One Health

Yesterday a headline in the online Sun Star Daily caught my attention: “Dog accompanies dying owner in rush to ER.”

When I clicked on the link I was greeted with a photograph of a man and a dog waiting at a door. The article explains this was taken last Saturday at the emergency room of the Davao Doctors Hospital, to where Elenito Bandayanon was rushed after suffering a heart attack. The dog had accompanied the patient and, presumably, his relatives, to the hospital and had waited at the door, occasionally barking.

Arvin Ceria, a nurse reliever, took the photograph and posted it on his Facebook page with an explanation in Cebuano about the patient being admitted for cardiac arrest and the dog wanting to enter the ER. The patient died, and the doctors, touched by the dog’s loyalty, allowed her in.

For the report, Sun Star quotes from the Facebook exchanges between Ceria and the patient’s stepson.  The dog, Saicy, has been with the Bandayanon family for four years and is said to be sad (mingaw). But “Saicy will be alright,” said the stepson. “We will be alright.”

Bonds

Reports on cruelty to animals, especially to dogs, are much too common, but there are also moving stories like that involving the Bandayanons and their dog. Stories of intense bonds between humans and, to be politically correct, nonhuman animals, are common, but many go unreported in the mass media.

It’s these bonds that need to be part of the agenda of One Health programs now being pushed by international organizations to link human medicine, veterinary medicine and the environment. This comes about in recognition of the many close links between humans and nonhuman animals that ultimately determine human health and welfare.

Last week at the University of the Philippines Los Baños, I attended an initial workshop to get One Health going in the country.  Several academic units in the UP system are involved, notably the College of Veterinary Medicine in Los Baños, the College of Medicine in Manila and, from Diliman, a rather eclectic mix of one anthropologist-veterinarian, biologists, and home economics people (more about the last in a while).  The project is being initiated with the North Carolina State University.

Much of the attention in One Health initiatives focus on three issues: food security, zoonoses (diseases that can be transmitted from animals to humans), and resistance to antibiotics. The first two concerns are easy to understand, but the third needs a bit of explanation.  At the UP Los Baños workshop infectious diseases specialist Dr. Raul Destura of the UP College of Medicine talked about seeing an increasing number of human patients with infectious diseases that don’t respond to antibiotics. In part, this is because human doctors prescribe antibiotics rather indiscriminately, even as patients themselves self-medicate, sometimes even using antibiotics to prevent diseases. I have to be clear: Antibiotics do not prevent diseases, especially sexually transmitted diseases, and have caused so many problem infections that are multidrug-resistant.

People are even less aware of a third contributory factor to antibiotic resistance: the use of these drugs in the livestock industry, again supposedly to prevent diseases. Unfortunately, antibiotic-resistant strains of microorganisms can be passed on from animals to humans, and there are serious long-term implications as we run out of effective antibiotics. I sometimes think we should include antibiotic resistance in our discussions of disaster prevention and management because many lives are at stake.

At that Los Baños workshop, I did remind participants that we should expand our agenda to view animals as more than just food, or sources of diseases. In UP Diliman alone, we have an estimated 7,000 dogs and heaven knows how many cats, in all kinds of relationships with humans.

Owner cats

There are the loved pets, fed properly, brought to the veterinarian for checkups and vaccinations. The College of Veterinary Medicine, with support from Rotary Club and the Diliman administration, conducts annual free rabies vaccination, a major endeavor that mobilizes dozens of professionals and students. But we are probably getting only about half of the animals.

There are many households with dogs and cats but without any responsible ownership. The dogs and cats come and go, mixing with another population of feral or roaming ones.  And then we have Diliman’s famous cats—I am told there is even a Facebook site devoted to them—that have established colonies throughout the campus.  I joke that these are “owner cats”—they don’t have owners; instead, they own the buildings and the humans.

There are valid fears about this large animal population’s threats to human health, but we forget that the animals also perform many functions. Besides companionship, and watchdog functions (the main reason, I suspect, why urban poor settlers keep dogs), both dogs and cats control household and building pests (sorry, not much they can do about human pests—you know, the overstaying ones).

With One Health coming into place in UP, I’m pushing our Institute of Biology to come on board with studies on the human-animal dynamics and urban ecology. Besides being inhuman, the old way of exterminating stray dogs and cats is just totally unscientific: New ones come in to fill the void and a new cycle begins.

Working out One Health will need people from all disciplines. I invited the College of Home Economics to send faculty members involved in early childhood education to the Los Baños workshop because pet ownership in homes goes a long way to teach kids compassion and responsibility.

One of the most active faculty members from Diliman involved in animal welfare is from the College of Mass Communication, which will be crucial for public education on responsible pet ownership. I would think that later, for this public education, we might bring in theater and the arts.  (In a future column I will talk about what people from the College of Arts and Letters are doing for disaster preparedness.)

I started my column with the story of Saicy from Davao.  In western countries, health-care institutions—hospitals, hospices, homes for the elderly—have been discovering the potentials of using trained dogs to comfort patients. Provided, of course, that patients love dogs and cats, and aren’t allergic to their fur, simply stroking a dog or cat has been known to calm patients down, even bringing down their blood pressure.

Saicy’s presence in the hospital reminds us of the two-way relationship between pets and humans. She tagged along to the hospital, apparently apprehensive about the owner; dogs know when their owners are not well or are in danger. She “needed” to be there.  Conversely, if her owner had survived the heart attack, he would have needed to see his Saicy, and would have been touched to know she had tagged along, a bantay (companion) in both canine and human senses.

I look forward to a time when our hospitals can tap trained companion animals for patient care, all part of an enhanced One Health.

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mtan@inquirer.com.ph