Monday, August 17, 2009

camne cara mexico atasi influenza H1N1

Sunday August 16, 2009
How Mexico licked the flu

Football matches were played to empty stadiums, no more than six people were allowed into an elevator, and press conferences were held in the open air. These were some of the strict measures taken to contain the influenza A (H1N1) in Mexico City, shares Mexico’s Deputy Foreign Minister Lourdes Aranda.

SINCE Mexico reported its first cases of the H1N1 flu virus to the World Health Organisation (WHO) on April 23, the virus has spread with unprecedented speed to 170 countries and territories worldwide, with 177,450 confirmed cases.

It was later that day that Canadian public health authorities announced that the Mexican virus was the H1N1 “swine flu” virus.

Health authorities around the world went on an alert as WHO disclosed that several hundred cases of “swine flu” were reported in Mexico, with Mexican authorities speaking for the first time of an epidemic.

Mexican President Felipe Calderon declared an emergency and ordered the closure of schools, nurseries, universities, theatres and museums until further notice in Mexico City, the world’s most populous city with 24 million inhabitants, to stop the spread of the disease.

The emergency gave the president powers to order quarantines and suspend public events. Football matches in the soccer-crazed nation were played to empty stadiums.

Aranda: ‘I think what is important is that we will learn from this experience and we are open about it.’
For those who had to go out, wearing mouth masks were a must as “swine flu” fear gripped the capital city.

“The Mexican way of life came to an abrupt halt. Imagine, in a colourful and bustling city, people had to stay home for days. And the president led by example,’’ Mexico’s Deputy Foreign Minister Lourdes Aranda tells Sunday Star in an interview.

“It was exemplary how the people came together and supported the effort. The health of Mexicans was a cause we defended with unity,’’ adds Aranda, who held discussions with Wisma Putra on Wednesday.

In the days leading to the state of emergency imposed, at least 20 deaths from the virus had been confirmed in Mexico, with 68 other deaths attributed to the virus.

While the deputy minister says that the worst is over for her country as far as the A (H1N1) threat is concerned, the latest news is that officials in Mexico’s Chiapas state postponed classes for over 1 million students in an effort to avoid a resurgence of the flu.

Aranda contends that there is no evidence that the outbreak actually started in her country.

“We must also find out where the outbreak began, it was not in Mexico. We (Mexico) believe that it started in the US but we don’t know which region,’’ she says.

Q: The world, including Malaysia, is facing a deadly H1N1 pandemic since it emerged in Mexico in April. How did you face the crisis?

A: It’s really incredible, now that we’ve had some months to reflect on it. We reacted with discipline. President Calderon was criticised by some sectors because he basically shut down the economy to stop the spread of the virus. It was a complete standstill in Mexico City with schools and offices closed. Only the police who were involved in duty during the emergency were allowed to go out with all precautions in place. And there was a very specific protocol to follow to take the elevator, and for washing our hands. Not more than six people were allowed in an elevator. Press conferences about the epidemic were held out in the open.

We already had a very good plan with the United States and Canada for an emergency situation but that was more for a terrorist or anthrax attack. In the beginning, nobody knew what it was except that it was a new virus. We didn’t know where it originated. We thought it was very deadly; later we found out that it was very infectious but not so deadly once we knew how to treat it. It was dangerous because Mexicans have this habit of not going to the doctor. So, many people with flu did not see a doctor. By the time they got to the hospital, they were really sick.

> All schools, nurseries, public and private institutions were closed in the capital?

> Yes, that’s correct. Only emergency services could operate. There were no cinemas, no bars, no parties. The president came on TV and told the people to stay home. He meant everyone – rich or poor; imagine, in 24 million-people Mexico City. The Mexican way of life came to a halt; people sitting at home without going to cinemas or to church. The capital city is ruled by the Opposition, but they worked hand-in-hand with President Calderon.

It was about 10pm when the president was told that it was a new virus, after the Canadians confirmed it (on April 23). The moment he knew that, he went on TV and addressed the people. He ordered schools (in Mexico City) to be closed immediately. It was a Thursday of the Holy Week (preceding Easter Sunday) and it was going to be a long weekend.

