Rabies: A 5 Point Primer for Expats and Travelers in SE Asia.

Rabies Immunization Clinic Photo

Creative Commons. Photo by C Newlin de Rojas

1. Fatal.

If you are exposed and don’t get treatment, it is 100% fatal. Receive treatment within first 24 hours of contact with a rabies carrier for best chances of survival.

2. Saliva.

That’s how it is transferred. It isn’t about the bite, though deeper bites are more dangerous. If you are licked by a stray animal in a country with a high rate of rabid animals, i.e. SE Asia and India, you should get yourself to an emergency room. You could take a chance but it’s a game of Russian Roulette. Once you develop symptoms, you can start planning your funeral.

3. Painful

On the up side, they no longer inject you in your abdomen. Yay! But if you haven’t been pre-vaccinated, you must have an injection of RIG or Rabies Immune Globuline in addition to the vaccine shots. RIG jump starts your immune system and this part of the treatment is *painful*. They need to inject as much of this stuff as possible under the surface of your skin where the bite/lick occurred. The balance goes in your bum.

To give you a sense of this part of the treatment, imagine slipping a deflated balloon under your skin and then inflating it as much as possible. My daughter’s hand looked like the hunchback…except on her hand. Many ‘brave’ candies and biscuits were doled out by the nurses. Oh and my daughter got some too!

If you haven’t had a Tetanus shot in the last 10 years you need one of these too. And if you have a deep puncture wound, you actually need shots every 5 years. (Without treatment or vaccinations 1/4 people infected will die of Tetanus. The rate is higher for infants)

4. Ka-Ching.$$$

It’s expensive. Well, the RIG is expensive. Prices will vary. At our local (Bangkok) Catholic non-profit hospital, for an adult, you are looking at THB20,000 or $200. Of course everything is relative. If you are an expat on a juicy contract, this is likely peanuts for you and you are probably already at the more expensive snazzy hospitals. If you are in the US, you’d shell out about $1500 for a RIG dose Which brings me to #5, and this will make you Mambo.

5. It’s un-necessary

Well the balloon injection pain and loss of cash is un-necessary. If you get the pre-exposure vaccination consisting of three shots over a month, you do not need the RIG treatment, saving you money, tears, and time.

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If you work for a government agency, chances are they will have obligated you to get this done. You should thank them. If you are negotiating an expat package as we speak, you could consider asking them to organize and cover the country’s recommended vaccines prior to moving.

If you are like the rest of us, moving or traveling by choice (or working for one of those shoddy companies who are increasingly cutting corners) I’d wait until you get to Asia to get it done. It costs a fraction of the price: In the US, the three shots will cost you about $600 total pp while in Bangkok, at the local travel clinic, we paid about $15 total pp. You also have the option to choose the intra-dermal instead of the intra-muscular jabs. They are cheaper, less painful, and just as effective.

Check in later this week for our amazing story: Horses, Humans, and Rabies Oh My!, where I recount how two of us were bitten in one week, by different animals, and ended up at a snake farm for our shots. For real folks. Welcome to Thailand.

 

Readers please note: This is a short and basic overview. There are many things to consider. For example: RIG shots must be given within the first 6 days. By day 7, it can impede your own body’s response. Depending on risk factors e.g. animal and exposure types, some doctors will recommend a ‘wait and see’ approach, given the cost and availability of RIG. But then all of this is avoided if you simply get pre-vaccinated.

Kids, Food, & How to Kill a Chicken, Improvised.

Poultry chart via etsy

My kids, overall, are good eaters. I won’t go into my philosophy in detail just that I take a French-mother/Man Who Ate Everything approach to feeding them. It seems to be working for us –despite the occasional protests.

One thing I have always tried to do is make sure my girls know where their food comes from. I do not want to find myself, burger in hand, facing my kid around 12 suddenly stricken with a look of horror saying:

Wait you mean burgers and cows are the same thing? So what was the animal we ate last night?

Me: Well we had venison so you could say we ate Bambi, well probably her mother.

Living in Thailand has made this pretty easy. Granted, we have not passed Daisy the cow on our way to ballet class, but we have waved hello to many other edible friends. I knew I was succeeding  with my mission when upon seeing new animals, SweetPea would point to the creature going by and ask first:

What is that

followed closely with

Can we eat it?

Both girls love chicken but for SweetPea, it’s an obsession. She will choose chicken over any other food including sweets and cake any day so chicken features pretty regularly on our menu.

While eating chicken for dinner the other night:

P: Maman why can’t I see the chicken’s blood?
Me: Well they remove it before they sell us the chicken.
P: How do they remove it?
Me: They cut the chicken’s head off and hang him upside down.
(At this point I know that chickens get heads cut off and pigs are bled so I am just trying to piece this together)
P: Like this? (Showing me with her dragon piggy bank conveniently located next to her).
I nod in agreement.
P: Maman can I please do that next time we have chicken for dinner? And how do we catch a chicken?
Me, quiet worrying about a Dexter in our house.
P: And I want the chicken blood.
Me, thinking it is time to redirect this conversation: Well how about some boudin noir which is blood sausage?

Close call.

The next day, I worried as we head out of the house. There’s been a trio of scrawny birds hanging out by the front of our mobaan –a cluster of houses, like a little village. I didn’t want SweetPea getting any ideas. Fortunately the chickens were so scrawny. They were like the Kate Moss of chickens: breast-less, always in black, and in need a good meal and long night of sleep. I figured she wouldn’t find them appetizing enough to want to make the kill.

