BIOTERRORISM: Inabilty to respond to threat

EGYPT: Did the government overreact to H1N1? CAIRO, 18 July 2010 (IRIN) - While a review is underway of how the World Health Organization (WHO) and national authorities handled last year's outbreak of the H1N1 virus, also referred to as swine flu, medical experts in Egypt have criticized their government for overreacting to the pandemic, provoking unjustified fear and wasting millions of dollars-worth of much-needed public funds. "Egypt is probably the only country in the world that acted in such an insane way towards the virus," Saed Aun, a former preventive medicine advisor to the Egyptian health ministry, told IRIN. "The Egyptian government applied the wrong policies in dealing with the crisis." When H1N1 was first detected in a university dormitory in April 2009, the Egyptian Cabinet in May decided to cull all the nation's more than 350,000 pigs obstensibly to avert the spread of the virus, although the link between H1N1 and pigs had not been officially established. [http://www.irinnews.org/Report.aspx?ReportId=84344] Apart from the enormous loss to pig farmers [http://www.irinnews.org/Report.aspx?ReportId=86742], the culling led to an accumulation of rubbish on the streets of the capital as pigs had been eating much of it previously. [http://www.irinnews.org/Report.aspx?ReportId=87853] In Cairo, the livelihoods of unofficial rubbish collectors - known as 'Zabalin' to Egyptians - and pig farmers were very much intertwined as the former collected organic waste from the capital's streets and sold it to farmers to feed their pigs. The cull hit the livelihoods of 70,000 former pig farmers and 'Zaballin' and their families in the Cairo area, according to local NGO Association for the Protection of the Environment. "The waste was a good source of profit for the rubbish collectors," said Israel Ayad, a pig farmer and unofficial spokesman for the rubbish collectors. "Why should they collect rubbish after the pigs are gone?" In reference to the health hazards posed by the piles of rotting waste in the capital, Chairman of the Doctors' Association Hamdy al-Sayed described the situation as a "national scandal". The government later said the cull was not related to H1N1 but was simply a general health measure. Schools hit hardest Experts say Egypt's schools were the biggest losers in the government's handling of the pandemic. In addition to the intermittent closures of some schools, the ministries of health and education ordered all schools to halve the sizes of their classrooms, which led to many children being able to attend only three days a week. [http://www.irinnews.org/Report.aspx?ReportId=86695] "The state of confusion surrounding the appearance of the virus harmed the educational process greatly," Nadia Youssef, an educational specialist at Cairo University, said. "The problem was that the virus appeared during the first months of the academic year. Some schools were closed down while parts of the curricula were removed, affecting the educational record of the students badly." Health officials in Egypt are divided over whether they can expect any more waves of H1N1 infections. [http://www.irinnews.org/Report.aspx?ReportId=88149] The country's 55 hospitals and health centres capable of dealing with H1N1 cases say they are ready to receive any new patients and have large stocks of vaccines. Fathi Shabana, head of Imbaba Fever Hospital, said his hospital had 60,000 doses of the H1N1 vaccine in preparation for winter, which is considered to begin in November. However, Mustafa Orkhan, head of the Swine Flu Centre, a local NGO which gives tips on H1N1, said he did not expect any more outbreaks of the virus in Egypt. "Egypt is safe as far as this virus is concerned," he said. Controversial vaccinations The issue of H1N1 vaccinations is at the heart of public and expert debate on the pandemic and how it has been handled. The government spent 30 million Egyptian pounds (US$5.4 million) to buy 1.9 million doses of the vaccine, having failed to secure the 5 million doses it was seeking to purchase. Later, a plan to inoculate 1.2 million schoolchildren went awry as hundreds of thousands of parents refused to send their children to schools to get the vaccine after rumours spread that the vaccines could cause physical deformities. [http://www.irinnews.org/Report.aspx?ReportId=87647] Now, the health ministry still has some 500,000 doses of the vaccine in its stocks. Some of these will be used to inoculate around 70,000 people travelling to Saudi Arabia in November to perform the annual Hajj pilgrimage, but the inoculation is optional. The remaining vaccines will expire in May 2011. "These vaccines will of course be thrown out after they expire," Aun said. "This is yet one more indication of the failure of the government to deal with the crisis wisely." Health officials said 16,356 Egyptians had contracted the H1N1 virus to date and 280 people had died - most of whom had other health problems. Globally, more than 15,000 people died as a result of the virus since April 2009 but the WHO had predicted two to four million deaths.