Tuesday, February 14, 2006

Iraq is a special case

A failed reconstruction that is broke. An insurgency resisting all efforts of the US military to eradicate it and instead confining the invaders to safe zones that aren't safe. And now, bird flu. Poor Iraq.
Some Iraqi farmers are letting their birds loose rather than slaughter them and the lack of a proper shipping container has kept the tissue sample of a man suspected of dying of bird flu sitting in Baghdad despite reports it was being tested abroad.

Poor communications, scarce equipment and the dangers of the insurgency are all plaguing efforts to combat bird flu in Iraq.


Officials say containing the spread of bird flu in Iraq may be beyond the capabilities of health authorities in some parts of the country, particularly volatile Anbar province, center stage of the insurgency.

"Iraq is a special case and has its unique challenges that are especially difficult, obviously because it is a complex environment," World Health Organization spokesman Dick Thompson said from neighboring Jordan.

So far, Iraq's only confirmed human case is a 15-year-old girl who died Jan. 17 in the northern Kurdistan region, Iraq's most stable area with a functioning local administration.

But Iraq has been slow to send samples of other suspect cases - including the girl's uncle, who died Jan. 27 - to WHO-certified laboratories in London and Cairo, Egypt, despite saying for more than a week that the shipment had been delivered.

"We didn't have the containers to ship the samples and without them, they wouldn't have been accepted for shipment," Dr. Ibtisam Aziz Ali, spokeswoman for a government committee handling the bird flu crisis, acknowledged Thursday. (AP; my emphasis)
Nor is the Kurdistan outbreak over:
Dr. Sam Yingst, an American veterinarian and virologist who led an international animal investigation team to Kurdistan last week, said the disease was currently an "agriculture problem" rather than a "human health problem."

The disease was not yet "definitely under control," but the Kurds were "doing the best they can" under the circumstances, Dr. Yingst said at a news conference with Dr. Aziz here on Sunday, just hours after he returned from Kurdistan.

Dr. Yingst estimated that in the effort to halt the bird flu outbreak there at least 200,000 chickens had been slaughtered in Sulaimaniya Province, in the north, and tens of thousands in neighboring Erbil Province. (New York Times)
Not that anyone seems to want to eat chickens anyway. The bottom has fallen out of the Iraqi poultry market.

Meanwhile a 900 kilo consignment of masks, gloves and gowns was being sent from the US to protect workers engaged in culling birds. WHO is sending Tamiflu and the UN sent veterinarians to the north for an inspection. The team concluded their trip Monday after urging Iraqi authorities to institute strict agricultural controls and to distribute educational materials.

But the chicken is out of the coop. Two human cases in the north are being joined by a number of suspected cases in the impoverished Shiite south. A sick fisherman who kept birds is undergoing tests as are five cousins who were also exposed to the birds. A man who raised pigeons has died of likely bird flu and his two siblings are hospitalized and three household members under observation. We await further tests.

As usual, the corrosive effect of lost trust is at work:
Residents in northern Iraq are sceptical that the government is telling the truth about bird flu in the region. Rumours that the disease had reached Iraqi Kurdistan have been circulated in the region for months.

"People knew the disease existed, and the girl died because of it. But they kept it a secret from the people," said Kazim Muhammad, 23, a medical student in Sulaimaniyah. "Now if they say they have gotten rid of the virus, people will not believe the authorities because they lied to them from the beginning."

Health officials at first denied that the victim, Shangeen Abdul Qadir, had died of bird flu based on initial test results. But they later confirmed that the H5N1 strain was to blame for her death.

Abdul Qadir was transferred to Sulaimaniyah hospital on January 17 for treatment for bird flu-like symptoms. She was from Sarkapkan village in Rania district, 150 kilometers (93 miles) northeast of Sulaimaniyah city.

Abdul Qadir fell ill on January 10 and was treated in a Rania hospital, but her condition continued to worsen. She died within 10 minutes of being transferred to Sulaimaniyah for medical treatment.

Abdul Qadir’s uncle, 40 year old Abdullah Muhammad, who had been nursing her, died on January 26. (ENS)
Iraq is both a special case and typical one. In other words, specially bad.