The SARAH program stops rabies in Sikkim, India

The Sikkim Anti-Rabies and Animal Health (SARAH) program is a state-wide animal birth control (ABC) and anti-rabies (AR) program initiated in 2005. This rabies program is the first government-sanctioned initiative involving animal welfare and public health sectors in India. It is a collaborative project between the Department of Animal Health, Livestock, Fishery & Veterinary Services (Government of Sikkim), France-based NGO Fondation Brigitte Bardot (FBB), Australia-based NGO Vets Beyond Borders (VBB) and the Sikkim Society for Prevention of Cruelty of Animals (SSPCA). The achievements and benefits of this state-wide ABC/AR and animal welfare program are now widely accepted in Sikkim.

The program started in 2005 in Gangtok, the main city of Sikkim, in response to community requests to stop dog culling. Building to villages and monasteries and finally reaching the whole state, the program has been very successful at eliminating dog-mediated rabies, with no human deaths from rabies since 2006. Sikkim aims to continue to be free of dog-mediated rabies and also sylvatic rabies with the support of program champions and the government. This program is a great example of starting small, proving success to the stakeholders, and rapidly scaling up to a state-wide program that could help guide the rest of India to eliminate dog-mediated human rabies.

From the outset, the SARAH program sought co-operation from stakeholders including government veterinary and para-veterinary staff in field stations, police, heads of panchayats (village councils), community leaders, the Forestry Department, army and paramilitary forces, and the Department of Health. Careful attention to the various stakeholders has directly enabled the program’s success.

Key activities of SARAH

Key activities fall into four main groups: 

1. Dog population control through surgical sterilisation

Over 37,500 sterilizations since the inception of SARAH have had an overwhelming, positive impact. There is now a smaller, manageable street dog population in Sikkim and fewer stray puppies in distress. There is less fighting amongst stray dogs particularly in the breeding season, and the majority are healthy and friendly.

2. Annual mass anti-rabies vaccination program

The mass dog vaccination campaign teams aim to visit every household throughout Sikkim over a four-week period. Even remote villages with no road access are visited by foot to vaccinate dogs and deworm puppies. We have achieved at least 70% vaccination coverage, and in East Sikkim have achieved 80% coverage. Vaccinated dogs in the border regions provide a buffer zone against rabies re-introduction from neighbouring rabies-endemic areas.

3. Provision of medical, surgical and hospital care to sick and injured domestic animals and wildlife.

SARAH primarily works with stray animals in distress but also treats many pet animals as referral cases when needing complex surgical procedures, chemotherapy (for treatment of contagious venereal tumours) and advanced diagnostic services including X-ray, ultrasound and clinical pathology.

4. Animal welfare and rabies advocacy & training

Public support is the cornerstone of a successful programme. Accordingly, SARAH works to increase public awareness of rabies, distemper (which may be confused with rabies), dog behaviour and animal welfare. Radio, television, newspapers, public meetings, school visits and World Rabies Day activities are used to reach the public. Community education programs have drawn upon local values of animal sentience.

Training of animal health personnel and field officers is also important so that better care can be delivered to stray animals. Training occurs at all levels, including animal first aid, dog catching, veterinary nursing, and surgical and medical skills for veterinary interns. The VBB's VetTrain program has helped build these capacities in Sikkim, West Bengal and other states in India. 

Introduction of legislation to support a rabies-free Sikkim.

In 2015, the Sikkim Government became the first state in India to issue a notification that rabies is a reportable/notifiable disease in both human and animals. To further support the control of rabies, the legislation requires: (a) compulsory registration and identification of pet dogs and cats; (b) compulsory, annual rabies vaccination of all dogs and cats; and (c) rabies vaccination and permanent identification of dogs and cats brought into Sikkim. Compliance with these laws is high.

The SARAH program continues to gain the support of the government and other stakeholders through ongoing meetings and reporting. It has been approved as a division of the Sikkim Government, ensuring that the program will continue permanently. Any suspect rabies outbreaks (infrequent and usually in the border regions in winter when food is scarce) are responded to rapidly and investigated thoroughly with both animal and human health sectors working together. 

Contributed on behalf of the SARAH team by Dr Helen Byrnes, SARAH Program Manager and Director of Vets Beyond Borders. Further details on the SARAH program are available on the Vets Beyond Borders website here. Acknowledgement must be given to Fondation Brigitte Bardot for their wonderful support since the inception of SARAH.