04/13/2006, 00.00
CAMBODIA
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Bird flu warning too late in many rural areas

The father of a girl who died from the H5N1 did not know anything about the disease. Organising awareness and information campaigns in the countryside is hard because few have TV. The government lacks the means to raise awareness concentrating instead its efforts in five provinces where the emergency is greatest.

Tuol Prik (AsiaNews/Agencies) – Health Ministry officials informed Cheoun Uork that his three-year-old daughter died of the bird flu. That was the first time he heard about the virus. But his case is not unique for Cambodian authorities have so far been unable to fully inform the population and explain to them how to prevent the bird flu in rural areas.

"Had I known about such a warning, I would have taken better precautions to protect my daughter," said Choeun Uork, 30, wearing a white T-shirt printed with a bird flu awareness message. "She was my only child, and now I have to live with the regret over her death."

Since surfacing in Asia in 2003, the bird flu has killed at least 109 people. The rapid spread of its deadly H5N1 strain of bird flu has triggered alarm worldwide, but in rural Cambodia, many remain ignorant of the threat.

"There's obviously a lack of awareness in this community [about] what bird flu is," said Megge Miller, a World Health Organisation epidemiologist in Cambodia. "When we went into the field, families were asking questions: 'What is avian influenza? What is this about?'"

Due to budget constraints, the government has focused on only five of the country's 24 provinces. The five are considered at high risk because they are near the borders with Thailand and Vietnam, two of the countries worst hit by bird flu, said Ly Sovann, head of the Disease Surveillance Control Branch at the Health Ministry.

Part of the problem is that in the countryside access to television is limited.

"Sometimes, [when] people are enjoying music on the radio, if a commercial or education spot pops up after the song, they will switch to another channel for more music," he said. "That is why face-to-face communication with villagers is more crucial for training and encouraging them to take part in the prevention of the disease".

Ms Miller estimated it would however take 40,000 volunteers to help spread the message throughout communities—an undertaking that would require substantial funding from foreign donors. She added that spreading the message would also have to include teaching villagers about personal hygiene and a clean living environment.

Douglas Gardner, a senior UN development official, said Cambodia needed about US$ 18 million to tackle bird flu for an 18-month period. The recent deaths, he said, suggest many outbreaks have gone undetected until someone dies and that unless bodies are counted the government won't know about it.

Volunteers are also trying to villagers to stop eating sick birds—a struggle in a poor country—a habit "practiced for hundreds of years without [. . .] problems," said Kao Phal, director of Animal Health Department in the Agriculture Ministry. But "when we tell them it now can cause problem, they hear it but sometimes refuse to believe it. And many of them still don't believe it now."

This is what happened to Mon Puthy, a girl who died last month. Her mother said she cooked chickens that died of a disease, but insists her daughter never touched the birds. Instead, the "kids next door played with and hugged chickens all the times, but they did not get sick," she said.

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