Bird Flu Alarm

2006-01-19-Bird flu preys on poverty in ill-fated town

Understanding Avian Influenza

2006-01-19-Bird flu preys on poverty in ill-fated town

VAN, Turkey, Jan 19 (Reuters) - The Ozcan family marked New Year's Day with a special meal of duck, slaughtered and prepared by 16-year-old Fatma with help from her little brother Muhammet.

A fortnight later Fatma was dead, the fourth Turk killed by bird flu. Five-year-old Muhammet is now fighting for his life on a respirator in the hospital where she died in eastern Turkey.

In the Kocyigits' home on New Year's Day, hopes for 2006 were devastated by the death of their teenage son. He was the first bird flu victim outside east Asia.

A week later his two sisters, infected by the virus, were buried in graves beside him.

This week's global pledges of $2 billion in aid to fight bird flu came too late to save these families from the poverty and ignorance which sealed their fate in the remote town of Dogubayazit, near the Iranian and Armenian borders.

The town's picturesque snow-covered setting below Mount Ararat belies the hardship faced by its 70,000 people, whose main food source -- the poultry they keep at home -- became a fatal danger.

In her final days, Fatma told another patient she was scared of dying in hospital because her mother had died there of kidney failure 8 years ago. Financial problems had delayed the mother's treatment - a plight which came back to haunt the family.

"I lost my darling because of my ignorance," said Fatma's tearful father Mehmet Emin, who took her to hospital 10 days after they ate the duck and 5 days after she fell ill.

"They made me sign a promissory note for my wife when I brought her to hospital. I thought of that note when my daughter fell ill ... so I didn't want to take her to hospital," he said.

Doctors at Van Hospital said Fatma and the Kocyigit children died because they had been brought in for treatment too late.

Others were more fortunate.

The parents of 8-year-old Sumeyye rushed her to hospital soon after she fell ill. She is now back home playing with her dolls. And with the memory of a pained-looking Fatma struggling to walk through the isolated ward on her arrival in Van.


The H5N1 virus has killed at least 79 people in six countries since late 2003, according to the most recent figures from the WHO. The victims normally contract the virus through close contact with infected birds.

The possibility that the four Turkish children's deaths could have been avoided has fuelled media and opposition criticism of the government's response to the bird flu outbreak.

Some 1,200 km (750 miles) west of Dogubayazit in the capital Ankara, a leftist association held a demonstration outside the health ministry this week, hanging children's shoes from its railings in protest against official handling of the crisis.

"People don't believe they won't be charged for the bird flu treatment because they fear they have to sign promissory notes," said Ender Buyukculha, a lawyer speaking on behalf of the group.

Keen to dispel the misconception that hospitals will charge for treatment, Prime Minister Tayyip Erdogan voiced his dismay at the families' reluctance to seek medical treatment.

"No hospital may turn back my sick people for money reasons. If they are turned away they should tell our relevant authorities immediately," Erdogan told reporters this week.

But in the mainly Kurdish southeast, ravaged by more than 20 years of separatist conflict which has killed more than 30,000 people, it is hard to overcome popular suspicion of authority.

The impoverished region suffers from under-investment and lacks any industry. Dogubayazit makes some income from tourism in the summer, when travellers use it as a base to visit the Ishak Pasha Palace ruins on a hill above the town.

Its also depends on small-scale smuggling across the border with Iran and the poultry in people's yards.

In freezing winter temperatures, poultry were often brought indoors from the cold. Birds that died from sickness would not go to waste and were plucked by the children to eat.


With one million birds now culled nationwide, poor locals are faced with the challenge of finding other protein sources.

Zeki Kocyigit, father of three of the dead, has not worked since his shop closed several years ago. He made ends meet by occasionally smuggling cigarettes from Iran while his dead son Mehmet Ali made candyfloss to sell to school friends.

The family lived in a four-roomed shack without running water on the outskirts of Dogubayazit. Only a path led to the house until the health minister visited this month and workmen with mechanical diggers carved out a road for his car.

The Kocyigits are also haunted by the knowledge that money worries kept them from going to hospital promptly.

"When Mehmet Ali first fell sick, we did not even have the two lira ($1.30) to take him to hospital," his mother, Marifet, sobbed in her native Kurdish.

In particular, she mourned the loss of her eldest daughter Fatma Kocyigit: "I am left alone. She was my everything. She was my friend, she helped with all the housework."

The family's only surviving son was 6-year-old Ali Hasan, who made a full recovery. As they look to the future and the task of bringing him up, his parents are at least spared the money worries faced by their neighbours in Dogubayazit.

Kocyigit met the prime minister at his parliament offices on Tuesday and took up a state offer to settle his family in Ankara, where he will be given a job and his son an education.

As for Fatma Ozcan, she never got the chance to go to school. She spent her short life caring for her family until her death this week.

Understanding Avian Influenza