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  • INDONESIA - Sumatra

    By Chad Bouchard
    Kaben Jahe, Indonesia
    31 August 2006

    Indonesia is struggling to contain the spread of the deadly bird flu virus in people and poultry. The country now has the world's largest number of human bird flu deaths, and critics say it needs to do more to eradicate the disease. But, as Chad Bouchard reports from the Indonesian island of Sumatra, the government's efforts are hampered by limited resources and resistance from local communities.

    In the isolated mountain community of Dairi in north Sumatra, about 200 villagers file into a packed meeting house. Everybody is talking about a frightening rumor that has been circulating all day.

    Bupati Tumanggor, head of the local Dairi district, addresses the restless crowd over a loudspeaker.

    He confirms that someone from the village has been hospitalized for avian influenza. Five chickens have tested positive for the H5N1 virus as well. He tells them the next morning all birds within a one-kilometer radius will be killed, to keep the virus from spreading.

    Other countries hard hit by the H5N1 virus, such as Vietnam and Thailand, have made significant progress against the disease by killing large numbers of poultry once an outbreak is detected.

    In August Indonesia recorded its 60th case of bird flu in humans, 46 of which have been fatal, the highest human death toll from the disease.

    And some scientists are concerned this high death rate is partly due to Indonesia's reluctance so far to cull birds.

    Tumanggor acknowledges Indonesia has had a difficult time stopping bird flu. But he says the country faces unique challenges. Its population is spread over 17,000 islands, domestic fowl roam everywhere, and there is widespread resistance to the central government among many of its diverse cultures.

    "Criticism from other countries is normal," he said. "But sometimes the critics assign blame because they don't really understand Indonesia. Information in the media about this country is not complete. But if they looked at the whole picture, people would understand how difficult our task is, and that we are doing our best with what we have."

    John Weaver is an advisor on avian flu with the United Nations Food and Agriculture Organization, which is helping Indonesia fight the disease. He says Jakarta's culling program is not rigorous enough. In some cases only 30 or 40 percent of the birds in an area are killed because villagers do not cooperate.

    "You know village poultry are recognized as a valuable asset both in terms of their food value, but also they're a liquid asset in that they can be sold to pay school fees or some medical fees, or something like that, so they are valued within the system. One needs to work within communities and address the fact that this is a potential loss to them," said Weaver.

    Compensating villagers for their poultry is expensive, and the government currently pays only half the market price for birds that are culled. Some villagers fail to report outbreaks of disease in poultry or they hide their birds during a cull.

    Indonesia says the high cost of compensation is one of the biggest barriers to controlling the virus. The government says it needs $900 million for bird flu containment programs over three years but can only afford $150 million.

    But international donors have been reluctant to commit funds. Donor nations have asked for details of how the money will be spent but the Indonesian government has so far failed to provide a plan.

    Indonesia also caused concern in August when it reduced its annual budget for bird flu programs from $57 million to $46 million. The World Bank said the cuts sent the wrong message to international donors.

    Under pressure from the international community, Jakarta has agreed to restore funding to its previous level.

    The U.N.'s Weaver says getting the virus under control in Indonesia will require sustained support from donors.

    "It's not going to be a quick fix," he said. "It's not a one or two year program, it's a five to ten year program. And it's very resource dependent. And it's dependent on both the commitment of the resourcing within Indonesia - but one has to recognize that that's finite - and the response that's expected is beyond the capacity within Indonesia. So there has to be greater international commitment."

    Back in Dairi, police demand residents bring out their chickens to be destroyed. Health workers dressed in sterile white clothes, masks and hoods sweep the village, slaughtering captured birds in the streets.

    At the end of a dusty road, a woman who goes by the honorary title of Nandetedi, or "grandma" in the local dialect, says the villagers do not understand.


    "You know, we don't even have words for 'avian influenza' in the local language," she said. "We do not know how and why the chickens die. We only know the chickens are sick. All of us are healthy. Moreover, I'm an old person, and I'm not afraid of chickens."

    Once the police and health workers have gone, simmering resentment remains over the loss of birds and the damage to the economy.

