It is estimated that 18,000 to 20,000 people lose their lives to rabies, a preventable disease, every year in India. Rabies is a disease caused by the rabies virus, which spreads through the bite of infected animals. Noticing the high and rising burden of rabies in India, the government launched a National Rabies Control Program in 2013.
Under the program, every animal bite victim is entitled to receive anti-rabies vaccine and anti-rabies serum up to the primary healthcare center level, free of cost. The program also aims to build the capacity of all doctors in the country and prepare them to manage an animal bite victim.
However, my recent experience of seeking protection from rabies after being bitten by a cat in NCR Delhi left me questioning India’s readiness to tackle this deadly disease.
The Incident
One night, I noticed that one of the community cats I cared for was visibly unwell. While trying to place him in a carrier to take him to the vet, he panicked and injured my hand. I wasn’t sure if it was a scratch or a bite, but I noticed bleeding. I immediately washed the area with water and soap and decided to visit the doctor in the morning.
The cat died early the next morning. Being a Sunday, nearby primary public health centers were closed, so I visited a private clinic. I told the doctor about the possible bite with bleeding and that the cat had died early that morning. The doctor there gave me the anti-rabies vaccine and advised a full course of five doses over Days 0, 3, 7, 14, and 28. She reassured me that even though it had been more than 12 hours since the incident, it still counted as Day 0.
With limited knowledge—thank you, Google—I followed the advice.
It was only 2 days later, when speaking to another doctor friend, that I realized there may be a need for another injection called “immunoglobulin”. After learning that this injection should ideally be administered within the first 24 hours after a bite, I began to panic, as it had already been three days.
Navigating A Broken Healthcare System
Since several doctor friends urged me to get the “immunoglobulin” injection, I began contacting general practitioners nearby to request if someone would be willing to administer it as soon as possible.
One clinic informed me they only collected blood samples for testing, but did not administer injections. Another doctor informed me that it was too late to get the injection and to simply continue the vaccine doses. Being concerned with the contradictory advice I was receiving, I booked an appointment for the next day with my general practitioner (GP) as I was due for my second rabies dose anyway.
On speaking with my GP and providing the entire history, he immediately informed me to get the immunoglobulin injection without any further delay. Though he mentioned that it would have been ideal to get it within 24 or at least 72 hours, it could still be taken within 7 days. He also warned me about the high cost of the injection in private hospitals (anywhere between INR 20,000 - 30,000) and advised me to try a government hospital, where it would be free. While I appreciated the guidance, I was at a loss for how to proceed.
Living over 50 km away from major government hospitals in Delhi, I began calling around to check availability. I called multiple Delhi government hospitals (all the known names) and, much to my frustration, even the emergency numbers were either unavailable or unanswered. Once, when someone picked up the call, they disconnected it after I informed them of my predicament and requested their assistance.
A Health System That Requires Extraordinary Privilege For Basic Care
Thankfully, with the help of doctor friends working in government hospitals, I was finally directed to a well-known private hospital that possibly had the immunoglobulin in stock. My friend had also given me the contact information of one of the doctors (Dr. S) who worked there, just in case I needed help. However, I expected things to go smoothly and didn’t intend to disturb the doctor unless absolutely necessary.
At the hospital’s emergency ward, the receptionist told me to speak with the on-call doctor. When I explained my situation, he initially claimed it was too late. When I mentioned my GP’s advice about the 7-day window, he reluctantly admitted it could be given, but warned it would be expensive.
He calculated the cost of the injection based on my weight, around INR 20,000, and then asked me to wait outside. He didn’t say how long it would take for the medicine to arrive, only that it was out of stock, leaving me anxious and uncertain. When I mentioned another doctor at the same hospital had confirmed availability and a lower price, he responded curtly, “fir unse baat karo (then go talk to her)”.
Feeling helpless, I called Dr. S, a privilege that a tiny fraction of people in this country can afford. Dr. S advised me to complete the registration formalities, so I completed the forms. But the staff refused to accept them without confirmation from the on-call doctor. It was only after Dr. S intervened that the doctor finally acknowledged me and let me complete the registration.
