Large Medium Small |
The case has been a powerful lesson for WHO officials in understanding the importance of early communication and education.
"We're seeing what problems we're going to run into on the ground," WHO spokesman Dick Thompson said. "We're learning with every step."
Jules Pieters, manager of WHO's rapid response and containment group in Geneva, said it is clear that people familiar with the culture, language and customs of this area should have been involved earlier to help villagers understand what was happening, how to protect themselves and the importance of allowing treatment if they develop symptoms.
Instead, many people who were never scared of doctors before are now terrified of them.
"We are afraid to be sent to an isolation room. You know an isolation room is a slaughtering room — a room for the people who want to die," said villager Caranta Perangin-Angin. "Therefore we are afraid of (letting doctors) take blood. Taking the blood, for me, symbolizes going to die."
Indonesian officials reported that at least one patient had fled the hospital to seek traditional medicine and was later caught and returned. In the event H5N1 should mutate into a form easily passed among humans, such behavior would likely spread the illness further — a serious worry for experts who fear the possibility of a bird flu pandemic.
"In these situations, we need to first earn the trust of the people most directly at risk," Thompson said. "I think one of the lessons we're learning from this outbreak is that you can't just drive truckloads of Tamiflu into this area and expect that the problem is solved."
He said some villagers began associating Tamiflu, the chief drug to treat bird flu, with death because members of the infected family — most of whom were given the medicine too late to help — were dying after taking the pills.
Not everyone in the village is spooked.
Parked on a bench outside his tiny shop and strumming a guitar, Bapak Karunia Sembiring smiled when asked about bird flu. "If the doctors said it's bird flu, then so be it."
He said he is happy officials are monitoring the villagers' health and spraying disinfectant. But the 60-year-old fears his village will be shunned.
"I'm a little bit worried about what will happen in the future to the village," he said. "The worst is that the world will hate us, will judge us."