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This study evaluates interviews with 17 people, mainly health care workers at various levels, who took active roles during the avian influenza outbreak in East Turkey during the first months of 2006.
The results emphasize some previously recognized risk factors such as young children preparing sick chickens for meals and later playing with the corpses such as using the heads for puppets and conditions of poverty leading to children sharing an indoor room with chickens esp in cold weather. From one general practioner who has a close
relationship with the local rural people "I mean why wasn't 'a child playing with chicken heads like puppets' put on the agenda? When she was discharged form the hospital, she came to visit me and I bought her a doll and adivsed her not to play with chickens. She slept with
the doll for many nights. Why wasn't attention paid to the problems related to the housing infrastructure or the lack of clean water?"
Another prominent concern was lack of protective equipment for health care workers who were of course wary of dealing with these patients. Fear of taking the disease home to their own families was high.
And as is also mentioned often good open communication at all levels is essential to build trust in a tense situation. And the realization of the extreme economic hardship of culling poultry.
Research article
Avian influenza outbreak in Turkey through health personnel's views: a qualitative study
Ozlem Sarikaya and Tugrul Erbaydar
BMC Public Health 2007, 7:330doi:10.1186/1471-2458-7-330
Published: 15 November 2007
Abstract (provisional)
Background
Avian influenza threatens public health worldwide because it is usually associated with severe illness and, consequently, a higher risk of death. During the first months of 2006, Turkey experienced its first human avian influenza epidemic. A total of 21 human cases were identified, 12 of which were confirmed by the National Institute for Medical Research. Eight of the cases, including the four fatal ones, were from the Dogubeyazit-Van region. This study aims to evaluate the efforts at the avian influenza outbreak control in the Van-Dogubeyazit region in 2006 through the experiences of health personnel.
Methods
We conducted in-depth interviews with seventeen key informants who took active roles during the avian influenza outbreak in East Turkey during the first months of 2006. We gathered information about the initial responses, the progress and management of the outbreak control, and the reactions of the health professionals and the public. The findings of the study are reported according to the topics that appeared through thematic analysis of the interview transcripts.
Results
Following the first suspected avian influenza cases, a Van Crisis Coordination Committee was formed as the coordinating and decision-making body and played an important role in the appropriate timing of decisions. The health and agriculture services could not be well coordinated owing to the lack of integrated planning in preparation for outbreak and of integrated surveillance programs. Traditional poultry practice together with the low socio-economic status of the people and the lack of health care access in the region seemed to be a major risk for animal to animal and animal to human transmission. The strengths and weaknesses of the present health system - primary health care services, national surveillance and notification systems, human resource and management - affected the inter organizational coordination during the outbreak. Open communication between the government and the public played an important part in overcoming difficulties.
Conclusion
Although there were problems during the avian influenza outbreak in Turkey, the rapid responses of the central and regional health authorities and the performance of the health workers were the key points in controlling the epidemic. The lessons from this outbreak should provide an opportunity for integrating the preparation plans of the health and agricultural organizations, and for revising the surveillance system and enhancing the role of the primary health care services in controlling epidemic disease. Developing successful strategies based on knowledge and experience may play a valuable role in delaying an avian influenza pandemic.
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.
The results emphasize some previously recognized risk factors such as young children preparing sick chickens for meals and later playing with the corpses such as using the heads for puppets and conditions of poverty leading to children sharing an indoor room with chickens esp in cold weather. From one general practioner who has a close
relationship with the local rural people "I mean why wasn't 'a child playing with chicken heads like puppets' put on the agenda? When she was discharged form the hospital, she came to visit me and I bought her a doll and adivsed her not to play with chickens. She slept with
the doll for many nights. Why wasn't attention paid to the problems related to the housing infrastructure or the lack of clean water?"
Another prominent concern was lack of protective equipment for health care workers who were of course wary of dealing with these patients. Fear of taking the disease home to their own families was high.
And as is also mentioned often good open communication at all levels is essential to build trust in a tense situation. And the realization of the extreme economic hardship of culling poultry.
Research article
Avian influenza outbreak in Turkey through health personnel's views: a qualitative study
Ozlem Sarikaya and Tugrul Erbaydar
BMC Public Health 2007, 7:330doi:10.1186/1471-2458-7-330
Published: 15 November 2007
Abstract (provisional)
Background
Avian influenza threatens public health worldwide because it is usually associated with severe illness and, consequently, a higher risk of death. During the first months of 2006, Turkey experienced its first human avian influenza epidemic. A total of 21 human cases were identified, 12 of which were confirmed by the National Institute for Medical Research. Eight of the cases, including the four fatal ones, were from the Dogubeyazit-Van region. This study aims to evaluate the efforts at the avian influenza outbreak control in the Van-Dogubeyazit region in 2006 through the experiences of health personnel.
Methods
We conducted in-depth interviews with seventeen key informants who took active roles during the avian influenza outbreak in East Turkey during the first months of 2006. We gathered information about the initial responses, the progress and management of the outbreak control, and the reactions of the health professionals and the public. The findings of the study are reported according to the topics that appeared through thematic analysis of the interview transcripts.
Results
Following the first suspected avian influenza cases, a Van Crisis Coordination Committee was formed as the coordinating and decision-making body and played an important role in the appropriate timing of decisions. The health and agriculture services could not be well coordinated owing to the lack of integrated planning in preparation for outbreak and of integrated surveillance programs. Traditional poultry practice together with the low socio-economic status of the people and the lack of health care access in the region seemed to be a major risk for animal to animal and animal to human transmission. The strengths and weaknesses of the present health system - primary health care services, national surveillance and notification systems, human resource and management - affected the inter organizational coordination during the outbreak. Open communication between the government and the public played an important part in overcoming difficulties.
Conclusion
Although there were problems during the avian influenza outbreak in Turkey, the rapid responses of the central and regional health authorities and the performance of the health workers were the key points in controlling the epidemic. The lessons from this outbreak should provide an opportunity for integrating the preparation plans of the health and agricultural organizations, and for revising the surveillance system and enhancing the role of the primary health care services in controlling epidemic disease. Developing successful strategies based on knowledge and experience may play a valuable role in delaying an avian influenza pandemic.
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.
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