When Prathum Buaklee dropped out of fourth grade to plant rice like his father and grandfather, he could not envision the revolution that would roll across the wetlands of central Thailand, lifting his family out of destitution and ultimately sending his own sons on to university in Bangkok. The royal capital, though only seventy-five miles southeast of Prathum’s village of Banglane, seemed like another continent in the 1950s. Those sons of Suphan Buri province fortunate enough to escape its hardships first had to find their way to the Tha Cheen River, which slices through the swampy, low-lying plain. Roads were few, little more than muddy tracks rutted by the wheels of cattle carts. So local journeys were often made in wooden rowboats that glided through weedy marshes and along a labyrinth of canals skirting the glistening emerald paddies. Once the travelers reached the river, they would hitch rides on the lumbering, two-story rice barges that hauled the province’s harvest southward. Departing after the worst of the midday heat, they would arrive in Bangkok at dawn the next morning.
Nearly everyone who remained behind grew rice. It was a hard life, long days under the searing, tropical sun, and the rewards were modest. “It wasn’t enough. Just barely enough to make a living,” Prathum recalled, a deep furrow cutting across his broad forehead like freshly tilled earth. He erected a small, traditional house, a leaky hovel of clapboard and corrugated metal on stilts, and bought himself a bullock cart.
At first, change came slowly to Suphan Buri. In the drier, upland area to the north and west of the province, villagers started cutting down the bamboo forest in the mid-1960s and planting sugar cane. Day by day, the jungle shrank until the cane fields eventually nestled against the base of the mountains. Long-distance bus service was introduced, putting Bangkok only four hours away along a rocky, bone-jarring road.
Then, two decades later, chicken made its debut. A pair of Thai poultry companies, including the Charoen Pokphand enterprise that would ultimately become the country’s premier multinational corporation, came to Suphan Buri, urging rice farmers to raise chicken instead. The companies offered them chicks, feed, and guaranteed prices for mature broilers. Some of this activity was driven by Thailand’s campaign to boost poultry exports. But far more profound changes were also at work. The kingdom had embarked on an ambitious course of economic development, tapping its wealth of natural resources, cheap labor, and open investment climate to become a low-cost manufacturing dynamo. As its shirts, shoes, and consumer electronics crowded American and European shelves, Thailand staked a claim as one of the new Asian tiger economies, recording annual growth rates of nearly 10 percent. This translated into rising incomes for many Thais, especially in the cities, and the new, burgeoning middle class had new, urban tastes. They demanded a better diet, in particular one rich in animal protein. Nowhere was this truer than in the boomtown of Bangkok.
Suphan Buri was strategically located to meet this demand. In the late 1970s, the government had built a paved road linking the province to the capital. Now the Bangkok market was barely two hours away. Many peasants took advantage of cheap land prices to expand their holdings and establish chicken farms. By 1987, Thais had doubled the average amount of chicken they ate. Yet production across the country was growing so fast that prices actually declined, making chicken an even cheaper source of protein than fish or pork and fueling demand further. The consumption of chicken would soon double again. But the new middle class yearned for variety, and that also meant soaring demand for eggs.
Even as Prathum continued to toil in the rice fields, fellow villagers in Banglane were starting to experiment with hen farms. In 1991 Prathum followed suit. He began with three hundred laying hens, soon adding several hundred more. When his flock grew into the thousands, he abandoned the paddies altogether.
“I never imagined the changes when I started out,” he told me, chuckling softly, creases deepening at the corners of his eyes. He spoke with the exaggerated inflection of a Suphan Buri native. Even today, this distinct accent marks people from the province as something of country bumpkins, at least in the reckoning of their cosmopolitan Bangkok cousins. But they’re hardly poor yokels. Prathum eventually bought twenty acres of land, more than tripling the size of his holdings, and erected seven open-sided sheds, each stretching about forty yards under pitched metal roofs. His flock reached fifteen thousand birds. And with average Thai consumption of eggs doubling in just a decade, Prathum’s hens were indeed laying gold. “We got a better income so we could do whatever we wanted,” he continued, gently shaking his head with wonder and then bowing it slightly to acknowledge the good fortune. “I feel grateful to the chickens. Chickens are like human beings. You take care of them and they’ll take care of you.”
Three years after he started chicken farming, this broad-shouldered peasant who had once been unable to afford even a motorbike bought a used Ford pickup. A few years later, after the increasingly prosperous village put in paved roads, he added a second, a new one. He knocked down his old shack, replacing it with an airy wood-frame dwelling three times as large. He furnished it with a refrigerator, color television, and air-conditioning. To give his teenage daughter privacy, he later built her a separate room, her territory marked by a Britney Spears poster on the outside of the door. He then went on to construct a second house, a retreat on the edge of some neighboring paddies, and started taking vacations with his family, renting a van twice a year and driving to the mountains of northwestern Thailand. For each of his three children, he bought a new computer. One son went on to study veterinary science at the university in Bangkok; the other, computer engineering.
But then, a dozen years after he answered their calling, chickens changed his life again. On a warm December morning in 2003, truck-loads of livestock officers swept into Banglane. It was no surprise. Prathum knew that flu had broken out in a neighbor’s poultry shed just beyond a nearby canal.
In less than a generation, a livestock revolution had brought unthinkable wealth to dirt-poor peasants, not just in Thailand but across much of East Asia, and dramatically enhanced the diets of tens of millions of people. But now this fundamental transformation of Asian farming was posing a threat unprecedented in the history of human economy. By packing together so many birds, often in close quarters with people, pigs, and other livestock, farmers like Prathum have created ideal conditions for a flu pandemic. The sheer number of birds has opened the door for the disease to take hold. The proximity of other creatures heightens the chance it will jump species, swap genes, and mutate. Cramped together, these flocks are dry tinder awaiting a conflagration that could race across farms, provinces, and national borders, burning through the unrivaled concentrations of humanity in their midst.
This far-reaching economic change is but one of the factors making East Asia so treacherous for those struggling to avert a pandemic. The same forces of globalization that birthed the Asian tiger economies can now speed the flu virus around the globe within a day. Traditional Asian practices, from cockfighting to live poultry markets, have acquired a sinister cast, defying efforts by WHO and its allies to reform them before they seed a pandemic. Confronted with these hostile realities on the Asian terrain, the world would hope for a demonstration of political will equal to the threat. Instead Asian governments have repeatedly hushed up their outbreaks until death’s reach caught them in the lie.
When the livestock officers descended on Prathum’s farm, he tried to turn them back. He vowed his hens were healthy. But he realized the battle was lost.
“Everyone has to abide by the government’s decision,” a senior officer urged him. “Go with the flow.”
Prathum shuffled through the sheds, counting his birds so he could apply for compensation.
“Where do you want us to dig the hole?” the officer asked.
Prathum motioned to the edge of his property and left. He couldn’t watch.
Since animals were first domesticated ten thousand years ago, they have promised humans a richer, fuller life but all too often delivered death. As scientist Jared Diamond notes, the peoples who first drew animals into their daily lives were the first to fall sick, infected by germs descended from those afflicting their livestock. Though these pioneers later developed a measure of immunity, mankind has continued to be ravaged by such offspring diseases. Many of the most prodigious killers of the modern era, including measles, tuberculosis, smallpox, and, of course, flu, have evolved from animal pathogens.
The majority of illnesses that now strike humans are cross-species zoonotic diseases. Of the 1,415 human pathogens that have been catalogued, about 60 percent also cause disease in animals. These microbes can hopscotch among species and mutate along the way, acquiring new, more lethal characteristics. An even higher proportion of previously unknown human diseases, about three-quarters, originate in animals. These maladies include recent arrivals like SARS, which passed from infected civets in China to humans before spreading to thirty countries in 2003, and West Nile Virus, which first appeared in the Western Hemisphere in 1999, before going on within a decade to sicken people across much of the United States and become endemic in the country’s wild birds. Indeed, the emergence of new, zoonotic diseases has ominously accelerated since the 1970s. “Similar to the time of animal domestication, which triggered the first zoonoses era a number of millennia ago, a group of factors and driving forces have created a special environment responsible for the dramatic upsurge of zoonoses today,” writes the National Academy of Science.
Chief among these causes is development, which is extending human settlement into new habitats and bringing people into contact with animals as never before. In late 1998 a mystery illness erupted in the Malaysian district of Nipah, infecting 265 people and killing more than 100. While local health officials initially identified the disease as encephalitis because it often caused inflammation of the brain, investigators later concluded it was an entirely new pathogen. They discovered that the virus was carried by fruit bats, which gathered in trees on newly developed pig farms. The bats infected the pigs and the pigs infected the farmers. To break this chain, 1.2 million pigs were ultimately slaughtered.
But the classic example of the unintended consequences of progress is not a new one: bubonic plague. Some scholars have posited that the opening of trade routes between China and Europe in the Middle Ages was responsible for conveying the Black Death from its source in Asia’s Gobi Desert to its killing fields in the West. The plague bacterium had found itself a permanent home in the burrowing rodents of the Asian steppe. Marco Polo himself had remarked on the great number of what he called “Pharoah’s rats” that he encountered in the Gobi Desert. Caravans of the mid-fourteenth century snaked through their habitat, steadily carrying infected rats and fleas onward toward the Crimea and Europe’s doorstep.
Some researchers have contested this account, saying evidence of plague in China centuries ago is thin. But another recent pandemic makes an even more convincing case for the fateful relationship between progress and plague and for East Asia’s starring role in this drama. In the late eighteenth century, plague erupted in southern China, not far from the Burmese border. During the preceding decades, hundreds of thousands of migrants had streamed into a largely undeveloped corner of Yunnan province, lured by a boom in copper mining. This explosive growth transformed the area from a rural hinterland into an increasingly urban outpost and exposed the miners, merchants, transporters, and various other fortune hunters, laborers, and camp followers to plague bacteria long harbored by local mice and voles. Caravan trade in copper, as well as other minerals, salt, cotton, tea, and grain, dispersed the disease around the province. With the acceleration of long-distance trade in opium grown in Yunnan, plague spilled beyond the provincial borders. This lucrative commerce carried the epidemic inexorably eastward, by land, river, and sea, past the border regions north of Vietnam until the Pearl River delta and Hong Kong fell prey in the last decade of the nineteenth century.
When the epidemic came ashore in the spring of 1894, it ravaged Hong Kong. Corpses were left abandoned in the streets of the British colony. Stores and houses were shuttered, draining the once teeming quarters of life but for the English infantry. The soldiers went from home to Chinese home in search of the sick and dead, forcibly disinfecting furniture, sheets, and kitchenware and carrying off the ailing to a great ghostly ship, the Hygeia, moored three hundred yards off the waterfront. “Little wonder, then, that this malevolent-looking hulk, pressed into service at the start of May 1894 as a floating plague hospital, should have become an object of terror,” recounts author Edward Marriott. Local Chinese resisted the raids, and some doctors took to carrying revolvers for protection. It was whispered that the Hygeia was no hospital but a sinister laboratory where the English were concocting a cure from the livers and other organs of patients. Fearing the abduction of their children, mothers pulled them from classes, and by the middle of May, half of Hong Kong’s schools had closed. About eighty thousand Chinese fled the colony altogether. And though international shipping companies urgently rerouted their vessels to bypass what had been the world’s fourth-busiest port, the plague would not be denied, eventually spreading as far as San Francisco.
Six years earlier, in 1888, another epidemic had struck Hong Kong. Its stay was less tumultuous but its symptoms nonetheless severe. James Cantlie, a fellow of the Royal College of Surgeons posted in the colony at the time, reported that patients suffered from headaches, backaches, and sore eye sockets and limbs. At times the pain was agonizing. Nearly all had runny noses, and many suffered from coughs, diarrhea, and vomiting. Some complained of jaundice, profuse rash, and mottled skin. Their fever would usually spike by the third day, approaching 104 degrees. When the disease first broke out, Cantlie misdiagnosed it as a form of “tropical measles.” Others called it dengue fever. But by the time Cantlie reported his findings in 1891, he knew what it was. In the intervening years, an influenza epidemic had sprinted around the world. The Europeans dubbed it the Russian flu, because it came from the east. The Russians in turn called it the Chinese flu. Cantlie told readers of the British Medical Journal that the Hong Kong outbreak had in fact been the first recorded appearance of this flu pandemic and its original source. Moreover, after conducting research among the Chinese, he concluded that flu was endemic in China.
Writing a century later, another Westerner who devoted his career to medical inquiry in Hong Kong determined that China was the “epicenter” of all influenza viruses. Kennedy Shortridge has been one of the world’s premier scholars of flu, a lanky Australian with thick, graying eyebrows and a deep melodious voice. He spent three decades as a microbiologist in Hong Kong before retiring to New Zealand. His research pinpoints southern China, and in particular the Pearl River delta of Guangdong province, adjacent to Hong Kong, as the cradle of the world’s flu. He noted that the natural hosts for flu viruses are aquatic birds, harboring the microbes in their guts, with ducks playing a unique and leading role. Before the rise of China’s Qing dynasty in the mid-seventeenth century, duck herders grazed their flocks along riverbanks and in canals and other waterways. But that changed in response to a mounting problem with pests in the rice paddies of southern China. Ducks were introduced into the paddies and fed on the insects and snails. When rice plants started to sprout, the flocks were temporarily rotated elsewhere. This elegantly balanced agrarian system made ducks far more profitable, and their population soared. With as many as five rice harvests annually in Guangdong, ducks became a year-round presence in the densely populated villages of the delta, and duck droppings, often larded with virus, became ubiquitous. Pigs snuffed up the fecal matter, offering themselves as a natural laboratory for gene swapping, because they can contract both bird and human flu viruses at the same time. Contagion was everywhere, Shortridge observed. It was a recipe for repeated epidemic.
