The Fatal Strain

newspapers, including Thanh Nien, were state-controlled, reporters had increasing latitude to dig into corruption, from crooked traffic cops to soccer referees fixing matches. Duc Trung and Hoai Nam had been tipped by sources that the government’s effort to keep sick poultry out of Ho Chi Minh City was a sham.

The pair headed to a livestock market near the city’s edge. There they asked around until they found a veteran chicken hawker who could tutor them on the poultry business. The merchant coached them on how to behave, what to wear, and what to say. They bought their cheap disguises and borrowed a cage for hauling chickens.

In the hours before dawn, in a teeming quarter of the city, they approached the Manh Thang slaughterhouse, cited months earlier by the city for health violations. Barefoot, like other retailers, they entered the building. It was chaos, chickens screeching, traders shouting over the roar of the plucking machine. “It was risky for us,” Duc Trung recalled. “The people at the market and the people at the slaughterhouse would threaten us if they knew what we were doing. And we were exposed to all those chickens and their virus.”

On a table, they spied two baskets stacked with health certificates, called quarantine papers, which were already stamped and signed. A staff veterinarian told the reporters they could buy the papers for just twenty cents. There was no need to examine their chickens. The document would allow them to claim their birds were free of disease, and it could be used over and over. Four more nights, the pair returned to the slaughterhouse. Each time, the reporters obtained government-issued certificates without any question.

They also turned their lenses on three of the city’s main roadside inspection stations, this time using a video camera concealed inside a plastic bag. The stations were little more than shacks erected along the highways entering the city. The infection had been widespread in the surrounding countryside. At each post, inspectors were to check that truckers hauling live animals had health certificates for all their livestock and that the number of animals matched the figure on the license.

But the reporters discovered that officials were at best taking a cursory glance at the paperwork, never inspecting the trucks themselves. “At least they should check the papers thoroughly,” Duc Trung said. “But whenever we observed them, the inspection activities were so neglectful.” At the post on the Hanoi highway, the reporters found that the officer serving on the front line of defense for the city, and potentially for the world beyond, was actually asleep in the yard behind the station.

Their revelations hit the streets under the headline, QUARANTINE PAPERS ARE SOLD LIKE VEGETABLES! Immediately, the owner of the slaughterhouse stormed into the newspaper’s offices, demanding a meeting with the reporters and their editor. He was furious and menacing. “We showed him our evidence,” Duc Trung recounted. “We know we’ll be threatened when we start an investigation and we’re ready to face the threats.”

Thanh Nien’s findings were also publicly challenged by the city’s veterinary agency. But members of the People’s Council, essentially the city council, were troubled enough by what they read that they ordered officials to look into the reported irregularities. The article had concluded ominously: “Facing the risk that bird flu might break out, the authorities of this crowded city should have the feeling they were sitting on fire. But according to how the work of inspections is carried out, the prospect of bird flu breaking out is unavoidable.”

At almost the very moment the virus had struck the farms of northern Vietnam in the middle of 2003, Indonesian chickens began to die two thousand miles to the south. And Indonesian officials, like their counterparts in Vietnam, would wait half a year to confirm the arrival of the virus. That delay allowed the scourge to spread to nearly one-third of Indonesia’s provinces without any official resistance and become entrenched. Human deaths were only a matter of time.

The Indonesian virus, like that in Vietnam, had its origin in China. But while scientists traced the Vietnamese subtype of H5N1 directly back to China’s southern province of Yunnan, the provenance of the Indonesian strain was Hunan province, farther to the east.

At first Indonesian poultry experts were stumped by the abrupt die-off of nearly ten thousand chickens at a commercial farm in Pekalongan, a town in Central Java known mostly for making batik. Soon after, another outbreak burned through a poultry farm hundreds of miles away in a suburb of Jakarta. The National Commission for Eradicating Poultry Disease was divided over whether the cause was bird flu or a less virulent ailment, Newcastle disease. So they called in Chairul A. Nidom, an Indonesian microbiologist at Airlannga University.

