Thursday, June 18, 2009

Letters from Port Moresby - Papua New Guinea scrambles to block swine flu virus

Letters from Port Moresby (Year 5)


Thursday, 18 June 2009

AS As this space, Letters from Port Moresby, hurtles across its fifth year on the cyberspace as a weekly column on Manila-based , Australia is gradually emerging as a flash point for a feared deadly swine flu outbreak in the Pacific region.

And the World Health Organization in PNG is deeply concerned. It now looks at this country as new breeding farm for the dreaded virus, thus a potential exporter to its 17 island-country neighbors that include Papua New Guinea, hastened by this continent’s direct air link with them.

From the recorded case on June 12 of 1,307, the confirmed new Aussie cases shot to a further 516 over the next four days on June 16, to 1,823.

With Australia’s soaring cases of the new swine flu strain being confirmed across the continent in just a matter of few days, and with a heavy concentration in the state of Victoria, what more could a neighbor like PNG do but get totally concerned, if not panic, for its people who are very much vulnerable to this kind of malady and for a number of reasons.

Not to mention that Papua New Guinea’s poor track record on HIV/AIDS and TB incidences – both deadly -- is classic

Right now, my second home is bracing against a feared possible entry of the deadly virus of swine flu, courtesy of recently-returned travelers who passed through Port Moresby, the nation’s capital city.

One good news is that, health authorities last night said the 15 or so Papua New Guinean travelers who have been isolated on suspicion of having the virus probed negative. Their blood samples were analyzed at the Public Centre for Influenza in Melbourne, Australia, shortly after they were quarantined upon arrival at the Jackson International Airport in Port Moresby. Among the “patients”, ten are Port Moresby residents who recently returned from swine flu-hit Australia.

As more and more Papua New Guineans and other travelers arrive each day especially from Australia, which accounts for the fifth biggest number of cases at 2,026, thus making this continent a would-be flashpoint in the Pacific region, health authorities in PNG are crossing their fingers that none of those who would be entering the country is a carrier.

With 1,210 cases in the state of Victoria, Australia closely follows the US (17,855), Mexico (6,241), Canada (2,978) and Chile (1,694). At least 145 of those infected had died.

Health quarantine officers at the Jackson’s International Airport are equally concerned about the endless inflows of travelers – most of them expatriate workers -- from Asian countries like Singapore, China, Malaysia and the Philippines with which PNG has direct flight connections.

Because somewhere along the way to the airport back home, one or two of them could pick up the virus and carry it to PNG.

In the Philippines, health authorities have confirmed 147 cases as of last Sunday, with 36 new ones being confirmed during that day. And health workers are puzzled how a very isolated village in Nueva Ecija, a province in Luzon island, became host to an outbreak involving 11 school children who are positive of the virus and showing influenza-like symptoms.

With no one from the village having traveled overseas, it has been suspected that the possible source of exposure to virus could be a team of doctors and nurses who held medical mission in the said village school last month.

A similar mode of influenza A(H1N1) virus-jumping is one which PNG health authorities are dreading of right now. Knowing that most of the locals simply are unaware of the so-called proper personal hygiene, they know that the possibility of contamination and then, outbreak, is high.

One hit is just enough to serve as a fuse to detonate a sudden violent spontaneous occurrence of this disease among the people, especially in the rural areas.

What is going around the world at a speed never before anticipated has been described by the World Health Organization (WHO) as the “new flu” – a new version of an old flu strain that has ignited the first global flu pandemic in 41 years. The strain was first monitored in Mexico during the months of March and April, 2009, where 6,241 cases have been recorded so far with 108 deaths.

With this, WHO declared last June 11 a pandemic to warn nations around the world to get ready for a long and unpredictable battle against the new virus.

However, the agency hopes nations will not overact, for instance, by carrying out or continuing draconian “fortress” measures designed to keep the infection outside their borders, or slaughter pigs in the mistaken belief that people can get swine flu from swine.

And so, the PNG government is not letting its guard down, while it looks at events taking place in many countries where A(H1N1) is now widespread.

While lacking yet in sophisticated instruments like the radar-like thermal cameras which are now in use in major airports in many countries including the Philippines, the PNG health authorities are making do with the basics in preventing an outbreak of this scale.

Incoming overseas travelers found having the symptoms of the disease are immediately whisked into a specially-provided isolation room where the needed medical help is immediately administered.

Suspected cases are referred to the Pacific International Hospital (PIH) in Port Moresby for tests and blood samples. Specimens are then sent to Melbourne, Australia for laboratory analysis.