The flu pandemic of 1957 is known as the Asian flu. Western countries learned of it after it was identified in Singapore. But Shortridge told me the strain had actually been isolated earlier in China’s southern Guizhou province. The 1968 pandemic was dubbed the Hong Kong flu. Yet Shortridge asserts that this, too, arose first on the mainland, specifically Guangdong, but the mainland Chinese were too preoccupied with the Cultural Revolution to take note. Hong Kong was just about the only conduit out at the time. It caught the bug and lent its name.
The origin of the 1918 Spanish flu is a matter of greater dispute. All agree the epidemic did not start in Spain. It only took this name because the Spanish were willing to report it. Unlike the United States and the European powers embroiled at the time in World War I, Spain was neutral and did not censor news deemed to undercut morale. Spain broke with their policy of censoring news about the outbreak. The flu made headlines in Spain, and eventually the press in other countries picked up reports of this “Spanish” flu.
American author John Barry has made a strong case for Haskell County, Kansas, as the origin of the pandemic. He cites medical reports as evidence of an extraordinary flu outbreak there in early 1918 and describes how the county’s young men would have reported to an army camp three hundred miles to the east before being deployed with their germs to the European front. British virologist John S. Oxford, by contrast, has postulated that the scourge first arose at a mammoth British army camp in northern France, where many soldiers had been treated in 1916 for what was then diagnosed as acute purulent bronchitis. Oxford’s review of those clinical findings concluded that the outbreak was actually pandemic flu.
But Shortridge maintains that even this great influenza of 1918 has a Chinese pedigree. Part of his proof is in the antibodies. Citing the medical accounts of an American missionary working in Guangdong at the time, Shortridge notes that Chinese children born after 1907 appeared to have a heightened immunity to the virus when the full-blown epidemic hit, suggesting they had already been exposed to a less virulent version of the same strain. “The virus had been smoldering in southern China for at least eleven years before it appeared,” he told me. Skeptics of his theory point out that the first wave of pandemic was recorded in the United States and Europe early in 1918, several months before it was documented in China. Yet Shortridge says this disregards the little-appreciated nature of flu in tropical climes like southern China. There, flu is primarily a summer malady, not a winter one, and would not have fully manifested itself until the middle of 1918 even if the pandemic strain was already circulating locally. So how, then, would the virus have found its way to Europe? Shortridge says he discovered a possible explanation by accident. While listening to a program about World War I, he unexpectedly heard the sound of Chinese. It was the taped voices of economic migrants who had set off for the European front to dig trenches for the Allied forces. He recognized their dialect. It was Cantonese, the dialect from around Guangdong.
Four centuries ago, it was a change in farming techniques that consolidated southern China as the world’s influenza epicenter. The introduction of ducks into paddies boosted agricultural productivity and set the conditions in which novel strains could smolder. But in the last generation, it’s all been about demand. Much of East Asia has witnessed a population explosion of chickens, ducks, and pigs in response to the region’s rapidly rising incomes. More money has meant a greater appetite for meat, milk, and eggs to complement and even replace the traditional staple crops. And nowhere has more money come more quickly than in East Asia. These countries, often benefiting from open market policies and tremendous Japanese investment, have achieved unrivaled growth as manufacturing exports have eclipsed rubber and rice at the heart of the economy. Steel and glass have thrust into urban skies from Shanghai and Guangzhou to Bangkok and Jakarta, attesting to the region’s ambitions.
Since China began adopting market reforms in 1978, it has consistently recorded annual growth rates of more than 10 percent, raising living standards and reducing poverty as never before in history. The Beijing government turned much of this raw energy southward toward the marshes and paddies of the Pearl River delta. By establishing a special economic zone in Guangdong, China unleashed what author Karl Taro Greenfeld labeled the “greatest mass urbanization in the history of the world.” The province became the world’s workshop, “where more of everything is being made than has ever been made anywhere at any time.” China now manufactures enough televisions to replace the world’s supply every two years and a quarter of everything sold at Walmart. Guangdong became China’s richest province, the boomtown of Shenzhen its richest city.
Yet for a decade after 1985, Thailand actually outpaced China and registered the fastest growth on Earth. No longer was the sex trade Bangkok’s main calling card. The capital built cavernous shopping malls, a hot fashion industry, and a sleek commuter Sky Train to whisk its young professionals among their high-rise office towers. Then it was Vietnam’s turn, emerging for a time as the fastest growing country in Southeast Asia by capitalizing on the Communist Party’s Doi Moi economic reforms. As growth rates topped more than 8 percent a year, storefronts along the romantic, tree-lined streets of Hanoi overflowed with iPods, computers, and digital cameras, and young Vietnamese plotted an even brighter future, expressing far greater admiration for Bill Gates than for anyone in their Politburo. Indonesia, in the meantime, diversified an economy long dependent on exports of oil, teak, and minerals, gaining recognition as a major newly industrialized country. The government in Jakarta eradicated much of the country’s poverty while motorbikes and cell phones became de rigueur even for many in the working class.
The Asian financial crisis of 1997 temporarily knocked the wind out of this fabulous progress. But the region’s economies rebounded, albeit some faster than others. Incomes and ambitions resumed their ascent. Malaysia, always one of the region’s best performers, pressed ahead with the completion of its Petronas Twin Towers in downtown Kuala Lumpur and boasted they were the tallest buildings on the planet. (As measured to the tips of their spires, a controversial standard, they were.) The towers were a pair of exclamation marks rising above Asia’s transformed landscape.
To a casual visitor, the agricultural changes that have accompanied this era of remarkable growth may not be as visible as the city lights. But as economist Christopher Delgado from the International Food Policy Research Institute and his fellow authors wrote, “The demand-driven Livestock Revolution is one of the largest structural shifts ever to affect food markets in developing countries… .” The revolution is not limited to East Asia. It has been manifest across much of the developing world as rising incomes, rapid population growth, and the broader diet that comes with urbanization combine to stoke demand for animal protein. During the two decades that followed 1980, people in developing countries doubled the average amount of meat they ate. By 1995 the volume of meat produced in developing countries for the first time surpassed that in developed ones.
But this is mostly because of China and Southeast Asia. China alone has accounted for more than half the developing world’s total increase in meat output. A large majority of that has been poultry products and pork, with the production of chicken meat growing fastest. The radical expansion of flocks that began in the 1970s and 1980s continued into the following decades, barely pausing for the East Asian financial crisis. From 1990 through 2005, China’s production of chicken nearly quadrupled, as did that of duck and goose. The amount of pork more than doubled.
Southeast Asia’s record ranks second only to that of China. During the same fifteen-year period, Indonesia more than tripled its production of chicken meat, Vietnam and Malaysia more than doubled theirs, and Thailand, which had registered a breathtaking growth of 10 percent annually in earlier decades, saw its output of chicken slow, increasing a mere 60 percent over this period. Malaysia more than doubled its output of duck and goose while Vietnam more than tripled its pork. To get a sense of the sweep of this revolution, consider the case of the Indonesian egg. In 1970, just as Indonesia’s long-slumbering economy was preparing to embark on a generation of sustained growth, the government statistics agency reported that the annual production of eggs was 59,000 tons. Three decades later, the total was 783,000 tons—a thirteenfold increase.
This transformation has literally put a chicken in every middle-class pot. Many among the urban poor have also secured better diets as meat prices dropped. (Consumers, fortunately, did not face the kind of inflated prices for grain and vegetables due to rising demand for animal feed that some economists had predicted.) But across vast swaths of rural Asia, the record is more mixed. Some small-time farmers have proven unable to compete with new industrial producers and lost their livelihoods. Others, by contrast, have found that livestock, one of the few sectors they could afford to enter, was their ticket out of poverty. For Prathum, the revolution was a bonanza—until the virus discovered the same thing.
Prathum’s wife said the livestock officers stormed into Banglane like marauding communists. “They came by the hundreds in trucks, bringing soldiers and prisoners to kill the chickens. We argued for some time. But they weren’t listening to us,” Samrouy Buaklee recounted. She raised her leathery hands in exasperation and then wiped her deep brown eyes with the checkered scarf around her neck. “It broke my heart. I felt that the chickens were like my children.”
Samrouy had retreated in tears to the house deep in the rice paddies and remained sequestered there, alone, for two days. When she returned, she noticed the silence. It’s always the silence. Over and over, farmers who lost their flocks told me it was the absence of the cackling and cooing they found hardest to bear. The village had gone dark. Farmhouse lights that once flickered on in predawn hours as villagers awoke to tend their flocks remained extinguished. The roads were abandoned. “No one walked around,” her husband recalled. “Everybody sat at home and nobody talked. With the chickens gone, we didn’t know what to do with ourselves.”
After more than half a year, Prathum decided to restock, rebuilding his flock though not his confidence. When I met him, his brown eyes had grown heavy, and bags hung low on broad, sunbaked cheeks. “Even if we’re afraid of the disease returning, what can we do? Nothing. We can’t run away,” he said softly. “It’s my job. If I don’t do chicken farming, what else can I do?”
Prathum left the question hanging. He rose from the wood crate where he’d been resting in the barn and emptied a sack of chicken feed into a wheelbarrow. Emerging into the morning light, he pushed it down a short concrete causeway jutting into the fishpond and trudged past a pair of spirit houses, those colorful, birdhouse-size shrines on pedestals he had once hoped would keep the local spirits content. At the end of the causeway, three open-sided chicken sheds on stilts extended across the green water. Prathum started with one on the left, the hum from hundreds of excited hens rising to greet him. He stepped nimbly along the aging wood planks that ran between the cages, his meaty hands shoveling grain from a bucket into the long feeding trays. The plaid shirt hanging from his stocky frame was soiled and his bare feet were caked with dirt. The planks were stained with droppings, the air rank with a cocktail of feathers, feed, and feces.
As a concession to new government rules, Prathum had draped fishnet along the sides of the two sheds. This was meant to keep out wildfowl, which could be carrying bird flu. But mice had already gnawed holes in the netting, and a few crows and swallows were darting about under the corrugated metal roofs. That was the extent of Prathum’s effort to prevent contamination and stem another outbreak.
The most important line of defense against a human pandemic is not at the hospital or vaccine lab but at the farmyard gate. A single gram of bird feces can contain up to 10 billion virus particles. A speck on a heel or a pant leg or a bucket or a tire can introduce an infection capable of decimating a whole flock.
Health officials have long made clear how to prevent epidemic contagion from spreading among flocks or from farm to market and on to other farms. The first principle is to severely restrict access to poultry flocks. This means keeping chicken sheds off-limits to most visitors. Those raising birds of their own must be categorically banned. The second is strict hygiene. Anyone entering a shed should wash his hands and don sanitized shoes. Poultry workers should change into clean, disinfected clothes and take them off when they leave so they can be washed. Feeding pans and cages should be cleansed daily. Equipment, such as pallets and egg crates, are easily contaminated and should never be shared among farms. Vehicles that have visited other farms could inadvertently be carrying the seeds of disaster and should be kept at a distance. Other animals must be barred from the chicken sheds.
When Prathum’s black dachshund trotted after him into the henhouse and then curled up for a nap beneath the cages, I knew there was trouble.
Nirundorn Aungtragoolsuk, a director of disease control in Thailand’s livestock department, later confirmed as much. He told me the government had adopted strict regulations, including a requirement that poultry workers shower with disinfectant before entering a farm and vehicles be sprayed with disinfectant before arriving on premises, but these applied solely to the large, export-oriented operations. The regulations were not meant for most farms, like Prathum’s. “They have done it their way for a long time and we cannot change it overnight,” Nirundorn said.
It took Prathum half an hour to finish feeding the hens in the three sheds. He returned to the barn, sweat glistening under his thinning hair, and hopped on his Honda motorbike. With a sack of feed in the sidecar, he buzzed up his gravel driveway, across the road, and down a dirt track that paralleled a canal on the far side. His other dog, a white crossbreed, had joined the dachshund, and now the pair gave chase, scampering behind Prathum until he reached two more chicken sheds suspended above another pond. As he resumed his feeding rounds, the dogs followed him inside.
A few moments later, as he emerged to fetch more feed, a silver Isuzu pickup coated with dirt pulled up right at the entrance to the sheds. It was the neighbors. The husband, Monchai, had bad teeth, and his wife, Boonsveb, had big hair. But they also had three times as many chickens as Prathum. They had culled the whole lot when the flu erupted and replaced them all. They told Prathum they had an uneasy feeling about another outbreak and wanted to compare notes. The talk turned to the question of whether they should erect modern, all enclosed, climate-controlled sheds.
“Of course that would be better,” the wife said. “It would keep out disease. But it’s expensive.”
“Yeah, that’s the problem,” Prathum agreed. “Who can afford it?”
“You certainly can’t afford it,” the husband quipped, needling Prathum. “You can’t even afford enough staff. You have to do the farming yourself.”
