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Tuesday, November 10, 2009

Swine flu panic - and politics - hit Ukraine

The H1N1 outbreak has led Ukrainian officials to accuse each other of inappropriate responses.

By David L. Stern - GlobalPost

Published: November 10, 2009 06:46 ET

KIEV, Ukraine — It was perhaps inevitable, given Ukraine’s hyper-politicized climate — heightened by a partisan, mudslinging presidential race — that the H1N1 pandemic would become the biggest political football of all.

Ukraine is gripped by a swine flu panic, as an outbreak of acute respiratory illness has swept the country. So far, more than 750,000 people have been infected, and on Friday, 109 were said to have died. Officials from the World Health Organization (WHO) say that they believe the majority of cases to be H1N1.

“There is no question that this is a rapidly involving illness,” said Jukka Pukkila, team leader for the WHO international expert team that arrived this week in Ukraine at the government’s request.

“We have all reason to believe that this is a spreading of the H1N1 illness,” he continued, adding that laboratories in the United Kingdom and Ukraine confirmed the presence of the disease.

The Ukrainian government has undertaken some of the most extreme steps in Europe to contain the contagion. Last week, officials closed schools and universities for three weeks, and banned large political demonstrations. (Elsewhere last week, others from high-risk groups lined up around city blocks in Canada to receive swine flu vaccinations, only to be boxed out by members from two professional hockey teams who received preferential treatment.)

In the capital Kiev, where only two have died so far, many wear face masks and restaurants and cafes have seen a dip in business. But movie theaters and swimming pools remain open, and while many individuals are concerned, panic has not erupted.

The situation is much worse in the country’s west, especially in Lviv near the Polish border, where the outbreak is centered. There, some 45 people have died so far and officials have urged cinemas, restaurants and other public institutions to close for the near future.

No sooner had the government announced its containment measures, however, than the pandemic became a way for the country’s politicians to beat each other up or score points.

Prime Minister Yulia Tymoshenko, who is running second at this point in the Jan. 17 presidential elections, made a public show of meeting — in a surgical mask — deliveries of the anti-flu medication Tamiflu at the Kiev and Lviv airports.

Others called this show-boating. “Ukrainian authorities are using the hysteria over the flu outbreak to distract citizens’ attention from the country’s economic and social problems,” said presidential candidate Sergey Tigipko, a former member of Tymoshenko’s team who is now running against her. “Flu is a serious threat, but in Ukraine they have contrived to turn it into a political tool used to distract public attention from real problems.”

President Viktor Yushchenko announced that he was asking the country’s prosecutor to launch an investigation into “criminal negligence” by Tymoshenko, front runner Viktor Yanukovich and former parliament speaker Volodymyr Lytvyn for holding mass rallies to launch their campaigns, just as the pandemic was breaking out.

“The parliament speaker and the leader of the opposition and, most importantly, the prime minister, ignored the facts of the epidemics,” Yushchenko said on national television.

“This is completely similar to the May Day rallies in Kiev after the Chernobyl disaster,” he said, referring to the mass demonstrations held by communist authorities in 1986, just after the world’s worst nuclear accident had taken place.

On Friday, one of Yushchenko’s close advisors suggested that the presidential elections could be delayed until May because of what he said was the Tymoshenko government’s mismanagement of the crisis.

Ihor Popov, deputy head of Yushchenko’s secretariat, wrote on the Ukrainskaya Pravda website that if conditions worsen, a state of emergency could be introduced. That would push back the election date since it would keep candidates from campaigning fully.

WHO officials actually praise the Kiev government’s reaction, however. Pukkila said that although his delegation’s main goal was not to deliver a verdict on the appropriateness of the Ukrainian response — WHO intends simply to assess the nature of the outbreak — he found the official measures “in line with the situation.”

There is a risk nonetheless that the outbreak will become much worse. Though the number of deaths in Ukraine is lower than in other parts of the world, health officials are concerned at the speed at which the illness is spreading, and the possibility that Ukraine may be experiencing a new strain.

More worrisome is the pressure that H1N1 will place on the country’s medical system, beset with corruption, inefficiency and Soviet-era practices. So far authorities in Lviv seem to be able to cope with the added demand, WHO officials say — hospitals have the necessary supplies and there is no shortage of beds.

But Ukraine has the first major H1N1 outbreak in an eastern European country. As it spreads eastward through the former Soviet Union, medical systems in Russia, the Caucasus and Central Asia — not known for their efficiency or high-standards — will come under similar stress.

“How does the virus behave in a country like Ukraine with a health system with low resources, and how does this system cope? This is what we’re watching,” said Pukkila.


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