A(H1N1): We don’t want to be reduced to mere statistics!

This is a time Malaysia wishes to see our politicians and government leaders stop politicking and power-grabbing; but becoming bi-partisan to deal with a national crisis. If a national viral crisis cannot shake the leadership up; we can only wait for the tragic record where Malaysia Boleh will score another first in the world H1N1 statistics. 

By Foong Wai Fong, Co-Founder, Pahlawan Volunteers

The alarm on the AH1N1 flu pandemic is escalating. Worldwide, governments are on high alert. The latest issue of Time magazine asks the question on its cover, “H1N1: How Bad Will It Get?” The answer: “more than 2 billion worldwide will get it. Thousands of schools may shut down. And millions will need to be vaccinated – twice.” 

It is also noted that the capacity of the world’s Pharma companies can only produce 800 million vaccines in a year; and there are 6 billion people in the world. We can imagine the consequences when the epidemic rages to its peak.  Besides, the vaccines are only available in October this year; and by the time the effect kicks in, it would be Christmas time! 

What is going to happen in between? How many more people are going to fall victim to this global flu pandemic? Do we all want to be reduced to a mere statistics in the global pandemic history? Can you do something? What should we tell our governments?    

It does look like we cannot rely on scientific or external too much. The only way to protect ourselves is to count on our own body; everyone needs to be resilient. We need to work on the surveillance system in our own community, our children’s schools and the neighborhood hospitals and clinics.  How do we do that?   

What do we know? 

Rule No 1: Take no chances, adopt a serious attitude towards the control of H1N1. 

One very important response is for everyone to take this matter seriously. When the Spanish flu took 100 million lives in 1918, it too started very mildly and people don’t quite care. Today, two particular communities that are taking the matter with high alert is Hong Kong and China. One of the reasons for their serious response is the tragic SARS experience, which had shaken communities to their core in these two countries.  
As a result of the SARS tragedy, it has made both citizen and government dead serious in their response to an impending epidemic. To date, no deaths have been reported in China and Hong Kong, a sign of the effectiveness of their response measures.  

Rule No 2: Boost your immune system; make sure you stay healthy.   

We must begin with what we know. AH1N1 is an entirely new virus; but it still works the way past flu has – by invading the body cell by cell. We are counting on our own immune system to respond in time to fight the virus. 

The other fearful thing about the virus is it can mutate; the challenge is whether new vaccines and treatments can catch up with its rate of mutation; and whether our bodies have strong enough immune systems to boost its defense against the disease.  

Rule No 3: Good hygiene and stay away if you are sick.

Yes, the good news about AH1N1, as we know it today is it is not a severe disease for those who are healthy. The groups most vulnerable are those with respiratory diseases such as asthma, children below 9. (Time Magazine shows 41% of all hospitalized are those below 9 years old, versus the normal flu only 19% of the same age group are hospitalized.)

We also know that pregnant women and older people with various ailments are high risks groups as well. The best news about the disease so far is it is not air borne. It only spreads via contact. Hence good hygiene and quarantine are the best mitigation strategy to containing the spread.  

Response Strategy 

Since there is only so much we can do to stop the spread; in fact, experts are now saying that in the H1N1 pandemic; it has become local in many regions. The response strategy cannot just be controlling its spread but moving on to mitigation of damaging effects.  While all the temperature checks and mandatory quarantine are still essential, time is overdue for us to move to raise the red alert among communities and to strengthen self-mitigation measures.  

  1. Government must demonstrate that it is not taking any chances. There ought to be a special ACTION Council in the health ministry; with links to all the medical and health groups in the country; disseminating information and put the entire health care system in preparedness.   

    First of all, all the nation’s health care workers must be adequately prepared and protected so that we don’t lose any capacity to deal with emergencies.  

    Second, the entire medical community in the country must be mobilized; specialists, doctors, paramedics and all community health care groups including native herbal medical shops be mobilized to help citizens cope with treatment as well as prevention. There should be a website, hotline and a 24 hour surveillance team, that can broadcast the latest information and provide help whenever it is needed.  