As if on cue, Prathum refilled his bucket and vanished deep into the chicken shed again. The husband, wearing cracked, dirty sandals, accompanied him inside. The dogs took up the rear as hundreds of red-crested heads poked out of the cages, viewing the procession.
Shortly after the neighbors left, another Isuzu pickup, this one red, rumbled down Prathum’s gravel driveway, pulling up in a cloud of dust just outside the barn. The cab door opened. Out got Nikon Inmaee, an egg vendor with a narrow face and short, wavy hair. Prathum had collected the eggs in the hours just after dawn, and now they were waiting, packed into plastic trays stacked ten high amid dirt and dead grass on the barn’s concrete floor.
Prathum helped Nikon gingerly hoist the trays into the truck bed. Three days a week, Prathum’s eggs were ferried to Bangkok, but this batch was headed for a closer market, about fifteen miles away. While Prathum calculated the tab on a small pad, Nikon returned to the back of his truck and began pulling out a separate set of empty trays. He deposited dozens of them in the barn for use later in the week. They were still soiled from the market. It was like addicts swapping dirty needles.
There was a time in the United States when chicken was a luxury, an indulgence for those weary of more affordable dishes like lobster and steak. Chicken was precious because it was relatively rare. In the ninteenth century, raising poultry was little more than a hobby for farmers’ wives, and in 1880, when the U.S. Census started counting chickens, they numbered only 102 million nationwide. By 2006, that number were butchered nearly every four days.
This American revolution would have been impossible but for a series of advances in animal husbandry, starting with the debut of commercially sold chicks in the late nineteenth century. Next came the development of artificial hatcheries, which lowered prices and brought chickens to selling weight faster. Companies specializing in feed emerged. Vitamin D was introduced to fight rickets. Broilers and later layers were shifted indoors, where temperature, lighting, and diet could be precisely calibrated, and then the birds were raised off the ground and confined to tiers of wire cages, where care and feeding was even easier. But the watershed was the introduction in 1971 of a vaccine for a poultry plague called Marek’s disease, which was killing 60 percent of the birds. Chicken prices plummeted, further fueling American demand already on the rise for familiar reasons: population growth, increasing income, and urbanization.
In the United States, where chicken was fast replacing beef as the animal protein of choice, safety measures to prevent disease followed quickly. The U.S. Department of Agriculture launched an aggressive campaign to educate farmers about biosecurity. Many family farms were swallowed by integrated agriculture companies, which insisted on stricter practices to protect their operations. In Europe, which was experiencing a similar chicken boom, many farmers had turned to banks for financing and inked contracts with feed mills. Both demanded measures to safeguard their investments.
Asia, for the most part, has yet to follow suit. So today, birds in China and Southeast Asia are amassed in once unimaginable densities, often weakened by their stressful confinement and exposed to the whims and wrath of viruses like influenza. The tremendous amounts of feed, water, and human traffic required to maintain these flocks offer a generous avenue to infection. In the unnatural setting of intensive agriculture, chickens are more vulnerable to contagion because they are pressed together and housed atop one another’s droppings, which are a main way, if not the main way, birds transmit the virus. A year after bird flu’s arrival in Thailand, a study found that Thai commercial farms were at a significantly higher risk of infection than the small, informal flocks of several dozen poultry that villagers have raised in their yards for centuries.
It’s not only the risks of infection on large farms that are greater. So are the consequences. The lack of genetic diversity in many commercial flocks means that a virus that infects one bird can likely infect them all, offering abundant opportunities for microbes to reproduce. The chances for the virus to mutate as it skips from bird to bird are multiplied many times over. “Once an influenza virus invades a commercial poultry farm,” scientists warned, “it has an optimum number of susceptible poultry for rapid viral evolution.”
But researchers have also found there’s something even more perilous than a country of dense commercial chicken farms. That’s one like Thailand, a country in transition, where commercial farms operate in the midst of extensive traditional flocks. These small holdings represent a vital link in the chain of infection. For the flu virus to migrate from its natural reservoir in waterfowl, it needs an initial toehold in domestic poultry. Asia’s traditional backyard farms, with their freely grazing birds and even fewer safeguards, offer just this opening. They are like kindling wood around the larger commercial farms. And the larger commercial farms, which have mostly sprung up near their markets, are concentrated around another vulnerable population: the unprecedented accumulation of humanity in the metropolises of East Asia.
As Jan Slingenbergh of the UN Food and Agriculture Organization and his fellow researchers write, “Agricultural practices have become the dominant factor determining the conditions in which zoonotic pathogens evolve, spread and eventually enter the human population.” More pointedly, the FAO said in 2008 that the rapid development of Asia’s poultry industry without due regard for animal health created a “virtual time bomb” that “exploded” with the outbreak of H5N1.
Sangwan Klinhom was a Thai country singer in the parts around Suphan Buri. His resonant tenor earned him a following, but little money. The tips couldn’t even pay the rent. “If you’re a singer, you’re very poor,” he explained. “Some die without a coffin.” So he eventually abandoned the circuit of farmyard weddings and cheap beer joints for the roving life of a duck herder.
When I encountered him in the shade of a coconut tree, Sangwan was rolling a homemade cigarette fashioned from a palm frond. He would occasionally glance up to check on his flock, nearly a thousand khaki Campbell ducks pecking and scavenging in the mucky waters of a rice paddy several miles north of Banglane village. Despite the intense midday heat, he wore a heavy brown knit cap with a blue pompom to keep the sun off his head. His brow was deeply furrowed, his jowls weathered. Beneath thick, graying eyebrows, his deep-set eyes were bloodshot from sun and stress. Once again, he was singing a plaintive tune.
The practice of grazing ducks in rice fields, which initially developed in southern China, had long since spread to the wetlands of Southeast Asia. Herders like Sangwan followed the rice harvest, trucking their flocks from province to province in pickups and feeding the ducks for free on residual grains, insects, and snails in the muddy water. “The ducks give you anything you want,” he told me. “If you want something, you wait a bit and you get it. I didn’t even have a house before.” But now this barefoot nomad and countless others like him were being pressed by Thai officials to renounce their wandering ways and shut their flocks up in closed shelters. Ducks had been fingered as silent killers.
Researchers had discovered that ducks were spreading the novel flu strain like never before while no longer displaying any symptoms of their own. Wild waterfowl had long been recognized as a natural host for flu viruses, carrying the infection without getting sick. As the pathogen grew more virulent, it initially turned on the cousins of these wild birds, domesticated ducks, and caused widespread die-offs. For a while, this helped tip public health officials to proliferating poultry outbreaks that could endanger people. But in 2004, the virus abruptly changed its modus operandi a second time. Infected ducks once again showed no symptoms, according to an international team of scientists based at St. Jude Children’s Research Hospital in Memphis. But now these infected birds spread the virus in larger amounts and for longer periods, in some cases a week longer than before. The virus also survived for more time in the surrounding water than it ever had. The duck had become “the Trojan horse” for Asian flu viruses, the researchers warned darkly.
When investigators in Thailand tested flocks of free-range ducks, nearly half proved to be infected with flu despite few signs of illness. Scientists warned that traditional duck farming posed a tremendous risk not only in Thailand’s central plains but also in the Mekong River delta of southern Vietnam and the Red River delta of northern Vietnam.
Separate studies of the bird flu epidemic in Thai poultry had also deeply implicated free-ranging ducks. The research showed that outbreaks in the chicken population were concentrated in areas where ducks commonly graze, primarily wetland areas of intensive rice cultivation. Suphan Buri was singled out as a hot spot for disease. By contrast, provinces with high concentrations of chickens but few ducks largely escaped the brunt of the epidemic. The authors suggested that paddies were a likely meeting point where migratory water birds relayed contagion to ducks, which in turn infected chickens before shuttling it to other fields and provinces.
Sangwan said his rambling took him through the rice paddies of more than ten provinces over the course of a season. Every two or three days he moved on, generally drifting southward with the harvest. Only hours earlier, after exhausting the pickings in a nearby field, he had herded his flock to a new paddy, where young rice plants were just starting to poke through the still surface. “I marched them here like little soldiers. ‘Keep walking,’ I told them. ‘Keep walking.’ ” He gestured with his open palms to show how he nudged them along, a smile settling on his stubbly face and crow’s-feet deepening at the corners of his eyes. The ducks had filed down the grassy banks into the water, waddling and ruffling their tail feathers. A flotilla set sail with a whoosh toward a low line of palms on the distant shore. Sangwan had claimed a rare sliver of shade on the dike. He lay down his long bamboo rod and stretched out his scrawny legs.
At the end of the day, Sangwan and his wife would line the birds up again and march them back to the campsite. The ducks spent their nights in a temporary enclosure of plastic sheeting. Sangwan looked for a dry patch of earth to pitch his tent. “I’ve gotten used to living in the open fields,” he said. “I love spending the time with the ducks rather than in a house, where you have to hear a television and people talking and traffic on the street.” In the hours before dawn, he would listen to his charges rustle as they scouted for comfortable nooks to lay their eggs. “That’s a nice sound,” he mused. “That’s the sound of making money.”
Sangwan had turned to herding two decades earlier as the livestock revolution was accelerating, doubling and redoubling Thailand’s duck production. As a younger man, he had dabbled in construction, growing rice, and raising vegetables. He took up singing after winning a local contest. Later, dead broke, he persuaded his uncle to teach him about ducks. He learned how to call to them in an authoritative voice so they’d respect and obey him. But alone on the dikes, Sangwan still serenaded his flocks with ballads of rural heartbreak.
Lowering his cigarette to his side, his melancholy voice began to carry across the glistening paddies, rising above the soft swooshing sound of birds foraging in the water.
He returned the cigarette to his lips and took a long drag. His sunken cheeks slipped even deeper into shadow. Then he continued.
He paused again, briefly, eyes lowered.
When he finished, Sangwan drew a bag of tobacco from the pocket of his baggy shirt and began rolling another cigarette. He fretted that the best days seemed to be over. Thai officials were already threatening to restrict the movement of ducks from one village to another. He could never afford to raise his flock in a closed shelter, he said. The feed bill would bankrupt him and the ducks would rebel.
After the government first floated the idea in late 2004, Sangwan had experimented with confining the ducks to a shed beside his house. It lasted a week. “I felt restless because the ducks couldn’t walk around and they didn’t have enough food,” he recounted. “The ducks were not happy.” That was bad news for business because, he confided to me, ducks are like pregnant women. They need to be pampered or they get nervous and lay their eggs prematurely. “I feel like I have a thousand little wives,” he said, a grin briefly breaking through. “When the ducks get tense, I get tense.”
To protest the proposed farming regime, his wife had led hundreds of peasants to the provincial capital. They besieged a government building for three hours, accusing officials of acting arbitrarily and sowing needless anxiety. “When the government says ducks carry bird flu, it just makes people panic,” Sangwan complained, growing agitated. “It’s not true that ducks get the flu. For twenty years I’ve been raising ducks and I’ve never seen one get bird flu.”
In the months after I met Sangwan, the Thai government would bar farmers from transporting their flocks from one region to another and eventually, in 2006, place a total ban on duck grazing. Thailand’s initiative sputtered, but the country ultimately achieved more than neighbors like Vietnam, China, and Indonesia, where duck herding remains common. When flu outbreaks unexpectedly erupted across more than a dozen provinces of northern Vietnam in 2007 after a long period of quiet, sickening people in the country for the first time in eighteen months, ducks were implicated. A special investigation blamed the epidemic on a dramatic influx of young ducks into the paddies of the Red River delta. By contrast, many of the estimated 10 million free-range ducks in Thailand were ultimately slaughtered or moved indoors.
But even there, compliance was spotty. Some Thai duck herders continued to follow the cycle of the crops as they had for generations, thwarting efforts to snuff out the disease. It had been several harvests since I met Sangwan when I heard about a group of herders who’d illegally moved three flocks with as many as fifteen thousand birds into the fields of Kanchanaburi province, just west of Suphan Buri. The chickens in several local villages began to die within two weeks. When those near the home of a peasant named Bang-on Benphat started to fall sick and collapse, the forty-eight-year-old man butchered them for dinner. His young son helped pluck the feathers. Both soon developed a fever and lung infections. Bang-on was hospitalized with severe pneumonia. Two days later he died, a casualty of flu.
Prathum sat cross-legged on his back porch, surveying all that he and his chickens had built. His eyes panned past across the barn and the sheds, where his amply nourished hens were settling in for the afternoon, past the fish ponds, where a fleeting fin glinted amid the vines of morning glory, toward a line of trees casting long shadows at the edge of his property.
His thoughts returned to those new, modern chicken shelters that farmers were chattering more about. They were called evap houses, short for evaporative cooling houses. They had automatic ventilation and used large fans and water to maintain mild temperatures even during intense tropical heat. Because they were enclosed, they could keep out most contagion. “Even insects can’t get in,” he noted, impressed. But the cost was tremendous. He would need a loan and have to quadruple the size of his flock to make the numbers work. He would need at least five years to break even. No need to be hasty, he reasoned.
“I’m not worried right now,” he put it to me. “We haven’t heard anything lately about the epidemic. Maybe the disease left with our last lot of chickens. The new ones all look healthy.”
His wife appeared in the doorway with a watermelon. She wasn’t buying his cool assurance. “I’m definitely afraid the disease will come back to this area,” she offered. “Some people say the disease came with the wind. Some say it came with birds. We have no clear idea. And deep down, he’s still worried about it, too.” She glared at Prathum, then laughed.
