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These images were captured by Dr. Deborah J. Briggs, in Medan and Nias, Indonesia, in 2011. Nias was considered to be free from terrestrial rabies until 2010.
This shows a view of Medan, Sumatera Utara, Indonesia, from the team's hotel window.
The team takes a brief walk in the park across from our hotel after arriving. People congregate under light tents to listen to a band perform live.
Dr. Betsy Miranda, a global rabies expert from the Philippines, is part of the anti-rabies team.
Dr. Betsy Miranda and Dr. Joanne Maki enjoy dinner after the long plane ride to reach Indonesia.
From left to right are Dr. Deborah J. Briggs, Dr. Betsy Miranda, and Dr. Joanne Maki, who all work in global public health.
The team walks across the runway to board our flight from Medan Sumatra to Nias, an island off of the coast of Sumatra.
The team has landed and are on their way to meet their Indonesian colleagues in Nias to see how they can help.
They will be here for short time and will be leaving on the return flight in a few days’ time.
They have met their local team of public health professionals that will be their guides while they are in Nias.
Nias is basically quite a rural region. They are being driven to interview the local public health workers on the island.
When they finally reach our destination at the other end of the island of Nias, they arrive in a small traditional village. This photo shows a traditional community building, typically raised several feet off of the ground to protect against potential flooding.
In the village, the best method of transportation is seen in the background, i.e. motorcycles. In the foreground, a free-roaming dog is being approached by children. This dog is not likely to be vaccinated.
In this village, the local leaders are worried about the incursion of rabies. Dogs are the main source of exposure to humans. It is believed that rabies was introduced to the island through one or more fishermen bringing in infected dogs on their boats.
Less than 0.5% of the dogs in Indonesia are vaccinated against rabies. Children are usually unaware that dogs can transmit the disease to them and often do not tell parents that they were bitten. Children often do not know how to treat dogs and end up being bitten by careless behavior.
The team of public health workers drives almost three hours to reach their destination in Nias.
The team waits to discuss the rabies situation with the local leaders.
Government workers explain the rabies situation in a meeting room. Civil servants wear uniforms in this country.
The health workers meet at the regional Department of Health office. The team listens to the explanation of the current situation in the rural area.
After information-sharing and planning, the group lets out of a meeting. The team leaves the meeting with a better understanding of what the local residents are facing.
The team drives into the jungle to visit a family that has recently had an exposure to a rabid dog.
The parents explain how their children were bitten by a dog that ‘went mad’. They had to drive several hours to reach a clinic where the vaccine was available but they all were able to receive post-exposure prophylaxis (PEP).
The parents are happy that they were able to be vaccinated as they know others that were not vaccinated after being bitten, and their children died of rabies.
The neighbors watch as the team interviews the family members that were bitten and subsequently received PEP.
Much of global public health involves partnerships between international and local personnel and various government entities on-ground.
As the team gets ready to leave, the local public health workers ask them for help to get rid of rabies in their communities.
The group meets with the Minister of Health in Medan, in Indonesia. The team debriefs the Minister on their trip and explain potential next steps.
The group visits a laboratory in Medan, Sumatera Utara, in Indonesia. This well-equipped lab in Medan was established after the influenza outbreak and could potentially be used as part of the surveillance system for rabies in Nias.
The laboratory has its own fluorescent microscope and thus can test submitted samples for the presence of rabies.
Such laboratory equipment is important in the prevention of the spread of rabies.
The professionals working in the laboratory are well-trained veterinarians and are eager to help with the rabies problem in Nias.
A flow chart explains the procedure for patients exposed to potentially rabid animals.
The team is tired after a few full days in Nias, but they better understand the problems that the local residents are facing on a daily basis after rabies was reintroduced to the island.