Some parents were upset, asking what they were going to do with the children at home. When the situation did not improve over the long weekend, the schools were ordered to remain closed for the full week.

> Did the president himself go to work? Where did you operate from?

> The president did not go to office. We did have meetings but they were held outdoors because it is harder for the virus to thrive outdoors. About 10% of the staff at the Foreign Ministry were allowed to work. I went in wearing a mouth mask or I wouldn’t be allowed to enter. Everything inside (buildings) was kept clean, including the elevators. We didn’t kiss or shake hands with anyone. The Health Minister held meetings with the press twice daily as sharing information was vital.

It was complicated because we are a Federal Republic, so not all governments complied as quickly by giving the exact number (of those affected by the virus). In the end, everyone, even the Opposition, put their faith on the central government. Our discipline was amazing. It was a great, positive attitude from the population for everyone’s well-being. There was no paranoia.

> All Mexicans were united? Nobody opposed the measures?

> At the start, there were those who opposed the president’s measures, as business was being affected. And during Cabinet meetings, some ministers disagreed with the president. But President Calderon told them he was not going to take any chances. He kept the schools closed. He wanted this as there was no other way to stop the spread of the virus among children. Mexico is a very polarised society with lots of political parties and opposition towards President Calderon. But everybody supported him on this. The authorities even closed down Congress. The president has no power to do this on his own.

> How long did it take for Mexico to contain the virus?

> It was about a month to a month-and-a-half. I think what Mexico did was very responsible in terms of global health. We took the blow economically but it was the best thing to do. We didn’t hide anything, right from the first case that was detected.

Now we are recovering, and tourism is getting back to normal levels again. We had some cases of discrimination (against Mexican travellers), but not as many as we expected. At this stage, the Mexican Ambassador to Malaysia Jorge Alberto Lozoya interjects: “Malaysia was wonderful. The reaction of both the people and the Government was excellent. We even had the support of the Malaysian government to mobilise (Mexicans) who were stranded in Singapore and Cambodia.”

> Was the supply of medicine adequate? How many million doses of anti-viral were distributed to Mexicans?

> The anti-viral Tamiflu was effective when it was administered to patients on time. We do not have the capacity to develop our own vaccine but we have very good doctors. We only gave the anti-viral to those who were sick and not to everybody, because supply would easily run out otherwise.

> Malaysia is now facing the brunt of the A (H1N1) virus. What was Mexico’s strong prevention strategy?

> We had to be very responsible. All those who were down with the virus were immediately isolated. We followed a very strict protocol, even in our homes. Every time we touched anything, we washed our hands. We used our arms to cover our mouths when we sneezed. We even used our elbows to press the lift buttons. During meetings, we will observe each other and if anyone put their fingers close to their face, we would alert them! I don’t know if it is the same here, but in Mexico, those who died were very young people. It was very strange. We still don’t know why.

There must be a study done to find out. We must also find out where the outbreak began; it was not in Mexico. We (Mexico) believe that it started in the US but we don’t know which region.

> According to the official information, the new virus was first reported in Veracruz, Mexico, on April 11. Are you disputing that?

> It didn’t start in Mexico. They say it is an Asian virus which has been confined several times but there is no point going on about this. What is true is that it didn’t start in the place they said it did. Do you know how many people cross the (US-Mexico) border daily? There is no point in blaming as right now, the virus is everywhere. Even WHO has stopped counting (the number of cases).

> The European media even referred to the influenza as “Mexican flu”. How did you counter that?

> There were about two or three countries, Germany and the Netherlands included. France was trying to suspend flights (to Mexico) but it didn’t happen. Our Ambassador explained the issue to the European Union. Argentina, Peru and Cuba also tried to suspend air links with us. Ignorance is terrible. In some of these countries, they were reacting to domestic issues. In Cuba, the problem was the health system was going down and they told us they couldn’t take the risk. Most of these countries later apologised.

> There was this proposal to close the US-Mexico border.

> It was just what one (US) Senator proposed. We didn’t really have a problem with the US and Canada. In fact, we detected what kind of virus it was first. It also helped to find where the deficiency was in our (Mexican) health system. What is important is that we talk about these issues openly, and not hide anything.