“Yes, I’m still scared,” he confessed. “But I try not to show it. What can I do? We’d never had bird flu before. It just came. I’m hoping it won’t come again.”
Prathum took the watermelon from his wife. He grabbed a knife from the bench and started carving the fruit.
His sons were urging him to invest in an evap house, he told me without looking up. It was all that fancy university education. His older son, the one studying veterinary science, he’d even visited several evap houses to check them out. But Prathum had seen enough change in his life.
“I may not be able to learn as fast as young people,” Prathum said. “I’ll retire after a while and pass the farm on to my son. Then, he can do what he wants.”
Professor Yi Guan gingerly placed the small cooler box with its mysterious contents into his black canvas satchel. He covered the box with a towel, then a newspaper, to conceal it from prying eyes. He wasn’t quite sure what he had. Whatever it was, it had already proven to be a ruthless killer. The cooler box contained about two dozen vials, and lurking inside each one, Guan feared, was enough biohazardous material to start a global epidemic. But the specimens could also be the world’s salvation—if only he could get them back to his laboratory in Hong Kong.
Guan slung the strap of the satchel over the shoulder of his gray suit jacket and headed for the door of the hospital. The medical staff at the Guangzhou Institute of Respiratory Diseases had nervously collected the mucus specimens from the noses and throats of patients stricken by the strange plague now burning through China’s Guangdong province. The institute director, an esteemed scientist named Dr. Nanshan Zhong, had agreed that Guan could take the samples back to Hong Kong University for identification. But Guan had no such permission from the Chinese government. If he was stopped, he had no papers to show. If the vials were discovered, they could be confiscated and Guan detained. He could be held until his Beijing contacts vouched for him, if he was fortunate. If not, he could be accused of stealing state secrets or espionage and sentenced to life in a labor camp.
Chinese officials were determined to keep the severity of the epidemic under wraps. That very morning, February 11, 2003, Guangzhou’s vice mayor had announced that the city was facing an outbreak of unusual pneumonia but it was under control and no extraordinary measures were required. But WHO was already picking up rumors of a far more serious outbreak involving a “strange contagious disease” that “left more than 100 people dead in Guangdong Province in the space of one week.”
Guan suspected avian flu. Three months earlier, in November 2002, the wild birds of Hong Kong had started to die, first in the New Territories bordering Guangdong Province, then at a park in the teeming downtown of Kowloon. Samples from the outbreaks tested positive for the virus. Guan’s suspicions hardened in February when bird flu was detected in a Hong Kong family. They had been traveling in China’s Fujian province for the Chinese New Year when a young daughter came down with a severe respiratory illness. She had perished before the family returned home and was never tested for the virus. Soon her father and brother also fell sick and were hospitalized in Hong Kong. The father died. Both tested positive. It was the same H5N1 subtype that had first struck Hong Kong in 1997. They were the first confirmed cases anywhere since then.
As a fledgling researcher, Guan had helped investigate the 1997 outbreak. He had been part of the team that uncovered the widespread infection among Hong Kong’s poultry, crucial information that helped energize the city’s decisive response. He believed a pandemic had been averted. Now he was trying to repeat the feat.
As he left the Guangzhou institute, an aging seven-story gray cement edifice along the Pearl River, and set out to catch his Hong Kong-bound train, Guan felt time was running out. He feared that the next time the virus departed the province, it wouldn’t be in securely sealed vials nestled inside a carefully prepared cooler box but unknowingly in the lungs of a victim. Once it escaped southern China, he was afraid, moreover, that the pathogen would spread to dozens of countries. Finally, he was sure it would then take only days to reach the far side of the planet.
Guan was tragically prescient on all three counts. The transformation of Asia over the previous generation had not only been internal, amplifying the hazards of an animal-born epidemic; but it had also redefined the region’s ties with the rest of a globalized world. And in this age, the magnitude of a pandemic threat was growing as the distance between its origin and the rest of the world was shrinking.
Guan, however, was wrong about one thing.
When Yi Guan was six years old, growing up in the impoverished Chinese province of Jiangxi, his sister changed his name. He had been born Qiu Ping Guan. Qiu meant “autumn,” the season of his birth. Ping meant “peaceful.” Guan was the family name.
He was the youngest of three boys and two girls raised in the remote countryside about 180 miles from the provincial capital. In 1966, when Guan was four, Chairman Mao Zedong launched China’s Cultural Revolution, a decade of violent upheaval targeting those considered as capitalists, intellectuals, or vestiges of the former ruling class. Guan’s mother was descended from property. Though spared the worst excesses, his family was forced to subdivide its six-room house to make space for others. His father, an engineer, was sentenced to reeducation and put to work threshing flax plants to extract an ingredient for wine.
One day, as Guan was preparing to enroll in first grade, his adult sister called him aside.
“Come on, brother. I need to talk to you about something,” she said. She seemed unusually earnest.
“What do you want to talk to me about?” the young Guan asked.
“I want to give you a new name,” she responded. “You are the only boy in our whole family who has the hope to become successful. So I’m changing your name. It’s becoming Yi.”
She wrote the name on a piece of paper. Guan couldn’t understand the significance. His sister said one of its meanings was “extraordinary.”
“I picked this meaning to make you remember you must become outstanding, extraordinary,” she told him. “That is your duty.” She took him to school and registered him under his new name. It was a heavy burden, Guan later recalled. But he took his charge seriously.
As part of his radical remaking of Chinese society, Mao had shuttered the colleges. But just as Guan was preparing to graduate from high school, China announced they would reopen. For nine months he crammed for the entrance exam. Less than 1 percent of high school students would make the cut, Guan recounted. He would be among them.
Guan went on to study medicine and specialize in pediatrics, winning a place at an elite Beijing institute where he hooked up with a senior scientist specializing in infectious diseases of the respiratory system. He was later offered a slot in the PhD program at Hong Kong University and, after that, a chance to go overseas. He continued his research with one of the world’s top flu scholars, Dr. Robert Webster, at St. Jude Children’s Research Hospital in Memphis, Tennessee.
Several years had passed when, on a Saturday morning in late November 1997, Webster called him. Guan had returned to Memphis hours earlier after defending his doctoral thesis in Hong Kong and visiting his aging mother for the first time in two years. “Don’t open your baggage,” Webster ordered him. Guan was to turn around and go back.
“What happened?” Guan asked.
“While you were in the sky crossing the Pacific,” Webster said, “they had three cases of H5N1.”
“Really?” Guan was shouting excitedly over the telephone. “Really?”
Webster instructed him to get his travel documents ready and prepare the biological materials he would need to transport to Hong Kong. They were going to join the virus hunt.
Guan never gave up the chase. He soon moved back to Hong Kong to become a researcher in microbiology at the university and quickly went to work sampling the city’s birds. Before long, he would emerge as one of the world’s great collectors of flu viruses. Even as memories of the 1997 outbreak were fading, he was compiling data on myriad strains and amassing thousands of samples from birds in Hong Kong and southern China. In the summer of 2000, he had extended the net to Guangdong, establishing a virology lab at Shantou University Medical College. The facilities there had been idle for a decade. Guan spent a week cleaning the lab. He scrubbed the floor and washed the research bench and its protective hood. Only then did he set off to collect specimens from nearby poultry markets. Within two years, he had set up a network of field researchers that was gathering samples from birds in four provinces of southern China.
Webster, his mentor, had helped recruit Guan to the post at Hong Kong University. Webster was convinced that the novel flu strain simmering in southern China posed a grave danger to the world and wanted someone, preferably a Chinese virologist with Western training, who’d be nothing less than bullheaded in tracking the evolving threat. “Yi doesn’t know the word no. He doesn’t take no from anyone,” Webster put it to me. “He believes in what he’s doing and he’s intellectually driven to do these things. He talks a million miles an hour, and a lot of it is not totally focused, but his overall mission is focused. You’ve got to have someone who is hard-driving to get out there and be able to interact with the people and understand the region, and he was the perfect person to do the surveillance.”
Rumors of a bird flu epidemic among the Chinese of Guangdong first surfaced in November 2002. WHO’s influenza chief, Klaus Stohr, who would later mobilize the agency’s flu hunters after bird flu exploded in Vietnam in early 2004, was at a medical conference in Beijing when a health official from Guangdong stood up and described an especially nasty outbreak of respiratory disease among people of his province. “He talked about deaths, very severe disease and deaths,” Stohr recounted. Chinese doctors had been unable to identify the precise cause, but they said it looked a lot like flu. Stohr was inclined to agree. “I just put two and two together, and it added up,” he recalled. “I thought this must be H5N1 coming back in precisely the way we had feared. It was our worst nightmare, and the world’s.”
But when WHO subsequently pressed Chinese officials for more details, they offered a terse, dismissive reply. It was indeed flu, they reported, but just routine flu and everything was under control. In essence, “Now buzz off.”
By the waning days of 2002, with wildfowl in Hong Kong starting to drop, Guan and his fellow researchers suspected that whatever was killing the birds was also afflicting the patients in Guangdong’s hospitals. So on Christmas morning he came to Kowloon Park, an exquisitely maintained expanse of manicured greenery, flower beds, and faux waterfalls at the heart of central Kowloon, just off a stretch of Nathan Road known as the Golden Mile for the bountiful commerce of its shops and boutiques. Toward the center of the park, fringed by palms and shade trees, was the man-made lake where several dozen species, including flamingos, ducks, geese, and teal, frolicked in the water and sunbathed on the banks. Guan laid out his gear. Meticulously, he clasped a small vial in his curled pinky, leaving the rest of his fingers free. As a colleague restrained the first bird, Guan slowly inserted a Q-tip-like swab into its cloaca and withdrew a specimen. Guan sampled at least a dozen birds this way. Most later tested positive in the lab for avian flu.
He and fellow researcher Malik Peiris also continued to stalk the strain into the Mai Po Marshes of the New Territories. There the mudflats and mangroves offered a refuge unique in Hong Kong for hundreds of species of wild birds. The scientists drove up before dawn. It was a cold, damp morning. Though they were wrapped in heavy coats, the chill penetrated Guan’s bones. He pushed a small boat into the dark water, mud soaking his sneakers, and then rowed across the narrow inlet. He came ashore on Duck Island, a sliver of land that fittingly boasted more than twenty species of ducks. It was too hard to catch these birds. So for an hour and a half, Guan scoured the ground for their droppings. Live virus would be lurking inside.
The specimens collected from scores of birds in Hong Kong suggested that the mystery outbreak in Guangong’s hospitals was H5N1. But by February 2004, Guan and his fellow microbiologists realized there was no substitute for actual human samples. Someone would have to go to Guangzhou to get them.
“Why not Yi?” Webster asked. “It’s not everyone who’s going to want to go into that room and risk his life.” Guan was impetuous and courageous, and it was obvious to him that this was his moment.
When Guan arrived at the Guangzhou Institute of Respiratory Diseases, he told the director, Nanshan Zhong, that the pathogen was most probably influenza. “It is possible this is the early stage of a pandemic. If we don’t deal with it carefully, this will be a disaster,” Guan warned.
To contain it, medical experts had to determine precisely what it was. Guangzhou didn’t have the necessary lab facilities, Guan concluded, but Hong Kong did. Zhong concurred.
With the vials stashed in his satchel, Guan hailed a taxi outside the institute gate on the afternoon of February 11 and set off into rush-hour traffic. He wanted to make the 6:30 P.M. express train to Hong Kong. If he did, he could turn over the cache of vials to his lab staff in time for them to begin the process of culturing the virus samples that very night. Guangzhou East Railway Station was teeming with travelers. The cavernous hall echoed with the announcement of trains departing for destinations in the Chinese hinterland. Guan headed toward the terminal for the Kowloon-Canton Railway, which would whisk him to Hong Kong. Police officers, some alone, some in pairs, meandered through the crowd. Guan avoided eye contact.
He ascended the escalator. At the top were the immigration counters. Guan liked to tell himself it was all one country, Hong Kong and the mainland. That was, after all, the official Chinese government line. And by that logic, he wasn’t smuggling the samples abroad. But in many practical ways, China still treated its border with Hong Kong as an international frontier. Guan showed his passport to the blue-uniformed immigration officer, who waved him through. When he reached customs and saw the X-ray machine, he momentarily considered looking for another way around. Then he thought better. “If you try to avoid that,” he told himself, “there will be more trouble.” He placed his satchel on the belt. Seconds passed before it reappeared on the far side. The white-uniformed customs officer didn’t say a word. Guan retrieved his bag and continued toward the waiting room.
There were families with large suitcases, and businessmen returning home after a day trip to their factories and suppliers. They were already queuing up when the train was announced. Guan joined the line. An immigration officer was conducting a final passport inspection. “The quieter you are, the safer you are,” Guan reminded himself. Usually he was a dervish of activity, a fast-walking, fast-talking impresario of scientific notions who pressed his theories, passions, and grievances on listeners in a shotgun spray of sentences, a chronically restless soul who found it nearly impossible to remain seated or stand still unless, of course, he was smoking a cigarette out an open window. Yet in his plain gray suit, inexpensive haircut, and large, silver-framed aviator glasses, he could melt into the undifferentiated mass of commuters if he could just feign the right air of indifference.
“The more you keep quiet,” he repeated to himself, “the safer you are.” The immigration officer asked for Guan’s passport. He flicked his cigarette to the floor and produced the document from his jacket with an affected look of weary annoyance. The officer returned the passport and moved on.
