Swine Flu, notable in its absence

Swine flu has been labelled ‘unstoppable’ by the World Health Organisation and countries across the world are stock-piling Tamu-flu and scrambling for the first available vaccinations. Away from the media bulletins racking the west, there is a calm and isolation in Rwanda and wider Africa. I was shocked when I saw a map detailing global outbreaks of swine flu, both by the very red and dense cluster of cases that smothered the UK and by its noticeable absence across vast tracts of the African continent. The relative fortune of Africa in avoiding the virus in part explains the disparity in reaction to the crisis. The UK has run ceaseless poster campaigns whilst in Rwanda I have been more exposed to Rwanda-tel than the crisis, and Barack Obama warns that the virus is ‘cause for concern’ as Minisante emphasises the ‘mild symptoms and quick recovery’. It is a relief for the overstretched health service that, or at least it seems - given the difficulty in diagnosis - there is no serious threat; East African cases are negligible, stemming largely from visitors. However the silence of the disease and subsequently the government is a cause of concern in itself. TRAC plus, an organisation representing the Ministry of Health is confident that Rwanda is prepared for the virus. Rwanda has received, as part of a WHO scheme, a stock of 14, 000 Tamu-flu doses. However a quick comparison to the UK - despite the different circumstances -who is stock-piling 120 million doses, it becomes apparent that preparations rest on a continuing good fortune. Health Services always take difficult decisions, plagued by an absence of resources to deal with health demands. It is logical therefore to assume an absent flu with a low mortality doesn’t constitute a sufficient concern to divert resources away from the endemic and deadly Malaria, or rapidly growing HIV/AIDS crisis. This absence of quantative concern and resources differentiate their response to Western states, drunk on tamu-flu. However this gives scant reassurance to the people of Rwanda; it remains highly likely that the Flu will arrive if it hasn’t already, and worse, no-one can predict its future form and virulence. There is little reason to suppose a continent ravaged with endemic disease and a highly susceptible population, whose international travel has never been higher, would escape an onslaught by the virus. From the 190 members of the WHO, 163 have reported cases, “we are nearing 100%, but not yet”. This is combined with sobering warnings that the virus will mutate, with one expert isolating three hundred variants of the virus, and Hartl, WHO spokesman, warning “we don’t know how this virus will change going forward”. The concern, as with previous flu epidemics, is the first bout shifting during fertile flu seasons to become deadly; experts simply don’t know. It is these concerns that heighten the demands for vigilance, prompting the WHO to raise its pandemic alert to an intimidating six whilst the deadly H5N1 avian flu strain never exceeded four. The concern for those who lack preventative infrastructure is, warns Sandra Mournier-Jack, a Professor in tropical medicine, ‘there is only a small window, and it may already be too late’. The difficulty for health authorities is how much should be done; speculation over the virus is weak compared to the real death rate of other major diseases. It’s also important to avoid paranoia and over-reaction; pre-emptive measures can be disruptive and harmful, reducing tourism and disrupting functioning national services. It would take a bold critic to accuse developing states of short-sightedness; it would be too easy to retort against the absence of international concern for diseases currently ravaging Africa. Indeed, Rwanda is more prepared than many, with tracking systems developed from measures to control avian flu. However, the threat of flu is existent; public awareness is a necessity and mobilisation of resources is prudent in the hope to arrest this crisis when it eventually arrives. philiprushworth89@hotmail.com