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    Sunday, November 27, 2005

    Avian Flu Update 2

    I am constantly impressed with Vietnam's public health response to disease. Vietnam is what the state department calls a "second tier country." Its economy and standard of living is improving, but it has lots of problems--corruption and inefficiency in the government, lack of unified health infrastructure between urban and rural areas, and liquid capital to build transportation infrastructure and buy necessary equipment to fight disease.

    Dealing with all that, Vietnam's Ministry of Health did an amazing job fighting SARS in 2003. They put aside the typical asian "don't want to lose face" attitude and were very open and cooperative with the WHO. It admitted it had problems that prevented Vietnam from effectively dealing with SARS. Its response led to rapid detection, quarantine, and treatment of the disease. Most importantly, it used SARS to learn and prepare for another eventual disease outbreak.

    So, this week Vietnam held a mock bird flu exercise. In it, the faked a human-to-human bird flu in Hanoi, quarantined off that part of the city, set up make-shift triage centers, disinfected buildings and cycles--all with 900 health professionals and soldiers. Obiously, translating a mock drill in one part of Hanoi into reality throughout the country will be difficult, but Vietnam is working on it.

    The bird flu is scary. 68 people have died in Vietnam so far, and the mortality rate is over 50%. That could mean nothing more than a little stronger flu if it went pandemic or a massive killer. It's hard to translate the mortality rate because many do not seek treatment until very sick and come from the rural areas where medical infrastructure is weak or non-existent. What we can know, is that Vietnam is doing amazingly well in making sure it is ready for any eventuality.

    In contrast, China has again shown ineptitude and extreme hubris with its handling of the benzene slick. Today, China returned running water to the city of Harbin, but it still cannot be drunk. Chinese politicians fiddled while Rome burned, and they should be publicly flogger for it. Regardless of political ideology, communist, republic, democractic, no government is allowed to coverup the needless deaths of citizens. Chinese leaders told nobody about the slick until the benzene slick was in Harbin and now five people are dead. Who knows how many more are sick. The city could have been far more prepared if people had known to stock up on water beforehand, instead of fearing the rumors. More importantly, other countries could have helped Chinese authorities deal with the slick before it hit Harbin, possibly avoiding danger all together. Now it is moving towards Russia, and if I was Pres. Putin, I'd be pretty pissed at Hu Jintao for not cleaning up the mess, and demand China pays for its cleanup and any problems it causes Russia.

    Cheers to Vietnam for effective health planning, and many large jeers to China for its bumbling.

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