EAST AFRICA: Swine flu scare prompts surveillance scale-up
NAIROBI, 28 April 2009 (IRIN) - The East African region is generally not well prepared for a pandemic like swine flu which has killed more than 100 in Mexico and is spreading to other countries, an expert said.
Most people in the region do not have access even to basic health care and many die from preventable diseases. The main problem is a critical shortage of health workers. While there are 250 doctors per 100,000 people in the UK, Sudan has only 16, according to the African Medical and Research Foundation (AMREF).
In Addis Ababa, a meeting of African humanitarian NGOs, Red Cross actors and diplomats discussed pandemic preparedness. "We are using Mexico as [a] teaching opportunity to promote planning in this region," said Gregory Pappas, senior coordinator and technical specialist for pandemic preparedness at InterAction, the American Council for Voluntary Action.
Swine influenza or "swine flu" is a highly contagious acute respiratory disease of pigs, caused by one of several swine influenza A viruses. Morbidity tends to be high and mortality low, according to WHO. The viruses are normally species specific and only infect pigs, but they sometimes cross the species barrier to cause disease in humans.
"This region cannot even handle cholera," the Nairobi-based pandemics expert said. "An outbreak or pandemic flu would be catastrophic."
Responses to date
Here is how some East African countries are responding so far:
- Somalia: No capacity to deal with such pandemics due to the prolonged civil war and destruction of medical facilities. "We are not prepared for anything like the swine flu; we don’t have the means to deal with it," Awad Abdi, adviser to the Somali Health Ministry said. "God help us if it reaches here."
- Rwanda: Mobile clinics set up for screening visitors at airports and other entry points; pork imports from European countries suspended; sale of grilled pork in cafes prohibited; epidemiologists deployed to work on preparedness in main health facilities and information points set up in 143 centres. However, according to WHO, there is no risk of infection from consumption of well-cooked pork and pork products.
- Uganda: All districts are being put on alert. "We met last night and are going to handle this with the ministries of tourism, agriculture and health," Paul Kaggwa, Health Ministry spokesman, told IRIN. "We have contacted airlines, the Civil Aviation Authority and Uganda Revenue Authority to be alert. We are going to screen all entries into the country."
- Kenya: Health facilities around the country have been directed to screen patients suspected of showing symptoms. Preparations to start screening people at all border and other entry points have started. "The government has set up teams for surveillance purposes - [we] had already set up teams to deal with the threat of bird flu a while ago. It is these that we are beefing up to deal with the threat of swine flu," said Shahnaz Shariff, director of public health in the Ministry of Public Health.
- Southern Sudan: Surveillance has been increased at the airport. A meeting between the Health Ministry, NGOs and other health agencies is due to be held on 28 April. "We are doing the necessary information-gathering and disease surveillance," John Runumi, director-general for preventive medicine, told IRIN. At this point, WHO advises no restriction of regular travel or closure of borders, but encourages people who are ill to delay international travel.
- Ethiopia: The Ethiopian Red Cross (ERC) announced plans to train 800 volunteers on public health messaging. "At this point, we have adopted public health messages which focus on hand-washing, isolation of the sick and following the norms of [handling] respiratory illness, " Mesfin Worku, national coordinator of ERC's human pandemic preparedness project, told IRIN.
- Burundi: No specific measures yet, but planning meetings going on and options for importation of Tamiflu drugs available. According to Fidèle Bizimana, who is in charge of the control of epidemic diseases in the Health Ministry, the government is aware of the swine flu pandemic. "We are confident we will be able to avert its spread," Health Ministry spokesman Louis Mboneko told IRIN.