Published on October 31 , 2005 - A community in Kanchanaburi may be showing the telltale signs of what can go wrong before the much-feared bird flu is allowed to develop into our worst nightmare. Nantiya Tangwisutijit visits the village and investigates. It was music to their ears when last July, Kanchanaburi province was back in the green zone and the government was talking about declaring Thailand “bird flu-free”.

The farmers in Benjapad village also started raising chickens again so they could yield a good price by Chinese New Year.

“It was all over the TV back then, so we figured it was safe to bring our chickens out of hiding, and start making money again,” said Paew Ruengrit, 52. “By next January, with a market price of Bt120 per kilo, my 300 chickens should have brought us a small fortune.”

But Paew’s chickens never made it to the market. After just three months, Benjapad village is once again at the epicentre of Thailand’s two-year battle against bird flu. Of the 13 Thais who have been killed by the H5N1 virus, the first, fifth, and now the most recent, have all lived in the village.

It would be easy to presume that the suffering experienced here would have added to a heightened sense of responsibility and caution among villagers and local officials, which would have significantly reduced the likelihood that the virus would return to wreak havoc in this quiet mountain region. Unfortunately this is not the case.

Rural income needs coupled with a confidence emanating from Bangkok that the virus was under control lead many villagers to return to raising chickens in their backyards. Add to this the apparent flaw in the government’s surveillance strategies and response mechanisms and it seems the climate for further outbreaks has remained virtually unchanged.

“It is outrageous,” said Benjapad villager Jongrak Boonmanuch, the mother of the six-year-old boy who became Thailand’s first bird flu fatality. Jongrak is also the cousin of Bang-orn Benpad, 48, who succumbed to the same virus two weeks ago.

Jongrak said that the government was unprepared for bird flu two years ago, and its capabilities for handling the situation was no better now. She added that it took livestock officials several days to arrive to examine sick chicken after receiving the initial reports, and another week before the confirmation came through.

She said that the district hospital did not suspect bird flu even though Bang-orn’s x-ray showed a collapsed lung. And instead, doctors sent him home where he died four days later.

Defenceless in the Wild

When arriving at the village it’s easy to see why it is virtually impossible to protect backyard chickens from contracting bird flu. Wild birds are everywhere; pigeons, sparrows and doves cover the roofs of nearly every home while flocks of storks congregate in paddy fields. All of these birds have been identified as potential carriers of H5N1, which is now endemic to Thailand’s wild bird population.

“We love these zebra doves,” said poultry farmer Yei, 54, Paew’s husband. “These birds have nice voices and they come every day for a bowl of grain we put out for them.”

This month, the couple’s backyard chickens were among the first in the village to get sick and die, but Yei still refuses to believe that the wild birds brought the disease.

Yei said he that has spent 30 years raising poultry and it is normal for groups of chickens to die every few years. He added that he has always managed to save a few of them with medicine and he didn’t understand why the government insisted on killing all of the poultry.

“I still have nightmares from last year when the livestock officials came to my village with a backhoe. They dug a big pit and dumped all my 3,000 ducks in it alive. They were perfectly healthy,” he recalled.

Missing the Warning Signs

“Yes, technically, we were supposed to keep an eye on bird flu, among other health problems in the village,” said Maneerat Suwannasingha, the head of Benjapad village’s health volunteers. “But in practice, we just don’t have the capacity. Health volunteer work is unpaid and all of us have our own families to take care of. We want to meet the public’s expectations, but it’s just not very practical.”

So with last year’s losses still fresh in their minds, Yei and Paew were reluctant to say anything when their birds became sick late last month. Chamnan Boonmanuch, Jongrak’s husband and the father of the six-year-old boy who became the first bird flu fatality, says he visited Yei and saw chicken dying, and found out that they had already been ill for four or five days. Jongrak, who became a village health volunteer after the their son’s death, immediately alerted officials.

In the meantime, Paew and Yei had already given away a number of the sick chickens to their relatives and neighbours. Paew said her nephew, Bang-orn, took five of the chickens. In the same week, more chickens in the neighbourhood started to die and their owners also passed on the birds to other villagers.

“It’s such a waste to throw the chickens away,” said Saeng Dokmaigun, who passed on her sick chickens to her cousin, Sakorn Benpad, the mother of Bang-orn. Sakorn is now taking the anti-viral drug Tamiflu.

“I didn’t think about bird flu,” Saeng said. “People clean and cook sick chickens here all the time. I never touch the chicken myself because I have never been fond of eating meat.”

However, Paew admitted that she suspected that her chickens might have bird flu. She added that she mentioned this to Bang-orn before passing the chickens on to him.

“Bang-orn told us it didn’t matter,” her husband Yei recalled. “He said the prime minister always says that eating well-cooked chicken is safe. He said who else should he trust if not the prime minister.”

Somyos Pangtru, Bang-orn’s cousin, recalled that the man was still certain that his slight fever and chest congestion had nothing to do with bird flu. He added that Bang-orn even went out to help Jatuporn Kumchuen, Panomtuan district’s livestock officer, when the officer led a team to cull chickens in the village on October 11.

Although the lab results did not confirm the return of the H5N1 virus until October 13, Jatuporn says he started culling chickens two days earlier. He said that he recognised the chickens’ symptoms as the same as those they displayed last year. The officer also disputed Jongrak’s claim that he failed to head straight to the village after receiving the confirmation that the chickens had the virus.

“I arrived at the village on October 4, the very day I received the reports,” he said. “I collected samples of chicken droppings and sent them to Bangkok.”

Farmer Klai Dokmaigun reported that when he found Jatuporn was also planning to cull his healthy chickens he decided to hide and transport the remaining chickens to another village.

“We were not as successful as last time, they eventually found them, but we didn’t have as much time, just one night,” Klai says.

Jatuporn acknowledged that the smuggling of chickens was a major problem but added that with limited resources and only two officials and one veterinarian per district, they could not effectively contain the virus. “We work on a borrowed old computer and don’t even have our own office space,” he said.

Doctors in the dark

Kanchanaburi chief doctor Surapong Tantanasikun said he was not aware of the re-emergence of bird flu until he received a report from the provincial hospital about Bang-orn’s suspected infection on October 17, just two days before Bang-orn’s death.

“I don’t know why livestock officials didn’t alert us of the disease, perhaps, they were in the process of doing so,” he says. “Now that the disease has returned, the best we can do is be extra vigilant.”

Since the death of Bang-orn, Surapong has prescribed the anti-viral drug Tamiflu to approximately 30 people in Benjapad village who have been in close contact with the sick chickens. However, some of the villagers, including Klai, decided to stop taking the drug after taking the first few capsules.

Surapong said that he does not think Kanchanaburi or Thailand can entirely rid itself of the bird flu virus and added that Benjapad is typical of so many rural villages where people have their own ways of doing things and there are still huge communication gaps between the farmers and officials.

“We have to stop talking about being a bird-flu free country,” he said. “The disease is here to stay and it would not be easy to convince farmers to stop raising chickens. The only thing we can do now is to repeatedly warn people to be vigilant, in the same way as we have done with dengue fever and malaria.”