Bird flu explodes among humans in Indonesia

Hard-hit nation reports new death every 2 1/2 days in May

	The only remaining family member of a family of seven, which has been decimated by bird flu deaths, is treated in a hospital in Medan, Indonesia.
Diaz Ridho / AP file

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updated 5:55 p.m. ET May 31, 2006

JAKARTA, Indonesia - Indonesia averaged one human bird flu death every 2 1/2 days in May, putting it on pace to soon surpass Vietnam as the world's hardest-hit country.

The latest death, announced Wednesday, was a 15-year-old boy whose preliminary tests were positive for the H5N1 virus. It comes as international health officials express growing frustration that they must fight Indonesia's bureaucracy as well as the disease.

"We're tying to fix this leak in the roof, and there's a storm," World Health Organization spokesman Dick Thompson said. "The storm is that the virus is in animals almost everywhere and the lack of effective attention that's being addressed to the problem."

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Indonesia, an archipelago of 17,000 islands with a population of 220 million people, has a patchwork of local, regional and national bureaucracies that often send mixed messages. The impression, health officials said, is often that no one is truly at the helm.

"I don't think anyone can understand it unless you come here and see it for yourself," said Steven Bjorge, a WHO epidemiologist in Jakarta. "The amount of decentralization here is breathtaking."

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He said Health Ministry officials often meet with outside experts to formulate plans to fight bird flu, but they are rarely implemented.

"Their power only extends to the walls of their office," Bjorge said, adding that the advice must reach nearly 450 districts, where local officials then decide whether to take action.

Indonesia has undergone a sometimes rocky transition to democracy since dictator Suharto was ousted in 1998, with many powers held by the central government being transferred to regional and community control.

But the process has been haphazard, and funding and policy decisions are often at the whim of inexperienced officials, mayors and village heads.

National government officials concede there is a problem.

"The local government has the money, thus the power to decide what to prioritize," said Hariyadi Wibisono, director of communicable disease control at the Ministry of Health. "If some district sees bird flu as not important, then we have a problem."

Indonesia has logged at least 36 human deaths in the past year — 25 since January — and is expected to soon eclipse Vietnam's 42 fatalities. The two countries make up the bulk of the world's 127 total deaths since the virus began spreading in Asian poultry stocks in late 2003.

CONTINUED : Family ties

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