On Tuesday, May 30, 2006, the Center for the Study of Community Epidemics (UPLEK) convened a round-table discussion including representatives of Bali's Agricultural Service, Health Department, Quarantine Department, veterinarian corps, the faculty of animal husbandry and Veterinarian Science at Bali's Udayana University, and local poultry producers.
In the free-roaming discussion that followed, the four main issues were identified in Bali's struggle to deal with the threat of Avian influenza or bird flu:
Controlling the Smuggling of Poultry into Bali
The discussions were led and moderated by one of Bali's leading experts in epidemiology, Professor Dr. A.A. Gde Muninjaya, MPH.
The participants in the forum identified a number of factors stimulating the illegal smuggling of poultry into Bali, including:
(A) The price differential of between Rp. 20,000 Rp. 25,000 (approximately US$2.12 US$2.65) per duck between Bali and East Java.
(B) Heavy demand from the people of Bali for poultry, such as free-range chickens and domesticated ducks, to meet ritual requirements for local celebrations. Meanwhile, current demands for cut poultry and eggs are being satisfied by local producers in Bali.
(C) New modes of smuggling poultry into Bali that circumvent controls in place at main ports, such as Gilimanuk and Padang Bai, together with sophisticated means of hiding poultry on trucks traveling into Bali.
(D) When smugglers are captured, the power of the police to hold the perpetrators in custody is restricted, with interference in the process by outside unnamed parties from Bali and Java.
(E) Difficulties in handling evidence in smuggling cases, with rules dictating that "evidence" cannot be destroyed prior to a final court decision creating procedural problems for the authorities.
(E) Limitations in the number of officers assigned in the field and a similar lack of support funding.
(F) The lack of defined procedures for control officers in the field assigned to prevent poultry smuggling.
(G) The extensive length of Bali's shorelines, making perfect supervision of smuggling of poultry onto the Island by boat extremely problematic.
The Role of the Governor's Special Team for Combating, Preventing and Controlling the Spread of Avian Influenza (P4AI)
Those attending the conference concluded :
A) Generally, the Government is failing in its responsibility to handle the problem of Bird Flu.
(B) The P4AI, appointed by Bali's Governor in 2005, is considered to be unrepresentative both in form and content to meet the demands of controlling the spread of bird flu in Bali. The policies of Bali's Government are insufficient in reaching the grass-root elements in the community needed to make such a program successful.
(C) The P4AI team is failing to establish synergy of action with various agencies in the efforts to prevent the spread of bird flu. Attention and focus on the regency and city level is still weak and fails to optimize their roles in the battle.
(D) A lack of intensity in education of the people in traditional villages and those involved in poultry production.
(E) The P4AI Team has failed to become the motor driving forums communicating the need and means to control bird flu in Bali.
Surveillance and Quarantine Issues
The forum concluded :
(A) Statements by Balinese officials that Bali is free of bird flu are not strictly correct and need to be clarified. Like other areas in Indonesia, Bali has the potential for the spread of bird flu although no human infections in Bali have been thus far detected. Surveillance efforts by the Veterinarian Department of Udayana University have discovered the bird flu virus in local populations of birds and duck. These results have suggested that local duck populations may play an insidious role as Trojan horses for a a more wide-spread contamination in Bali.
(B) Surveillance efforts to observe the infectious opportunities for bird flu in Bali are considered sufficient, but sctual implementation of measures in the field are lacking order and proper planning.
(C) Surveillance effort in Bali to date have been limited to efforts to prevent poultry smuggling and have yet to be intensively introduced for traditional markets and for pet populations of poultry kept by the Balinese.
(D) The capacity of quarantine facilities in Bali are very limited. Funds need to be urgently put in hand to increase these facilities.
(E) In order to anticipate the spread of bird flu among Bali's human population, sero-testing must be expanded beyond the 180 people tested to date. Target populations susceptible to infection must be identified and tested.
Role of Mass Media
The forum concluded that news coverage of bird flu in Bali remains unclear and incomplete. Current Reports on bird flu in the print media are generally only adding to public confusion and disinformation.
The participants at the round table discussion called for greater attention to be paid to the problem of bird flu in Bali in order to preserve the Island's reputation as an international tourism destination, protect the human animal population, and meet the demand of poultry for local ritualistic ceremonies.
In order to continue and improve efforts to control the spread of bird flu in Bali, the following recommendations were put forth:
Controlling Smuggling of Animals and Poultry into Bali
(A) One alternative to be considered is to open Bali to the importation of poultry but with standard quarantine inspections to ensure that no infected poultry affected by the H5N1 virus are allowed entrance to the Island. Inspection stations, both in originating ports outside Bali and at Bali's air and sea ports should be developed and improved in terms of facilities, quality of manpower and funds available for their operation.
(B) The other alternative is to continue with the current program to prevent the importation of poultry to Bali. If this alternative remains the status quo then the legal aspects of how to handle those involved in smuggling must be discussed to ensure a just, consistent and non-discriminatory application of the rules apply; local communities must be involved in improving the work of field officials assigned to prevent smuggling; the government must undertake an intensive, consistent and ongoing socialization of information to the general public on the prevention of the spread of bird flu; and those assigned to handle the prevention of the spread of bird flu in the field must be equipped with clear and well-formulated standard operating procedures.
Upgrading the P4AI Team
The following recommendations were put forth :
(A) The Governor decision (No. 384/03-J/HK/2005) establishing the P4AI team must be reviewed. The team assigned this task must include all affected stakeholders to ensure a synergetic and effective team is in place.
(b) The P4AI team must be funded to include operating funds with provisions made for a secretariat.
(C) Local lobbying efforts must be undertaken to obtain a share of the provincial budget for the prevention of the spread of bird flu in order to create public information and educational materials.
(D) The P4AI team should establish a communication forum to meet once every three months to discuss the prevention of bird flu.
In order to enhance surveillance, the forum recommends :
(A) Ongoing studies on poultry in Bali must be undertaken to know the current sixe of poultry and wild fowl populations and projected consumer demand for poultry products.
(B) Surveillance must be intensified to include
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