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Ciptapangan Visitor
Bird-Flu Festers in Indonesia as Deficit Hinders Disease Fight
posted by admin on 04/10/06

Indonesia's sprawl also makes it difficult to combat the disease, says Burkhard Rieke, a doctor at the Center for Travel Medicine in Dusseldorf, Germany.

By Karima Anjani

Oct. 4 (Bloomberg) -- The deadly avian influenza doesn't faze Setyabudi, who raises chickens and pigeons at his home in Jakarta, Indonesia's capital.

``Why should we be afraid of bird flu?'' says the 39-year- old janitor, who uses a single name, as he caresses a pigeon. ``People die because it is God's will.''

Fatalism, geography and a lack of money are hindering Indonesia's battle against bird flu, as public health officials say the struggle to avert a global pandemic may hinge on the Southeast Asian nation. The world's fourth-most populous country will spend $54.4 million to fight the disease this year, a fifth of what is needed, the government says.

``It's the No. 1 place that we should be concentrating our efforts on identifying outbreaks and containing them,'' says Ira Longini, an epidemiologist at the University of Washington in Seattle and an adviser to the U.S. on influenza issues.

While Indonesia -- like China, Vietnam and Thailand -- has traced clusters of disease, vaccinated poultry, disinfected coops and culled infected birds, a widening budget deficit has limited spending on the bird flu fight. Corruption concerns have slowed international donations, says Tri Satya Putri Naipospos, vice chairwoman of the government committee on the disease.

Indonesia's sprawl also makes it difficult to combat the disease, says Burkhard Rieke, a doctor at the Center for Travel Medicine in Dusseldorf, Germany.

Indonesia, consisting of about 18,000 islands strung along 3,282 miles (5,281 kilometers) of the Malay Archipelago in Southeast Asia, is home to 238 million people, more than any other country except China, India and the U.S.

`Handling Dynamite'

``Do physicians and vets on one particular island really know they are handling dynamite?'' Rieke asks. ``Do they have an idea how important their actions and their reporting habits are for Jakarta and for the whole world?''

Poultry are raised in the backyards of about 80 percent of Indonesia's 55 million households, increasing the chances that people will come in contact with birds or their droppings, says Agriculture Minister Anton Apriyantono.

On a recent day, children chased chickens that roamed freely in front of Setyabudi's home, less than a kilometer (0.6 miles) from Jakarta's central business district. Diseased fowl were reported in the neighborhood in April.

Prized Pets

Indonesians, most of whom eschew dogs for religious reasons, prize birds as pets and pay as much as 3 million rupiah ($328) for a yellow-vented bulbul. Some Indonesians keep Bali starlings, pigeons or parrots in cages in front of their houses. The country's richly colored wild birds, such as the Sumatra green pigeon and the Javan scops owl, also still abound.

While some people splurge on pets, the Indonesian government plans to cut its spending on programs to control avian flu. Such outlays may decline by 15 percent to $46.5 million next year, Bayu Krisnamurthi, secretary of the bird flu committee, said in August. The country needs about $250 million a year to fight the disease, he said.

A series of natural disasters, beginning with the Sumatra- Andaman earthquake of December 2004, which triggered tsunamis in the Indian Ocean, has widened the government's budget deficit. Indonesian legislators on Sept. 12 approved a revised budget that includes a deficit of 40 trillion rupiah, or 1.3 percent of gross domestic product.

The earthquake left more than 220,000 people dead or missing in Indonesia and other countries.

Economic Threat

Avian flu represents another potential mass killer, capable of spreading throughout the world, health experts say. An outbreak would erase 2.8 percent of Indonesia's $276 billion economy, according to a June report by the Washington-based World Bank, which aids developing countries.

Bird flu occurs worldwide. The so-called H5N1 virus, a deadly form of the disease, began to become more common in both birds and humans in mid-2003. The flu has killed at least 148 people since then, according to the Geneva-based World Health Organization, an arm of the United Nations. The fatalities occurred in Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Thailand, Turkey and Vietnam.

Indonesia has had 52 verified fatalities, the most of any country. In Vietnam, where 93 cases have been confirmed compared with 69 in Indonesia, 42 people have died, WHO statistics show.

One of the latest Indonesian victims was a 9-year-old boy who died Sept. 22 in South Jakarta after contact with sick chickens he kept as pets, according to the Ministry of Health. Indonesia's 40 confirmed bird-flu deaths this year exceed the dozen in all of 2005.

Worldwide, most of the deaths took place after people were exposed to the blood or feces of infected birds, according to the WHO. While the virus doesn't spread easily between humans, some transmission may have occurred.

Flu strains can mutate, so scientists say H5N1 may grow more contagious. Each human case represents a new opportunity for the virus to adapt.

Verified Deaths

Indonesia on Sept. 1 began a radio and TV ad blitz to increase awareness of bird flu. The messages are in the official national language, Bahasa Indonesia.

``Don't touch diseased or dead fowl, immediately wash your hands if you do, then report to the village chief,'' says one appeal. Another says: ``Separate fowl from living areas and separate new poultry from old poultry for two weeks.''

The government is also developing radio announcements in some of the nation's 300 ethnic languages and is passing out handbills to encourage people to report sanitation hazards.

International Aid

International assistance for Indonesia's bird flu fight has totaled $35.4 million so far this year, out of $55 million pledged, says Krisnamurthi, secretary of the bird-flu committee.

Concerns about graft have made some donors loath to give money, says Naipospos, the committee's vice chairwoman. Donor countries also are waiting for Indonesia to provide details about what needs to be done and the nation's priorities are, she says.

Indonesia ranks 137th among 158 countries in the corruption index compiled by Berlin-based Transparency International, which campaigns against bribery and graft.

The shortage of funds means Indonesia doesn't have enough money for programs such as vaccinating birds and compensating people whose poultry is killed to prevent the spread of H5N1.

Indonesia needs about 10 times more money for vaccinations than it can now afford, according to the World Bank.

Vaccinations

In 2006, the Agriculture Ministry will administer about 40 million doses of vaccine, government officials say. More than 200 million chickens in backyards require two doses each.

``The gap certainly highlights the country's weakness in the fight against bird flu,'' Naipospos says.

The government this year increased the compensation paid for culled birds by 67 percent to 12,500 rupiah ($1.40) per fowl. It also sped up reimbursements by appointing local administrators to pay claims from emergency funds.

``It's a way to gain trust from the community that culled poultry will be quickly compensated,'' Krisnamurthi says.

The payments are still less than the 30,000 rupiah a chicken costs in Jakarta, and they fall short of the compensation in some other countries. The Nigerian government pays 250 naira ($1.95) for each bird culled.

The H5N1 virus has spread to poultry in 30 of Indonesia's 33 provinces. Since 2004, almost 29 million chickens have been culled, 20 percent of which were backyard poultry, Apriantono said Aug. 9. Authorities have vaccinated 262 million chickens.

The full extent of Indonesia's bird flu may not be known. A regional-autonomy law that took effect in 2001 increased bureaucracy and weakened reporting systems in the veterinary services, says Peter Roeder, an animal health officer with the Rome-based UN Food and Agriculture Organization.

``There's far more disease in poultry in the field than is reflected in the official reporting system,'' Roeder says.

Until the cases are found and wiped out, the threat of a pandemic looms.

``Bird flu remains a major problem in Indonesia,'' says David Nabarro, leader of the UN's response to the flu and the pandemic threat. ``It is going to be very hard to get rid of.''

To contact the reporter on this story: Karima Anjani in Jakarta at kanjani@bloomberg.net ;

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