Eastern Europe 2019: The Rabies Scare
I suppose I ought to start by saying that there are two things about me that I have come to realise are pretty reliable:
- My love for cats trumps anything else including my own safety
- Every single trip I go on, I come back with A Story or stumble across a protest/strike/political event
This one might be the most ridiculous (and interesting?) story yet.
So, I’m on a trip to Romania, Moldova, Transnistria (ahem, Pridnestrovian Moldavian Republic) and Ukraine. In Tulcea, Romania, I was walking up to the Independence Monument with a couple of other people when I heard a meowing from the side of the pavement and saw… A TINY CAT.
I of course, held said tiny cat, and cuddled it:
I sent the photo to my parents who immediately freaked out and said “ARGH RABIES” but I assured them that it was really friendly and happy to be picked up, hadn’t scratched me, etc.
Fast forward, erm, ONE day. We’re in Moldova, in a village called Valeni eating home made lunch (which I didn’t enjoy) and watching some women dance. A family of cats was hanging around the table, and there were two kittens — they were really skittish but I kept trying to coax them over, and give them the food that I wasn’t going to eat. (It seemed rude to not eat it and also rude to waste it?)
I held out the pork in my fingers and didn’t let go, so this little thing, in trying to simultaneously grab the food, and also avoid having to be near me a second longer than it had to, bit into my thumb accidentally, and drew a bit of blood:
I was fine until I suddenly remembered the message about rabies from my parents the day previous, and then I started Googling.
Becoming an expert on rabies
I think in my head rabies had always been a bit of a remote jokey thing and I had assumed that it’s curable or not really an issue. WRONG. It’s 100% fatal if you get it, and you can’t do anything about it if you show symptoms because by that point, it’s too late. So as you might imagine, I freaked. the. fuck. out.
Like, while everyone was dancing, I had images of dying a slow, painful and undignified death in my flat. That sort of freaked out.
Statistically speaking, the chances of the kitten having rabies is really, really small. a) it wasn’t showing signs of aggression or rabies when it bit me; b) if it was born with rabies it would have died earlier; c) if it had been bitten by a bat or something, it likely would have died; d) these cats live alongside the humans in the village and I feel like they would have all been destroyed long before, if rabies was an issue.
But, ALSO, only ten people have ever survived rabies, and it’s 100% fatal. So despite feeling like a massive twat, I figured that I would rather feel like a twat and live, than not do anything and die six months later of a horrible disease.
The GOOD thing about rabies is that it is a really delicate virus that can’t survive outside a host, and it’s one of few (if not the only!) diseases that can be vaccinated against *after* exposure. It takes anything from a few weeks to years for the virus to travel up to your brain where it causes irreversible damage. So you can get vaccinated afterwards, but the vaccination schedule is pretty strict if you haven’t had a pre-vaccination: One shot as soon as possible (day 0), a second on day 3, a third on day 7, and a fourth on day 14. Some doctors recommend a final and fifth vaccination on day 28.
Feeling severely freaked out about the idea of dying horribly because I like cats, I decided to seek medical help immediately, and for the rest of the trip.
The hospital tour of Eastern Europe begins!
I’m not going to lie, a part of me was secretly really intrigued as to how the health system would work in Moldova and Ukraine. So I saw it as an opportunity to get an insight into the different health systems and how their hospitals were different to the ones I have visited at home.
Thankfully I was with a group and my tour leader (Casper) organised two of the vaccinations using his contacts, while I organised the third one in Kiev.
The Moldovan hospital
The first vaccination was in Chișinău, the capital of Moldova. Casper rang his friend Andrei and asked him for help, so he agreed to meet us and take us to the hospital. I was warned “it’s a public hospital, so don’t expect the same level as you get at home” and was expecting some sort of horror. But it was ok, if a little dark. Here’s the entrance hall (the bit to the right is the exit):
Following a series of confusing events involving taking a ticket and walking into a numbered room unannounced, I was seen by a very stern Moldovan lady doctor speaking Romanian. Andrei translated everything for me — she was concerned because I was basically still slightly drunk from visiting a winery earlier in the day, and did not want to vaccinate me with alcohol in my system, so she wanted me to come back.
We went back the next day to the same room (we literally just walked in there unannounced, again), and she explained that I was being given Abhayrab which is an Indian-made vaccination. She went over and over the restrictions repeatedly — no alcohol for six months(! I have my doubts), no vigorous exercise for three months, no saunas for three months, etc. I asked about side effects, and about cost (“nothing, because it’s a vaccination”). +1 Moldovan healthcare!
I was taken to another room in a different section where I think they just do vaccines etc. Here’s what that section of the hospital looks like:
There, I met an older nurse speaking Russian, and I must have looked absolutely terrified, because she took great pains to show me the expiry date on the medicine, and make sure that I saw it was sterile. As I watched her flick the needle and squeeze the liquid out, I wondered how much she would squeeze out and how on earth there would be enough to vaccinate me properly. But hey, I’m not the expert here.
Having been stabbed, I was given the instruction booklet from the packet, and the vaccination schedule which I was told to stick to (“or it’ll be pointless” was the translation). They asked me to stick around for 20 minutes to see how I felt, and then let me go.
Me: OK, I will definitely stick to the vaccination schedule. Thanks so much.
