Ready for a flu disaster?

But, small ports just don’t have big city services. However, careful, common sense planning could mean smaller is better – local action by local people for speedy local reaction.

Call the dentist!

WHO’s 25 action ‘protocols’ are not ready, but officials have talked World Fishing through the drafts so that small ports, coastal or lake, can steal a march on the big cities.

If you are harbour master with few staff then draw up a list of ‘hidden’ resources. For example, you may not have a hospital, but dentists who are trained in resuscitation. Health staff who double up as health inspectors could also be useful. So you need to call a meeting of such people for flu action.

In the industry, some vessels have first-aid trained crew – call the skipper or boss of the company owner and find out who they are. Next talk to the truckers or the company owner. You will also want to tell them if an outbreak happens that there will have to be chemical dips in the road on the approach to the port or the local market where fish and poultry are often slaughtered. They can advise which contraband ‘back routes’ should also be covered.

The private, cold-store warehouse managers are also key players. Meat and fish are stored on the same site nowadays. Staff will be first to know if someone is trying to pass off a batch of condemned poultry from out of town and trying to ‘launder’ it through the official distribution system.

Catch the bus

Don’t forget that drivers of out-of-town buses, minibus taxis and three-wheeler tongas also hear if someone has fallen sick in a village. These vehicles are used by rural folk to bring livestock to market and their routes can be a principal means of infection transmission.

This network of bush telegraph information can become a very fast and active machine which can also take practical prevention steps – but you then need to organise get-togethers so everyone is aware, involved and ready to act.

Just as bus terminals can be a major infection zone, you need to think about quarantine if cases are found. If a coastal vessel comes in with someone infected (this is about avian flu now, but it could be a meningitis outbreak) then the skippers should know that they must be safe not sorry and tell you that they have a problem. It may be that they have also collected a batch of fish and poultry from a village on the coast or lakeside. It could be a vessel on Lake Victoria which carries all kinds of fish and meat cargo. They should be aware you might want to hold a vessel, in a part of the port where they are away from others. Don’t forget they will need food and water brought to them.

You might agree with one of the storage companies that they will be ready to lend you a warehouse which can be isolated from other parts of the town. And that isolation also means ensuring that taxis or minibuses carrying infected people, (because you do not have fleets of ambulances) also have to be disinfected and not simply sent off again to spread an infection. You also need to think about a system to check and monitor containers and, if contaminated then they have to be cleaned.

Money

That raises the question of ‘who pays for what?’. WHO has generally said there should be no profiteering on such actions, so you have to watch that doubtful local ‘service companies’ are not trying to extort big costs when there is an emergency. The police or customs can watch that aspect for you.

And you also need somewhere isolated and safe to examine potentially infected livestock – the last thing is for it then to be dumped in the harbour, up the coast or on the local rubbish heap.

When your informal network is in place, you can then run an emergency drill and see your weaknesses. None of this will have cost you any money. But, WHO has made it clear that it will give money and technical assistance to poorer areas. If there is a local outbreak and the central bureaucracy is being difficult contact www.who.int direct.

Drugs and noses

Microbiologist Professor Graeme Laver is a specialist in flu pandemic control. He says you will know straight away if someone has avian flu – it sledgehammers the body’s system. The drug Tamiflu, if given in the first 12 hours (or with a bit of luck up to a day or more) will stop the virus. So, should you stock a small emergency supply? Check with health professionals. It is still ridiculously expensive at between $35 to $50 for a course of 10 tablets. And beware internet web scams selling rubbish. The price should drop as more factories are licensed by drug company Roche.

For flu, or any other infectious disease, Prof. Laver says it is best to wash your hands but points out that can often be difficult “…the best thing is to remember not to touch your nose or mouth or eyes or any cuts if you think you have” handled something or someone infected. If you have not got disposable rubber gloves…use a plastic shopping bag. The message is – improvise imaginatively!