At the height of the year’s first rice harvest, the Mekong Delta appears a land of plenty.
Near the hamlet of Tan Phu Xuan, at dusk, villagers are finishing off a paddy using a smelly, noisy ride-on harvester they acquired two years ago, which nevertheless shrinks to a few minutes what used to be hours of back-breaking labour with a sickle.
Outside virtually every riverside home, even the poorest, the newly threshed rice-grain is spread out to dry before being husked and put into sacks for sale or storage.
But the season also triggers a reminder of the very real threat of avian and human influenza (AHI) that still hangs over Dong Thap province’s Phu Long communal district, for one, well known for the trade in the duck meat that is no more a rarity in this part of the world than chicken is in the West.
Soon after the rice is gathered up in the paddies, poultry traders in canoes herd thousands upon thousands of ducks up and down the rivers and into the empty fields to gobble up small grains and straw from the harvest.
No money need change hands: the traders get their ducks nicely fattened for market, and it’s one less bonfire of harvest waste for the farmers to build.
But the duck population is an important reason why Phu Long is still considered “high risk” for AHI by the local authorities and the Vietnamese Red Cross (VNRC) specialists who yesterday finished a four-day field assessment of the International Federation-supported programme to combat bird flu.
The World Health Organization (WHO) has said ducks can act as a “silent reservoir” of H5N1, the virus that causes bird flu, by infecting other birds like chickens without showing any symptoms themselves.
The third and, for the moment, final phase of the Red Cross AHI “prevention and preparedness” programme in Vietnam ended last month, and the VNRC is now hoping for further international assistance through the Federation’s global appeal to enable it to continue.
Animal outbreak
Bird flu in humans – as opposed to the “epizootic”, the animal outbreak – has been all but beaten in Vietnam, with a combination of mass poultry-vaccination by the government as well as a very large-scale public information campaign to which the VNRC contributed at grass-roots level.
The latest WHO figures (in late May) show five cases this year – all fatal – compared to 61 cases, 19 fatal, in 2005, the worst year of the current outbreak.
After Indonesia, which has suffered just over 100 deaths, Vietnam is the second worst-affected country in the world, with just over 50 in total.
“We cannot let our guard down,” says Vu Thi Phuong, the 36-year-old leader of the VNRC team in Dong Thap.
“Five volunteers for every communal area is about enough, and in principle we have them,” she adds.
“But we need much more training, and people to train the trainers, and that’s a cost to the National Society.”
According to Richard Cewers of the International Federation, who has been helping to coordinate the VNRC bird-flu effort at the National Society’s Hanoi headquarters, “the history of many of those who fell sick with avian influenza shows they picked up the H5N1 virus not at work but from day-to-day activities in their backyards, like slaughtering or handling poultry”.
About three quarters of Vietnam’s 12 million farming households are estimated to rear poultry – an important source of income, especially for women. Even in cities many householders keep up to about 20 birds in their backyards.
“The animal virus now endemic in most of the country and will continue to pose a risk to human health,” says Cewers, “and the most effective way to deal with this is through the community-based education that’s fundamental to the Red Cross way of working.”
“We also hope there’s an added value from the AHI programme for public health and livelihoods in general, if we avoid too ‘top-down’ an approach.
“The human-health message will enhance hygiene overall, by encouraging people to keep poultry out of living areas, for example, while the animal-health message ought to reduce the risk of other diseases, like foot and mouth and blue ear.
“Mass culling is a real threat to farmers and compensation is an issue.”
Environmental challenges
For the Red Cross, disentangling whose message has got through, the government’s or theirs, is not always easy. But 41-year-old Dang Thi Hue, who lives in Phu Long, is a success story for someone.
“When I buy birds now I ask for a vaccination certificate,” she tells the Red Cross team, “and when I sell them again I get asked for one.”
“And I wear a mask and boots to feed the birds and clean their pens.” (She has very little spare money for such equipment.)
Vietnam is one of the most disaster-prone countries in the world and, according to scientists at a seminar held in Ho Chi Minh City last week to mark world environment day, faces “eight major environmental challenges”, including a reducing supply of arable land, stronger typhoons and pollution.
These threats might look more real than a disease which now kills almost exclusively birds.
But it’s not necessary to spend very long in the Vietnamese countryside to realize how absolutely central to people’s nutrition and livelihoods poultry is – and how wary of H5N1 they still are.
Thirteen-year-old Quynh Giao, who lives in a particularly impoverished part of nearby Tan Phu commune, explains that she’s learnt all about bird flu at school, and how to avoid catching it. Her father says he recently buried some dead birds quickly for fear people who didn’t know better “might eat them”.
Even here, where people can afford the accoutrements of hygiene even less than Dang Thi Hue can, some families have invested in netting to keep their birds in, and other people’s out.
In any country that still suffers a well-developed epizootic, experts believe, this kind of consciousness about the risk to people has to be maintained if the numbers of human cases and deaths is to be brought down to zero, as it almost has in Vietnam.
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Duck traders herd their birds along a tributary in the Mekong Delta in Vietnam's southern Dong Thap province, heading for newly harvested paddy fields where they will eat leftover rice grains and other waste and be fattened for slaughter. The duck population in the area is an important reason why it's still considered high-risk for bird flu by the local authorities and the Red Cross since it's believed ducks can act as a “silent reservoir” of H5N1 by infecting other birds without showing symptoms themselves. (p17767)
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Le Van Quyen (right) and Tran Van Chinh volunteer for bird flu prevention work backed by both UNICEF and the Red Cross, wearing the T-shirts of the former and the caps of the latter. The riverside hamlets of Vietnam's southern Dong Thap province, where they live, were a focal point of the third phase of the avian and human influenza project of the Vietnamese Red Cross, which ended in May 2008. (p17768)
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