    Indonesia has announced it will expand the culling of backyard poultry, and the country is rolling out a widespread public awareness campaign about bird flu on television and radio stations.

    The H5N1 virus cannot spread easily among people but there are fears a mutation may occur that will allow it to do so if more humans catch the disease from infected birds.

    And as long as an estimated 300 million chickens continue living in close contact with people, the chance remains for a deadly epidemic in Indonesia. But for now, many bird owners remain unconvinced of that risk.


    http://www.voanews.com/english/2006-08-31-voa9.cfm
    Last edited by Laidback Al; August 31, 2006, 05:58 PM. Reason: Removed confusing photo captions from text of article

  • #2
    Re: Indonesia - North Sumatra

    previous thread

    http://www.flutrackers.com/forum/showthread.php?t=9572

    Comment


    • #3
      Re: Indonesia - North Sumatra

      PonyGirl Post #1, this article is confusing. According to my map, and references, Java and North & South Sumatra are two different Regions.

      Quotes from article:

      "Chickens on a farm in central Java, Indonesia"

      "In the isolated mountain community of Dairi in north Sumatra".....

      Comment


      • #4
        Re: Indonesia - North Sumatra

        North Sumatra - Fatimah Released - Blood Tests Negative
        Tebing Tinggi: Fatimah, one of the assumption patients of bird flu from the Bulian District, the Tebing Tinggi City, North Sumatra, on Thursday (31/8), was permitted to come home after being treated for several days in Adam?s Hospital the Owner, Medan, North Sumatra. He was treated because of being expected flattest the bird flu virus because of experiencing the high and breathless fever. This assumption was increasingly strong because hundreds of chickens around the Fatimah house died suddenly because terjangkit the bird flu virus. However, was based on results of the laboratory test against the sample of blood, Fatimah was ascertained by the negative was infected by the bird flu virus. The Fatimah condition that continued to improve made the hospital side allow Fatimah to come home. Now in the Turikale Village, Maros, South Sulawesi, the Livestock Breeding Service again carried out spraying against the poultry. However, the insignificance of counselling about bird flu as well as the extermination that not equitable made some citizens restless. They hoped that the official did not choose the love in destroying the poultry. His article, still was having the poultry belonging to the certain person who was not destroyed

        Comment


        • #5
          Re: Indonesia - North Sumatra

          Originally posted by Commonground
          PonyGirl Post #1, this article is confusing. According to my map, and references, Java and North & South Sumatra are two different Regions.

          Quotes from article:

          "Chickens on a farm in central Java, Indonesia"

          "In the isolated mountain community of Dairi in north Sumatra".....
          Those quotes were captions on photos in the original article. They have been removed to avoid confusion.
          http://novel-infectious-diseases.blogspot.com/

          Comment


          • #6
            Re: Indonesia - North Sumatra

            Commonground

            Wanted to respond to your statement.

            Quotes from article:

            "Chickens on a farm in central Java, Indonesia"

            This text from the article was a caption below a photo.

            If you refer back to the link you can see it.

            It is confusing and had to go back to view myself.

            Comment


            • #7
              Re-testing RL (35F)

              toggletext-ed from Indonesian:

              The condition for the Patient 'Suspect' Stable Bird Flu after the Currete Operation
              Sept 1, 2006

              Medan, (Analisa)

              The team of the Obgyn part (midwifery and the content) the Hospital H Adam the Medan Owner (RSHAMM) finally did the Currete operation action on the patient's embryo suspect bird flu [R]L br Saragih (35) the citizen Seribu Dolok the Subdistrict Silimakuta the Simalungun Regency.

              The operation that was carried out on Wednesday (30/8) took place the success and the condition for his patient in the stable situation.

              Was like this it was said Wadir I the Medical Service and Education Dr Nur Rasyid Lubis SpB HM through public relations RSHAMM Sinar Ginting SE to Analisa in his office, on Thursday early afternoon (31/8).

              According to Sinar, L br Saragih since being reconciled from the Community Health Centre Seribu Dolok to RSHAMM suspect terjangkit bird flu has had signs of the deviation in his [her] embryo. This was the first case suspect bird flu that was containing [pregnant].

