Whom you blame for the dog bite incident?
For any kind of incident, we either blame ourselves or someone. Similarly, on discussing the bite incident with the participants, they were asked whether they consider someone responsible for the dog bite they suffered. Majority eight participants did not blame the dog for the bite. They discussed the unsanitary conditions of the roads, rising dog population, indiscriminately throwing house hold waste on streets and inefficiency of the municipality department in clearing piles of wastes from the streets as a reason for their dog bite incident. Three participants directly stated that they blame the dog for the bite incident as they were normally walking on the streets and were unaware of the presence of dog in their vicinity, whereas one participant blamed himself in some way for the bite incident and viewed it as his fault. Those participants who did not blame the dog directly for the bite incident discussed that they should have behaved differently to prevent the bite as in their perception dog was acting on natural instinct and just being an animal.
”Im to blame for the dog incident. I remember I was walking on the road holding a carry bag containing some vegetables and meat. The dog started following me, I got afraid and a bit nervous. I stepped faster, so does the dog. When I felt that the dog came much closer to me, I charged towards him. I still hold that my reactions to his behavior was inappropriate.”
(Waheed)…bitten by the dog on his arm
”I blame the society and the municipality department for the bite I suffered. I was going for my tuitions like every normal day. There was a heap of household waste on the banks of the road. Almost 3-5 dogs were searching the heap for food. I got a bit anxious as I was walking alone and no one seemed to be nearby. The dogs were barking and when I reached closer, they barked again. I started running, so does one of the dog. I fell down and lost my consciousness for some seconds. I felt a kind of a pain on my leg. Someone reached the spot and helped me to get over. Later I found my pants torn and a bite mark on my leg.”
”If the dog was not present in the vicinity of the victim nor was he provoked by the abnormal behaviors and aggression of the victim. Then we are of the view that the dog had elements to blame for the incident. The same was reported by the participants that they only blame the dog for their bite incident.”
”I was waiting for the bus to get off to my office. That day the bus took some extra time as I was standing and discussing something with my friend. There were no dogs around as per my knowledge. Suddenly out of nowhere, I saw a dog running towards me and holding my leg from behind. The dog was not willing to leave my leg. I tried escaping from his jaws but all in vain. My friend kicked him many times, then only I was left free. One of the bad experiences of my life.”
(Mohd Ashraf)…bitten by dog on his leg
”I am of the belief to feed any animal usually dog when we see any unusual dream. Early morning I started feeding some dogs outside my home and while feeding one of the dog jumped over me to catch hold the piece of bread. In the meantime, he bitted my hand. I feel the dog was aggressive and I could perceive that earlier.”
(Adil Ashraf)…Bitten by a dog while feeding
The responsibility of the victims in prevention of bites varied much depending on their situation and knowledge to perceive that they could have predicted the bite at the first instance. These findings suggest that it may be difficult for the victims to prevent bites if they are not aware about the possibility of bite to occur in advance.
However, in our study some victims felt that the dog was responsible for what happened with them while some considered themselves as a reason for the dog bite. These finding varied depending on how well the victim had the experience and knowledge about dogs.
We concluded that it is a simple factual matter who was bitten and who could have prevented the bite. The responsibility and onus of bite are a construction made in hindsight based upon the victim, situation and their level of knowledge about dogs. Those victims who self-blamed themselves can have regret of what happened to them. Feelings of self-blame are constructed when someone makes a poor decision and the outcome is usually severe.[11] Feelings of self-blame and regret were even higher when the participant considered themselves not adapting an alternative to what they have done while their experience with dogs.
Can you define what you consider a dog bite?
The understanding of the study participants regarding what they considered a dog bite did not differed much. All participants reported that a bite involved contact between dogs teeth and victims skin. One of the participant considered jumping of the dog on the victim as dog bite. Another participant reported scratches by the dog on the skin as dog bite. All the participants agreed upon that bite along with breach of the skin and oozing blood is a serious concern and calls for treatment at the hospital.
