Beyond the Bite: The psychological impacts of rabies experiences

As part of the African One Health University Network (AFROHUN) — Transition Award Professional Development (TAPROD) Fellowship of 2023, I had the privilege of being one of two interns from Muhimbili University of Health and Allied Sciences (MUHAS) selected to collaborate with two esteemed faculty fellows from Sokoine University of Agriculture (SUA) and MUHAS on a research initiative tied to the award.

During the research initiative, while collecting data, I realized that rabies had a far more significant impact beyond the facts and figures. Our engagement with the community highlighted personal stories that vividly demonstrated the deep emotional and psychological impact of rabies.

Figure 01: The research team: From the right Dr. Mourice Mbunde (Faculty fellow - MUHAS), Myself - Given Sam (Intern - MUHAS), Dr. Janeth George (Faculty fellow – SUA), and Dr. Loveness Kimaro (Intern – MUHAS)

While collecting data for the study, I encountered a case at the Rwamgasa village that reframed my understanding of rabies. This story sheds light on the emotional trauma borne by families grappling with the disease. In Tanzania, where rabies claims approximately 1,500 lives annually, one question looms large: Are we integrating mental health support for those left behind to amplify the impact of rabies elimination efforts?

At the heart of this tale is Mr. Lameck (name changed for privacy), who endured the devastating psychological effects of rabies through his father’s battle with the disease.

The story unfolded in a place known as Rwamgasa in Geita DC, where a family found themselves in a distressing and heartbreaking situation due to a rabies case in the family. At the center of this narrative is Mr. Lameck, who had to witness his father's suffering following a dog bite. Initially, it appeared as a minor incident, but what unfolded left emotional scars that extended beyond physical injury.

Figure 02: Free roaming dogs at Rwamgasa: A threat of the ongoing rabies risk in the community

It all began when a dog bit Mr. Lameck’s father. The family sought treatment from traditional healers, believing that the traditional medicines would heal him. For nearly two weeks, their hope held steady. However, his health began to deteriorate — fever and malaise set in. Alarmed, the family rushed him to the hospital, where he received specialized care, including post-exposure prophylaxis.

The doctor, perhaps attempting to reassure the family, remarked that if the patient didn’t “start barking like a dog,” he would be safe. But soon, he started complaining that he felt like his heart would leap out of his chest whenever he saw water — this was hydrophobia, an intense fear of water — a chilling sign that rabies had taken control. Witnessing their father recoil in terror at the sight of water was agonizing for the family. Then, the unthinkable thing happened — he began to show unusual involuntary vocalization symptoms (barking like a dog).

Tragically, their father didn’t survive the disease as rabies is 99.9% fatal, leaving an unfillable void in the family. For Mr. Lameck, the experience altered him permanently. He lost trust in local healthcare providers and developed a lifelong fear of dogs — swearing never to keep them for companionship or security. In narrating his experience, I realized that neither Mr. Lameck nor his community understood the psychological impact of the tragedy. The lack of psychological support made it difficult for him to cope, leading to his extreme fear and avoidance of dogs.

Figure 03: An Illustration of Sustainable Development Goal 03, which ensures healthy lives and promotes well-being for all at all ages

Witnessing this case has been an eye-opening experience for me, highlighting an often-overlooked reality: rabies is not just a physical affliction. It inflicts deep emotional scars on families and communities, leaving invisible wounds that are just as important to address as the disease itself. As we work toward the global goal of ending rabies by 2030, I realize that eliminating the disease is only part of the solution. Addressing the psychological and emotional toll it leaves behind allows families, like Mr. Lameck's, who bear these invisible wounds, to feel seen and supported.

The psychological effects of rabies not only shape the individual but also influence the community’s ability to engage in prevention efforts. I see now how, if families and communities receive emotional and psychosocial support after losing a loved one to rabies, they are more likely to become advocates for awareness, vaccination campaigns, and other preventive measures. In Mr. Lameck’s case, for instance, had he been supported emotionally, he may have channeled his grief and fear of dogs into action by advocating for dog vaccination in his community, helping to reduce the risk of rabies. This shared understanding transforms rabies prevention into a collective responsibility, rather than something left solely to vaccinators, researchers, or government authorities.

To conclude, it’s crucial for global and national health policies to acknowledge the psychosocial impact of rabies, ensuring that resources are allocated to provide psychological support to affected families. Good health goes beyond eliminating the physical burden — it requires us to address the social and emotional challenges that arise in its wake. By prioritizing holistic care, we not only save lives but also begin to heal communities. Moving forward, greater investment in mental health support, community education, and psychosocial services must become integral components of rabies elimination strategies. As we’ve seen, addressing both the visible and invisible wounds of rabies empowers communities to become advocates for change, creating a future where no one is left behind.

Article contributed by Given Sam — Health Environmentalist | Mental Health Ambassador 

The thoughts and views in this article belong to the author and do not necessarily reflect the experiences or views of GARC.