              ?Melalui was in a meeting of the team from the Obgyn part then must do the action on the embryo by doing the operation Currete,? firm Sinar.

              Beforehand was done by the sample inspection of blood to the Centre of Laboraturium Department of Health Jakarta and results of the negative terjangkit bird flu. ?Tapi from clinical him still had doubt, then for more information the team will carry out the inspection ulang,? obviously Sinar.

              So the team was still being waiting for the further inspection. However results until this was not yet received from RSHAMM.
              Sinar added the condition for the patient L br Saragih during his [her] fever week has begun to decrease. However he [she] must be still needing the maintenance.

              Was based on the data from RSHAMM the number of bird flu patients since 2006 totalling 12 people. Seven including dying.

              ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

              Comment


              • #8
                Re: Indonesia - North Sumatra

                Raminta Br Lingga (Saragih) (35F) from Saribudolok, the Subdistrict Silima Kuta, the Simalungun Regency, Northern Sumatra is the only suspected H5N1 patient in Northern Sumatra that has not been tested or not yet tested negative for bird flu.
                http://novel-infectious-diseases.blogspot.com/

                Comment


                • #9
                  Re: Indonesia - North Sumatra

                  Indonesian bird flu victims fled from doctors
                  PREVENTIVE MEASURES THWARTED
                  By Alan Sipress
                  Washington Post
                  JANDI MERIAH, Indonesia - Dowes Ginting, the most wanted man on Sumatra island, lay dying. He had abandoned the hospital where he had seen his relatives succumb one after another, and he had fled deep into the mountains, trying to outrun the black magic he feared had marked him next. For four nights, witnesses recalled, a medicine man hovered over him in a small clapboard home, resisting the evil spell.

                  Ginting, a wiry 32-year-old, had watched disease burn through his family over the previous two weeks, killing six and sickening two others, including himself. International health experts grew increasingly concerned when laboratory tests confirmed they were sickened by bird flu, the largest cluster of the disease ever recorded. But Dowes feared medical treatment more than he did the flu. And so he ran, potentially exposing villagers across the province to the highly lethal virus.

                  In the end, the outbreak in May did not presage the start of a worldwide epidemic. But the enormous difficulties that Indonesian and international disease specialists confronted in investigating the outbreak and protecting against its spread raised fundamental questions about whether bird flu could be contained if it mutated into a form more easily spread among people.

                  ``If this were a strain with sustainable transmission from human to human, I can't imagine how many people would have died, how many lives would have been lost,'' said Surya Dharma, chief of communicable disease control in North Sumatra province.

                  Officials from the World Health Organization (WHO), drawing on sophisticated computer modeling of a theoretical bird flu outbreak in Southeast Asia, have suggested that a pandemic could be thwarted through a rapid containment effort in the affected area, including the right mix of drugs, quarantines and other social controls.

                  To succeed, the anti-viral drug Tamiflu would have to be distributed to 90 percent of the targeted population, roughly defined as those within at least a three-mile radius of each case. The drug would have to be administered within 21 days from the ``timely detection'' of the initial case of an epidemic strain. Residents would have to stay home, limit contact with others and take the medicine as prescribed.

                  In the case of the North Sumatra cluster, almost none of this happened, according to extensive interviews with health officers, family members and villagers. The underlying problem was that most family members and villagers were convinced that magic, not flu, was to blame.

                  ``How can you ever get people to cooperate if they don't even believe you?'' Dharma said.

                  Scientists are still working to determine how bird flu is transmitted to and between humans. More than 200 people worldwide have contracted the deadly H5N1 strain of the virus since 2004. Most of the cases have resulted from contact with infected live or uncooked poultry, or with surfaces contaminated by infected birds.

                  Health investigators have concluded that the eight-person cluster in Sumatra began with Ginting's older sister, who fell ill in late April. They suspect she was infected with bird flu from live chickens sold in a market where she peddled oranges, limes and chili peppers, or from contaminated poultry droppings in manure used in her garden. She died and was buried before any samples were taken to confirm bird flu.

