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Indonesia's new bird flu policy on reporting deaths leads to confusion, anger
Indonesia's new bird flu policy on reporting deaths leads to confusion, anger
The Associated Press
Published: June 14, 2008
http://www.iht.com/articles/ap/2008/06/14/asia/AS-GEN-Indonesia-Bird-Flu-Policy.php
BITUNG, Indonesia: Ali Usman's wife died of bird flu 10 days ago, but the government has yet to notify next-of-kin about the cause. He searches for answers in newspapers, which until recently reported aggressively on deaths linked to the virus, but finds nothing.
That's because Indonesia has stopped publicizing fatalities immediately, part of a campaign to shift focus instead to successes in battling the disease in the hardest hit nation. The Health Ministry said Friday it would start announcing deaths on a monthly basis ? not several times a year as earlier implied ? clearly spelling out its new strategy for the first time.
The development was welcomed as a step in the right direction.
Health workers and residents said the government's information slowdown had left them confused and frustrated. It took The Associated Press a week to track down and confirm the June 3 death of Usman's wife, Susi Lisnawati, which raised the country's toll to 110.
Though Lisnawati was suffering from classic symptoms of the disease ? breathing difficulties, coughing and high fever? the 34-year-old was not kept in isolation during her two days of hospitalization. Family members said they gave her a traditional Muslim burial, washing and shrouding the body with their bare hands, before placing it in the ground without a casket.
"I'm terribly scared, I need to know what the test results were," Usman, a 44-year-old tailor and father of three. "How else can I protect my family?"
Indonesia, which has tallied more human deaths than any other country, is seen as a potential hotspot for a pandemic because of its high density of people and large number of backyard chickens. The virus remains hard for people to catch, but scientists fear it could mutate into a form easily transmitted between humans, potentially killing millions across the globe.
The World Health Organization, which has been engaged in a bitter yearlong dispute with Indonesia over the sharing of virus samples, said Health Minister Siti Fadilah Supari promised to keep it informed about new deaths and did not appear to be violating international health regulations with her new policy.
"Indonesia has agreed to continue notifications to WHO .... they have never said they would not do that," said David Heymann, the U.N. agency's top flu expert, adding it does not matter if it takes several weeks to publicize the country's official toll "as long as the virus is known about and handled properly."
But for now, the lack of transparency has forced people to rely on word of mouth and rumors. It has also raised fears that deaths could be covered up, especially because the government has been exclusively responsible for carrying out genetic sequencing needed for diagnosis and risk assessment since its standoff with WHO.
Relatives of victims are still shown official bird flu test results almost immediately and Usman's case appeared to be an aberration.
But when asked for an explanation Friday, the Health Ministry said test results had come back negative and would be delivered to the family within days. Nyoman Kandun, a senior ministry official, later confirmed the tests came back positive.
Neighbors, too, were confused after seeing bird flu investigators visit Usman's house, taking blood samples from family members and handing out the anti-flu drug Tamiflu, but only to his youngest son and a child living next door. Residents were asked if they had backyard fowl.
In the past, they too would have turned to the media for information if official notification was slow in coming, not uncommon in a sprawling nation of 235 million people that spans the width of the United States.
Gusti Ngurah Mahardika, a virologist at Udayana University on Bali island, said Saturday the decision to announce deaths monthly instead of several times a year was welcome news. But he urged the government to go further, releasing information immediately, as it did up until May 1.
If people aren't kept informed regularly about deaths, he said, they "will become complacent about bird flu and its threat."
This is not the first time Indonesia's handling of bird flu has raised eyebrows.
Supari, the health minister, got widespread attention ? and some praise ? when she bucked the WHO's 60-year-old virus sharing system in January 2007, saying it was unfair to developing nations. She's worried pharmaceutical companies will use her country's virus strain to make pandemic vaccines that are ultimately unaffordable to her own people.
But by refusing to share virus samples, Supari is making it almost impossible for international scientists to make sure the virus isn't morphing into a more dangerous form.
Supari defended her new policy on reporting deaths last week, saying the focus now should be on positive steps taken by the government to combat bird flu. She pointed to a "declining trend" in cases, with at least 18 people infected in the first six months of 2008, down from 27 during the same period in 2007 and 35 in 2006.
