Everybody’s life or death has been pre-ordained by Allah,” says Caswali, a small-scale farmer who sells chickens in a Jakarta market and was quoted by Indonesian news agency Antara. It’s a sentiment full of portent given the developments of the past year. Indonesia recently made headlines as the country with the highest death toll from avian influenza, also known as bird flu.

 

So far, there have been 52 fatalities in Indonesia attributed to bird flu, and the number is increasing. Cases have been found in 30 of the 33 provinces, making it a national concern. These figures pale in comparison to the number of Indonesians dying from tuberculosis each year: approximately 140,000.

 

But what makes health experts nervous is the possibility that bird flu may mutate into something that easily transmits from human to human. And that’s when a pandemic, akin to the Spanish Flu of 1918, could begin. There have already been cases where patients have contracted bird flu and the possibility of human-to-human transmission cannot be ruled out, according to Dr Georg Petersen, the World HealthOrganization’s Indonesia Country Representative.

 

Avian influenza has many variants and the effect on birds and poultry ranges from ruffled feathers to death within 48 hours. The most virulent and dangerous strain to birds and humans is H5N1. Humans can only contract H5N1 by being in close contact with afflicted birds, their droppings or their remains.

 

Campaigns by the government and aid agencies to educate Indonesians about the potential threats from avian influenza reveal how much rural Indonesia and poultry are tied together. “Indonesia is a nation that likes to have birds around the house,” says Robby Susatyo, Managing Director for Synovate Indonesia. “People even like to have chickens as pets and they are not necessarily seen as a financial investment.”

 

Susatyo says some families will only slaughter their chickens for religious or cultural ceremonies. An estimated 30 million households keep chickens or ducks. Most of these households may have between five and ten chickens.

 

The government’s attempts to educate farmers about the threat of bird flu have not been successful, according to Susatyo, who conducted research for United States Agency for International Development. “Rural people don’t realise that avian influenza is something new. In fact, bird flu isn’t new as there have been bird diseases around for some time. What is new is that this disease can pass to humans,” he says.

 

“Most people, when they look at the communications concerning avian influenza, don’t see a lot of detail. Communications from the government only say ‘watch out for avian influenza’. But they don’t say what the dangers are, what it looks like or what is to be done,” Susatyo says. “This seems odd to people – they are asked to look out for it, but they don’t know what to do.” Even the term “bird flu” can be misleading to small farmers, as “chickens” are not considered “birds” in the Indonesian language.

 

The fact that so many Indonesians keep chickens as pets has inured them to the warnings about bird flu. Some small farmers say chickens have been dying of various diseases for a long time, and that the government has created a hullabaloo without actually doing anything. So while large-scale poultry businesses have had their chickens vaccinated, the backyard chicken ground is the front-line against the spread of bird flu.

 

Two other factors work against bird flu campaigners. First, small-scale farmers usually let their chickens or ducks roam freely. “They don’t keep chickens in cages,” Susatyo says, adding, “if you keep a chicken in a cage, you have to feed it and spend more looking after it – and that can be a significant economic investment.” This is especially true for people who don’t view their chickens as a serious source of income.

 

Government campaigns to have people cage and separate diseased chickens have largely fallen on deaf ears. For many, it doesn’t make economic sense.

 

The second factor is the village mentality that persists. “Many rural people will say, ‘well, no one has died in my village. Chickens have been dying for years but not people, so why do I have to worry about this?’” Susatyo says. He adds that many think that bird flu won’t happen in their village. This attitude is prevalent not just among village dwellers, but also in cities like Jakarta, where residents may regard bird flu as a problem in the countryside.

 

Indonesia’s media has been active on the issue, though not necessarily productive. “On TV, you’ll see people wearing masks and gloves – sensationalist images – and every death that occurs receives a whole lot of media coverage,” Susatyo says.

 

The problem is that this kind of coverage can quickly lead to people dismissing what they see on TV. Susatyo makes the point that while the media is “blasting everyone with stories about how dangerous avian influenza is,” most rural people will simply think, “there’s nothing new with chickens dying – it’s seasonal.”

 

Dr Petersen says that there has been progress by Indonesian officials spreading awareness about avian influenza, but there is “a long way to go”.