There is no way in such an inter-dependent world anything is going to be kept from each other, good or bad. As the crisis has shown, the solution is not going to be found individually. What Mexico is trying to be is a responsible actor on the world stage. And that’s part of the reason why I have travelled here.

> So there are only a few isolated cases of A(H1N1) cases in Mexico now?

Very few, in the southern part. When I left Mexico, we didn’t have any recent deaths. Our total number of cases is nothing compared to the US or UK. I think what is important is that we will learn from this experience and we are open about it. We have to understand that we live in a global world, when something happens to a country as far away as Mexico, it can affect another.

> What more did Mexico derive from its experience dealing with this new, highly contagious virus which is killing humans?

> We had a very active diplomacy explaining to the world how we were dealing with the crisis. And we sent our scientists and doctors to Spain, France and WHO. We also convened a High-Level Meeting on Learned Lessons from the Influenza A (H1N1) in Cancun in July. An initiative of the Government of Mexico, it was attended by Health Ministers from 40 countries. The objective of the meeting was to analyse the international response to the epidemic. The conference decided that there was a need to review how WHO decreed whether it was a pandemic or not, and that international co-operation was one of the most efficient tools to attend to this kind of disease.

> You’ve been in and out of airports. How did you find the screening of passengers for the flu virus at the KLIA?

> I don’t think what happens in the airport is that important. It is disseminating information and creating awareness. People have to be responsible. If you feel sick, don’t get into a plane. But if you’re healthy there is no reason not to travel. In Mexico, the flu is not an issue anymore. We know that when winter comes, we will have to be more careful. But it is no longer an issue now. We are just dealing with the downturn in tourism. We are investing in a Visit Mexico campaign. There are new promotional packages, for example to Cancun. Prices are really good (smiles). Things are getting back to normal.

> Lastly, how did Mexico mitigate the impact on its economy?

> As you know, we are the 13th largest economy in the world. We took the blow economically and things were complicated but now things are returning to normal. We’ve had a lot of investments from the private sector and the government to get things back on track.

People were not eating pork because it was associated with swine flu at the start. Mexicans are big eaters of pork. Now consumption is back to normal. We are large exporters of pork to Japan and Korea and our exports are back to normal


ini adelah artikel yang sya dapat kongsikan..fahamilah....

bE aWARE H1n1

H1N1, sampai skrg x abes2, sumer duk bercerita, tapi adakah kesedaran dah ada lam rakyat malaysia, bukan nak cer 1 malaysia lah, tgk kat aku pnyer u pon same..sumer duk bimbang, tp apa langkah yang diorg ambil..brape org sgt yg pakai mask???brape org yang jage kebersihan tangan??? kawan-kawan sedarlah bahaya H1N1, dah berapa org dah mati..majoriti org melayu, kesian anak2 yg baru lahir, x sempat nak tgk dunia.sekejap je..Ya Allah Juahlah bencana ini.. ni ade sket fakta2 mengenai H1N1, sapa yg rase konpuse agy korang leh lawat web yg aku nyta kat bawah ni..aku harap ni dapat lah bantu kawan-kawan sumer yg belom tahu ttg H1N1 ni

Virus influenza A (H1N1) adalah virus baru dan semua orang tiada daya ketahanan kepada jangkitan ini. Vaksin bagi melindungi jangkitan juga belum ada. Jika penularan dalam komuniti tidak dikawal dengan baik, penyakit yang mudah menular ini (contangious) akan merebak dengan cepat serta melibatkan kejadian kes-kes yang tinggi atau banyak dan jika keadaan ini tidak terkawal kejadian kes berkomplikasi akan berlaku termasuk kematian.

Sebagaimana yang dilaporkan sebelum ini, untuk membendung wabak pandemik di Malaysia (to slow down the spread), aktiviti kawalan dan pencegahan yang sedia-ada akan diteruskan melalui langkah-langkah pencegahan dan mitigasi. Langkah pencegahan dan mitigasi ini perlu diambil bagi memastikan kes-kes yang berisiko dikenal pasti dan diambil tindakan awal untuk mengelakkan komplikasi. Orang ramai adalah diminta untuk sama-sama mengambil bahagian dalam menangani pandemik ini.

