by Genese Sodikoff
For thousands of years, people on every continent (save for uninhabitable Antarctica) have recognized the behavior of rabid animals and seen the ravages that rabies inflicts on the human mind and body. While the biological symptoms of rabies are universal, it, like many global diseases, manifests in different places with unique cultural markers and histories. These include everyday etiologies, or the ways people trace the origin of a disease or condition. They include the specific images or emotions expressed by victims in a feverish state, or the treatments applied to rabid animal bites. Beyond the cultural ideas and practices that shape any illness, rabies' origins and unpredictable incubation period, which can range anywhere from a week to months (or years!) before symptoms appear, invites the human imagination to fill in the blank.
In Madagascar, where I do anthropological fieldwork, rabies has been around since at least 1896, when the French colonized the island. Historian Eric T. Jennings writes that by 1899, a Pasteur Institute was established to forcefully combat human rabies, known as hydrophobia, but the virus was never eradicated. Jennings writes that to French colonial scientists experienced in treating rabies, Madagascar appeared to have a particularly acute and fast-spreading strain, requiring “more frequent injections of more active virus.” Rabid dogs in Madagascar appeared more ferocious than elsewhere, aiming right for the face.
Given the prevalence and history of rabies in Madagascar, I was surprised to learn that many Malagasy people (including doctors and veterinarians) attribute the viral source to a wild species that has only recently appeared on the landscape: a creature they call “little big chest” (kelibetratra). I refer specifically to people in the region of Moramanga District, about a three-hour drive east of the capital, Antananarivo, but knowledge of the kelibetratra as the rabies source extends far beyond this district.
The creature was described to me as a furtive wild dog from the rain forest that only roams late at night. It is built like a pit bull, but with shorter legs and a bigger thorax. Because of deforestation, they said, the animal has been scared out of its natural habitat into villages and towns, where it attacks pet dogs and cats, infecting them with rabies.
On the face of it, the story is plausible because the destruction of Madagascar's rain forests has not only endangered countless rare species, but, paradoxically, has also made hidden creatures more discoverable. Scientists have been finding “new” species, already on the brink of extinction, with alarming frequency. But no species of wild dog exists in Madagascar, and in fact, no one has ever seen a kelibetratra. They have only heard the howls and growls of dogfights.
The tale of the kelibetratra is a political statement, even though people are not consciously offering political critique when they discuss it. They do, however, lay blame for deforestation at the feet of the foreign-run mining industry. (Foreigners have long blamed deforestation on Malagasy agriculture.) Graphite mines in the region date back to the French colonial period of the late nineteenth and early twentieth centuries. Then in 2007, a giant nickel and cobalt mine, Ambatovy, was established on the outskirts of Moramanga town, employing hundreds of people. Its open pit and buildings perforated a hole in a large contiguous rain forest, and its slurry pipeline, spanning a couple of hundred miles to a processing plant on the east coast, slashed through forest and fragile wetlands. In an effort to offset the ecological damages, the Ambatovy operation secured about 5000 hectares of surrounding rain forest forbiodiversity conservation. I won't go into the upshot of the mining industry becoming a conservation authority in the region. Suffice it to say that Malagasy residents think of Ambatovy when they discuss deforestation, and they think of deforestation when they discuss rabies and the kelibetratra.
The image of the kelibetratra seems to have emerged by the early 2000s. A Malagasy political commentator wrote a column in 2007 suggesting that that rumors of this nature, of dangerous, fantastical creatures, are mobilized when the state becomes too oppressive. The rumors agitate the population, but their sources remain obscure.
The elusive kelibetratra did not illuminate to me what was the real source of rabies in Moramanga. That is, beyond the problem of rabid stray dogs, I wondered was there a wild reservoir of rabies? Civets perhaps? I thought bats were a likely source, since they are abundant in the region and frequently enter people's homes. Bats carry lyssaviruses, including rabies, as well an array of other pathogens, making them common vectors of zoonosis.
I learned, however, that bats are not to blame for infecting dogs or people with rabies. For the past several years, Cara Brook, a doctoral student of Dr. Andrew P. Dobson at Princeton's Department of Ecology and Evolutionary Biology, has been studying fruit bats (fanihy) in Madagascar and their contribution to spillover diseases, including rabies. Fruit bats or flying foxes (of which three endemic species exist in Madagascar) indeed carry the rabies virus, but it is a different strain than canine rabies (RABV). Canine rabies is the strain that occasionally, though rarely, infects humans.
One might assume that processing or eating wild animals that harbor rabies would put people at risk. In some villages of the Moramanga District, Malagasy eat fruit bats though it is not a common dish everywhere and many people in town find the idea of eating bat distasteful. The cooking process appears to render the meat safe for consumption. Rabies needs vital material– saliva, spinal fluid, or brain (but not blood)–to survive.
