# 2387
Indonesia is, arguably, the world's biggest hotspot for avian influenza.
Since they stopped reporting poultry outbreaks to the OIE more than 2 years ago, we have no idea just how rampant the virus is, but local news reports would indicate it is rife in that nation.
Officially, they've counted 112 deaths. But no one really knows how many people have contracted the disease, or how many deaths have occurred.
Admittedly, Indonesia has a terrible logistics problem when it comes to the surveillance and containment of avian flu.
- They have 235 million people inhabiting more than 6,000 islands.
- The bulk of Indonesia's population reside on the largest islands; Java, Sumatra, Kalimantan (the Indonesian part of Borneo), New Guinea (shared with Papua New Guinea), and Sulawesi.
- They speak a variety of languages including Bahasa Indonesia (official), English, Dutch, Javanese, and other local dialects.
- Add in widespread poverty, poor communications, corruption, a lack of doctors and veterinarians, and what seems like a never-ending parade of natural disasters . . .
As I say, it is a terrible logistics problem. And one they obviously are not winning.
Japan - which worries mightily about the possibility of an influenza pandemic - has offered to send a medical team to Indonesia to help monitor for new types of flu in South Sulawesi.
While one medical team may not sound like much, it is a start.
Here is the story from the Daily Mainichi.
Japan to send medics to Indonesia to monitor new flu outbreaks
(Mainichi Japan) October 15, 2008
The government will dispatch a medical team to Indonesia to start monitoring possible outbreaks of a new type of influenza.
The Foreign Ministry will send five doctors and one medical worker from the International Medical Center of Japan to Indonesia on Oct. 20 in an attempt to survey new cases of flu as part of a project to support Indonesia's medical surveillance system.
It will be the first time for Japan to combat new flu viruses by seeing patients overseas. The dispatch is aimed not only at making an international contribution but also at applying field experience gained overseas to domestic cases.
Under the project, which comes in response to a request by Indonesia's Ministry of Health, the Japan International Cooperation Agency (JICA) will conduct medical surveillance in southern Sulawesi in central Indonesia for three years, using about 380 million yen from Japan's ODA budget.
According to the World Health Organization (WHO), human transmission of bird flu was first confirmed in Indonesia in July 2005. The national death toll from avian flu rose to 112 as of Sept. 10 this year, comprising about half the fatalities worldwide.
However, the medical surveillance system in Indonesia has not been working sufficiently. It wasn't until three months later that the causal virus was determined in the first avian flu case. Although guidelines for surveillance were drawn up in 2006, the system is not functioning well amid insufficient education of and lack of cooperation with local medical staff.
With a large population and key traffic junctions, southern Sulawesi has been home to mass outbreaks of avian flu and could be an epicenter of an even wider spread of new flu viruses.
Under the latest project, surveillance teams will be set up in 20 prefectures and three cities in Sulawesi to monitor the outbreak of flu patients in conjunction with local public health centers, while sharing information with these institutions. After the project is completed, the surveillance system will be expanded to cover all 33 provinces in Indonesia.
"Early detection (of avian flu) in Indonesia is essential in reducing the damage in Japan," said Takanori Hirayama, 33, a doctor from the International Medical Center of Japan, who will join the medical team as chief adviser.