At this point, the on-call doctor informed me that there are two types of immunoglobulin injections which can be administered – human and equine-based. Further, that Dr. S was recommending the equine based one which was “cheaper” and could cause “life threatening allergic reactions”, telling me “aap khud dekhlo (you figure it out yourself)”.
Inside The Hospital: Judgment, Delay, and Disrespect
As a literate lay person with no real understanding of the medical options being presented, I was alarmed by his casual mention of life-threatening allergic reactions. Still, I said I would go with the equine-based injection as I just wanted to get the dose and be done. He then asked me to return to another payment counter and submit the forms he’d handed over. Once I received the acknowledgment receipt, I was directed to a nurse who would guide me through the next steps.
The nurse who was supposed to help next berated me for arriving late, questioned my choice of equine-based immunoglobulin, and criticized me for not going to a government hospital. When I asked where to buy the injection, she waved vaguely behind her. Another staff member took pity on my confused look and walked with me to show me the way to the pharmacy.
By this point, I was on the verge of tears. I had been scolded for arriving “too late” for a medication I hadn’t even known I needed—one that was hard to find to begin with. I’d been told it would cost INR 20,000, only to then be informed it wasn’t in stock. I was questioned about my choice to take an equine-based injection that could cause severe allergic reactions, and repeatedly asked why I was even at a private hospital when I could have gone to a government one, never mind that, as I would later learn, the medicine was rarely available there either.
Emotionally drained, I returned with the vials and was directed to a bed. The first nurse who approached me said she needed to confirm the appropriate dosage with a doctor based on my weight. After another 15-minute wait, the doctor arrived, assessed the dosage, and gave her the necessary instructions. A little while later, the nurse examined the wound site and remarked that it was too bony to administer the injection there. She then consulted the on-call emergency doctor, who instructed her to give it intramuscularly instead.
Trauma Beyond Treatment
Finally, the nurse informed me she would be administering two injections in my “back.” I was asked to lie down on a bed and told they’d draw the curtains for privacy. I was slightly confused—why would an injection in the back, which I assumed meant the upper back, require that much privacy? Still, I followed instructions without protest.
Then, lying on my stomach, I was asked to loosen my pants. That caught me off guard, but I reasoned that maybe the injections were meant for the lower back and required easier access. It was only after I lay back down that I realized what she had actually meant by “back”—without warning, she pulled down both my pants and underwear and asked me not to move as she prepared the shots.
Needless to say, I was surprised, but stayed still, though a little heads up would have been appreciated. After two painful injections, one on each buttock, I was asked to button up again and lie on my back for 5 minutes. After that, I was informed that I was free to leave – and believe me, it was a relief to get out of the hospital.
Leaving With More Scars Than The Bite
My experience left me with a series of unsettling questions. Why would anyone ever go to a hospital where care is a distant dream, even for the privileged? Why should one even bother calling the hospital or emergency numbers when they are nothing more than a waste of time? Why is the information given to patients so unclear and confusing, with no one willing to take the time to explain things properly?
I am fortunate to have compassionate doctors as friends, but why is it that the very professionals in the field often leave patients feeling more anxious and scared than before they arrived? Why do medical professionals, who insist we shouldn’t rely on Google for information, seem to lack the reliable knowledge themselves? How can we ever verify whether the advice we’re given is correct when there’s no way to cross-check it? Why are we forced to blindly trust the guidance they give us?
For a place where people seek help when they’re already at their lowest, why is the treatment of patients in hospitals so despicable? If I, someone who is literate and capable of advocating for myself, can be treated this way, what must it be like for those who have been systematically oppressed and marginalized and suffering from more serious conditions?
While overburdened healthcare workers deserve empathy, does that justify the apathy, confusion, and lack of preparedness in a system that holds people’s lives in its hands? If I, with education, resources, and medical contacts, struggled to access a basic, time-sensitive treatment, what hope is there for someone without those privileges?
Rabies is preventable. India’s National Rabies Control Programme promises free, accessible treatment for all bite victims. But in reality, vaccines are often unavailable, emergency systems unresponsive, and frontline staff untrained or indifferent. Until public health systems match their policies with functioning care, the fight against rabies won’t be won with vaccines alone, it will require dignity, accountability, and a healthcare system that puts people first.
Edited by Parth Sharma
Image by Janvi Bokoliya