Nidom reported that the carcasses showed unmistakable signs of avian flu. Their combs had gone blue, their legs tattooed with red stripes. Those suspicions were reinforced by the separate findings of a pathologist, who cut open a stricken bird soon after the initial outbreak and discovered abnormal brain tissue consistent with bird flu. Within two months, Nidom’s lab research determined it was indeed that virus and moreover a strain genetically related to the H5N1 pathogen identified in southern China seven years earlier. He urged an aggressive response. “When the outbreak began in Pekalongan, if the government had acted to stamp it out and closed the case and did it properly, it would not be going like now. It would be finished,” Nidom told me about two years later as the virus continued to rage.

But the country’s poultry industry blocked the disclosure. Indonesia’s national director of animal health later said that poultry company owners, who had personal ties to senior agriculture ministry officials, had insisted that any containment efforts be pursued in secret. Eight farming conglomerates in Indonesia account for 60 percent of the country’s poultry, and they feared the publicity would harm sales. The owners even lobbied Indonesia’s president, Megawati Sukarnoputri. “They said, ‘It’s better to do it with confidentiality. Do a hidden, silent operation,’ ” recounted Tri Satya Putri Naipospos, Indonesia’s animal health director at the time. “I said, ‘It won’t work if you do a silent operation. This is a disease that can’t be hidden. It’s too risky.’ ”

Yet through January 2004, the government maintained the deception. To allay growing suspicions, the agriculture minister and several of his lieutenants summoned the media and feasted on chicken satay. “As of now, there are no findings in the field that can confirm the spread of the disease in Indonesia,” insisted the director of animal husbandry in an interview with the Republika newspaper. “For the moment we are still free from bird flu.”

The very day that interview was published, Nidom broke ranks and announced his findings to the competing Kompas newspaper. He said 10 million chickens had succumbed to the disease over the previous three months. He said he had forwarded at least a hundred samples from infected birds to the central government as proof.

A day later, the agriculture ministry publicly confirmed the outbreak. But already the disease had spread across Java and on to the islands of Bali, Borneo, and Sumatra. The plague was bleeding from the commercial sector into backyard holdings, infecting tens of millions of free-range chickens that had been left unprotected. “It was too late. The virus was everywhere,” Nidom recalled.

Though scientists concluded that the virus had been introduced into Indonesia on only a single occasion, the disease would go on to infect at least thirty-one of the country’s thirty-three provinces, transmitted by the trade in poultry and poultry products. The virus would eventually leap to people, and by the end of 2005, Indonesia was registering more human cases than any other country. WHO and other international agencies would grow ever more exasperated with Indonesia’s continuing negligence. “It is important for the Indonesian government, in its interest and the interest of the international community, to take the necessary political decision” to tackle the virus, urged Bernard Vallat, head of the World Organization for Animal Health, in comments he would make nearly three years after the outbreak started. “Indonesia is a time-bomb for the region.” He could have added, “for the world.”

As soon as Nidom went to the media with his findings, the national poultry commission fired him from his advisory post. But he continued to press. Nidom grew increasingly nervous about the prospect of the epidemic spreading to people in Indonesia, a country with an impoverished health-care system and the largest population in the region. He arranged a conference in late 2004 at his university to discuss the disease, inviting four of the world’s premier influenza researchers, from the United States, Japan, Hong Kong, and mainland China. Yet shortly before its scheduled date, he told me, a senior agriculture official contacted the head of Nidom’s institute and ordered that foreign participants be barred. Officials threatened to have police break up the conference if it went ahead as planned. Nidom canceled the program altogether.

The Indonesian government also turned its ire on foreigners, including WHO staff, who spoke out of turn. The agency’s team leader for avian flu in Indonesia told the media in 2006 that human cases would continue as long as the disease was circulating widely among birds. This was not only WHO’s official position but basic science. But the government subsequently expelled him from the country. Though the health ministry never supplied a formal