Finally the line moved. The passengers filed downstairs to the red tile railway platform and onto the train. Guan claimed his seat. He placed the satchel carefully on the overhead rack. Then he took out his cell phone and called his lab. “Are you ready?” he asked. “The samples are on their way.”
But as they were analyzed over the coming days, the samples stumped Guan and his fellow researchers. The virus wasn’t H5N1. It wasn’t flu at all. It would later be identified as SARS, and that was fortunate. Because in the age of globalization, flu would have been much worse.
Half a year after the SARS epidemic had subsided and life had returned to Hong Kong’s deserted streets, the city’s legislative council would conduct an inquiry in January 2004 into the government’s handling of the crisis. The outbreak had killed 299 people in Hong Kong alone. Nearly six times that number had been infected. Amid stinging criticism, Hong Kong’s secretary of health, welfare, and food and the chairman of the hospital authority would lose their jobs.
Margaret Chan, the city’s health director who had so ably steered Hong Kong through the bird flu outbreaks of 1997, had also skippered its emergency response to SARS. As she testified before the legislative council, she broke into tears. “We tried to do our best,” she assured the members before being overcome by emotion, forcing them to briefly suspend the hearing. During her testimony, Chan told the council she had tried several times in early 2003 to confirm the press reports of an epidemic brewing in neighboring Guangdong province. On February 11, 2003, the very day that Guan was making his clandestine run to the Guangzhou institute, Chan and one of her departmental consultants had repeatedly phoned health officials in Guangdong about the rumors. No one answered their calls. “Usually, with other infectious diseases, there was no problem with communication,” she testified. She added that a Guangdong official later told her “there was a legal requirement for infectious diseases at that time, that infectious diseases were classified as state secrets. That is why they cannot share the information.”
The council went on to censure Chan, who by that time had resigned from the health department for a post at WHO in Geneva. She was faulted in part for leaving Hong Kong vulnerable “in that she did not attach sufficient importance to ‘soft intelligence’ on the [acute pneumonia] epidemic in Guangdong.” The report suggested she could have dispatched a team to the mainland to investigate.
Ultimately, it was a doctor named Liu Jianlun who had brought the disease to Hong Kong’s attention. Liu was a retired kidney specialist from southern China. At age sixty-four, he still worked part-time in an outpatient clinic at a hospital in Guangzhou. It was this hospital that first treated one of the earliest victims, a forty-four-year-old seafood seller from the suburbs who came in January 30, 2003, with a severe cough and fever. This patient stayed only two days before being transferred to another hospital. But in that remarkably brief time, he infected at least ninety-six other people, including ninety health-care workers.
Liu himself started feeling sick two weeks later. He worried that he had contracted whatever horrible illness was besieging his hospital. But his chest X-rays looked clear. So he dosed himself with antibiotics and set out with his wife on a three-hour bus ride for a nephew’s wedding in Hong Kong. When they arrived, he felt well enough to go shopping and enjoy a long lunch with relatives. Late that afternoon, on February 21, Liu and his wife checked in to their room on the ninth floor of the Metropole, a three-star hotel in Kowloon with a large swimming pool on the roof and a karaoke bar in the basement. Their room was what marketers call cozy, with two single beds and a pale olive carpet. From the window of room 911, they could see a Shell service station, an Esso service station, a YMCA guesthouse, and beyond, one of the most congested quarters in all Hong Kong.
Long before the term globalization was coined, Hong Kong was the definition. As a colonial entrepôt, it evolved into a bridge between Occident and Orient, a global financial center, and one of the world’s busiest ports. The ninth floor of the Metropole was true to form. Staying on the floor that same evening were also three women from Singapore, including a former flight attendant on a shopping excursion, four Canadians, among them an elderly woman from Toronto visiting her son, a British couple on the way to their native Philippines, a young German tourist headed for a two-week vacation in Australia, and three Americans, including, right across from 911, a Chinese-American garment merchandiser bound for Hanoi to meet his denim suppliers. Sometime in the course of that evening or early the next morning, before Liu checked out of the hotel with a searing headache and dragged himself five blocks to a hospital, he managed to infect all thirteen of those neighbors. Three others at the Metropole also caught the virus. Based on intensive sampling, health investigators later theorized that Liu, upon returning to the ninth floor from dinner, had thrown up on the teal-colored carpet outside the polished, wood-trimmed doors of the elevator. Someone, perhaps his wife, cleaned up the mess. An invisible mist of infectious particles wafted along the corridor.
Liu would become Hong Kong’s first case. Before he died, he told the doctors and nurses caring for him about the disease raging in his own hospital.
The Singaporean hotel guests returned home, where they were all hospitalized, and one, the woman on the shopping spree, in turn sparked an outbreak that sickened at least 195 people in her own country. The doctor who treated the initial Singaporean case later flew to New York for a medical conference and on the way infected a Singapore Airlines flight attendant.
The Chinese American merchandiser continued to Hanoi, where, before succumbing to his sickness, he seeded a Vietnamese outbreak that infected sixty-three others. A French physician in Hanoi who cared for a stricken colleague later carried the virus home to Paris, along the way infecting three others on the Air France flight.
Just four days after Dr. Liu had boarded the bus in Guangzhou, the elderly Canadian woman from the Metropole was back in Toronto, halfway around the globe, and feeling ill. Before she died, this grandmother passed the virus to four family members, ultimately igniting a cluster of 136 cases in Canada. One of those stricken in Toronto was a nurse from the Philippines, who later flew home to help find a faith healer for her cancer-stricken father and instead infected her family with the killer virus, volleying the illness right back to Southeast Asia.
This is how an epidemic becomes a pandemic. This was the first great wave of a still-unnamed virus washing over the world. More would follow.
Of all those sickened at the Metropole, the one who went on to infect the most people directly wasn’t a guest at all. He was a twenty-six-year-old airport freight handler from Hong Kong itself who visited a friend staying on the ninth floor. About two days after this young worker started feeling lousy, he went to the emergency room, where he was diagnosed with a respiratory infection and sent home. Almost a week later, as his condition worsened, he was admitted to Prince of Wales Hospital. As the main referral hospital in the New Territories, this modern medical complex has the feeling of a bus terminal at rush hour, with crowded corridors and long lines at the reception windows. The young man was placed in Ward 8A. He went on to infect at least 143 others, all at the hospital.
From here, the virus again exploded into the world. Nearby in Ward 8A was an elderly Chinese man being treated for an unrelated salmonella infection. His seventy-two-year-old kid brother visited him often. On March 11, the younger brother developed a fever and three days later came down with a cough and chills. Though a physician urged him to get hospital care himself, the man insisted on flying back home to Beijing as planned. On March 15 he did so.
“It was like seeds thrown into the wind,” a doctor in Beijing later remarked. “Who knows where they will land?”
Air China flight 112 was nearly full that Saturday. The Boeing 737 had 112 passengers and 8 crew members. The ailing seventy-two-year-old was slumped in seat 14E. He looked pale, his brow was drenched. He couldn’t quiet his coughing and kept hacking until his handkerchief was soaked. He went to the galley to ask a flight attendant for water to take some pills. In the three hours it took to reach Beijing, he infected 22 passengers between rows 7 and 19 and 2 flight attendants. The first victim would spike a fever within days. By the middle of the next week, three-quarters would develop what initially felt like a bad head cold. Five would later die, as would the elderly traveler himself.
The two flight attendants were from Inner Mongolia, a region of northern China. When they returned home, they sparked an outbreak that accounted for most of its 290 subsequent cases. From there, the virus leapfrogged across the border to the independent country of Mongolia.
Ten of those infected on CA-112 were members of a Hong Kong tour group.
Four were employees of a Taiwanese engineering firm, who eventually carried the virus home with them.
Another was a young woman from Singapore, who later flew home and was hospitalized there.
Yet another was a Chinese official who journeyed to Bangkok. As he headed back to Beijing from that subsequent trip, on a Thai Airways flight, he in turn infected a Finnish official of the International Labor Organization, who had been seated next to him.
It had only been five weeks since Dr. Liu got on the bus. Of the 8,098 cases of SARS ultimately detected, more than 4,000 could be traced back to his overnight stay in the Metropole.
When the Spanish Lady came calling in 1918, no place was too remote to elude her entreaties. She even found the islanders of the Pacific. In prior centuries, when seafaring ships were driven solely by the wind, an epidemic disease brought on board would have time to burn itself out before coming ashore on these distant islands. They were beyond reach. Maritime technology changed that. In October 1918, a U.S. Navy transport called the Logan sailed from Manila with an infected crew and put in at Guam. Nearly everyone on the island fell sick with flu. About 800 died. Another vessel, the Navua, set out from the stricken port of San Francisco and in mid-November docked in Tahiti. Three thousand Tahitians caught the disease, and more than a tenth of the population perished. From the ailing port of Auckland in New Zealand, a steamer named the Talune set sail, scattering death at each stop along its tropical itinerary. In Fiji, 5,000 died. In Tonga, as many 1,600, about a tenth of its inhabitants, died. The Talune fatefully docked at Apia, the capital of Western Samoa, in early November. By the time the suffering subsided early the next year, an estimated 8,500 natives had succumbed, more than a fifth of the population.
For many Eskimo villages of Alaska, the plague was even less forgiving. As winter was closing in, the final ship of the season, a vessel from Seattle called the Victoria, moored in the port of Nome on Alaska’s Seward Peninsula and deposited its lethal cargo. From there, sped by the wanderings of white missionaries, influenza advanced along the frozen tundra, penetrating the coast to the north. It killed every last Eskimo in the village of York, about 150 miles from Nome by dogsled. The inhabitants of nearby Wales, the westernmost point on the North American continent, joined in a funeral for a boy from York. Soon more than half those from Wales were also dead. At another outpost, Teller Lutheran Mission, disease erupted after a pair of visitors from Nome had joined a local church service. The first native fell sick two days later. Soon corpses stacked up inside the igloos. All but eight of the village’s eighty residents perished and were buried beneath the permafrost. One was a woman who ultimately helped crack the genetic code of the Spanish flu after researchers excavated her grave seventy-nine years later and retrieved a sample of infected lung tissue from her well-preserved body.
The global reach of pandemic flu is thus nothing new. But globalization is. And over the last generation, it has fundamentally recast the threat of infectious disease. As with SARS, the next flu pandemic will spread at the speed of jet aircraft, coursing along an ever-thickening web of international travel, each new thread reducing the time the virus must wait before breaching another frontier.
“As the first severe contagious disease of the twenty-first century, SARS exemplifies the ever-present threat of new emerging infectious diseases and the real potential for rapid dissemination made possible by the current volume and speed of air travel,” said Mark A. Gendreau, a senior attending physician at the Tufts School of Medicine, in testimony before the U.S. Congress. Margaret Chan was even blunter: “SARS was a wake-up call for all of us. It spread faster than we had predicted.” Within six months, it reached more than thirty countries on six continents.
More people are traveling more places than ever before. Though Hong Kong remains an exceptional crossroads, Yi Guan rightly suggests that the world increasingly resembles the ninth floor of the Metropole.
“Today you are in England, tomorrow in New York, and the third day you might be in Hong Kong,” Guan noted. Imagine how many people an infected traveler encounters along the way. “The case lands in London or New York or Hong Kong. Maybe ten thousand people have connecting flights in that airport within two hours. It spreads to the whole world. Globalization accelerates the transmission speed, maybe by a hundred times.”
A century ago, he continued, a novel flu strain could take more than a year to circle the world. “Now, currently, does it take one year? I don’t think so. Maybe one month,” he said.
Over history, each advance in transport and trade has sped disease on its way. The Black Death of the Middle Ages spread faster by merchant ship on the Mediterranean than by horseback on the Asian steppe. The last of three cholera epidemics in nineteenth-century America was the swiftest, exploiting the country’s new railroads. Even since 1968, the date of the last flu pandemic, change has been dramatic. Air traffic has increased about tenfold since then. Using data on the volume of travelers at fifty-two major cities around the world, a team of American researchers projected how long it would take a flu pandemic to spread and compared it to the Hong Kong flu of 1968. They found that the same virus, if it had erupted in 2000, would have struck cities in the Northern Hemisphere nearly four months earlier. And while the Hong Kong flu required almost a year to sweep the globe, in 2000 the virus would have peaked in every one of the cities in half that time. A separate team of researchers in Britain, using a different statistical approach and more recent data, from 2002, concluded that in some cities in the Southern Hemisphere, the epidemic actually would have peaked a full year faster than it had in 1968.
An accelerating epidemic leaves public health officials little chance to top off their stockpile of antiviral drugs or distribute them. There’s less lead time to prepare measures meant to slow the inexorable advance of epidemic—for instance, isolation policies and school closings—or to make sure that strategic infrastructure and crisis manpower plans are in place. Most crucially, scientists expect it will take at least six months to develop a pandemic vaccine and far longer to make sure everyone gets it.
“All of technology cannot keep up,” Guan warned. “To manufacture a vaccine takes months. The transmission of disease is by the hour now.”
