reached a grim milestone recently, recording its 43rd human death from bird flu, the highest fatality figure in the world. Health Minister Siti Fadilah Supari spoke with Jakarta Post's Tubagus Arie Rukmantara about the government's efforts to contain the H5N1 virus.

Question: recently recorded its 43rd human death from bird flu, which is the highest number in the world. What does this number mean to you?

Answer: I have to explain this carefully. Yes, we are the highest in the world in terms of total number of bird flu human fatalities. But, if you view it from the perspective of population, it is because we have 220 million people living across 17,000 islands. Meanwhile, has only about 80 million people with fewer geographical barriers than us. The situation of the two countries is incomparable.

Nevertheless, we will not play it down. We are very concerned. Losing even one single life means a lot to us.

The real question is -- why have so many people here gotten infected? We have to understand that the spread of bird flu accelerates in dense populations, both human and poultry. The problem is, in the highest density poultry populations are found in backyard farms. And in backyard farms, many people are unaware of the importance of sanitation for the birds' cages and their surroundings.

Many people just don't care about the importance of wearing gloves or personal protective equipment whenever they have contact with their birds, making them very much vulnerable to various health problems.

Q: The government has been campaigning against bird flu, so why are so many people still unaware of the threat posed by bird flu?

A: The fact is many regions are bird flu-free. That has made many people just ignore the problem. If you go to Tanah Karo, North Sumatra , most people think there is nothing to worry about with bird flu, although the region has recorded seven bird flu deaths from one family cluster, the largest cluster in the world. Nobody there is willing to undergo tests, they won't even let their chickens be tested. Fortunately, there have been no more outbreaks there.

The present situation is not favorable. There are no systematic programs to stamp out bird flu. Our vaccination and disinfectant spraying campaigns have not had a significant impact. Such a situation might tempt people to feel they don't have to worry about bird flu. So, it is obvious that we have to improve our public campaign against bird flu.

Q: How has the international community reacted to the situation here?

A: The world community has criticized us for failing to address the issue of infected poultry. They do not criticize how we treat human patients. They can't say we have failed to cure patients, because there's no cure available. They worry about how we deal with the problem of sick chickens. The international community wants us to introduce mass culling of fowls, which is simply not feasible. In , for example, poultry culling succeeded in containing the spread of the virus. But the public there accepted the policy and participated in the program, although it was not clear whether the government would compensate the farmers for their losses.

In , the country has regularly culled sick birds, but the program is considered ineffective because the virus cannot be completely eliminated. And now, they are mobilizing thousands of students to conduct a bird flu campaign in villages.

The two countries have succeeded in implementing such strategies partly because of their geographical conditions and partly because of people's awareness of the problem.

Q: The WHO says that there has been limited human-to-human transmission of bird flu in , but you consistently deny this. Why?

A: All the data and samples of cases occurring here are kept by us. We haven't shared them with other institutions because we are still conducting our research. After studying samples taken from 56 patients, including those from the Karo cluster, we believe there has been no mutation in the virus.

Those who say there have been human-to-human transmissions are epidemiologists, because when they see the virus infect a group of people they take that to mean transmission has occurred.

I myself still believe that the virus has not mutated, because all the samples show the virus comes from chickens, not from some other sources.

Q: What is your office doing to prevent more deaths?

A: Because the key is public awareness and prevention, we will work together with organizations such as Muhammadiyah and Nahdlatul Ulama, to increase people's awareness of sanitation and health matters. We will ask them to spray their backyards with disinfectant, have their chickens vaccinated and wash their hands frequently, which has proven to be the most efficient and effective way to stop the virus

Indonesian vets, sleuth-like, comb the countryside for infected poultry

In a more positive note, Margie Mason reports for the Associated Press as follows:

, the world's latest hot spot for bird flu, appears to be taking steps at last to beat back the spread of the disease in its poultry flocks.

