January 31, 2008
KONCANG, Indonesia: The rooster started to crow at the unusually early hour of 3 a.m. and Partoparmin, a farmer in this small hillside village, went into his yard to look. All around him, chickens were lying on the ground, twitching and shaking.
"A few minutes later they were dead," said Partoparmin, 60. "Right away I thought, this might be bird flu."
Partoparmin, who like many Indonesians uses only one name, buried the chickens as he had learned to do from televised announcements, and no tests were done to confirm the cause of their death.
But all around Indonesia, since late 2003, chickens have been dying of bird flu. And more than in any other country, people are dying as well, infected either by chickens or from other sources.
Three people died of bird flu this week, pushing the number of deaths in Indonesia to 101 - nearly half of all the bird flu deaths in the world. The other countries with the highest reported death tolls are Vietnam, with 48; Egypt, with 19, and China and Thailand, each with 17.
The mortality rate in Indonesia is also the highest in the world. Only 24 of 125 people reported to have been infected have survived.
The virus is known to have infected 358 people around the world in 14 countries, killing 224 of them, according to the World Health Organization. Experts say that because of poor reporting of infections and deaths, the true number could be much higher.
The concern among health workers is that the virus could mutate to allow transmission from human to human, raising the possibility of a worldwide epidemic.
No one is sure why so many people are dying in Indonesia or why the survival rate is so low. Public health experts say that there could be a lag in response and treatment here or that the strain of the virus could be more difficult to treat than elsewhere.
The disease is particularly hard to contain in Indonesia because most chickens, known as backyard chickens, run loose around people's homes in villages and even in cities, rather than being cooped in chicken farms, Trisatya Putri Naipospos, the former director of animal health in the Ministry of Agriculture, said in an interview by telephone.
Eighty percent of the chicken population of 1.4 billion is scattered in 395 million backyards, where people raise poultry to eat or to sell, she said.
The Indonesian authorities have attempted to stem the spread of the disease by vaccinating chickens, but this is an almost impossible task, Naipospos said.
"You can imagine how difficult it is to catch and vaccinate these chickens," she said. "How many chickens can you vaccinate in a day?"
After Partoparin's chickens died three years ago, the infection seemed to spread from house to house in this remote village in Central Java and people were burning and burying dozens of dead chickens or flinging the carcasses into the woods.
A government team visited and asked everyone to round up their chickens to be vaccinated, said Partoparmin's wife, Sukarno, 55, but it seemed to be a futile enterprise.
"I couldn't catch them all because they were playing around," Sukarno said. "Even when they're in the house they are hard to catch. When you come in, they run in every direction."
The government periodically airs television warnings that Naipospos said contained instructions to guard against infection: Wash your hands, don't touch sick chickens, cook your chickens well and keep your chickens in cages.
But if the origins and transmission of bird flu remain unclear to health experts, the disease is even more of a mystery to the people here who are at risk.
"On television all I hear is bird flu, bird flu, but I don't understand what it's about," said Warsono, 35, who sells sweetened crushed ice from a cart at a school near here. "A lot of people are saying they had healthy chickens one day and the next day they were dead. Is that bird flu?
"And now I'm asking you, If it really is bird flu, what should I do? Is there any medicine for it?"
Household chickens serve as a small bank account for poor Indonesians.
Warsono said he has 20 to 25 of them, running in and out of his house as he talked, pecking the ground for food.
"Mostly we eat them," he said. "But if we need a little extra income we sell them."
Generally, he said, he can sell a chicken for the equivalent of $2.
Naipospos said it could be hard to get people's attention when they live under constant threat of more immediate disasters.
Pummeled by earthquakes, volcanos, tsunamis, ferry sinkings, air crashes, floods and deadly mudslides, Indonesia almost seems to have been fated to become the world's epicenter of bird flu deaths.
"A lot more people die of tuberculosis, malaria and dengue fever," Naipospos said. "If you tell them 100 people have died within two years, do you think it's enough to explain to people that this is a real threat just in front of them?"
