Monday, April 27, 2009

Mexico faces criticism over swine flu response


MEXICO CITY – Two weeks after the first known swine flu death, Mexico still hasn't given medicine to the families of the dead. It hasn't determined where the outbreak began or how it spread. And while the government urges anyone who feels sick to go to hospitals, feverish people complain ambulance workers are scared to pick them up.

A portrait is emerging of a slow and confused response by Mexico to the gathering swine flu epidemic. And that could mean the world is flying blind into a global health storm.

Despite an annual budget of more than $5 billion, Mexico's health secretary said Monday that his agency hasn't had the resources to visit the families of the dead. That means doctors haven't begun treatment for the population most exposed to swine flu, and most apt to spread it.

It also means medical sleuths don't know how the victims were infected — key to understanding how the epidemic began and how it can be contained.

Foreign health officials were hesitant Monday to speak critically about Mexico's response, saying they want to wait until more details emerge before passing judgment. But already, Mexicans were questioning the government's image of a country that has the crisis under control.

"Nobody believes the government anymore," said Edgar Rocha, a 28-year-old office messenger. He said the lack of information is sowing distrust: "You haven't seen a single interview with the sick!"

The political consequences could be serious. China was heavily criticized during the outbreak of SARS for failing to release details about the disease, feeding rumors and fear. And Mexico's failed response to a catastrophic 1985 earthquake is largely credited with the demise of the party that had ruled the country since the 1920s.

"That is foremost in the minds of Mexican policymakers now," said George Grayson at the College of William & Mary in Virginia. "They're thinking, 'We don't want another '85.'"

Indeed, Health Secretary Jose Angel Cordova was defensive at a news conference Monday as he was peppered with questions about why Mexico took so long to identify the outbreak, attempt to contain its spread and provide information.

"We never had this kind of epidemic in the world," he said. "This is the first time we have this kind of virus."

It remained unclear where and how the epidemic began, how it has spread, who it has killed or how fast it is growing. And the government has yet to take some basic steps critical to containing any outbreak, such as quick treatment of people who had contact with the victims.

In the town of Xonacatlan, just west of Mexico City, Antonia Cortes Borbolla told The Associated Press that nobody has given her medicine in the week since her husband succumbed to raging fever and weakened lungs that a lab has confirmed as swine flu.

No health workers have inspected her home, asked how her husband might have contracted the illness or tested the neighbors' pigs, she said.

Cordova acknowledged that her case isn't unique.

"We haven't given medicine to all of them because we still don't have enough personnel," he said.

Cordova said he couldn't provide information on the victims for reasons of confidentiality, but promised to eventually release a statistical breakdown. He said he couldn't provide that data now "because it's being processed."

Asked whether he could at least say how many of the 20 confirmed victims were men and how many were women, he said: "I don't have that information."

The government has insisted it acted quickly and decisively when presented with the evidence of a new virus.

But even as it did so, it acknowledged the outbreak began earlier than April 12, the date it had previously linked to the first case. Cordova confirmed Monday that a 4-year-old boy who was part of an outbreak in eastern Veracruz state that began in February had swine flu. He later recovered.

Residents of the town of Perote said at the time that they had a new, aggressive bug — even taking to the streets to demonstrate against the pig farm they blamed for their illness — but were told they were suffering from a typical flu. It was only after U.S. labs confirmed a swine flu outbreak that Mexican officials sent the boy's sample in for swine flu testing.

Meanwhile, some people complained that health workers were turning them away, even as officials urged people to seek treatment quickly if they felt symptoms of flu coming on.

Elias Camacho, a 31-year-old truck driver with fever, cough and body aches, was ordered out of a government ambulance Sunday because paramedics complained he might be contagious, his father-in-law told the AP. When family members took him to a hospital in a taxi, Jorge Martinez Cruz said, a doctor told him he wasn't sick.

Camacho was finally admitted to the hospital — and placed in an area marked "restricted" — after a doctor at a private clinic notified state health authorities, Martinez said.

In Mexico City, Jose Isaac Cepeda said two hospitals refused to treat his fever, diarrhea and joint pains. The first turned him away because he wasn't registered in the public health system, he said.

The second, he said, didn't let him in "because they say they're too busy."


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