HEALTH-DRC: An Epidemic Waiting to Happen

By IPS Correspondents Reprint | | Print |

Anjan Sundaram

KINSHASA, Nov 2 2005 (IPS) - A vast forested valley stretches out below the office of Jose Mpindi, an ornithologist at the University of Kinshasa in the Democratic Republic of Congo (DRC).

“This winter (in the northern hemisphere), the trees will be chirping with birds from all over the world,” Mpindi says, his fingers outlining migratory routes that at least a million birds are said to follow every year. “In fact, they have already started coming.”

Ordinarily, the arrival of these birds would simply signal a change of seasons. But for thousands of citizens in the capital of the DRC, they may now carry a potent threat: a strain of bird flu virus, H5N1.

About 60 people have died in Asia since 2003 after contracting avian flu from birds. Scientists fear that a small mutation would allow H5N1 to pass between humans – sparking a pandemic similar to the outbreak of Spanish Flu in 1918 that killed, by some estimates, 50 million people globally.

Cases of avian flu over recent weeks in Turkey and Greece support the theory that migrating birds traveling in the coming weeks from Eastern Europe and Asia will bring H5N1 to East and Central Africa.

Health officials fear the virus could spread uncontrollably in these regions, where poverty is endemic, health services inadequate û and millions already weakened by AIDS.

In the DRC, where nearly one in 20 nationals is estimated to be HIV-positive, whole families sometimes live in tiny rooms in Kinshasa. These would provide an ideal environment for the spread of an airborne virus such as H5N1. An epidemic of bird flu, ravaging already debilitated bodies, could place entire communities in jeopardy.

“People in this country are malnourished, their immune systems are weak,” says Jeff Mutombo, a doctor who works in the DRC for the international charity Doctors Without Borders.

And, “Poorly paid health workers are difficult to motivate, especially when dealing with contagious diseases like flu,” he adds.

Last month, Health Minister Emil Bongeli announced a halt to imports of all live fowl in an attempt to address the threat posed by avian flu.

“There is no reason to panic, but we must prepare,” he noted.

Agricultural officials say they have alerted farmers across the country about the hazards of bird flu. While migrating wildfowl are capable of harboring H5N1 for long periods without falling prey to the virus, chickens can succumb to H5N1 within hours.

Bongeli has also said he is negotiating with Indian drug manufacturer CIPLA to secure medicines for treating avian flu. CIPLA claims to be capable of manufacturing a generic version of pharmaceutical giant Roche’s expensive anti-flu drug, Tamiflu.

For the most part, however, Congolese officials are looking to foreign donors to step in should a crisis arise.

“We appeal to the international community in such cases,” says Pierre Lokadi, a senior official at the health ministry.

The limitations of funding and medical personnel notwithstanding, a representative of the World Health Organisation (WHO) believes the Congolese government could do more.

“Even problems that it can handle with its own resources are left to the international community to resolve,” says Florent Ekwanzalu, DRC coordinator for diseases at the WHO.

Less than a third of the 80 million dollars allocated for health in the national budget was spent in 2004. In contrast, the WHO estimates that foreign aid slightly in excess of 200 million dollars is currently spent on healthcare in the DRC every year.

“We would like to see some real political commitment, and maybe then we can move forward,” notes Ekwanzala.

Most people in Kinshasa only heard of avian flu when the Minister of Health announced last week on national television that the virus posed a threat to the country.

“When is this bird flu coming?” asks Marie Biloke, who sells pre-paid mobile phone cards on Kinshasa’s streets. “One thing is for sure, our government will not help.”

“Our politicians are busy putting money into their pockets,” she adds. “When have they ever thought about us?”

Nearby, a ragged, six-year-old boy gathers his red football from a gutter beside Kinshasa’s Puissant clinic û and throws the filthy toy back into his school’s playground across the street. Hundreds of people rush by, barely noticing, seemingly habituated to the surrounding decay.

“If some rich white people help us, maybe we will be protected,” Biloke says, bending over her stall. “But even if we die, will anyone care? I don’t think so.”

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