Right, I must brush up on my art of butchering skills. Til the next time readers.

Lara Rose: Update from Family Spokesperson.

Update January 25, 12.55pm. Family has requested that all updates come from Samitivej Hospital. The hospital’s facebook page: https://www.facebook.com/Samitivej. 

My understanding is that needs are in constant flux. Also Rh – blood is very rare among Thais and there are other patients around Thailand in need of Rh- blood. If you are Rh- and reside in Thailand, please consider donating regularly.

————–
for cordelia

I’ve been contacted by a close friend of the family, who is a physician, is working closely with Lara’s family and doctors at Samitivej , and has been the  family’s “spokeperson”.

Here is the OFFICIAL update:

Bottom lines:

> > 1. Lara still needs blood. Please keep donating. Please keep encouraging folks to donate. Both B- and O- blood can be used.

> > – It takes 24-48 hours for blood to reach Samitivej from the red cross, not everybody who shows up to donate, can donate blood. “30” people may have showed up yesterday (this is still in question) but in actuality less blood is available for Lara.

She’s using at this point around 3-5 units a day, and will continue to do so at this rate for the foreseeable future. She’s not out of the woods yet. There may even be an incident which would require more blood. I know for a fact what’s available at Samitivej right now —Saturday January 25th 9:30AM-– and it’s not enough for tomorrow. This is not a matter to “low-ball” or be conservative on. Please trust me on this.

> > 2. The Thai Red Cross will not turn eligible blood donors away.

> > 3.  Please check your blood donor eligibility/criteria here:

http://english.redcross.or.th/article/1114

> > 4.  Do NOT show up at Samitivej Hospital. ALL DONATIONS must be made at the Thai Red Cross.

Thai Red Cross Society Donation Hours
Mo, Wed, Fri: 0800-1630hrs
Tu, Thu: 0730-1930hrs
Sat, Sun and Holiday: 0830-1530hrs

Tel 0-2256-4038 , 0-2256-4048
Address 1871 Terdprakiat Bld., Henry Dunant Rd., Patumwan, Bangkok 10330

Nearest BTS: Sala Daeng  / Nearest MRT: Silom

I realise tweets can be flying around and sending confusing messages. If you are confused or need clarification on any points, you can email me at Multilingualmama22@gmail.com or tweet @multilingualmum. I will do my best to liaise with the spokeperson and get back to you as soon as possible.

Thank you and remember:

donate-blood1

Photo pinched for a good cause.

Bangkok Living: 20 Ways You Know You’re Embracing Your Inner Thai

Expat blogs in Thailand  

I’d like to thank the many readers and friends who helped me win the Thailand category and made me one of the top commented on blogs during this year’s expat blog’s competition.

Here’s the winning post, in case you missed it first time around!

If you had told me two years ago that I’d eat in the gutter off plates washed in a plastic basin, filled by a garden pipe, and prefer it to most restaurant meals, I’d have called you as mad as the hatter from Alice in Wonderland. Yet Thailand is just that, a country as wonderful and beguiling as it is perplexing. No sooner do you think you’ve cracked the code that another contradiction presents itself to figure out.

So here I am, squatting on a plastic stool, finally ordering things other than Pad Thai and Thai Green Curry and loving every second of it. This is my attempt to create a list of my experiences that encapsulates the tell-tale signs that I’ve finally acclimatized to my new home.

Drumroll please!

20. You no longer bat an eyelash when seeing a man riding on a pink bicycle or a python slithering across your garden.

19. Friends are chosen less by chemistry and more by the number of miles of traffic between your homes.

18. When you talk about a white Christmas, you are referring to a white sandy beach.

17. You stop wondering if you’ve found yourself on the set of Charmed when everyone suddenly freezes in a public place to that lovely tune in the background (aka the national anthem.)

16. TukTuks are for tourists unless you are trying to transport a dining table or 15 friends to a party.

15. You can finally use a squat toilet without peeing on your ankles.

14. You automatically switch between mouth and nose breathing as you walk by sewers and street food, respectively.

13. Sidewalks are for street vendors and open-air eating, not pedestrians.

12. You think it’s weird when you don’t find sugar as a condiment.

11. You don’t think twice of riding amazon (for us ladies) on a motorbike taxi while texting on your phone.

10.  You loose your wallet more often than you loose face.

9. You cringe when new arrivals do the Wai (hands together in a prayer-like position) in stores and restaurants.

8.You’ve accepted that YES, means ‘yes’, ‘no’, & ‘ I don’t understand a word you’ve just said

7. You aren’t surprised that your waitress, with full foundation and red nails, is sporting  a three-day beard stubble.

6. You eat all baked goods, including chocolate chip cookies, muffins, and –as a New Yorker this last one pains me– bagels with a fork and knife.

5. Seventy-Five degrees Fahrenheit (24C∘) feels like jeans and sweater weather.

4. You finally stop trying to shop for booze between two and five in the afternoon.

3. You eat by pushing food onto a spoon with the back of your fork and your knives haven’t seen the light of day in months.

2. You can’t bear to flush toilet paper and keep reaching for the ‘spray’ when back home.

1. You no longer wonder if that’s his niece.

Sawatdee khaa Y’all!

P.S. Feel free to share any examples you think should have made the top twenty!

To read other amazing entries including my favorite: N is for Nomads, an A-Z on why Mongolian living is awesome. Click here!