H5N1 Coming -
So, What Do We Do?

By Oscar P. Lagman, Jr.
Local newspapers, international news magazines, and the internet have been replete with articles about the probable outbreak of an avian flu pandemic. All paint a grim picture of between 7.4 million and 150 million deaths within a period of five and a half months. It is not a blown-up figure they project, as they cite the pandemic of 1918 which claimed 100 million lives in that span of time.
Some scientists say it is not a matter of if, but when the disease will sweep all over the world. For this reason, the World Health Organization has sent out warnings to all nations and advised them to develop preparedness plans. Travel ban, quarantine, closure of public places, cancellation of mass gatherings, and declaration of state of emergency are among the measures the Philippine government is ready to adopt when migratory birds bring the virus to our land.
That is preparedness at the national level. But are the gated communities where most of the readers of this newspaper reside prepared to cope with the grim situation? I asked a friend, a public health practitioner, who is now posted at the Kobe office of WHO, if the organization has pro-forma plans which communities can adopt to deal with the daunting situation. It has none.
Public health officials have created the chilling scenario of hospitals and other health facilities being overwhelmed by the number of patients seeking treatment and other health services; health professionals being reduced in number because they, after being exposed to the virus, are themselves down with the sickness; anti-viral agents and antibiotics being exhausted; basic services like power, water, transportation, and communication severely strained by absenteeism; drugstores, grocery stores, restaurants, and public markets closed and padlocked to prevent looting by a desperate population.
Most people would have to fend for themselves. If a member of the family got infected, he will have to be taken care of and treated by the others at home. Should families now stock up on anti-viral agents and medicines, and foodstuff like rice, canned goods, drinking water, and even face masks and rubber gloves? Who would determine when and what dosage of medicine should be given the sick person, or who would administer intravenous antibiotics since health practitioners may be fully occupied at health centers or are themselves incapacitated by the flu?
The household help, who ordinarily take the brunt of the burden of helping in the care of the sick at home, like fetching drinking water, washing stained linen, and cleaning the dirtied floor, may not be of much help as they might also be down with the flu. The stay-out family driver may not report for work as he may also be afflicted or has to take care of a sick member of his own family. Given their normal living conditions of congested community and poor sanitary conditions, they would be more vulnerable in the event of an epidemic. If a maid gets afflicted, she would have to be isolated so as not to infect others who, in most instances, sleep in the same cramped quarters. Where will she be placed? If she had infected other household help, who would take care of them? You, their amos?
If the subdivision draws water by pumping it out of its own deep wells, what happens when electric power is reduced or completely cut off due to the absence of operators at power stations? The outsourced security force might also be reduced markedly in size by the epidemic. Like the family driver, security guards would be more vulnerable to the flu due to their living conditions. Garbage collection will completely cease as collectors, in all probability, would be incapacitated.
If we go by the mortality rates, it is inevitable that there would be deaths among the afflicted cared for at home. With traditional funeral services not available due to the unavailability of a funeral crew, what does the family do?
As public health organizations or institutions have no suggestions as to how communities can deal with the frightening situation, it is time for community leaders to come up with their own preparedness plan. They should exchange ideas with leaders of other communities.
Some ideas are the conversion of the subdivision clubhouse into the nerve center of contingency activities, formation of security details with the young male residents of the village under the supervision of former military officers (in our subdivision, there must be 10 generals, among them heroes of EDSA 1), acquisition of an incinerator for burning garbage, and conversion of a school in the subdivision into a temporary infirmary to be supervised by physicians and other health professionals residing in the village, with able domestic helpers taking turns going on duty.
Other contingency measures would be the pooling of generators of homeowners to power water pumps, the formation of a provision committee composed of the ladies of the community who will procure the basic needs, supervise their storage, and manage the distribution or even create a temporary commissary for more efficient use of cooking fuel, their daughters helping out, and the formation of a brigade of young boys who will gather firewood.
These may all seem laughable at this point. A year before Hurricane Katrina hit New Orleans, a scenario of deluge, destruction, and death was drawn and presented to city officials and community leaders. In typical American braggadocio, they shrugged it off and said, "We will know what to do if and when it does happen." No hurricane in the long history of the city has ever wreaked damage that was anywhere near the scenario. When Katrina unleashed its fury on the city, creating a situation that was strikingly similar to the picture painted a year before, the people were caught not knowing what to do. Many policemen, overwhelmed by the disorder and destruction, turned in their badges and went home. Some even joined in the looting out of desperation.
When the avian flu sweeps over the land, its impact would be much more tremendous than that of the tsunami that hit parts of Indonesia, Thailand, and Sri Lanka, than that of Katrina that blew away the age-old city of New Orleans, than that of the earthquake that destroyed parts of Pakistan. Unlike the victims of the tsunami, hurricane, and the earthquake, we won't get help from any country as the desolation will be global.
We have to prepare and now!
Copyright 2005 BusinessWorld Publishing Corporation




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