Conclusion:
Our findings suggest that the apparent instantaneous nature of bites and recognized psychological barriers to being receptive to educational intervention may mean bites are not as easily preventable as previously assumed.
Dogs especially street dogs have always been living among the human population. Like other developing countries, dogs live in harmony with the people of rural or urban India. Over the years, the population of street dogs has seen a sudden rise which can be attributed to the availability of more food waste due to the changing socioeconomic status, increased population, urbanization, and lack of proper measures to control their population.[1] In fact, it is believed that dogs were the first animals to be domesticated due to their loyalty and friendly nature.[1] The other side of the story is that these street dogs do bite whenever they are provoked or sometimes without any external stimulus. These stories do evoke public outcry and spark highly motivated debates.[2] Dog bites are common nowadays and they represent a significant public health problem in India.[3] Some bites are not significant (Category I) and require no medical attention while many bites belong to Categories II & III and require immediate medical attention.[4] Some may require hospitalization also. All these circumstances pose a burden on the health care system, economic status of the victim and usually adds to morbidity rates and loss of work days.[5] Here the question arises, is our approach to dog bite prevention working in full capacity or it has been compromised. In order to know the answer, we need to ascertain the reasons behind the biting behavior of dogs and the perception of victims at the time of bite for effective prevention in the future.
Aggression among the dogs has been stated as the most common cause of their biting nature by many dog experts.[6] Sometimes what concerns the public is the bite itself not the reason behind the bite, which adds to more confusion. Most of the dog experts opinion that many of the dogs bites are preventable.[7,8] Its the victim who is unable to recognize the fearful behavior of the dog or somehow misinterpret his actions. To understand this phenomenon, we need to educate children, adults, and old about the warning signals that a dog is aggressive and may bite.[9] Many of the qualitative researches have been conducted and the reason for dog bites and its evidence has been inconclusive. This may be due to different mechanisms and situations involving dog bites. Either some might have considered the mechanism behind a dog bite very simple, but in reality it involved many complex multifactorial events that led that dog to bite.[10] Most common model adapted by dog experts is socio-ecological model which states that the dog might have genetically motivated behavior to react on minor events, less social exposure or any medical condition of the dog. Some events related to the victim may be a triggering factor for the dog bite like influence of alcohol, inappropriate way of approaching and behaving in front of the dog.
What we believe is that a qualitative approach addressing all the risk factors and events related to dog bites must be addressed. Literature search revealed some data regarding this very aspect of experiences of dog bites.[6,7,8,9] Some suggest the aggression and medical conditions of the dogs as a reason for biting, whereas some suggest the behavior of victims responsible for the bite.[5,6,7] They do not address multifactorial causations responsible for dog bites. In order to carry out effective preventive measures and interventions at multi stage level, the focus should be on the perception of the victims behavior and prevention of injuries resulting from dog bites. We conducted this study at the anti-rabies clinic of a tertiary care hospital with the following aims and objectives: – Explore the victims perception regarding dog bite, its circumstances and events that led to the bite and prevention of future bites by dogs. The finding of our study will be helpful for the public health policy makers for effective program management and prevention of dog bites through theoretical mechanisms of prevention.