No matter how many ways Guan and his colleague Malik Peiris tried to find a flu virus in the specimens smuggled back from Guangzhou, they couldn’t. For that matter, they couldn’t isolate a virus of any sort at all. In the lab, they tried to grow the puzzling pathogen using chicken embryos, dog cells, monkey cells, and even human larynx and lung cells. Nothing. But each disappointment refined the search. Each time they failed to corner their quarry in the Guangzhou samples—for weeks, the only ones outside the hands of the Chinese government—the Hong Kong University team weeded out false pretenders, bringing the researchers that much closer to the golden moment of discovery.
When it came, it was Peiris who made it. His lab isolated a pathogen called Coronavirus in a new specimen taken at a Hong Kong hospital from the dying brother-in-law of Liu Jianlun. Precisely one month after Dr. Liu had checked into the Metropole, Peiris sent an e-mail to a global network of laboratory scientists announcing that he had found the cause of the disease now named SARS.
The discovery was an unprecedented coup for WHO. Peiris was part of a virtual laboratory network that Klaus Stohr had assembled in mid-March 2003 for the SARS hunt. He had recruited eleven premier labs from nine countries for a rare collaborative effort, appealing to many of virology’s brightest and most competitive researchers to set aside their egos and their lust for scholarly publication. Instead they compared notes, speaking daily by teleconference to review their progress. Crucial findings were shared through a secure Web site. WHO also established parallel networks, so epidemiologists could analyze how SARS was spreading and clinicians could consult about how to treat it.
The overriding fear was that this killer could become endemic, like HIV-AIDS, before the world had time to diagnose the threat, contain its spread, and eradicate it. WHO rallied scores of disease specialists from inside the agency and out, dispatching them to East Asia. Keiji Fukuda, for one, spent eight weeks in mainland China and Hong Kong. It was what Fukuda saw in the wards of Prince of Wales Hospital that prompted WHO to sound its first global alert about this severe, unidentified pneumonia in mid-March 2003 and urge that patients be isolated. A second, stronger alert followed three days later after Mike Ryan, WHO’s global alert coordinator, was awakened with news that an infected physician had boarded an airplane in New York bound for Singapore. The man was bundled off the airplane during a stop in Frankfurt by German emergency medical staff in orange hazmat suits. Within hours, WHO had begun taking measures to curtail the international spread of SARS.
This was the agency at its best. “The quality, speed and effectiveness of the public health response to SARS brilliantly outshone past responses to international outbreaks of infectious disease, validating a decade’s worth of progress in global public health networking,” according to an assessment by the U.S. Institute of Medicine. “The World Health Organization (WHO) deserves credit for initiating and coordinating much of this response.”
Yet even after the Coronavirus had been isolated and containment efforts put in place, the source of the disease remained a mystery. WHO investigators suspected a link to wild animals. Some of the earliest cases in Guangdong had been in restaurant employees who prepared exotic fare, often from small imported mammals, to sate southern China’s appetite for what locals called “wild flavor.” To choke off the epidemic, researchers would have to determine which creature was the culprit. Someone would have to literally stick a needle into the heart of an animal and a swab up its anus. Once again, the mission would fall to Guan.
In early May 2003, he crossed to the Chinese city of Shenzhen, just beyond the narrow river that serves as Hong Kong’s border with the mainland. Once a fishing village, Shenzhen had been designated a special economic zone in 1979 to attract foreign investment. The gold rush had transformed it into an audacious boomtown with a population rivaling New York’s and skyscrapers to rival Hong Kong’s. It had become China’s wealthiest and fastest-growing city and the quintessence of excess. In the city’s storied restaurants, the new rich spent hundreds, even thousands of dollars to dine on nearly any form of life they hankered after. At Dongmen Market, the hungry and the adventurous perused wire cages stacked high with writhing snakes, barking raccoon dogs, growling ferret badgers, turtles, hares, palm civets, hog badgers, house cats, scaled pangolins, rabbits, beavers, and the miniature Asian deer called muntjac.
By the time Guan set foot on the slick, bloody floors of the covered market, he had lost count of how many thousands of birds he’d sampled over the years, looking for flu. But he’d never collected specimens from the kind of grim menagerie that now confronted him. Many of these animals were carnivores with claws and fangs. The merchants, engaged in a shadowy yet highly lucrative trade, could be equally vicious. Guan had won prior permission from Shenzhen health officials for this expedition. At least that would keep the police off his back.
Dongmen Market was huge. It sprawled across an entire city block, consuming the ground floor of a mammoth clothing-and-textile center. Stalls disappeared into the twilight of scattered fluorescent bulbs dangling from the metal ceiling. The odor was oppressive. “Where do I start?” Guan asked himself. He had applied his full deductive powers to the question even before he arrived. Whatever creature was the source of the virus, it had to be a mammal, he reasoned. That would explain why the microbe was so quick to become transmissible among humans, which of course are also mammals. So no turtles, snakes, or, for once, birds. The creature would also have to be fairly common. If it was too rare, the virus might have burned itself out before it had a chance to cross to people. Guan narrowed the list to eight species. He was especially interested in Himalayan palm civets, also known as masked civets because of the black and white stripes that run from forehead to nose and white circles around their eyes. About two feet long and ten pounds in weight, these catlike creatures have long been a popular Chinese delicacy.
He approached the traders. He explained that he and his team were looking to take a few samples from the animals: a throat swab, a rectal swab, and some blood. To get the blood, he would have to jab a needle into the heart of each beast. It would be too hard to find a vein through all the fur.
The dealers wanted no part of it. They were afraid Guan might kill or otherwise harm their lucrative creatures, perhaps somehow rob them of that raw bestial energy that made them so coveted by customers. But if Guan was willing to buy the animals, well, then they could do a deal.
Guan pulled a thick wad of Chinese banknotes from his pocket. He had thousands of dollars worth. Yes, he’d pay, he told them. But not full price. Here’s how it was going to be: He would give them one hundred yuan to sample an animal, about twelve dollars each. If the animal died within a day, the trader could notify Shenzhen’s disease-control officers and be compensated in full. The traders agreed and crowded around, eager for easy money.
There wasn’t enough space at each stall to take specimens, and it was too dark to see. In any case, Guan didn’t want to scare off anyone’s business. So once he made his selection, he had the merchants lug the cages to the muddy alley outside. There, amid all the hustle, among the army of porters hauling crates of poultry and produce, exotic roots, mushrooms, and broad bushy vegetables, in between the handcarts, trolleys, and bicycles stacked with boxes, Guan spread a plastic tarp, put down his gear, and prepared to operate. He slipped on a white lab coat and mask. He donned thick protective gloves. The curious quickly crowded around. Guan and his colleagues asked the security guards to push them back. “There’s virus,” he warned.
Before they could begin, Guan’s team had to anesthetize each animal, pump it full of ketamine. That meant coaxing an often hostile creature out of its cage and plunging a needle into its flesh. “It’s very, very dangerous,” Guan advised. “They can bite you. The civet, his head can spin around 360 degrees and you never expect it. To catch it by its back, it’s too hard to do that.” Some beasts cowered, some lunged. So to restrain them, the researchers used a special tool fashioned from a long tube with a Y-shaped attachment that fit around the animal’s neck. With its head thus pinned down, Guan and his colleagues wrestled the critter to the ground and injected the anesthesia.
The subject soon went limp. Guan stuck a needle into its heart, filling a vial with blood. “My medical training helped me a lot,” he recalled. Next he inserted a swab into the animal’s throat and finally into its anus. Over the course of two days, he jabbed and swabbed twenty-five animals, including a half-dozen civets and assorted beavers, hog and ferret badgers, muntjacs, raccoon dogs, and domestic cats.
Back at the university lab, he quickly found the evidence he was looking for. He isolated the SARS Coronavirus in samples from the civets and one raccoon dog. These animals plus a ferret badger had antibodies that indicated they had been infected. There was no way to know whether these species were the ultimate origin of the pathogen or had caught it somewhere else. But it was now clear how the virus was spreading to people. The wild-game markets had to be shuttered.
Based on Guan’s research, WHO urged China to close them down. This time, at least for a while, China listened. New infections ceased.
On July 5, 2003, the world officially defeated what Shigeru Omi, WHO’s regional director for East Asia, later called “the first emerging disease of the age of globalization.” The agency reported that the SARS epidemic was over. The last chain of transmission had been severed in Taiwan, with no new cases detected there since mid-June. The global death toll had been kept below eight hundred.
This epidemic had been contained, first and foremost, through the successful isolation of those infected. Some countries, like Vietnam and Singapore, had tackled it more aggressively than others, adopting measures like temperature screening for airplane passengers and hospital visitors, isolation rooms at airports, designated wards for suspected cases, and rapid tracing of those who’d been exposed. But in the end, the key everywhere was preempting the virus before it could infect again.
Had the pathogen been a novel strain of flu, the strategy would have failed.
Pandemic would have followed, potentially with millions of deaths, and not because of any human miscue. The difference is wired into the biology of these two viruses.
On many scores, there is an uncanny resemblance between influenza and SARS. They are both cruel respiratory afflictions that originate in animals and cross to the humans who prey on them. Like SARS, flu has often if not always emerged out of southern China, where live markets have proven central in amplifying and spreading the disease. Yet flu is far more sinister.
Flu, for starters, is a more nimble virus that spreads with an ease unmatched by other respiratory diseases. “Flu replicates far more efficiently in humans than SARS,” Guan reminded me. “After adapting to humans, SARS can spread quite quickly. But if compared to flu, it is still quite slow.”
In analyzing outbreaks, researchers focus on what they call the basic reproductive number. That figure represents how many other people are typically infected by each sick person. Obviously, the higher the number, the more infectious the disease. An early study of SARS concluded that its reproductive number was lower than that for other respiratory viruses. Researchers said this accounted for why SARS could be contained. Later research compared SARS and flu and found that the transmissibility of flu, as represented by its reproductive number, might be three times greater or more.
SARS was also a soft target because its victims became contagious only after developing a fever and other symptoms. An analysis of SARS patients in Hong Kong found the amount of virus in their nose and throat remained low for the first five days after they started feeling sick, only peaking on the tenth day. When researchers looked at the actual pattern of cases, they reached a similar conclusion that people were rarely contagious in the first few days after they came down with symptoms. Typically it took almost a week or more. For public health authorities, this pattern was a blessing. It gave them ample chance to identify and isolate victims before they disseminated the virus further.
“It is difficult to escape the conclusion that the world was very lucky this time,” wrote a team of researchers from Britain and Hong Kong, adding that an anticipated flu pandemic by contrast could have a “devastating impact.”
With flu, people may be contagious even before they develop symptoms. One analysis estimated that between 30 and 50 percent of those infected with a novel flu strain would catch it from someone who wasn’t yet ostensibly sick. The true figures will depend on the specifics of the strain. But still, in a brewing flu epidemic, there may be no sure-fire way to determine who is contagious and isolate them. Even those infected might be ignorant of their fateful role in spreading the plague until it’s too late.
“Once adapted to human-to-human transmission, influenza is highly transmissible, both in the late incubation period as well as early in the disease. Therefore, its spread may not be amenable to interruption with the same public health measures used to contain SARS,” wrote Peiris and Guan in the cautious language of scholarly publication.
In person, Guan was more succinct: “From a single spark, you can burn up the world.”
I visited Guan several times in the years after SARS. When I last met him at his university office, he was agitated as usual. It was flu, not SARS, that was keeping him up late at night.
“I can see what many people cannot see,” he told me. He had always been a bit of a Jeremiah. “For me as a scientist, my record and reputation are fully acceptable to the scientific community. So why do I keep working so hard?”
He paused and reached across the table to pour me a cup of traditional Oolong tea from a white ceramic pot.
He resumed. “The flu virus is not easy to track down. I am building up information so I can know where and how a pandemic might happen. I want to tell the world we can create a different future.” He was on his pulpit, urging humanity to prepare for the inevitable mutation of the virus and adopt economic and political reforms that would stem its spread. These should include restructuring farms, markets, and trade and improving how disease is monitored. Most important, he preached, was candor in disclosing outbreaks when they occur. “If not, who will be the losers? The whole globe.”
Guan shifted on the edge of his chair and told me he envied Al Gore. As a former U.S. vice president, Gore could find the financing to make his film An Inconvenient Truth about the threat of global warming. Guan had been finding it hard to make his own exhortation heard.
“We are all sitting at the same table,” he continued. “We share the same benefits, share the tea. Globalization is good for promoting civilization. But if you’re part of globalization, you need to take responsibility. If not, it will damage not only one country but many, many countries.”
Guan himself had come to epitomize the age of globalization. From Jiangxi, where he grew up reading in the courtyard with chickens for companions, this country boy had worked his way to Tennessee to study with the dean of all influenza researchers and then found a perch at Hong Kong’s most exclusive university. There, he was quickly promoted to professor, awarded his own laboratory, and installed in a corner office on the fifth floor of the Faculty of Medicine with a spectacular hillside view of the western approaches to Victoria Harbor and Lantau Island beyond. When he breaks for a cigarette, he stares out the floor-to-ceiling picture windows, watching the procession of freighters and the setting sun burning into the mist. He travels the world, lecturing and consulting. Shortly before my last visit to see him, he had flown to my home city of Washington for a meeting with U.S. health officials, sending me a message by BlackBerry when his airplane landed but departing again before we could meet. Just three days after he’d set out from Hong Kong, he was home again. “Fifty hours in transit,” he told me afterward, somewhat bemused. The pace had left him little time for Jiangxi. Though he sent money home to support his brothers and sisters, he could only spare five days a year for his aging, melancholy mother. “I’m so sorry, mother,” he told her. “For 360 days a year I belong to the world.”