A big question that Cara Brook is investigating concerns how bats have evolved into such long-lived, resilient hosts, immune to tumors and the viruses that kill other mammals. The answer, she explained, may lie in their ability to fly, a metabolically costly process that may have generated mechanisms to lessen oxidative stress, which causes cellular damage. These mechanisms, in turn (or in a feedback loop, as evolution goes) may have generated effects responsible for bats' imperviousness to certain pathogens and tumors.
Malavika Rajeev, a fellow doctoral student at Princeton in the lab of Dr. Jessica Metcalf, is also studying rabies dynamics and rabies control measures in Madagascar, focusing on dog populations. Prior to her new project in Madagascar, Rajeev did research on rabies in Tanzania with Dr. Katie Hampson (University of Glasgow) examining the dynamics of rabies transmission and the interaction of the virus with different landscape attributes, including vaccinated animals.
Rajeev confirmed that in Madagascar, the virus is maintained within the dog population. There is no need to look beyond for a wild source that boosts the virus into the domestic animal population. (And there is no need for cryptozoology.) Rabid dogs, in their confusion, often stray into other localities without being noticed, bite other dogs, and leave. These isolated moments of contact in which the virus jumps from its still living host into another body has sustained rabies for over a century, and possibly longer. Dog vaccinations, needed every two years, are exorbitantly expensive (approximately $3.00 per shot) for most Malagasy to buy. The state agency in charge of rabies control lacks resources to round up and exterminate unvaccinated dogs and strays (which is anyway very unpopular with residents), so the cycle continues unabated.
When walking through villages and town, it is difficult to distinguish a snarling mean dog from a mad one (romotra is the Malagasy word for rabid). So although most human victims of animal bites get vaccinated (and hospital staff over-cautiously vaccinate family members and neighbors of human rabies victims), not everyone thinks it is necessary, particularly if they have never witnessed a case of human rabies.
Rabies, like the plague in Madagascar, is a disease that impacts traditional funerary practices, and restrictions on customs makes it all the more distressing for relatives of rabies victims. Persons who die of the plague in the hospital may not be wrapped in the traditional white burial cloth (lamba fotsy), which requires close contact with the corpse. The state requires that plague victims be buried in separate graves rather than familial tombs for a period of seven years, the duration of time deemed necessary to ensure that the bacterium is no longer active (and so cannot infect the extended family, including deceased ancestors, presumably). Rabies victims must be buried in separate graves for a period of at least five years before the family may transfer the remains to the family tomb. These rules of internment for certain diseases are overcautious, and in the case of rabies death, mysterious. They extend a family's period of suffering for years because for Malagasy, to be buried far from the familial tomb is to pass eternity in exile. Family members must bear the guilt of failing their loved one.
The blight of rabies in Madagascar includes, but is not limited to, acute poverty and all the infrastructural obstacles that sustain the rabies virus in dogs, as well as a policy that stifles the grieving process for families. I am also interested in a deeper exploration of the culturally specific symbols that infuse a rabies victim’s state of mind (as dreams are also infused).
I turn to an interview with Madame Irene, a woman in Moramanga District whose 12 year old son died of rabies in 2013. She told me and my Malagasy collaborator, Dieudonné, how her son got infected and what happened afterward. She recounted that the family dog had been in the courtyard and managed to swallow a poisoned rat, or so that's what the boy thought when he saw his dog walking and behaving erratically. He reached into the dog's frothy mouth in hopes of pulling out the rodent, which made the dog retch. But the boy could not retrieve the rat. The dog died the next day, and the family buried it in their yard.
About a month later, Madame Irene's son fell ill with an intense headache that progressed quickly to “crisis.” She called the local midwife who advised he get tested at the hospital. The doctors determined it was rabies and kept him there. Meanwhile, the family and their neighbors received prophylactic vaccinations.
The boy was febrile and intensely anxious. He could not sleep in the hospital and writhed in bed. Hugging him close seemed the only way to soothe him. His mother recalled that he could not tolerate the color white, particularly white clothes. They seared his eyes. Note she did not say he had recoiled from sunlight or electric light. She specified white clothing. Dieudonné and I both had the same thought, which we discussed that evening. Could it be how the boy's mortal fear found expression, through a terror of white clothes? We were only leaping to this conclusion, but Dieudonné seemed convinced. The lamba fotsy, the white cloth used to wrap a corpse. Madame Irene's memories of her son were not generalizable to other cases and other terminal illnesses. Her son's experience was no doubt unique, but it tapped into a symbolic repertoire that resonates with Malagasy people and makes Madame Irene's story all the more chilling.