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Is Indonesia the weakest link in the Southeast Asian fight against bird flu?

Updated On: Aug 15, 2006

Regional health and government officials from the Asia-Pacific are meeting in Singapore on 14 and 15 August to discuss “ways to strengthen the region's response to avian influenza pandemic”.

This follows the “bird flu exercise coordinated by Australia in June involving the 21 Asia-Pacific Economic Cooperation (APEC) Member economies”.

According to Helena Studdert of the Australian Department of Foreign Affairs and Trade, the June exercise emphasized the need for effective communication in curbing the spread of the virus. She told the media, “The next step is for the Singapore workshop to discuss the report, decide how to move forward and make a series of recommendations to ministers.” After the August discussions, a final report will be submitted to leaders at the APEC Ministerial Meeting in Hanoi in November.

This meeting could not be more timely in view of the seeming recurrence of bird flu in countries such as Thailand and Vietnam and the continuing spread of the H5N1 virus to other parts of Southeast Asia. The situation in Indonesia is particularly worrying.

According to the Associated Press, international experts are most worried about Indonesia as it has not proven itself capable in fighting bird flu successfully – the virus plagues its “billions of backyard chickens” while culls do not often occur even after outbreaks. Moreover, “vaccination is spotty and surveillance is weak”. Added to all this is the worrying situation in which hospitals can release a person with the virus just because the family insists, when elsewhere in the region quarantine measures are being put in place.  The Associated Press reported an incident in which Indonesia's latest bird flu patient, 17 year old Umar Aun, has gone home to be treated with prayers and traditional remedies, upon the insistence of his family. This is despite the widespread suspicions that his cousin died last week of the H5N1 virus. Dr. Eka Sony, a Health Ministry official investigating the case has visited Aun and says he remains very ill.

According to the World Health Organisation (WHO), about 60% of those who contract H5N1 will succumb to it. Hence Dr Sony’s disappointment, “Our team felt very frustrated we were not able to persuade the family to let doctors take care of Umar… His father said he has the right to choose the treatment for his son, whatever the risk.”

Disappointment or not, this is remarkably irresponsible behaviour, in the light of public health interests.

Elsewhere in the region, bird flu patients are kept under close surveillance of public health officials. Already the 46 Thai patients who are suspected of having H5N1 are under close medical supervision, according to the Bangkok Post. Prime Minister Thaksin has also “approved a budget to build 100 more patient rooms at hospitals nationwide”, the Public Health Minister Pinij Jarusombat announced to the media. These wards are meant to “isolate patients from others to contain the spread of the disease” and “will be set up in infected areas such as Phichit, Uthai Thani, Kamphaeng Phet and Nakhon Sawan”.

In addition, Thai Deputy Agriculture and Cooperatives Minister Adisorn Piengkes discussed bilateral cooperation to combat avian influenza. He has also suggested that the Ayeyawady-Chao Phraya-Mekong Economic Cooperation Strategy grouping (ACMECS) – comprising Cambodia, Laos, Vietnam, Myanmar and Thailand – meet in Thailand so as to share ideas and tactics on how to tackle the spread of bird flu.

Alarmed by the onset of bird flu in Thailand and Indonesia, the Vietnamese prime minister has called on the people to be vigilant. When Vietnam reported its first case of bird flu in poultry on August 11, there has been public fear that the virus may wreak havoc as it did three years ago.

Sources:

Indonesian bird flu patient refuses treatment, officials say (Jakarta Post, 14 August 2006)

46 patients monitored for bird flu (Bangkok Post, 14 August 2006)

Quarantine wards to be built in badly hit provinces (Bangkok Post, 14 August 2006)

Thailand, Laos talk bird flu (Bangkok Post, 14 August 2006)

No bird flu victim in Bangkok so far, says minister (Thai News Agency, 13 August 2006)

ADB finances regional cooperation in fighting bird flu (Xinhua, 13 August 2006)

ASEAN nations concern over bird flu (The Nation, 12 August 2006)

Migrating southward (The Nation, 2 August 2006)