Bird Flu Threat Ignored in Indonesia

[chetnarayan]

When chickens began dying at his local market, Darmanto gratefully collected them from vendors, chopping them up and tossing the raw meat to his pet catfish.

He never wore gloves, and remembers smoking a cigarette with a bloody hand as he watched hundreds of fish greedily gobble up the scrawny black carcasses.

The thought of bird flu never crossed Darmanto's mind. It couldn't have. He never heard of it until he himself became ill, hospitalized with a burning 105-degree fever, a racing heart and a tightness in his chest that left him struggling to breathe.

Indonesia - with 32 human deaths from the H5N1 virus, the world's second-highest number after Vietnam - has come under fire for failing to slow the spread of the virus, which some fear could mutate into a strain that passes from human to human, potentially causing a global pandemic.

Others, like Vietnam, have succeeded thanks largely to strong political will and vaccination campaigns. But Indonesia has so far refused to carry out mass culls of poultry in all infected areas, one of the U.N. Food and Agriculture Organization's most basic containment guidelines, saying it cannot afford to compensate farmers.

Bio-security measures are virtually nonexistent and, as Darmanto's case illustrates, there is a lack of awareness about bird flu in the densely populated countryside, home to hundreds of millions of backyard chickens.

'If I had known about bird flu, I would have done a lot of things differently. I would have taken precautions to protect myself and my family,' said the 46-year-old father of two, who does not understand even today how he could get sick from dead chickens - or how he survived.

Darmanto, who like many Indonesians uses only one name, attributes his good fortune to 'traditional herbal medicine, a strong spirit, and the will to live.'

Indonesia's cash-strapped government says it is doing all it can to fight bird flu, which has been found in poultry in two-thirds of its 33 provinces. It is confident the sprawling archipelago will be free of the disease within two years.

'We are on a declining curve,' Agriculture Minister Anton Apriyantono said recently, vowing to boost chicken vaccination drives and carry out limited culls in areas where humans have died.

But the problems run deep, in part because of radical decentralization introduced after the dictator Suharto was ousted amid massive street protests in 1998.

The government handed control of public services to regional and local authorities in 2001, but their roles were unclear, experts say, funding inadequate and priorities left to the whims of inexperienced officials, mayors and village heads.

That has affected almost every sector in the government, from health, to public information, to agriculture.

'There's no line of command and they're disorientated,' said Peter Roeder, an FAO animal health expert working in Indonesia, adding that district veterinary officials seem more concerned with delivering clinical services to farmers, for instance, than controlling trans-boundary animal diseases.

And in the villages, where most people live on less than $1 a day, there are other things to worry about, from getting food on the table to more common illnesses like dengue fever, malaria and cholera.

Though health officers have gone door-to-door in some places, carrying educational brochures about the importance of personal hygiene and a clean living environment, the message often falls on deaf ears.

'We have been raising chickens and ducks from generation to generation without having any problems,' said Mohammad Sodat, a rice farmer who owns more than 80 birds.

Adding to the worries of international and local health officials was confirmation this week of one of the world's largest clusters of H5N1 human deaths ever - least five in one family living on Sumatra island, according to the World Health Organization.

The multiple infections initially raised fears the virus mutated to a form that passes more easily from human to human. But health officials now say it appears the infected family members had contact with sick poultry.

Darmanto, the man who survived bird flu, knows how lucky he is.

Doctors did many things right, suspecting immediately that he had the H5N1 virus that has killed more than 120 people worldwide and sending his swab and blood samples to laboratories in Jakarta and Hong Kong.

He was transferred Dr. Moewardi Hospital in nearby Solo, one of dozens nationwide equipped to deal with avian influenza.

Though he continued to lose weight - 30 pounds in two weeks - and X-rays of his lungs showed the rapid spread of the virus, he eventually recovered, thanks in part to the anti-viral drug Tamiflu.

But his problems did not end.

When Darmanto returned to Muntilan, his village 260 miles southeast of the capital Jakarta, in December he was hurting financially and eager to resume his job as a tailor.

'My neighbors avoided me,' he said. 'They didn't want anything to do with me.