Lessons From Turkey's Bird Flu Outbreak

Rapid responses by Turkey's health authorities and key health personnel were critical in bringing the 2006 bird flu outbreak under control, according to research published in the online open access journal, BMC Public Health. Those involved cite poverty and families sharing their homes with poultry as factors behind the virus' transfer to humans.

During early 2006, 12 avian influenza cases were confirmed in Turkey, of which eight cases occurred in the Dogubeyazit-Van region. Ozlem Sarikaya of the University of Marmara, Istanbul and Tugrul Erbaydar of the University of Yuzuncu Yil, Van, conducted in-depth interviews with senior health professionals to evaluate attempts to control the outbreak.

The authors found that, although a crisis committee was created quickly, healthcare workers felt anxious and ill-prepared due to a lack of clarity about their responsibilities in emergency disease plans, and delays in receiving protective clothing. The researchers also found that the coordination between the human and animal health services was not sufficient. Despite these difficulties, open communication between the government and the public, as well as the health authorities' and health workers' efforts, helped control the epidemic. Poultry rearing practices, coupled with poverty and poor access to healthcare, were the primary risk factors for infection.

"Lessons learned from this outbreak should provide an opportunity for integrating the
preparation plans of the health and agricultural organizations," say Sarikaya and Erbaydar, "and for revising the surveillance system and enhancing the role of the primary health care services in controlling epidemic disease." They add that informed response strategies will play an invaluable role in the control of a future avian influenza pandemic.

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Iraqi Refugees Urgently Need Help from U.S., Other Nations

The International Rescue Committee (IRC) is urging the United States, the European Union and otherleading nations to respond quickly to the plight of refugees who have fled Iraq and to support U.N. efforts to assist them.

"The flight of almost 2 million Iraqi citizens to other countries makes this a refugee crisis of historic proportions," says George Rupp, president of the IRC. "It is urgent that the international community meet the U.N. refugee agency's appeal for $60 million as a first step in addressing the needs of these people."

The funding would assist the nearly 2 million refugees who the U.N. says have fled to Egypt, Jordan, Lebanon, Syria and Turkey, as well as 1.7 million citizens who have been displaced inside the borders of Iraq itself.

The IRC also called on the U.S. government to launch an expandedinitiative to resettle Iraqi refugees in the United States, with a focus onthree groups: the most vulnerable, particularly religious minorities; thosewith relatives already in the United States; and those at special risk because of their association in Iraq with U.S.-led coalition forces or the coalition's civilian contractors. A number of these Iraqis -- including translators and drivers -- have been killed, and the security of their surviving family members has been compromised.

"The U.S. bears a special obligation to such individuals, and they should be afforded protection and, when necessary, the opportunity of expedited resettlement in the United States," says Robert Carey, the IRC's vice president of resettlement.

"Even with an expanded program, only a small portion of refugees from Iraq can be resettled in the United States," Carey says. "So it is urgentthat the U.S. and the international community begin supporting the U.N.refugee agency's efforts on the ground to coordinate aid and ensure thesafety and security of the huge population of displaced Iraqis."

These measuresneed to be undertaken immediately, both for humanitarian reasons and toprevent a destabilization of the region that could be caused by thepresence of massive numbers of desperate refugees, he says.

Founded in 1933, the International Rescue Committee is a global leader in relief, rehabilitation, post-conflict development, advocacy andresettlement services for refugees and others uprooted or affected byviolent conflict and oppression. In the United States, the IRC has resettled thousands of refugees who fled Iraq while it was ruled by SaddamHussein, and provided relief services in Iraq in 1991 after the Gulf War and in 2003 after the invasion that toppled the Hussein regime.


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