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Ciptapangan Visitor
Alertness matters
posted by admin on 04/10/06

Bayu Krishnamurti's interview (The Jakarta Post, Sept. 26) confirms that Indonesia is the world's weakest link in the battle against bird flu.

The government faces an insurmountable dilemma, which can be summed up as follows: How can we ensure that 220 million people who live on hundreds and hundreds of islands have adequate information about prevention and then implement it? And how can we implement centralistic policies in a country with a heavily decentralized environment and a health-care system that is in tatters?

The government has realized almost too late that there is a desperate need to raise public awareness, rather than just undertake a poultry vaccination campaign or compensate farmers who cull sick birds. There is no doubt that the campaign launched recently on radio and television will bear fruit, but only if we adopt an adequate tone in warning against the real danger, especially in rural areas, because the situation is alarmingly serious.

Indonesian people are not ready to toss aside thousands of years of tradition and change their way of life (with chickens) if they don't feel the real danger, or to put it frankly, if they are not waspada (alarmed).

That is on the prevention level. On the disease management level, the situation is worse and is an omen of the disaster it would be, should a pandemic strike. What alarms most is the regrettable absence of the medical community from the battle field as a whole. Cases of infected patients who have seen a doctor a week or a few days before being admitted with the wrong diagnosis to the wrong hospital are rising in number. The majority of the victims reached specialized medical centers too late. How can general practitioners, in the most affected country in the world, continue to overlook the diagnosis despite suspicious pneumonia-like symptoms?

Greater public awareness is of no use if all ( yes, at all ) if doctors at the provincial and district levels are not trained well enough to recognize the disease and provide a rapid response. The H5N1 strain of the bird flu virus is much more lethal than the normal human variety, and antiviral treatment is ineffective when administered too late.

A 75 percent mortality rate in Indonesia should blow the whistle on medical lethargy. Medical doctors and departments must gear up for the situation. Look at the Vietnamese scientists; they are producing groundbreaking research in avian flu again and again. Why can't our scientists do the same when they have more patients and data? The answer to this question cannot be the lack of funds.


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