Indonesia's new bird flu policy on reporting deaths leads to confusion, anger
The Associated Press
Published: June 14, 2008
http://www.iht.com/articles/ap/2008/06/14/asia/AS-GEN-Indonesia-Bird-Flu-Policy.php
BITUNG, Indonesia: Ali Usman's wife died of bird flu 10 days ago, but the government has yet to notify next-of-kin about the cause. He searches for answers in newspapers, which until recently reported aggressively on deaths linked to the virus, but finds nothing.
That's because Indonesia has stopped publicizing fatalities immediately, part of a campaign to shift focus instead to successes in battling the disease in the hardest hit nation. The Health Ministry said Friday it would start announcing deaths on a monthly basis ? not several times a year as earlier implied ? clearly spelling out its new strategy for the first time.
The development was welcomed as a step in the right direction.
Health workers and residents said the government's information slowdown had left them confused and frustrated. It took The Associated Press a week to track down and confirm the June 3 death of Usman's wife, Susi Lisnawati, which raised the country's toll to 110.
Though Lisnawati was suffering from classic symptoms of the disease ? breathing difficulties, coughing and high fever? the 34-year-old was not kept in isolation during her two days of hospitalization. Family members said they gave her a traditional Muslim burial, washing and shrouding the body with their bare hands, before placing it in the ground without a casket.
"I'm terribly scared, I need to know what the test results were," Usman, a 44-year-old tailor and father of three. "How else can I protect my family?"
Indonesia, which has tallied more human deaths than any other country, is seen as a potential hotspot for a pandemic because of its high density of people and large number of backyard chickens. The virus remains hard for people to catch, but scientists fear it could mutate into a form easily transmitted between humans, potentially killing millions across the globe.
The World Health Organization, which has been engaged in a bitter yearlong dispute with Indonesia over the sharing of virus samples, said Health Minister Siti Fadilah Supari promised to keep it informed about new deaths and did not appear to be violating international health regulations with her new policy.
"Indonesia has agreed to continue notifications to WHO .... they have never said they would not do that," said David Heymann, the U.N. agency's top flu expert, adding it does not matter if it takes several weeks to publicize the country's official toll "as long as the virus is known about and handled properly."
But for now, the lack of transparency has forced people to rely on word of mouth and rumors. It has also raised fears that deaths could be covered up, especially because the government has been exclusively responsible for carrying out genetic sequencing needed for diagnosis and risk assessment since its standoff with WHO.
Relatives of victims are still shown official bird flu test results almost immediately and Usman's case appeared to be an aberration.
But when asked for an explanation Friday, the Health Ministry said test results had come back negative and would be delivered to the family within days. Nyoman Kandun, a senior ministry official, later confirmed the tests came back positive.
Neighbors, too, were confused after seeing bird flu investigators visit Usman's house, taking blood samples from family members and handing out the anti-flu drug Tamiflu, but only to his youngest son and a child living next door. Residents were asked if they had backyard fowl.
In the past, they too would have turned to the media for information if official notification was slow in coming, not uncommon in a sprawling nation of 235 million people that spans the width of the United States.
Gusti Ngurah Mahardika, a virologist at Udayana University on Bali island, said Saturday the decision to announce deaths monthly instead of several times a year was welcome news. But he urged the government to go further, releasing information immediately, as it did up until May 1.
If people aren't kept informed regularly about deaths, he said, they "will become complacent about bird flu and its threat."
This is not the first time Indonesia's handling of bird flu has raised eyebrows.
Supari, the health minister, got widespread attention ? and some praise ? when she bucked the WHO's 60-year-old virus sharing system in January 2007, saying it was unfair to developing nations. She's worried pharmaceutical companies will use her country's virus strain to make pandemic vaccines that are ultimately unaffordable to her own people.
But by refusing to share virus samples, Supari is making it almost impossible for international scientists to make sure the virus isn't morphing into a more dangerous form.
Supari defended her new policy on reporting deaths last week, saying the focus now should be on positive steps taken by the government to combat bird flu. She pointed to a "declining trend" in cases, with at least 18 people infected in the first six months of 2008, down from 27 during the same period in 2007 and 35 in 2006.
