H5N1: Lost in transition

Emmy Fitri ,  The Jakarta Post ,  Jakarta   |  Fri, 06/20/2008 10:34 AM  |  Opinion

It seems like deja vu. In the past, Indonesians saw the New Order government in constant denial over touchy issues like the number of people with HIV/AIDS, deaths caused by the disease and, most importantly, what the government was doing to address the problem.

When AIDS becomes widespread it is heavily stigmatized. And the public does not seem to be moved by campaigns for preventive measures, and there is a very strong tendency to cover up the reality. As the old saying goes, the chickens come home to roost. Now we have to deal with the results of mistakes that we made in the past.

These days, the chickens are running again, and we are reverting to past patterns in facing bird flu.

After withholding bird flu virus samples from the World Health Organization, which earned her special mention as a national hero, Health Minister Siti Fadillah Supari has decided to withhold information on deaths caused by the virus -- H5N1 -- as part of a new policy to improve the image of the country hardest hit by the disease.

And what we get is confusion. We've lost the death count. It could be 109, 200 or more.

No one knows for sure how many people have died of this disease or where the virus has hit? Moreover, do not expect to learn what abilities the virus has developed because it is free-ranging, unobserved, on the loose, or let loose.

Officials at the Health Ministry are also in the dark. "We're not supplied with updates on bird flu cases in humans anymore. Try tomorrow, I can ask around," a ministry official replied last week to a query on the latest death toll.

Even worse, the usual standardized procedure for treating a suspected case of bird flu reportedly has not been performed since the minister decided no longer to publicize human cases of bird flu. The procedure includes placing the suspected patient in an isolation room during treatment, requiring doctors and nurses to wear protective masks and gloves and the distribution of antiviral drugs to close family members of the patient. In the past, suspected bird flu patients were not charged a rupiah for treatment, medicine and even for coffins if they did not survive.

When cases were still publicized months ago, even for one case officials would rush to the neighborhood where the suspect lived, examine people and give oseltamivir medication as a preventative measure. The local animal husbandry agency too would deploy officials to check birds in the area to determine the source of the virus.

If there were infected chickens, standard procedure was to perform a selective cull. The public would know what to do next if there were these aforementioned activities in their neighborhood thanks to media reports and aggressive campaigns by health agencies and their partner organizations.

Before the minister started holding back information, the media (and the public) could just call a hotline number at the ministry designated for providing updates on bird flu cases in humans. The media then would pick up the updates to keep a record of the virus.

These days, no one seems to know about bird flu cases. But a case in Bitung brought to the surface by The Associated Press confirmed the absence of previously standard procedures. The news report centered on a 34-year-old woman from Bitung who died after showing symptoms similar to those of bird flu. The woman's family was left confused because they were never informed of the cause of her death because no examination was ever conducted on her.

The Associated Press also reported that the minister herself promised she would announce bird flu deaths as cumulative data, probably several times a year. One reason the minister decided to do this was that she didn't want "people to be preoccupied with the death toll and turn away from the efforts that have been done by her ministry".

Worldwide, the virus has killed 241 people, with half that tally coming from Indonesia.

It's public knowledge that although bird flu was originally a poultry disease, experts fear someday it will gain the ability easily to move from person to person, sparking a pandemic.

Isn't it the government's duty to make available information that is needed by the public? The new law on freedom of information grounds such demand. Collective learning on how to keep a clean environment, not to touch sick birds and important hygienic practices can be learned from cases reported in the media. Changing people's behavior cannot be done overnight, it takes time, even longer in a country whose media is still madly in love with sensational news.

Bird flu deaths are not criminal cases in that investigators have to withhold some facts as they pursue their investigation.

The country should be embarrassed that bird flu is still claiming lives despite the campaigns and other efforts. Holding back information on deaths will not help improve anybody's image, doing just the opposite.

But when the policy to hide information from the public comes from the minister herself, we can only hope that somehow it is all part of a sound plan to contain bird flu, although that looks very unlikely.

The writer is a journalist at The Jakarta Post.

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