                  Several days after she became sick, the extended family had gathered in the village of Kubu Sembilang for a feast of roast pig and chicken curry to celebrate the annual harvest festival. That night, many of the relatives slept in the same small room with the sister, who had developed a serious cough. By the time she died, a sister, a brother, two sons, a niece and a nephew had become ill. Flu specialists said the final victim, her brother Dowes Ginting, in turn probably caught the virus from his infected son.

                  Health experts have concluded this was the first time the bird flu virus had been passed from one person to another and then on to a third person.

                  ``None of us thought it was bird flu. We thought it was black magic,'' said Anestia Tarigan, the wife of the youngest Ginting brother, Jones, the only victim to survive. ``Everyone in the family was getting sick and no one else was. Someone had put a spell on our family. Black magic is very common in our place.''

                  Indonesian and WHO investigators discovered that many residents in Kubu Sembilang were unwilling to share information or give blood samples that could reveal how widely the virus was circulating. Many villagers believed that claims of bird flu were a lie. Some even threatened the investigators. When a team of officers first arrived from the provincial health department, they were warned by their local counterparts that it was too dangerous to enter the village.

                  ``We chased them away,'' said Hendra Tarigan, whose wife, one of the Ginting siblings, died. ``Each time they came back, we gave them no information. We just told them to leave.''

                  ]Investigators were able to take samples from only two people in the village, including the local midwife, said Diana Ginting, chief of the district health department, who shares a common surname in the region.

                  Indonesian health officials working with an international team returned day after day to the village and made progress. They recruited 20 local volunteers to monitor fellow residents for fever and set up a temporary health post on the soccer field offering free medical care. The investigators methodically pieced together the chronology of the outbreak. They traced those who had contact with the victims and provided them with Tamiflu.

                  But many of those closest to the Gintings refused to take it.

                  As a medicine man treated Dowes Ginting, Indonesian and international health investigators finally tracked him down and urged his family to take him to a hospital. They demurred: He needed two more days of traditional treatment, they said. That night, he took a turn for the worse and died.

                  Comment


                  • #10
                    Re: Indonesia - North Sumatra

                    Update - Looks like Rasmita Boru Lingga (35F) is/has been released.

                    I?m confused on the lower section of the article that I highlighted?..Kondisi?, and also?..Keluarga?

                    On Sunday, on September 03 2006 Medan (SIB) the sufferer?s Patient suspect bird flu was permitted to come home by the side of RSUP H Adam the Owner because of his condition. Stated improved and the negative contracted this illness.

                    The assurance of returning of R Br L (34) the inhabitants Saribudolok Kec Silimakuta Kab Simalungun were sent directly by Wadir 1 Field and Education of the Medic?s Service RSUP human rights Dr H Nur Rasyid Lubis SpB FICS to SIB, on Saturday (2/9). ?Kondisi him has improved, his fever already was not again and we again the co-ordination with Jakarta to pemulangannya? he said.

                    Nur Rasyid said, his side uptil now knew results of the sample inspection of the patient R Br L that he him was stated the negative was affected by bird flu and currently RSUP human rights only were waiting for the facsimile from Jakarta results of this inspection. Keluarga him indeed ask for came home and when this afternoon (on Saturday. Red) came faksimil from Jakarta the possibility R Br L will be returned.

                    However, before being returned by the doctor will check his health before to more decisive kondisinya,? he said again.

                    Medicine tamiflu that already this Sunday was given to the patient R Br L, Nur Rasyid words, currently are stopped and produced by Curretese (sucked) that was carried out by good results. ?Bila already did not have the problem was returned by us the patient tersebut,? he said again.
                    http://tinyurl.com/ksgm5
                    Last edited by AlaskaDenise; September 3, 2006, 08:38 PM. Reason: reformatted for readability

                    Comment


                    • #11
                      Re: Indonesia - North Sumatra

                      Originally posted by Commonground
                      Kondisi him [her] has improved....

                      Keluarga him indeed ask for came home....
                      Kondisi=condition; keluarga=family.

