Madagascar
Madagascar's poor hit hard by deadly flu

afrol News, 10 August - Around 5,000 people are already infected by two virulent strains of influenza, with a fatality rate of 7.5 percent, on the island, weakened by a recent political crisis. According to officially registered numbers, the flu epidemic has killed 374 people, but real numbers are expected to be higher. 

The World Health Organisation (WHO) has received reports from the Malagasy Ministry of Health, confirming the rapid spread of the flu epidemic and the rapidly rising death toll. The illness was mainly affecting the southern part of the country, WHO reports. One strain is mainly reported from the inland highlands zone of Fianarantsoa. The other strain is reported to spread from the south-western port city of Tuléar. 

The Malagasy Ministry of Health has sent a team to the areas that had collected samples which were sent to the Antananarivo-based Institut Pasteur. The institute established the presence of influenza A (H3N2) viruses in the samples. This virus "causes acute respiratory infection." 

WHO was constantly "monitoring the situation," the UN agency added. 

The Malagasy government now has launched a nationwide awareness campaign, urging citizens to seek urgent medical care should they have flu-like symptoms. Those infected by the virus complained of severe headaches followed by neck and chest aches, and a dry cough, a statement by the Health Ministry said. 

Health services are however very limited in Madagascar, especially in the province of Fianarantsoa, which is the poorest region of the country. Additionally, the region's health and social services had been severely affected by the partly armed conflict earlier this year. Fianarantsoa Province was isolated by road blocks put up by followers of ex-President Didier Ratsiraka, causing the already sparse health infrastructure to collapse. 

Data from WHO and the Malagasy Ministry of Health confirm that the high death toll of the flu epidemic is related to poverty and the collapse of public health services. The majority of those affected by the virus influenza live in poor, isolated, rural communities and they are visibly under-nourished prior to catching the virus.

A WHO representative said samples taken from victims and studied by the Institut Pasteur had indicated that with the lack of primary health care, people in parts of Madagascar may have lost their immunity to flu. The Malagasy government confirms that, in many rural parts of the island, the political crisis had caused over half of the staff at health centres to abandon their post as living conditions became too harsh. 

While the political situation un Madagascar has stabilised over the last month, the damages made by the 7-month conflict are still felt. The infrastructure - included roads and blown up bridges - still needs to be rebuilt, and most rural health centres are still without basic medicines and staff. 

Further, GDP and government revenues have fallen significantly as a result of the crisis, making a quick recovery impossible. Madagascar was among the world's ten poorest countries even before the political crisis earlier this year. 

Sources: WHO, press reports and afrol archives 

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