The study was conducted in the anti-rabies clinic of Department of Community Medicine, Government Medical College, Srinagar, Jammu & Kashmir. The clinic became functional in the year 2004 and is under the administrative control of the Department of Community Medicine, Government Medical College and associated Hospital, Srinagar. It caters to the needs of the adjoining areas and often patients from all the districts of Kashmir division visit the said clinic whenever required for expert opinions related to animal bite cases. This study involved one-to-one detailed interviews of dog bite victims to tell their tale and allowed the interviewer to ask questions related to all the circumstances that led to the bite. We included adults aged >20 years living in the Srinagar city who had been bitten by the street dog within last 24 h. A total of 12 patients gave consent and were recruited for this study. The participants were interviewed at the anti-rabies clinic of Department of Community Medicine, Government Medical College, Srinagar by a male doctor who has more than 4 years of research experience. The participants included eight males and four females aged between 22 and 58 years with education levels ranged from illiterate to graduate level. Interview schedule of the dog bite victims and sociodemographic characteristics of the participants are described in Tables and respectively. Description of the dog bite incidence as stated by the dog bite victims is described in . To reduce the recall bias that would have been a major issue in this study, we conducted interviews in only those subjects with history of dog bite within the time period of 24 h. That increased the validity of the recall. Interview protocol guidelines were drafted before the commencement of the study and were used to draw important information from the study participants chronologically in order to capture all the events surrounding the dog bite incident. During the interview, the participants had the full liberty to detail any important event which they considered significant surrounding their dog bite incident. The interviewer made it sure to clarify any point which needed any further elaboration. The interview was audio recorded and lasted for 20-30 min time. The recordings were transcripted and extensive notes were made to draw themes related to dog bite incident. Following the interview, sociodemographic data were collected.
| Have you ever been bitten by any dog in the past? |
| How many times? |
| Now You have been recently bitten by a dog? |
| Was it a street Dog or a Pet Dog? |
| How many hours back were you bitten by a dog? |
| What do you consider by a dog bite? |
| When did the dog bite incident happened? |
| Where were you that time? |
| What were you doing that time? |
| Were you familiar with the dog before? |
| What was the dog doing just before the bite? |
| What were you doing before the bite? |
| Can you please explain your whole dog bite incident in detail? |
| Did you approached the dog or dog approached you? |
| At what site you suffered the bite? |
| How many bites and how much deeper? |
| Why do you think, the dog bite you? |
| What do you think the bite was intentional or unintentional? |
| What you did soon after you realized you suffered a bite? |
| Whom you consider responsible for the incident that happened to you? |
| Did you ever felt that you would suffer from the dog bite incident ever? |
| Did your perception about dogs changed after this bite? |
| Did you ever felt that you past knowledge about dogs was sufficient enough to prevent yourself from the current bite? |
| What else you will do to prevent future bites? |
| Participant | Gender | Age in Years | Education | Employment | Marital Status |
|---|---|---|---|---|---|
| Hameed | Male | 58 | Illiterate | Laborer | Married |
| Adil Ashraf | Male | 45 | Graduate | Government Job | Married |
| Talib | Male | 30 | Middle School | Hawker | Unmarried |
| Insha | Female | 22 | Student | Not Employed | Unmarried |
| Waheed | Male | 35 | Higher Secondary | Private Job | Married |
| Naseema | Female | 53 | Illiterate | Home Maker | Married |
| Ghulam Ahmad | Male | 49 | Higher Secondary | Shop Owner | Married |
| Gulzar | Male | 50 | Illiterate | ATM Guard | Married |
| Mohd Ashraf | Male | 47 | Graduate | Government Job | Married |
| Ghulam Hassan | Male | 55 | Illiterate | Gardner | Married |
| Shameema | Female | 26 | Graduate | Private Job | Unmarried |
| Mehbooba | Female | 38 | Graduate | Home Maker | Married |
| Name of the victim | Context of bite | Reason for bite | No. of bite | Location of bite | Medical treatment sought* | History of previous dog bite | Time between dog bite and interview |
|---|---|---|---|---|---|---|---|