                      If toggletext doesn't translate a word, Kamus-online is often a good back-up:



                      Thanks for the post, Commonground.
                      ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

                      Comment


                      • #12
                        New bf suspect in Medan

                        Hat-tip, Dutchie!

                        toggletext-ed from Indonesian:

                        Pre-schoolers Suspect Bird Flu entered RS Adam Malik
                        Medan, Waspada Online
                        Sept 12, 2006

                        One of the citizen's Medan pre-schoolers was suspected (suspect) bird flu entered RSUP H Adam the Medan Owner, on Saturday afternoon (9/9). Further casualties underwent the maintenance in A space of the Longing isolation with the condition for the high fever. Information in the Longing of A RS Adam the Owner mentioned, casualties were the citizen's 2 years [*snip*], the Market of V Medan. old When entering casualties experienced the high fever with reached 39 derjat celcius.

                        From the mother's information of casualties, around the location of the house was gotten by two chickens died suddenly. Several days afterwards casualties experienced the high fever and were brought took medicine to the closest Community Health Centre. In the temporary inspection, high fever casualties. Saw that, the doctor the Community Health Centre referred to Adam's hospital the Owner et cetera took the sample of blood and the liquid of casualties's throat to be sent to the Centre of the Jakarta Health Laboratory.

                        Deputy Director Pelayanan Medis RSUP H. Adam the Owner Dr. M. Nur Rasyid Lubis, SpB was accompanied by the head treated inap suspect bird flu Dr. Adlin Adnan during it was confirmed, on Monday (11/9) justified one of the citizen's Medan pre-schoolers experienced suspect bird flu.

                        And casualties were at this time undergoing the maintenance in Adam's isolation space the Owner. However, results of the sample of blood that was sent to the Centre were not yet accepted by results. So, casualties were not permitted to come home him, although the temperature of casualties's body has descended.

                        "We continued to monitor the condition for casualties to results of the sample of blood that was sent it was known. However, casualties at this time did not yet make use of respiratory aids (the ventilator)," said Adlin. Adlin added, the condition for casualties at this time was stable, but still was treated in isolation space intensively to guard matters that were not wanted. In fact, casualties's family ask for to come home.

                        ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

                        Comment


                        • #13
                          BF suspect from Tebing Tinggi, North Sumatra

                          Hat-tip, Dutchie!

                          toggletext-ed from Indonesian:

                          The Sample of the Patient's Blood Suspect Bird Flu was sent to Depkes
                          Sept 14, 2006

                          Medan-RoL -- The Sample of the patient's blood suspect bird flu (avian influenza) from Tebing Tinggi, North Sumatra, that was treated in RSU H. Adam the Medan Owner was sent to the Department's Laboratory of the Health (the Department of Health) in Jakarta.

                          Deputy Director Bagian Medik and Education RSU Adam the Owner, Dr. M. Nur Rasyid Lubis, in Medan, on Thursday, said, the sending of the sample of blood was carried out to know whether the patient was positive or not terjangkit the bird flu virus.

                          The patient who still was 15 years old was reconciled to RSU Adam the Owner Breakingprep Wednesday (13/9), around struck 16.00 WIB. Beforehand he had an opportunity for three days to be treated in RSU Tebing Tinggi.

                          This patient experienced hot the high body until achieving 39 Celcius levels, after three the previous day (on Sunday, 10/9) the poultry belonging to parents of sudden casualties died.

                          Rasyid added, the patient suspect bird flu from the city "lemang" that at this time still was placed in the room of the Longing isolation of A RSU Adam the Owner.

                          The patient was given medicine Tamiflu, now the temperature of his body until this was still staying high. He said, the team of the doctor every time three hours carried out the inspection to know the condition for casualties.

                          ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

                          Comment


                          • #14
                            Re: INDONESIA - North Sumatra

                            More on the case above...

