Jakarta – Indonesia, the world's fourth most populous nation, is scurrying to ready for a potential bird flu pandemic but health and animal husbandry officials warn they so far lack crucial resources.
The deadly H5N1 strain of avian influenza has claimed the lives of at least eight Indonesians – possibly many more – and millions of poultry have died in scattered outbreaks across the archipelago of more than 17,000 islands.
The government has appointed 44 hospitals nationwide to treat bird flu patients and President Susilo Bambang Yudhoyono said last week the government was preparing a national monitoring system involving millions of people at village level.
But officials on the ground complain they have not received funds or equipment from the central government, which oversees a health system that was hard-pressed responding to last year's catastrophic tsunami after enduring years of chronic underfunding.
The General Hospital at Garut in densely-populated West Java, about 200 kilometres (124 miles) southeast of Jakarta, had not received any extra funds or equipment since being named as one of the facilities treating bird flu patients, its head of medical services Wijayanti said.
"We are a government-funded hospital which is not profit-oriented, so we make do with what we have," she told AFP.
"The room we have converted into an isolation room is actually not suitable for isolation because it is not well sealed," she said. The hospital has not received any patients yet.
Halid Saleh, a doctor in charge of bird flu at the main state hospital in the South Sulawesi provincial capital of Makassar, the country's sixth largest city, said they had prepared two rooms which could accommodate six patients.
But they are not equipped with emergency equipment such as ventilators, syringe pumps, electrocardiogram monitors and oximeters, which are helpful to treat extremely ill bird flu patients, he said. "We were promised the equipment by Jakarta last month but we haven't received it," he told AFP.
Ilham Patu, spokesman for Sulianti Saroso hospital, which has provided medical care for most bird flu cases in Indonesia, said he was satisfied the facility had enough equipment to cope, with Japan making donations recently.
The hospital has designated 44 beds and four intensive care units available for bird flu patients. Currently there are six suspected cases at the hospital.
Animal husbandry officials meanwhile say they are hard-pressed monitoring poultry in Indonesia, where many people even in urban areas keep chickens at their homes.
It is precisely this close proximity between infected birds and humans that scientists fear may result in the H5N1 virus mutating into a form that could be easily passed on by humans – sparking a pandemic that could kill millions. Nearly 70 fatalities have been reported since 2003 in Asia.
The animal husbandry office head in South Sulawesi, where about 550,000 fowl have died of bird flu since 2003, said no outbreaks had been reported in the province since September – but a dearth of funds was hampering surveillance. "To be highly mobile we need motorcycles and cars. We need more funds from Jakarta," he said.
His counterpart in West Jakarta, Riana Faiza, told the Jakarta Post last week that his office had not received any funds from the central government or the local Jakarta administration.
"We have heard the government has been allocating money to local administrations to deal with bird flu for the last several months, but we have not received any money," he said.
Hariyadi Wibisono, director of vector-borne disease control at the health ministry, said officials were taking inventory of the regions' needs.
"We are preparing everything, training people, buying equipment. It's not like if we decide on something today then tomorrow everything will be ready. It doesn't work that way," he told AFP.
He said hospitals were generally well-equipped because they had previously prepared for outbreaks of Severe Acute Respiratory Syndrome ( SARS), which struck the region without warning in 2003 and claimed almost 800 lives. No cases were however eventually confirmed here.
World Bank country director Andrew Steer told reporters last week that Indonesia was paying serious attention to the disease, but he urged the government to immediately "put together some really detailed plans."
"The worst thing to do obviously is to claim that you've got things under control and I think now Indonesia recognises it doesn't have things under control, because it's so extraordinarily difficult," he warned.