Bird Flu Update in Iraq Kurdistan

With little information coming out of Iraq Kurdistan concerning the bird flu, it is appreciated to see some information. Kamal Mirawdeli wrote an article about the bird flu and other issues beseeching the Kurdish people. As I do not get political, I will not comment on most of the article; I believed it covered too many issues at once.

I had the opportunity back this past fall to meet the Minister of Health in Sulaimaniya and my person opinion was that he seemed competent, but even the most competent “leaders” in normal situations may fall short during crisis, from their own decisions or from external misinformation, pressure and influences. As we know now, during the aftermath of Hurricane Katrina there was and perhaps still is disorganization, poor decisions, misinformation, etc. I will point out, although the Ministry of Health has made great strives in training and updating the healthcare system in the region, but they are still far behind. One example I pointed out to the Ministry after spending a day at a hospital was the issue of unprotected shoes in the OR. The personnel were required before going into the unit to change from their street shoes to clogs which just happened to be mixed with the street shoes. On top of this, these clogs were communal, except the few who brought their own… Once they go into the unit, they are free to walk around, including the bathroom (eastern) and then go into the OR without sterilized shoe covers.

The answer to this question was yes, this was not appropriate protocol but they do not have shoe covers. Then we discussed the ideal solution. Encourage health care supply and distribution industries to open shop in Iraq which would provide for the hospitals, generate jobs and foster a sustainable economy. I am working on this second part professionally.

The second topic was the healthcare system in Iraq and Iraq Kurdistan have requested additional visiting doctors and healthcare professions to come and teach, present updated information, even for a week. I know this personally, but some international organizations do not wish to send people at this time. There have been medical delegations and the US military medical units who have been conducting trainings in Iraq. There are safe zones in Iraq and the international medical community would be wise to send people to train and evaluate.

Back to the bird flu before my temper rises, this is a very serious issue in Iraq Kurdistan and in fact the entire region without consideration to borders and nation states. I am surprised the major media networks have not covered it with deep concern (maybe they are barred from footage or information). I consider Sulaimaniya my home and it is very difficult to be away from my home especially during this crisis. Kamal reports the following:

"Today the story is different. Bird flu epidemic is gripping Kurdistan. Two other people have already died; four are under intensive care. Until yesterday the minister of health was talking about 18 people being isolated for the suspicion of the disease. Today, according to DPA news “a fresh bird flu scare has erupted in the Kurdish region in northern Iraq with reports of 162 suspected cases almost two weeks after a 15-year-old girl died of the deadly strain.” The report adds that the head of pre-emption committee in the Kurdistan Province Najm Mohammad has asserted to al-Hayat newspaper that the virus has proliferated throughout Rania, a region southwest of al-Sulaymania on the border with Turkey, and described the influx as a "crisis."

In fact, a few days ago the number of reported cases was around 156 people, I believe this number is in fact, much higher. Call it intuition, the same as last October when we saw a dark cloud over the area concerning the bird flu and a possible epidemic. In this region, the people seem to suffer over the years from unknown mini “fever” spells frequently. I do not have an answer on this malaise but currently those people with “fever” spells may not have the typical fever.

The other issue in the article is the late availability of funds which were requested months ago. Kamal writes, “The most important response I read to the risks of the spread of the disease from neighbouring North Kurdistan was a decision by Sulaymaniya administration to allocate 850,000 dollars for the efforts to prevent the spread of the disease in the region! Yes, 850,000 dollars! But whether even this amount is truly allocated and how it would be spent, can be anyone’s guess. This, however, shows again the degree of lack of interest in the death of people, social issues and any sense of responsibility and accountability.”

Back in the fall with an NGO, we devised a public health education program for the villages. The amount of money to carry out this program was a drop in the bucket, literally, with step up plans to include training for rural healthcare facilities and agricultural centers. The initial program was public health education with the support and consultation of medical and agricultural professionals from both sides of the ocean. All that was required with the initial program was a dedicated vehicle, gas (which is expensive), printing costs for flyers, and small salaries for the local NGO staff (some of us were to volunteer our time) to go out to the villages.

Give me a tiny drop of the budget, I will gather my people and head out (Mom cover your ears and eyes). What is more important at this point is accurate reporting and updated information from WHO, the CDC and the medical community on a daily basis. Why are they so quiet? WHO stated they could not get there quickly, excuse me, but that is not true. They can fly a charter into the area. Now, it is beyond a simple public health educational strategy (although this still needs to be carried out). Furthermore there are continued outbreaks in SE Asia which must not be forgotten. There is a growing concern, one which can affect the world.

For more information on the Avian Influenza
http://www.who.int/csr/disease/avian_influenza/avian_faqs/en/index.html#control

Miriam