                            toggletext-ed from Indonesian:

                            Suspected of being infected by Bird Flu, the Tebing Tinggi Citizen was reconciled to RS Medan
                            Sept 15, 2006

                            Tebing Tinggi, (Analisa)

                            The series Edi Fauzi (15), the citizen of <snip> Kampung Lalang Kelurahan Lalang Kecamatan Rambutan Kota Tebing Tinggi, on Tuesday (12/9) struck 07.40 WIB was run off with to RS the Public H. Adam the Medan Owner was expected was determined the bird flu illness.

                            According to the source, parents of the Series of Edi Fauzi beforehand suffered the fever illness shivered several days ago. Because his condition continued to descend, parents of casualties had finally brought his child to RS the Tebing Tinggi Public.

                            Results of the medical inspection showed, casualties in the photograph in the condition for the fever shivered and the temperature of his body 38 levels celcius, the cough did not spit and breathless. Before suffering the illness, casualties beforehand held the chicken poultry that has died.

                            Tomorrow his day casualties in the re-photograph. Evidently results were still being good, his blood was good but the temperature of his body rose reached 39 derjat celcius. Nasal mucus and dahak enough, besides this was still breathless. The same day casualties the Series of Edi Fauzi in referred to RS the Public H Adam the Medan owner.

                            "According to medical, casualties have been affected by the bird flu illness and have been given medicine penangkalnya,? said Kabag Infokom Pemko Tebing Tinggi Drs H Asmali, MBA.

                            The problem of the cost perobatan. According to Asmali, all was borne Pemko Tebing Tinggi through the health fund. To mengantipasi the spreading of bird flu happened, his side had strive for and co-operated Officially the Health of the City and the agricultural Service. In this case we have carried out the meeting of the co-ordination in order to looks for the good road.

                            Besides this, the Tebing Tinggi mayor Ir H Abdul Hafiz Hasibuan has ordered the sub-district head to collect data on all the poultry. How many in fact the number of poultries, so not only the chicken then. After completely had data collected on it, there was help from the North Sumatran Service of Province Livestock Breeding.

                            The budget fund was from WHO, all the lacks from the budget that was accepted the Province will be dealt with from APBD just was carried out by the extermination. So the conclusion of the meeting must through the conscientious evaluation, so that later the owner's community of the poultry does not feel the owner's community of the poultry incurred a loss.

                            ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

                            Comment


                            • #15
                              BF confirmed in poultry in Limapuluh, West Sumatra

                              toggletext-ed from Indonesian:

                              The chicken died Suddenly in Limapuluh Positive Bird Flu
                              Sept 16, 2006

                              Limapuluh (SIB)

                              Dozens of tails of the chicken died suddenly in Limapuluh Asahan got attention dari the related agency. One team consisted of Drh Eddy Vanhuri with Risada Sinulingga the supervision part of Asahan bird flu was accompanied by the Head UPTD Limapuluh Guntur Sinaga SP as well as the official of the Musdiani Manik animal, on Friday (15/9) descended to the District of Limapuluh Kota.

                              One chicken that died suddenly belonging to Fahruddin was checked by making use of the implement rapid test. Positive results were resulted in by the virus susfect bird flu and not resulting from the virus of Niskatle Deasus Acute (NDA) that usual was acknowledged as the Tatelo illness.

                              Risada Sinulingga when being confirmed SIB justified results of the positive inspection bird flu. The similar matter was also said by the official of the Musdiana Manik animal. In the meantime, Drh Eddy Vanhuri that was contacted was separated also justified results of the positive inspection. ?Hasil him was positive but still necessary the further inspection in order to gets results whether positive results of flu burung,? he said answered SIB.

                              To prevent so that the bird flu virus does not spread in Limapuluh Kepala UPTD heads (the Executive's Technical Unit the Village) as well as the official of the same day animal the co-ordination with the Village Head Limapuluh Kota Solehati Harahap SAg as well as the Subdistrict [Kecamatan] Limapuluh. Planned on Saturday (16/9) will be carried out by mass spraying of all the chicken coops belonging to the citizen in the District Limapuluh.



                              Limapuluh, West Sumatra:


                              ( Really cool building in West Sumatra!: http://en.wikipedia.org/wiki/Image:Rumah_Gadang.JPG )
                              ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

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