Aktiviti-aktiviti yang sedia ada akan dikaji dari masa ke semasa untuk memastikan pelaksanaan aktiviti kawalan dan pencegahan yang cekap dan berkesan agar penularan kes di Malaysia dapat dikurangkan ke tahap yang minima.

Apa itu Fasa Mitigasi (Peredaan)

Aktiviti mitigasi adalah tindakan membendung wabak pandemik H1N1 di Malaysia dengan memperkukuhkan langkah-langkah pencegahan dan kawalan seperti mengamalkan kebersihan diri, kerap mencuci tangan dan mengamalkan adab batuk yang sesuai.

Strategi utama fasa ini adalah untuk mengurangkan kesengsaraan dan kematian akibat penyakit ini, melambatkan jangkitan penyakit dan mengurangkan kesan terhadap gangguan perkhidmatan utama.

Siapakah yang berisiko tinggi akibat jangkitan Influenza A (H1N1)?

Kanak-kanak berusia kurang 5 tahun

Individu berusia 65 tahun dan ke atas

Kanak-kanak dan remaja (< 18 tahun) yang menggunakan terapi aspirin untuk jangkamasa yang panjang

Wanita mengandung

Dewasa dan kanak-kanak dengan asma, penyakit pernafasan kronik obstruktif, kegagalan organ, penyakit kardiovascular, hepatik, heamatologikal, neurologik, neuromuscular atau masalah metabolik seperti Diabetes Mellitus

Dewasa dan kanak-kanan yang mengalami daya ketahanan yang rendah (immunosuppression)

Individu yang menginap di rumah kebajikan dan institusi penjagaan yang lain

Peranan Masyarakat Semasa Fasa Mitigasi

Masyarakat perlu mengetahui cara virus ini merebak.

Influenza A (H1N1) virus berjangkit dari manusia kepada manusia melalui titisan cecair, (yang dikeluarkan semasa bercakap, batuk atau bersin).

Mana-mana individu yang berhubung rapat (lebih kurang 1 meter) dengan individu yang mengalami gejala selesema (demam, bersin, batuk, hidung berair, menggigil, sakit sendi dan lain-lain adalah berisiko untuk mendapat jangkitan penyakit akibat dari titisan cecair.

Oleh itu, masyarakat perlu mengambil langkah pencegahan berikut:

Amalkan kebersihan diri dan adab batuk yang betul

Amalkan kawalan jangkitan sama ada di rumah, tempat kerja atau pengangkutan awam

Peranan penutup mulut dan hidung (mask) dalam masyarakat

Tiada bukti kukuh mengenai keberkesanan memakai mask di tempat awam. Namun, ia telah digunakan dalam ruang yang sesak/tertutup apabila berhubung dengan individu yang mengalami gejala selesema

Individu boleh memakai penutup mulut dan hidung (surgical mask) di rumah dan di kalangan masyarakat, terutamanya jika mereka berhubung rapat dengan individu yang mengalami gejala influenza, contohnya semasa menjaga ahli keluarga yang sakit.

Penggunaan mask membolehkan individu yang mengalami gejala influenza untuk menutup mulut dan hidung mereka bagi menghalang titisan cecair dari tersebar, salah satu kaedah adab batuk yang betul/baik.

Surgical mask juga disyorkan kepada golongan yang berisiko tinggi apabila berada di kawasan yang sesak.

Pesakit dinasihatkan untuk tinggal di rumah, elakkan berhubung rapat dengan ahli keluarga yang lain serta mengambil langkah kawalan dan pencegahan dari menjangkiti mereka yang menjaga pesakit.

Sekiranya gejala influenza semakin teruk, pesakit hendaklah SEGERA mendapatkan rawatan di hospital.

Sekiranya individu yang tergolong dalam kumpulan yang berisiko tinggi mengalami gejala influenza, segera dapatkan rawatan awal

Elakkan berada di kawasan sesak dan seboleh-bolehnya tangguhkan/ batalkan / kurangkan menghadiri majlis keramaian

Dapatkan maklumat terkini mengenai situasi semasa dari sumber yang boleh dipercayai seperti Kementerian Kesihatan Malaysia dan Pertubuhan Kesihatan Sedunia (WHO)