To Afghanistan’s many problems, now add the flu

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A man wears a surgical face mask while walking through the central city marketplace in Kabul, Afghanistan on Saturday, November 7, 2009. The government has declared a state of emergency, and closed schools, universities and even wedding halls and public b
Chuck Liddy/Raleigh News

KABUL, Afghanistan — As if the Taliban, car bombs, roadside
bombs, leftover Soviet land mines, political unrest and errant NATO air attacks
weren’t enough, Afghans are facing a new killer: the H1N1 flu pandemic.

The government has declared a state of emergency, and closed
schools, universities and even wedding halls and public bathrooms for three
weeks to slow the spread of the virus, which has killed 10 people in the
capital in less than two weeks. Cases are popping up in provinces spanning the
country, with new outbreaks reported in two more provinces on Saturday.

“There is no doubt that we have an epidemic in our
country now, and we are moving into the fall season when the conditions make it
more likely to spread,” said Ahmad Farid Raaid, the spokesman for the
Ministry of Public Health.

In the past few days, surgical face masks have bloomed like
poppies on the faces of worried pedestrians along crowded streets and markets
of the capital as more cases were reported.

The effectiveness of such masks in preventing a wearer from
contracting flu is uncertain, according to the Centers for Disease Control and
Prevention, but they are selling quickly in Kabul. Many vendors are boys who
would be in school except for the emergency closing.

“I would prefer to be in class, but I can sell these
for 10 afghanis (about 20 cents),” said Hafzuillah, 12, waving a fistful
of masks as he stood among money changers and carts of roasted pine nuts in the
chaotic human tide of Kabul’s open-air central market. Like many Afghans, he
uses just a single name.

In the past few days, the government has ramped up its
response to the epidemic, Raaid said. Most of the 456 cases among Afghans — and
all the fatalities — have occurred in Kabul. Friday, his ministry distributed
flu medicine and 10 tons of related medical supplies to 34 hospitals and
clinics in the capital.

The Afghan government has enough anti-viral medicine to
treat about 50,000 flu patients, with another 30,000 doses on the way, Raaid
said. But there is no H1N1 vaccine on hand, although the government expects to
receive 550,000 doses through the World Health Organization and is asking for
11 million doses of vaccine.

The initial round of vaccinations will go to a prioritized
list of people, starting with health care workers, then pregnant women, young
children, the national army and police, then students.

Since August, the health ministry has been running a public
awareness campaign aimed at stopping the spread of the disease, Raaid said, but
last week, it ratcheted up the effort, signing contracts with several TV and
radio stations for about $200,000 in additional ads.

Signs in government buildings urge workers not to shake
hands, to wash their hands often with soap and to uses masks. Posters bearing
similar messages have been places in public locations around the city.

Even as the health ministry spreads information about
prevention and treatment, though, it’s having to fighting rumors that undercut
the effort. A common one, because of what some regard as the suspicious timing
of the emergency declaration, is that the government is exaggerating the danger
to discourage gatherings to protest the outcome of the presidential election,
which left incumbent Hamid Karzai in place despite massive election fraud in
his favor. The runoff that had been scheduled for Saturday was called off after
his main rival, Abdullah Abdullah, pulled out and Abdullah’s supporters remain
angry.

Asked about that rumor while touring a Kabul clinic Saturday
with journalists and an official of the U.N.’s World Health Organization,
Afghan Health Minister Amin Fatemie said there was absolutely no truth to it.

Raaid said the rapid spread of confirmed cases and the
deaths mean the government had to take aggressive measures. The three-week
shutdown was modeled after the way other countries have responded to the
pandemic, he said.

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Several other countries have shut down schools briefly to
block the flu, among them neighboring Iran, which recently closed its schools
because of an outbreak similar to Afghanistan’s.

“This was not a political decision, it’s a pure
technical decision,” Raaid said.

Still, in Afghanistan, talk on the street can carry more
weight than the official line.

Abdul Karim, 46, a moneychanger in Kabul’s chaotic central
market — one of the busiest in the world and exactly the kind of place flu
experts say to shun during an outbreak — said that several of his friends
stopped using masks when they heard the rumors.

Karzai, meanwhile, accidentally added to his flu troubles
during a television address Friday night when he referred to the illness by its
common name, swine flu, rather than H1N1. The strain is transmitted from person
to person, not from animals to people.

The first reported cases in Afghanistan were among U.S.
soldiers and other foreigners working on military bases. Muslims are forbidden
to eat pork, and so some Afghans have begun saying clearly the flu is passing
from pigs to the foreigners then to Afghans. For them, there is one logical
solution.

“They say that we should throw out all the
foreigners,” Raaid said. “As you can imagine, this is a delicate
matter for us.”

As the epidemic has grown, prices for the masks have jumped
from less than two cents to more than 20 cents in some places, he said.

That may not sound like much, but in one of the world’s
poorest countries, it’s enough to prevent many people from buying the masks,
said Atash, 30, who makes $12 to $15 a day selling international calls on three
dirty cell phones he carries in the market.

By Afghan standards, he is prosperous, but spending the
equivalent of even a few cents on a fresh mask every day or so is a burden, he
said.

“If the price is one afghani, then everyone will wear
it,” he said. “And for sure if the government brings a truck and distributes
them free, then you will see everyone wearing them.”

Raaid said the government discussed plans over the weekend
for an upcoming massive mask giveaway.

The masks are believed to be helpful when worn by those who
have flu because they can stop some of the spray from coughing or sneezing, a
key means of transmitting flu.

Still, it’s clear even some Afghans who have a vested
interest in the illness understand little about it.

Even though he sells the masks in the market Padsha, 15,
sells masks in the central market but said he had a good reason for not wearing
one.

“I had one before,” he said. “But I took it
off and sold it.”

Via McClatchy-Tribune News Service.