The Transnistrian hospital
The original plan was for my day 3 vaccination to be done in Odessa, Ukraine, but time was tight. I wasn’t expecting to get it in Tiraspol (Transnistria) but when Casper said he organised it, I was really really excited to go and see what the hospital would be like. Moldova is the least visited country in Europe, and Transnistria is a region inside it which has autonomy, its own borders, police, etc, but is not fully independent, and I don’t think Moldova will ever grant it independence. It’s a weird situation, because it’s like being in Russia several decades ago. Everyone speaks Russian, and it’s very Soviet-y, to my untrained eyes at least.
Anyway, I digress! Maria, the tour guide who took us around Bender and Tiraspol, picked me up from my hotel and drove me to the hospital. She said she was also excited to go, because she hadn’t really done it before. She’s Russian and moved to Transnistria six years ago. Here I am, an idiot, in Transnistria for a holiday…
We got to the clinic and here it is, the front entrance of a mad Soviet-era labyrinthine health complex:
Maria spoke to the receptionist who pointed her one way, and I duly followed her, rushing through corridors with walls that were *literally being demolished as we walked through*:
I did consider asking whether this was really sanitary, but sometimes you have to roll with the punches, and I just prayed that my room was somewhere else. Given my experience in Moldova, I was feeling fairly relaxed about the procedure because I swear to God in Chișinău I had expected some horror 80s style massive needle which would hurt like shit, or being injected into my stomach. I figured Transnistria would be similar.
On our journey, we took an accidental detour into a random doctors’ room which I sneakily photographed:
Sure enough, we walked upstairs and finally found the people we were looking for. In the corridor, writing down records under a lamp. I was in awe — it was like I was watching something from the 1950s:
The nurse took me into the room off the corridor, sat me down and talked to me. Where was the bite, what happened, when did I have my last injection? I showed her the two bits of paper I’d left Moldova with, and she understood. They also use Abhayrab. I was asked about side effects of the first one, and explained that my arm had just felt pretty heavy. “She says that’s because you were feeling nervous,” Maria translated. I asked about the alcohol restriction and was told once again to not drink alcohol for six months. “But,” Maria said, “I think they are being over-cautious.”
“Me too. I figure I can probably have, like… One drink a day? I mean, I’m not a big drinker, but I’m on holiday and I don’t want to not drink at all…”
“Yes, something like that, I think,” Maria and I exchange knowing looks.
I got my injection, in the other arm, and then I sat in the corridor while the nurse filled out my information. Name, date of birth… Then where I live. I started with Cardiff, but the nurse has no idea how to spell it, so Maria said something in Russian to the effect of “it doesn’t really matter, just put she isn’t from here/she’s British”. I asked about cost and was told that they don’t charge. +1 Transnistrian healthcare!
Then the nurse said I needed to sit around for 15 minutes, and offered me a drink of water which I gratefully accepted. A few minutes later she came back with a cup, and said something else. “She says breakfast starts in a few minutes if you want something to eat.”
“Wow, I can get breakfast?! Awesome!”
“I had no idea they did breakfast either. But we don’t have time…” The nurse comes back, they exchange a few words… “She asks if you want some bread because you can’t have breakfast…” Maria and I laughed at the absurdity — yes, I’ll take some bread, sure.
I ate bread and drank water until we needed to leave, since the group was moving to Odessa, and both of us were feeling pretty amused about the breakfast thing.
“She’s so sweet. I can’t believe it.”
The private clinic in Kyiv
I had panicked a bit about the last injection I would need on this trip because it was in Kyiv and on the departure day, meaning I would have no help in organising it from Casper. So I Googled random clinics in Kyiv and emailed around to ask if they had the rabies vaccination. I explained I couldn’t ring because I had no access to the network, and I could either email or WhatsApp intermittently, if they had a number I could WhatsApp.
Thankfully, Mariana from Medikom in Kyiv emailed me her number so I could message her and organise the appointment. Since no one else emailed me back, I decided to go with them, despite the fact that the first picture on their Google Business page is of a series of cartoon doctors that look very similar if not inspired or taken directly from Theme Hospital. She told me how much it would cost (2,000UAH, or around $90). I can suck up the cost, and also maybe claim it back on my travel insurance.
Mariana met us in the complex, and explained what would happen — I would see a nurse, they would assess me, we would do the injection, I would pay then leave. The clinic was extremely fancy, even better than every single hospital I’ve been in the UK!
Unfortunately Ukraine only has one type of rabies vaccine available — Indirab. I checked with the nurse that it was compatible with Abhayrab (though I am skeptical that there is any such ‘incompatibility’ across rabies vaccines given that they are life-saving treatment!). The nurse said that I only needed four injections, not the five I was originally told in Moldova, which is what I had suspected. I asked Mariana about the six months of not drinking alcohol, and as she asked the nurse, they both laughed and shrugged the idea off: “Not six months! Three days! Then you will be fine.”
I had to be injected into my THIGH which was a first. I tried to reason with them to avoid having to drop my leggings, because who wants to pay to suffer that indignity — but it was to no avail. I was given a weird and overly long list of things to avoid in the next three days:
- Alcohol
- Coffee
- Citrus fruits
- Honey
- Chocolate
I couldn’t fathom why, but perhaps something to do with immune system reactions. I did actually have coffee, because I cannot live without it, and I only ever have one cup a day. I figured it wouldn’t do too much harm.
What next?
I have to arrange to get my last one (or two?) vaccinations here in Cardiff. I’m going to have fun explaining to my GP why I need the vaccination. I have no idea how likely it is they will have it, but we have a few days to go before it’s day 14, and I would like to think that as a capital city, Cardiff is prepared for any eventuality. Even idiots who like cats too much.