| Waheed | Fetching vegetables from the market | I remember I was walking on the road holding a carry bag containing some vegetables and meat. The dog started following me, I got afraid and a bit nervous. I stepped faster, so does the dog. When I felt that the dog came much closer to me, I charged towards him. I still hold that my reactions to his behavior was inappropriate.” | Single | Leg | ARV + RIG | No | 6 Hours |
| Insha | Going for tuition | There was a heap of household waste on the banks of the road. Almost 3-5 dogs were searching the heap for food. I got a bit anxious as I was walking alone and no one seemed to be nearby. The dogs were barking and when I reached closer, they barked again. I started running, so does one of the dog. I fell down and lost my consciousness for some seconds. | Single | Leg | ARV + RIG | No | 4 Hours |
| Hameed | Going to offer Prayers | I was just unfortunate to be bitten by a dog. I went for usual prayers in the morning and some dogs came running from the opposite end. I watched them doing so and to my surprise one of the dog jumped over me and caught hold of my arm | Single | Arm | ARV + RIG | No | 8 Hours |
| Adil Ashraf | Distributing bread among dogs | Early morning I started feeding some dogs outside my home and while feeding one of the dog jumped over me to catch hold the piece of bread. In the meantime, he bitted my hand. I feel the dog was aggressive and I could perceive that earlier | Single | Hand | ARV + RIG | Yes | 12 Hours |
| Gulzar | While going to office | I took a short cut that day. There was an open field with presence of some dogs. I was in hurry to reach the bank. They got scared because of my actions and attacked me. I was unlucky to have received a bite from a dog. | Single | Leg | ARV + RIG | No | 1 Hour |
| Mohd Ashraf | Waiting for a bus at bus stand | There were no dogs around as per my knowledge. Suddenly out of nowhere, I saw a dog running towards me and holding my leg from behind. The dog was not willing to leave my leg. I tried escaping from his jaws but all in vain. My friend kicked him many times, then only I was left free. | Single | Face | ARV + RIG | No | 2 Hours |
| Ghulam Hassan | Fetching vegetables from the market | I was just buying vegetables from the market and suddenly a mad looking dog caught hold my leg. As soon I could react, he jumped over me and caught my hand in his jaws. | Multiple | Hand & Leg | ARV + RIG | No | 16 Hours |
| Shameema | Roaming in and around the market | I was just purchasing some personal items from the market. Usually there are many dogs in the market and nobody cares about their presence. I too did not saw any one in my vicinity. Suddenly I felt someone holding my leg from the behind. May be someone might have hurted him and I came in his way. | Single | Leg | ARV + RIG | Yes | 12 Hours |
| Naseema | Morning Walk | Just like every normal day I was having a walk early morning. Many dogs roam freely on streets and their population is on the rise. When I was walking, they were running and barking. They started running towards me and I was afraid. I too started running and one of the dog caught hold of my leg. I am still in shock. | Single | Leg | ARV + RIG | No | 5 Hours |
| Ghulam Ahmad | Trying to save a child from dog bite | I was heading towards my home and I saw some dogs chasing a little boy. I tried saving the boy. I tried picking up a stone to threaten the dogs while one of the dog caught hold my arm in his jaws. I think I was too late to respond. | Single | Arm | ARV + RIG | No | 3 Hours |
| Talib | Cycling | I was driving my cycle and a bunch of dogs were present alongside the road. As soon I passed, they barked over me and chased me. One of the dog bite me on my thigh. I could have changed my way. I took pity on myself. | Single | Thigh | ARV + RIG | No | 2 Hours |
| Mehbooba | While throwing away House hold waste | I was about to throw garbage along the road side. Every one stocks their garbage there. There were no dogs at that time but suddenly a dog jumped on me from behind. I turned back and he bite me on my chest. | Single | Chest | ARV + RIG | No | 8 Hours |
Data analysis: Extensive notes, impression and important discussion points were line listed. Recordings were transcribed maintaining the secrecy of the participants. A thematic framework was used for analysis which enabled the lead researcher to detail every aspect of the circumstances surrounding the dog bite incident. A wide range of themes emerged while transcripting the data representing complex experiences stated by the victims of dog bite. The transcript was entered in Microsoft excel spreadsheet and were given a specific code. Key features of the interview of the dog bite victims were identified and classified into specific themes. Repeated or common perceptions expressed by the participants were ignored. The themes selected were those addressing objectives of this study only.
How to Survive a Dog Attack
1Dr. M. Ikram Ali, MBBS, DMJ. Assistant Professor, Department of Forensic Medicine, Ziauddin University, Karachi, PakistanFind articles by