A thermal camera hoped to be installed soon at the Jackson’s International Airport arrival area is still being sourced in the neighboring country of Australia.

Costing at least US$40,000, this gadget monitors the body temperatures of passengers arriving on international flights and detects those with an unusually high temperature, who would then be quarantined for further observation.

With its meager budget that needed some beefing up with another K10 million, health department is making sure that the country is prepared for the inevitable entry and spread of the virus. More stocks of antiviral drug Tamiflu, anti-biotics and personal protective gears like masks and gloves are now being procured.

WHO top man in PNG, Dr Eigil Sorensen, has seen the need for collective preparedness in how best the nation can effectively mitigate the spread of H1N1 in the country.

“It is no longer a matter of prevention for swine influenza in PNG, but it is now our collective preparedness in lessening the impact of the virus should it eventually reaches our shores…” Dr Sorensen said, aware of the very limited reach of government health services in rural areas where the bulk of the country’s more than 5 million people are living.

Despite a relatively small population, the government could face difficulties in dealing with the virus should one from the grassroots fall victim to A(H1N1). With about 63 settlements nestled on the outskirts of Port Moresby populated by close to 300,000, Port Moresby is a potential powder keg waiting to get detonated.

It is a common knowledge that most of Papua New Guineans are unaware of what proper hygiene is as it is known among educated citizens. One reason they are simply careless, health-wise, in the same way they carelessly litter the city with betel nut husks as they chomp their favorite nut.

The simple task of washing hands with ordinary soap bar after using the toilet or after touching soiled things (most of the time, they eat with their bare, unwashed hands) is one habit they have yet toacquire – one that is the most basic requirement in preventing the spread of swine flu virus, according to medical practitioners.

And all this boils down to one thing: the lack of potable water in most homes across the country, especially in villages. Many people could not wash their hands as often as they should, or at least before eating meals with their bare hands simply because they have no easy access to clean water. How much more with washing themselves or taking a bath regularly so they wouldn’t stink, and thus avoid offending the “noses” of the person next to them?

That washing hands is a habit developed from childhood could never be disputed. But since many homes across the country don’t have easy access to clean water – a landmark of inherent poverty in this country -- a child could grow to become an adult without being exposed to this simple task.

And just like other races across the globe, Papua New Guineans interact with one another prolifically especially in public areas like markets, shopping centers, sports arena, beerhouses and nightclubs. These places are convenient spots for breeding new carriers of A(H1N1) virus who would remain undetected.

And even if an individual, after contracting the disease, has been subjected to intense medication which is administered at home, there is no assurance that the “patient” would complete taking the anti-virus drugs. Usually, they believed that after a day or two of treatment, they would be healed by then. But they had been wrong, as always.

Filipino-friend doctors had told me that they have problems with their patients for being so stubborn in refusing to complete medication although they have the medicines with them at home.

And this was quite true among those TB patients undergoing treatment. They complained they never get healed by their medications, but only to admit later they had stopped taking their drugs after a day or two.

Such attitude makes up the bricks that would fortify the presence of A(H1N1) should it finally descend on the unfortunate masses. While the government continues to wage information drive on health care awareness, only very small section of the masses -- only those in urban areas -- is reached.

The bulk of population outside POM, especially in remote villages, remains uninformed as they don’t have television or radio by which the information is being disseminated.

It goes without saying all these efforts to prevent the spread of swine flu would be naught unless the targeted audience takes the proper attitude, which includes knowing about proper hygiene in the first place, such as covering the mouth with handkerchiefs when coughing or sneezing, and washing hands immediately after that at the very first opportunity.

But how fast could it be learned? For all you know, hygiene is an acquired habit developed over a lifetime – at home, in school and at work places.

But the irony of it all is that most of Papua New Guineans have no homes to roost on, no schools to go to, and no work places from which to earn a living. So how else could one acquire the knowledge on proper hygiene which is crucial to life’s survival?

This one, really, would qualify as gem for “Ripley’s Believe It Or Not!”!

Just like a bundle of dynamite sticks that could blow up with only a single fuse being lit, the swine flu virus incubating in one or two individuals could one day finally take wings, and hop onto the next careless, but not necessarily unknowing person. Then, that would be the day.

Australia needed only one case of A(H1N1) to start piling up with confirmed cases that have now soared to more than 2,000 to date since it was first known in the Americas last March.

And just to think that this nation is a First World country with all the resources it could muster to deal with any disease or virus epidemic. Yet it has been hit for more than 2,000 times now.

Under this scenario, what are PNG’s chances of being spared from any outbreak?

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