In just six months, teams of veterinarians marching along dusty, twisting paths in the remote villages of this sprawling country have uncovered more flu outbreaks among birds than experts had even imagined.

"It's still just the tip of the iceberg," said Jeff Mariner, an animal health expert from Tufts University who has been working with the effort since it began in January. This new, but still limited, cooperation through a pilot project has somewhat heartened world health officials who have watched with dread as Indonesia's human bird flu cases quietly mounted while the government did little.

With 42 deaths since July 2005, is now tied with as the world's hardest-hit country in human avian flu deaths. However, has had no bird flu deaths since last year.

's new effort to gain control of the disease has dozens of veterinarians and other health workers doing detective work - going door-to-door to uncover hidden outbreaks in poultry flocks. They've found about 90 so far and look for key tip-offs.

When it comes to sleuthing out bird flu, (vets like) Aprianti, 27, and Dewi, 31, have the skills of a Sherlock Holmes. They carry out five-minute tests on sick or dead birds. If the H5N1 virus is found, they notify a response team that helps with slaughtering and vaccinating.

Eventually, hundreds of similar detectives will form community-based surveillance and response teams. The project is a cooperative one between 's government and the U.N. Food and Agriculture Organization.

The task is mind-boggling in an archipelago that roughly stretches the width of the , with 220 million people and billions of backyard chickens. Health workers hope to reach a third of 's nearly 450 districts by next spring.

grabbed world attention in May when seven of eight infected members of a single family died. The World Health Organization concluded that limited human-to-human transmission was likely to blame, but the virus did not spread beyond the blood family members - the world's largest cluster.

Experts fear the virus will mutate into a form that spreads easily among people, potentially sparking a global pandemic. So far, at least 134 people have died worldwide since the disease began spreading in Asia in late 2003. (WHO officials later reconfirmed that despite the cluster, the H5N1) flu virus has not yet mutated to human-to-human infection – ed.)

Most human cases have been linked to contact with infected birds.

"We have to control it in animals because the transmission is not human-to-human," says Dr. Douglas Klaucke, of the U.S. Centers for Disease Control and Prevention, who recently met with Aprianti and Dewi's surveillance team. "The transmission is coming from the animals."

While 's mass poultry slaughter helped nip the threat there, circumstances are very different in . While communist has a strong centralized government, the power to fight bird flu in lies largely at local levels. Jakarta 's recommendations mean little unless community officials are on board.

The surveillance and response teams are a way to reach those leaders, by empowering local veterinarians to work directly with backyard farmers. "This is presently the best option because it can detect that our reporting is very weak," said Elly Sudiana, who oversees the program for the Ministry of Agriculture. "So, through this ... early detection can be improved and response can be improved."

So far, the program has received more than $8 million from international donors, but FAO has said it needs at least $50 million for a nationwide system.

"It's making a huge difference," said Lisa M. Kramer of the U.S. Agency for International Development. "It's a great way to get information out for prevention and a great way to understand how disease is moving through communities and a great way to control it and to contain it."

Government Culls Poultry in the Karo Highlands of North Sumatra

In the latest development, the ’s Trade and Investment News published by the Coordinating Ministry of Economic Affairs filed the following update in ’s fight against Bird Flu, both in poultry as well as in humans:

Animal husbandry officials launched a raid on poultry infected with bird flu on Tuesday (25/7/06) in the Karo area of North Sumatra , killing hundreds of birds in an area where residents had earlier defied attempts to cull flocks.

By Wednesday afternoon, 1,890 birds had been culled by a task force backed by military and police. The carcasses were burned.

The raid occurred in the same area from which eight members of a single family were infected by the virus, with only one surviving. Another member of the family was buried before samples could be taken for testing.

Officials said three birds in the area tested positive for bird flu at 6 PM on Tuesday, with the raid to cull the birds beginning only three hours later.

(Sources:  the Jakarta Post,  Associated Press and ’s Trade and Investment News))