Swine flu risks increase for Oz's aborigines


For most Australians, swine flu has turned out to be a highly infectious but not particularly life-threatening virus. But the disease is taking a disproportionately heavy toll on indigenous people, highlighting the deep inequalities between them and the white majority in Australia.

“It is depressingly predictable, and you don’t have to evoke complex biological explanations for it,” said Dr Andrew Pesce, president, Australian Medical Association. “It brings home the well-known and quite sad fact that indigenous communities are at risk for all sorts of reasons.”

Australia is in the middle of its winter flu season, and aborigines have much higher rates of the diseases that cause flu complications every year. In Australia, aborigines, who are only 2.5 per cent of the population, are hospitalised and die from swine flue at five times the overall national rate.

They have two to seven times the rates of heart disease, asthma and diabetes of other Australians, said the government’s Human Rights and Equal Opportunity Commission, and their life span, on average, is 18 years shorter.

Health officials say they are stepping up measures to stop the flu in Australia, but some aboriginal leaders and health activists say it is not enough.

In the outbreak’s first weeks, the government imposed severe measures, like sending even healthy schoolchildren home for a week if they had visited a country with cases, and quarantining an entire cruise ship. It also used radio and television messages to urge people to wash their hands, cover their mouths when coughing and stay home when sick.

Indigenous leaders say these messages have rarely reached their remote towns, where health facilities are scarce, illiteracy rates are high and English is often a second or third language.

“There are a lot of barriers in terms of culture and particularly cultural awareness for people who are working in aboriginal communities,” said Alf Lacey, mayor, Palm Island, a large aboriginal community in tropical northern Queensland. “Putting up a generic poster isn’t going to do much good if you’re dealing with people who can’t read.”

More than a dozen people fell ill when swine flu swept Palm Island in July, including a 19-year-old woman who was airlifted out in critical condition. Schools and day care centres were closed, and many people panicked.

Efforts put in

As a result, the Queensland government opened a flu clinic on the island, created health messages aimed at aborigines and sent extra supplies of drugs and equipment.

But Lacey and some health experts are skeptical that such a top-down approach will work.

Although health officials realise that they must recruit local leaders to have a chance of success, aboriginal communities vary greatly in culture, language and tradition, forcing national officials to devote more time and effort than they want to spare, said Dr Michael Gracey, who has been working with Aboriginal communities for 40 years.

Experts predict that more than a quarter of Australia’s 21 million people will eventually catch swine flu, and Nicola Roxon, health minister, warned that as many as 6,000 could die this year. The typical seasonal flu kills about 2,800 Australians, most of them frail and elderly.

Human trials of a vaccine began in Australia in July, even earlier than they did in the United States, which is just beginning them. The government has contracts to purchase 21 million doses, though it is not clear yet whether each person will need one or two shots.

“Everyone is clamouring for it,” said Russell Basser, of CSL Biotherapies, the Australian biotech company making the vaccine. Unfortunately, he said, it cannot be used until the trials are finished, by which time the Southern Hemisphere’s flu season will be largely over.

If all goes well, the government will begin vaccinations in October, giving priority to aborigines, as well as to healthcare workers and to others at high risk. Until then, many indigenous people remain nervous.

The New York Times

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