This globalized age offers untold firepower for fighting disease. It was via the Internet, for example, that some of the earliest rumors about SARS in southern China found their way to WHO, and the intense scrutiny of global media made it untenable for Beijing to keep the secret indefinitely. The agency’s virtual lab network wired together the world’s leading scientists as never before. Public health officials, even in poor, far-flung corners of the world like Mongolia and Vietnam, were quick to learn how to recognize, treat, and contain the disease with guidance from foreign reinforcements.
Yet for all the advances of this era, someone still has to grab the bird and swab its underside. There is no substitute for the grunt work of influenza field research.
Guan had continued to expand the sampling program that he launched with the lab at Shantou University Medical College. By 2005 he had about eighty people working for him, quietly collecting specimens every week from poultry and wild birds in seven provinces of southern China and Hong Kong. He had tapped into an old-boy network that dated as far back as Jiangxi, locally recruiting what he called his band of heroes. “They’re very brave,” he said. It wasn’t just the health risk. Most had some background in veterinary studies or health care, so they knew how to take proper samples and protect themselves from infection. It was also politics. The Chinese government was wary of this outside meddling and at times tried to block it. But using the cultural smarts he’d developed as a boy, Guan helped win his staff access to poultry markets across the vast belly of China even as officials grew increasingly uncomfortable with the extent of infection his program was uncovering. He demurred when I pressed him for more details. “This is a kind of top-secret weapon, a top-secret system.”
The logistics of maintaining this network were almost beyond Guan’s ability. The financial burden of paying the staff was tremendous. “They are working for the good of China, working for the good of Hong Kong, working for the rest of the world,” he kept telling himself. But the sampling of more than two hundred thousand birds over nearly a decade yielded an unrivalled library of ever-mutating influenza viruses. It came to represent the most comprehensive accounting of the pandemic threat, in essence an early-warning system for the world.
Guan told me in late 2007 that his research showed the virus was now smoldering in poultry across much of Asia, waiting to flare up. China had ordered a massive campaign to vaccinate chickens against bird flu, as had Vietnam and Indonesia. While this had helped curtail poultry outbreaks in many places and reduced the overall level of infection in birds, the practice had not eliminated the pathogen altogether. Birds were still spreading it but without overt symptoms. “The virus is covered up,” he warned. “We’re giving the virus a chance. Now the virus can travel freely and undetectably and easily be transmitted.”
Many in government and media had mistaken silence for peace.
“Because we don’t have a pandemic today,” he said, “don’t accuse of us of crying wolf.”
Guan had been at his apartment watching television on Boxing Day 2003 when his wife called. Though the day after Christmas was a legal holiday in Hong Kong, she had gone in to work, where she’d heard a disturbing report. After a half-year hiatus, there was a new suspected case of SARS in China.
Guan was not surprised. The Chinese government had reopened the wild-game markets months earlier despite his objections. The world’s concern over the disease had waned but not Guan’s. He had continued sampling wild animals. He had even expanded his effort beyond Shenzhen to cover other markets across Guangdong province. His findings were alarming. Not only was he discovering the SARS Coronavirus in most of the civets he tested; he was also turning up evidence of infection in a wider range of species than before. When he learned in December that a Chinese television producer had been hospitalized with the disease and been put into isolation, Guan knew what he’d have to do.
A week later, he met with senior Guangdong health officials at a Guangzhou hotel to argue his case. The civets had to be slaughtered. Guan was emotional, perhaps too emotional. The officials were skeptical of his judgment and resisted such a radical recommendation. The trade in wild animals was worth at least $100 million a year to the provincial economy. But when Guan had them compare the genetic signature of the virus from the ailing journalist with the one he had isolated from civets, they were stunned to see that the two were practically identical.
Later that day, the governor of Guangdong ordered that all civets on the farms and in the markets of the province be culled. Though three more human cases would surface in Guangdong that month, the outbreak would be rapidly contained. WHO credited Guan for helping preempt a second SARS epidemic.
“Before it got into humans, I knew it was coming, but other people said I was crying wolf,” he recounted. “After the first case, I said, ‘Let’s use direct scientific information to stop the outbreak.’ So it was averted.”
Guan now finds himself playing a prophetic role again. To anyone who listens, he says the moral of SARS is clear. The flu virus must be controlled in birds. Whatever it takes, the microbial agent must be extinguished before a readily transmissible flu strain jumps to people, because once it does, global spread is inevitable. There won’t be time to stop it.
But he laments that his counsel is again being shunned. Only now, with the flu virus so widespread, it could be too late.
“I did my job,” he said, rising to light another Mild Seven. “I can face God and say, ‘OK, God, this mission I did. I gave all this advance warning. I provided evidence. I did everything a scientist could do. The remaining job is for governments and politicians. And each person must pay the price if they go against the laws of nature.’ ”
The pair of Thai fighting cocks, long-legged and elegant, stalked each other around the dirt ring, feinting and probing for an opening. They puffed out their broad chests, flaunting their foot-tall physiques. Then they each settled into a brief crouch, face-to-face, beak to razor-sharp beak. As they spread the majestic plumage around their necks, electricity coursed through the arena with anticipation of first blood.
Generations of breeding had brought the prizefighters to this moment of steely, instinctive, hard-wired aggression, nurtured and shaped by hundreds of hours of training.
They attacked as one, lunging at each other through the air, colliding in midflight with the muffled thud of meat on meat and the frantic flapping of ruffled wings and tails.
Spectators leaped from their concrete-block bleachers, surging against the edge of the ring.
Feathers flew. Blood oozed from the wounded eye of one combatant, a lean, handsome rooster with rich black plumage and golden brown along the neck and back. Even more was flowing from the throat of his adversary, an equally graceful creature with a white body and black trim along the wings and tail. His neck was quickly staining red.
Cries swelled in the bleachers as the spectators doubled and redoubled their wagers like frenzied traders on the floor of a stock exchange. Phapart Thieuviharn, a lifelong cock breeder with intense brown eyes and straight black hair speckled with gray, shifted anxiously on the edge of his seat, clutching the notepad on which he had scribbled his bets. Hundreds and perhaps thousands of dollars in Thai baht would ultimately change hands once one of the roosters finally surrendered to its injuries.
But Phapart and 125 other spectators were wagering more than their banknotes. They were gambling with their lives. In the years since bird flu began racing across Southeast Asia, cockfighting has repeatedly been implicated as a killer. It has sickened cock breeders and enthusiasts from Thailand to Vietnam and spread the virus on to Malaysia and perhaps even to Indonesia through the smuggled exports of prized fighting birds.
Cockfighting has long been a prominent feature of rural Southeast Asia, intertwined with its history, a spectacle for kings and peasants alike. For centuries, it seemed to pose no human threat but was just one more tradition that wove together the lives of man and bird into the fiber of daily existence. Villagers shared their homes with their chickens, peddled poultry at live markets, and integrated wildfowl into religious rituals. But these traditions, benign for humans if not the birds, have lately acquired a sinister edge. They have proven largely impervious to the admonitions of public health officials, who have urgently warned that the practice could unlock flu’s devastating potential.
In fundamental ways, modernity has recast this corner of the world, unleashing dramatic economic changes that have magnified the potential for a pandemic strain and weaving the region into a globalized planet now exposed as never before to viral threats born of Asia. Yet Asia’s past could also be mankind’s undoing if age-old conventions give the virus entrée into the human population. Time and again, the intimate contact between fighting cocks and their doting breeders has proven a fatal attraction. Even for spectators at the cockpit, the brew of rooster blood, breath, and mucus that sprayed the ringside could be lethal.
Yet flu seemed of little matter on this sultry Sunday when Phapart had agreed to take me to the fights. We had driven about forty miles from his home in the northern Thai province of Phayao, where the sport had been banned because of public health concerns, to neighboring Chiang Rai province, where it was still allowed. But gambling was not. So local villagers thought it prudent to build their arena away from the main roads, far from the inquisitive eyes and outstretched palms of law enforcement. We turned off the paved road and headed down a long, unmarked dirt track that stretched deep into the emerald rice paddies until we reached a clearing. Though barely midday, the dirt and grass lot was already filling up with dusty pickup trucks. A young man collected fifty cents from Phapart. By midafternoon, the attendant would net about two hundred dollars in parking fees.
We walked over to what Phapart called the stadium. It was actually a whole cockfighting complex, a cluster of open-sided sheds with thatch and corrugated metal roofs. The main events were held in the central arena, a twenty-foot-diameter pit with red padding along the sides surrounded by three rows of concrete bleachers and a fourth fashioned from bamboo. Side matches were staged in three smaller rings without any seating. Food stalls peddled Thai noodles, soup, and other simple dishes.
The matchmaking had already started. Several dozen men, looking for action, had carried over roosters in woven bamboo cages and set them down near the entrance. There they sized up the competition, judging the other birds for weight and size, the other owners for the depth of their pockets.
A middle-aged farmer in a plaid work shirt had struck a match with a teenager in a red soccer T-shirt, and they shook hands on the first bout. Their birds, the black rooster with golden brown patches and the white rooster with black trim, each weighed in at about five pounds. Their base wager, sure to escalate over the course of the bout, would open at thirty-three hundred baht, or slightly more than eighty dollars. The fight organizer wrote their names on a blackboard outside the main arena, Golf Chai versus Mae Yao, and dispatched them to their corners.
For fifteen minutes, they prepped their fighters. Like trainers at a boxing match, they massaged the roosters to loosen their muscles. They wiped down the birds with moist towels warmed on a portable gas stove. The white rooster had somehow lost a wing feather. So his teenage owner, determined that his bird be properly accoutred, produced a spare white plume and glued it in place.
The spectators, mainly men from surrounding districts, filed into the arena, claiming spots on the bleachers. Those on the far side were silhouetted against brilliant sunshine. But beneath the metal roof, the ring was shady and cool. The stadium workers distributed small note-pads to the crowd so they could record their bets, and the scribbling began even before the referee barked the fight to a start. With a few words of whispered encouragement, the owners released their impatient, agitated birds into the ring.
The roosters strutted and stalked, and then they struck. Over and over they flung themselves at one another. They craned their lissome necks, red crowns high, and jousted with their beaks. They jabbed and kicked with the daggerlike spurs on their legs. Resolute and reckless, beautiful and brutal. First blood was just that, only the first. This fight was scheduled to go two rounds, twenty relentless minutes each, and toward the end of the opening round, their fine, well-groomed feathers were growing ragged and red from combat.
The spectators had crowded the lowest rows and were now hanging on every thrust and parry. Dozens leaned forward into the ring, their arms dangling at times within inches of the action. They scrutinized the rivals for a glimmer of doubt or weakness, a slight hesitation or momentary loss of heart that could presage final retreat sometime later on. The betting swelled, with the crowd barking out side bets across the ring almost as fast as they could jot them in their pads.
Two hundred baht. Five hundred baht! One thousand baht! Two thousand baht!!
When the referee called an end to the first round, the two owners rushed into the ring, swept their roosters up into their arms, and hustled them away. There was much to be done during the break.
On adjacent patches of dirt, the two owners followed the same, urgent regimen. First they scrubbed the blood from the birds. Clutching soggy rags in their bare hands, they firmly washed the roosters’ faces, followed by their necks, stomachs, and legs, repeatedly wringing out the bloody cloths on the dirt. Next they slipped the birds painkillers to help get them through the final round, prying open their beaks and popping in pills with their fingers. Each owner then grabbed a spare feather and inserted it into his cock’s mouth, twisting it in the throat to help clear blood and mucus. They withdrew the feather and ran it between their fingers, squeezing the slime onto the ground. Then they repeated the procedure.
As we joined the small circle of onlookers, Phapart explained that bruising and internal bleeding can become so painful that an owner must nick the swelling with a knife and suck out the blood with his mouth. Some owners have been known to remove excess mucus the same way. They do what it takes to keep the cocks in the game. “If the beak breaks loose from the mouth during a fight,” he continued, “you can reattach it with a small net wrapped around the head and then begin fighting again. If a claw breaks off, you can bandage it. If the wing feathers are loose, you can glue them back on.”
In the boxing matches of the West, prizefighters often rely on a “cut man” in their corner to help stanch bleeding from around the eyes so they can tough out another round. Since roosters are no better at battling blind, cockfighting has a similar craft. On this afternoon, the eyes of both birds were swelling shut. So in the final minutes of the break, the two men produced needles and thread and deftly stitched their roosters’ eyes open.
The referee summoned the competitors for the second round. Their owners, now smeared with blood and mucus and bird droppings, returned the patched-up cocks to the ring. There, they resumed the brawl where they had left it.
When the climax came, toward the end of the round, it came quickly. The white rooster had been stripped of more and more feathers and ultimately of his confidence. The spectators immediately noticed this tentative turn, and the sound of cheers and jeers swelled in the bleachers. Those few who were still seated jumped to their feet.
The black-and-gold aggressor continued his pursuit, pressing his advantage, pushing his foe up against the side of the ring. Attacking over and over. The white rooster was broken, its spirit finally crushed. In a wholly unfamiliar act that betrayed his very nature, he scampered away in retreat. A holler rose from the crowd.
This unforgiving competition is an acute form of natural selection. Losers perish in the ring or become supper for their owners. Winners prevail to fight another day and, if they win enough, go on to father the next generation of fighters.
