Egypt, chickens and Indonesia

Bird flu is a viral disease but its effects go beyond viral infection. An obvious but important fact. Consider Egypt.

The first poultry cases in Egypt were only a little over two years ago, but the virus quickly took root there. The poultry infections were a harbinger of human infections, 18 that year (2006), 25 the next year, 4 so far this yar. Egypt now has more human cases of the disease than any other country outside of Asia (47 cases, 20 deaths). Like other countries with bird flu problems they also have a large population who lives in close contact with birds. Many people keep poultry in their backyards and houses and depend upon them for eggs and protein. Or at least they used to. Effective public education and the perception of risk have changed in two years a lifestyle that probably goes back millennia:

"People lost a lot when the disease first appeared in Fayyoum," recalled Sahar Rabie, who educates people about bird flu in Tawfiqiya. "They would cull all the chickens in one square kilometre around a case, so people started to hide their chickens to protect them - some slaughtered them, others hid them under the bed."

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In Fayyoum villages, once famous for their chickens, five human cases have been recorded and three people have died, most recently a woman on March 4.

The U.S. Agency for International Development has funded grass-roots education through TV and house visits by local residents such as Rabie to explain the disease to villagers - especially women.

People are taught to keep their chickens in coops, rather than let them wander freely, especially into human living space. Villagers are also told to wear masks and gloves in the coops and wash carefully after cooking poultry.

But more than anything, the deaths have taught people to change their ways.

"There is total awareness now. People know to vaccinate their chickens," said villager Ragab Ahmed, who was quick to say his own chickens were healthy and had been inoculated with government-provided vaccine.

"Everyone is worried after Tirsa," he said, referring to the nearby village where the woman died two weeks earlier. (AP via Canadian TV News)

Egypt is doing something that Indonesia seems unable to do. In fairness, the Indonesians face many obstacles the Egyptians don't, including a population three times Egypt's size, a highly fragmented geography and a weak and ineffective central government. But Egypt also has a much better public health system and better and more effective medical professionals, not to mention a rational public health leadership. Egypt is showing what is feasible.

Egypt is taming is chicken problem while Indonesia is playing chicken with the world.