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Training of the field veterinary technicians
New staff recruitments have been made by HARSH to carry out veterinary and epidemiological surveillance
activities. To this end, from December 2012 to June 2013, training was organized on public health education
and rabies prevention. The training included both theoretical courses in the classroom and practical
activities in the field. A total of 18 participants made up of veterinary agents (9 weeks para-professional
training plus experience), and veterinary technicians (2 or 3 diploma) were selected by the MARNDR to
undergo training that enabled them to engage in rabies surveillance work [9,18-20] .

The step for the strengthening of the rabies diagnostic capacity and the training of the field veterinary
professionals has been extended from 2011 to 2013.

Strengthening of the field veterinary agents and technicians (2013-2017) team for better notification
In October 2013, HARSP recruited three additional veterinary officers to expand the program’s coverage in
the West Department, where there was only one technician. In October 2014, nine additional technicians
were recruited to work in the communes of Center and Artibonite. Rabies vaccination activities for dogs
were conducted in accordance with the vaccination procedures jointly defined by the Animal Health
Department of the MARNDR and the CDC. This marked the first integration of smartphones and GPS
technology to record the geographical coordinates of the vaccination posts, ensuring effective monitoring of
vaccination programs. In October 2016, with funding from the World Bank under the RESEPAG Program,
ten additional technicians were reassigned to work as HARSP professionals in the South and North
departments [9,21] .

The HARSP surveillance system relies on event reports from the medical, veterinary and community
sectors, as indicated in Figure 3. These events consist of animal bites, particularly animals suspected of
rabies, which will lead to an investigation by rabies technicians within the MARNDR. In Haiti, bites
recorded in hospitals or health centers are events that must be notified to the Department of Epidemiology,
Laboratory, and Research (DELR) of the MSPP. Therefore, HARSP really relies on inter-ministerial
collaboration under the “One Health” approach to animal surveillance, which allows the MSPP to report
bites on a daily basis to the MARNDR for investigation [Table 1].

Summary reports of rabies investigations are shared at weekly DELR meetings for case reporting,
investigation, and diagnostic testing of animals suspected of rabies. All the results obtained at the level of the
Veterinary Laboratory have been communicated to the Department of Epidemiology, Laboratory and
Research of the MSPP [9,18] .

HARSP investigations were conducted at two levels: (i) public health (investigation of bites at the
community level) and (ii) Agriculture (investigation of animal rabies by the Veterinary Services). Suspected
animals were placed in home quarantine for 14 days with instructions on proper care and prevention of
rabies exposure. If the animals were in good health, then they were released from observation. If, on the
contrary, they showed clinical signs of rabies during the investigation or the quarantine period, they were
anesthetized and euthanized according to the standards of the American Veterinary Medical Association.
Animals suspected of rabies that were euthanized or found dead were tested at the MARNDR National
Veterinary Laboratory. The results of the investigations were communicated by telephone to the victim of
the bite, the health center that had made the declaration to DELR, and all persons who were identified
during the surveys as being exposed to bites in the community for evaluation of post-exposure prophylaxis
(PEP) against rabies.