    Third, publishing the hot spots is a must; and any rising trends in any area must be broadcast immediately.  If one does not exist now; the Health Ministry should waste no time in setting it up. We would like to see the health minister canceling all his other political engagements to focus on getting this national surveillance and emergency-response system set up immediately.

  1. Raising citizen awareness is key to coping with the disease. The death toll today shows that something more needs to be done as soon as possible. It is noted that the disease is not that serious for those who are healthy. So the key here is to make people healthier; and to do that; we begin with diet and exercise.  
    Malaysians ought to examine its diet carefully; avoid greasy and deep fried stuffs; drink lots of liquid and detox, either exercise or have a constant input of detox tonics such as Chinese medicinal herbal drinks.  
    Those families who have the habit of preparing “balanced” meals know the theory of “nurturing life,” getting the body in balance so that your immune system can be strengthened to cope with viral attacks.
  1. Good ventilation and high quality air. Enclosed structures with air conditioning ought to check their air circulation system. Don’t make the air conditioning system the medium of transmission of the virus. Good ventilation at home and at work is key to promoting stronger respiratory immunity.  
    Again the authorities must act on the rampant haze and polluted environment. There is so much the people can do; it is critical that the enforcement departments get to work to tackle the root of the problem. The Ministry of Housing and Local Government and all the State Governments must be mobilized.
  1. Spread the response capacity as wide as possible. Mobilize all grassroots organizations to have the capacity to respond. For example, the decision to close the schools, offices or buildings must be left to their immediate heads.  
    In the case of schools; the headmaster, sensing the seriousness of the flu situation among students can recommend closure; and so long as the PTA and the Board endorse it; they should be allowed to close immediately. The school need not wait for any confirmed H1N1 case, if the incidence of flu is high enough, the school should take precaution to keep the children home; while coming up with new ways of occupying the children.  
    The worry here is if higher government authorities are involved; they are usually terribly slow and bureaucratic to be effective in dealing with a crisis. Many unnecessary victims die from inaction or delayed action, not from the lack of cure. The government has to come down from the high cathedral of power; and descend to the grass root to work with community groups.
  1. Don’t panic. Many people who are “worried well” may jam the health system and deprived the “seriously ill” timely treatment opportunities. To disperse the crowd, any clinic in the neighborhood should be equipped to deal with treatment, and no one has to wait in the queue of hundreds at government hospitals. Imagine, mixing the healthy with the infected; the sum total would be more infected cases! We should equip everyone with the knowledge to deal with the problem in order not to stress out the already ill-prepared health care system.
  1. Good hygiene and neighborhood cleanliness is key. This we hope to see all the Members of Parliament and State Assemblymen and women leading their communities to strive towards better hygiene habits. In Malaysia, don’t forget we are not just fighting the H1N1; we also have to deal with the increasing fatal cases of dengue fever – all these have something to do with the declining standard of hygiene in our neighborhoods.  Local leaders ought to mobilize community groups to initiate clean up operations as well as to promote good hygiene education. MPs and ADUNS, time to come out to do your real job.

This is a time Malaysia wish to see our politicians and government leaders stop politicking and power-grabbing; but becoming bi-partisan to deal with a national crisis. If a national viral crisis cannot shake the leadership up; we can only wait for the tragic record where Malaysia Boleh will score another first in the world H1N1 statistics. Politicians must also remember they and their families are not spared in this crisis as well; the sooner they buck up the better the chances of their survival. Besides, what is that to fight or gripe if your valuable life is threatened!  

Many of us are also realistic about systemic inertia of bureaucracy and know that we can only pray for the best. In the meantime, if none of us want to become a statistics in the global pandemic; we must rise to act; be responsible personally, reach out to the community to promote the mitigation response. We must all remember that no one could stay healthy if the community is not.

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Foong Wai Fong is Co-Founder of Pahlawan Volunteers, a Malaysian voluntary and advocacy group since 1997. She is also director of Megatrends Asia and author of many bestselling books on Asia.