as his family could not afford to pay for it and did not have a BPL card. The fact is that it is mostly the poor and those living on the streets, especially children who are bitten by dogs," said Kshitij Urs, of the Association for Promotion of Social Action (APSA).

Vaccine availability

While some government hospitals are geared up to deal with dog-bite cases, others are not.

Even though authorities at K.C. General Hospital reassured The Hindu that they had adequate stock of the vaccine, the hospital has reportedly experiencing shortage on and off.

According to sources, the hospital had not been receiving adequate supplies from the Government Medical Stores (GMS) and there were times when it had to turn away dog-bite cases.

Even now, only those with BPL cards are given the vaccine while others are sent away.

"The situation has improved now. Presently, we have 200 vials and we are expecting another batch from the GMS shortly," Resident Medical Officer (RMO) Byra Reddy said.

When pressed, he admitted that only patients with BPL cards were provided the vaccine.

The Epidemic Diseases Hospital, which received some 250 dog-bite cases in January this year, has adequate stock of rabies vaccine, sources said.

According to K.V. Ashok Kumar, Medical Superintendent of Victoria Hospital, the hospital has 3,000 vials of the vaccine in stock and is expected to get 6,000 more by the end of next week.

Last year, 16,000 vials were used, while this year already around 3,000 vials have been used.

As for BBMP's 29 health centres, 19 urban family welfare centres, 23 maternity homes and six referral hospitals, their position is comfortable unlike a few months ago when there was a severe shortage.

"If there are no stocks in the stores, the assistant surgeons can buy them from outside and get the bills reimbursed," Chief Health Officer L.T. Gayatri said.

Last April when more than 16 people of Lakshmanapura slum tenement in Gandhinagar had been bitten by a rabid dog, the victims were rushed to a private hospital, as the nearest BMP hospital and K.C. General Hospital did not have stocks.

According to medical experts approximately 6,000 dog-bite cases are reported in the city every month. But according to BBMP, only 1980 cases were reported in the city limits in January while 942 cases were reported in February.

"We used up more than 55,000 vials of ARV vaccine from April 2005 to March 2006. But from April 2006 till date, we have used only 30,000 vials. This means the number of cases are less this time and this is the only consolation," a doctor at the BBMP's Referral Hospital at Banashankari pointed out.

© Copyright 2000 - 2009 The Hindu