“This the best way to breed,” said Apichai Ratanawaraha, an agriculture professor at Bangkok’s Thammasat University and a scholar of this blood sport. “You get the best of the best. Because Thai people in the countryside have selected their birds this way for generations, the fighting cock breed in Thailand may be the best in the world.”
Cockfighting spread centuries ago to Europe and onward to the Caribbean and Latin America. The fighting cock has transcended cultures as a symbol of virility and manhood. But the sport’s roots are in Asia.
Apichai told me that the peoples of East Asia have been raising chickens as gamecocks for just as long as they have been raising them for food: about 7,500 years. It was in Southeast Asia that mankind first domesticated chicken, most likely in Thailand itself. The poultry found today on farms across the world are descended from the region’s red jungle fowl, wild pheasants with golden bronze plumage draping the necks, wings, and backs and with black chests and tails that shimmer blue and green. The male of the species is much larger than the female, with a fleshy red wattle on his head and, during breeding season, an intense dislike for rival suitors. Early farmers found that pitting the males against one another made for a welcome diversion from the slog of subsistence agriculture, a way to unwind during the weeks after the harvest was finally in. “Cockfighting,” Apichai claimed, “was the first sport for human beings.”
Archaeologists around Southeast Asia have repeatedly uncovered relics portraying the pastime. Bronze artifacts discovered in Thailand’s Kanchanaburi province near the Burmese border depict cockfighting from 1,700 years ago. The sport also appears on the sculpted walls of the magnificent Angkor Wat temple complex in Cambodia, one of the grandest finds of modern times. Along the exterior of Angkor’s twelfth-century Bayon Temple, a three-tiered mountain of stone that rises at the heart of the complex, are extensive bas reliefs depicting the everyday life of the Khmer people nearly a millennium ago. Among the images of women peddling fish and giving birth, and of men hunting, kickboxing, and playing chess, is a scene of cockfighting that would be instantly recognizable anywhere in Southeast Asia today.
In Thailand, cockfighting assumed a special place in the national culture during the reign of King Naresuan, an accomplished military strategist and avid breeder of the late sixteenth century. When Naresuan was a still a boy, the armies of Burma overran the Thai kingdom of Ayuthaya and took him prisoner. They carried the nine-year-old prince off to Burma as a royal hostage to ensure the fealty of his father, the king, but allowed Naresuan to take his favorite rooster. In captivity, he pitted the bird against those of the Burmese prince and, as Thais tell the tale, vanquished them all. “Not only can this cock champion a money bet,” Naresuan told his jailers, “it can also fight for kingdoms.” The Burmese returned him to the vassal state of Ayuthaya at age sixteen in a prisoner exchange. During the following years, Naresuan became a renowned warrior, campaigning to drive the Burmese occupiers from Thai lands and declaring the restoration of the Ayuthaya dynasty. The Burmese dubbed him the Black Prince. On his father’s death in 1590, Naresuan acceded to the throne and reigned for fifteen years, extending the Thai domain to unprecedented frontiers. He adorned his palace gates with images of the cock. Monuments to the king still depict him surrounded by his roosters. The fighting cock became a symbol of national resistance. Even today, one of the most sought-after breeds is the Gai Leung Hang Khao, a fierce black-feathered bird with gold around its throat like a necklace and a long white tail; a cock that traces its ancestry back to the one Naresuan had carried into exile.
After Naresuan, the sport took a firm hold on the Thai imagination. The woven bamboo baskets of fighting cocks became ubiquitous in the front yards of peasant villages across the country. And it remains a pastime for the elite, with the most coveted breeds selling for $10,000 or more and up to $250,000 in bets changing hands at top matches. Thai celebrities and entertainment moguls have rallied to the cause of cockfighting as the tradition came under fire from public health specialists. The country’s most prominent devotee and outspoken partisan is a long-haired pop icon named Yuenyong Opakul, the godfather of Thai country rock ’n’ roll. Yuenyong rose to the top of the charts penning edgy songs about social injustice and performing them as the singer and lead guitar player of his band, Carabao. He cashed in on his fame as the spokesman for a Thai beer company and then launched his own brand of energy drink, called Carabao Dang, which quickly claimed a significant share of the market. Then, after bird flu erupted in Thailand in late 2003, Yuenyong emerged as vigorous defender of cockfighting, clashing with the government over its demand that roosters in infected areas be culled, defying a ban on vaccinating the birds against the virus by immunizing his own. (Thai officials worried that any poultry vaccination could undercut the confidence of foreign markets in Thailand’s massive chicken exports.) Ever the rebel, Yuenyong included the song “Vaccine for Life” in his CD Big Mouth 5: Bird Flu, which reportedly sold at least a hundred thousand copies.
Today Thai magazines devoted to cockfighting proliferate. Dog eared copies are a common sight in farmyards and the front seats of pickups. For a few more dollars, glossy books with colorful plates detail the attributes and ancestry of different breeds, including some that trace their bloodlines even further back than Naresuan. The black-tailed Gai Pradu Hang Dam, for instance, is descended from birds raised by King Ram Khamheng of the Sukhothai dynasty, who six hundred years ago extended the Thai kingdom as far as modern-day Laos and Burma.
The Burmese have never accepted Thai claims of superiority, whether in politics or cockfighting. If Thai cocks are famed for their aggressiveness, then the Burmese retort that theirs are smarter and more stylistic. Many Thais in fact do not contest that. Like Thailand, Burma has traditionally been a major exporter of gamecocks to other Asian countries.
But passion for the pastime spread across the region centuries before these exports. In Indonesia, cockfighting has a long history on the main island of Java and the Hindu outpost of Bali. Despite Bali’s mystical reputation as an oasis of transcendental peace, the island’s villagers have long preferred spending their afternoons betting on blood sport than joining tourists to watch dance performances of the Ramayana epic. Remarkably, the Balinese have assimilated this sanguinary diversion into their spirituality, making the neighborhood temple a prime venue for cockfights. When officials in Bali tried to combat gambling by suggesting that cockfights should be limited to major festival days, villagers balked. “We believe that to purify our sacred temple, you should have cockfighting regularly,” a Balinese matron named Made Narti told me when I spent an afternoon in her village. “The blood splattered by the cock will protect the temple and protect the whole village. If you go without cockfighting for a long time, our god Dewa gets unhappy. The bricks will fall out and the temple walls will collapse.”
If fighting cocks are bred for valor, strength, and stamina, then Phapart Thieuviharn was bred to be a breeder. His grandfather had emigrated as a young man from China to northern Thailand at a time when thousands of other Chinese were making a similar migration to the lands of economic promise in Southeast Asia. He settled in the pleasant farming province of Phayao just outside the infamous Golden Triangle, where Thailand, Laos, and Burma all come together in a remote, hilly region that for years produced much of the world’s opium. He found a piece of land in a valley nestled between high mountains, built a traditional wood home on stilts, and began raising chickens. His prize possessions were about ten cocks he bred beneath the house. He fed them on scraps from the family table.
Phapart’s father substantially expanded the family’s landholdings but always found time away from farming to pursue the family passion, raising cocks and training to become a cockfighting referee in local arenas. Later, around 1970, he bought a parcel of land in the province and built his own.
Phapart, who was forty-seven when I first met him at an empty fish restaurant beside the province’s scenic Kwan Phayao Lake, said fighting cocks were a part of his life from birth. “Even before I can remember, I was already caring for them,” he told me. When he was seven or eight, he would refuse to get a haircut unless he could take his favorite rooster with him to the barber. As a teenager, he rose hours before school to train his cocks and then pitted them against those of his teacher.
“When you raise fighting cocks, you see them from the moment you open your eyes in the morning. You can recognize the way each one coos,” Phapart explained, pushing up the sleeves of his green work shirt and chomping on an ever-present piece of gum. He had recently recovered from heart surgery, and though he was fit and vigorous, cigarettes were no longer an option. “We give them more love than we would a baby. You see, you and your children can talk in the same language. They can tell you what they want. But fighting cocks can’t. So you have to be even more attentive and give them even more care.”
Over the years, his flock grew and grew. He raised dozens of cocks at his home in Phayao town and kept hundreds more at a family farm near Thailand’s northern capital, Chiang Mai. Many of these cocks were bred as an investment and sold for a small fortune. Proven winners went for up to $2,500. Others he retained and personally groomed as champions. Their framed portraits now adorn Phapart’s house. But none was more accomplished and lucrative than a beautiful bird named Lucky, who retired undefeated after twelve matches. A picture of Phapart embracing the champ occupies a place of honor in his living room.
“It wasn’t about the money,” Phapart stressed. “It’s not like other gambling, like at a casino. It was about social status. It was about my pride as a winner.”
Not long after Lucky called it quits, tragedy struck. In late 2003, bird flu erupted across Thailand, ravaging the country’s poultry and outracing the government’s ability to contain it. The epidemic reached Chiang Mai and within days had sickened the roosters at the family’s farm. Birds bred for fierce character turned listless. “We saw the symptoms. We just killed them all,” he recounted, too pained to say much more. He never notified the government, just slaughtered six hundred roosters himself and burned their bodies. The economic loss was staggering, at least $150,000, and the emotional loss was worse. For good measure, he gave away ten other cocks he was grooming beneath a metal awning behind his house, fearing they might be next to catch the bug.
Phapart eventually restocked. He drove me over to his house to see his new flock. There were eight birds, still too young to fight but promising. They had good bloodlines, strong builds, and character. “I can tell they’ll do well,” he said with pride. He drew one of the roosters from its wire-mesh cage and cradled it in his arms. It was a handsome, frisky creature with a red head and black feathers tinged with brown.
“I love them, and I’m looking for more,” he said. But he continued, “If the disease comes back again, I will do it again and cull them again.”
He returned the bird to its cage and sat down on the edge of the practice ring he had built in his backyard. So far, the young cocks were healthy, he said. A government veterinarian had recently examined them and declared them free of bird flu. But Phapart quipped that he did not need some bureaucrat to tell him that.
“I know my birds. I check them every morning,” he said, irritation flashing in his eyes. “You have a very close relationship with your fighting cocks, and the closer you are, the more confident you are about their health. You know their condition.” Emphasizing each word somewhat defensively, he added, “That is why I am not afraid.”
“The villagers around here and their fighting cocks communicate heart to heart,” Phapart told me as we set off in his Isuzu 4x4 for a breeder’s tour of Phayao town. “They share the same spirit and the same daily life.” He had volunteered to give me a crash course on the care and conditioning of gamecocks. It would also be a chance for him to dispense advice to some of the townspeople who were planning to enter their birds at a few of the more competitive arenas. Phapart estimated that at least two-thirds of the local families raised fighting cocks. “Cockfighting connects people in the same community,” he continued. “We’re a farming country, and after we work hard in the fields, this is how we like to relax.”
We drove though a leafy neighborhood and pulled up in front of a farmhouse set well back from the road. The front yard had been converted to a training camp. The air was heavy with the tart smell of poultry and the crowing of roosters. Two dozen metal cages were arrayed around the grounds.
In a makeshift ring fashioned from concrete block and plastic tarp, a hired trainer was teaching a young prospect how to feint and dart. The man, a dour fifty-six-year-old named Decha with a black shirt and green cargo pants coated with dander, had wrapped his bare right hand beneath the chest of an old, retired rooster, palming it like a basketball and rocking it back and forth toward the young cock. Decha lunged forward with the old bird and then jumped back. He thrust it in and pulled it out, then swung it from side to side. The young cock followed the moving target intensely, ducking and dodging, pecking and kicking. Decha looped the old bird over and behind his student, and the young prospect spun around furiously, feverishly trying to land a blow.
Decha had wrapped strips of black sponge around the spurs on the young cock’s claws, both to keep them from cracking during practice and to protect the old rooster. But blood was still drawn, including the trainer’s. His hands and arms were scarred and swollen from the errant attacks of his pupils.
When the exercise finished, Decha released a second young cock into the twenty-foot ring and let the two prospects spar for about five minutes. They puffed out the plumage around their necks and repeatedly pounced at each other in a whoosh of feathers and fluff.
“Train harder,” Phapart counseled Decha. “They’re not really strong enough.”
Phapart explained that roosters must be exercised every day. They should be drilled on walking to build their leg muscles and drilled separately on kicking. At least once a month, he continued, they should be pitted against other cocks in full-length practice bouts, their beaks covered with little sacks much like boxers sparring with headgear. The birds would require three months of intensive training before they were ready for the arena.
Our next stop was the Khun Dej Camp on the edge of town, a sprawling training facility that Phapart billed as a “gymnasium” but was really more of a boarding school for would-be contenders. In a long shed toward the rear of the property were ample quarters fashioned from wood and screen for promising candidates, with smaller cages for breeding hens. The owner, Sitthidej Sanrin, a solidly built forty-nine-year-old with a high forehead, thick mustache, and disarming smile, had been in the business for twenty-five years, following in the footsteps of his father and grandfather as a breeder and trainer. Many of the roosters were his own, but some belonged to clients who had entrusted him with the rearing and seasoning of their pricey investments.
When we drove up, Sitthidej was seated on the edge of a practice ring, clad in a red tank top and gray shorts. His legs were scratched and smeared with bird droppings, his feet bare. He had placed two roosters in the pit, an older one still inside a metal cage and a young prospect loose outside. The latter, an exquisite bird with yellow and white feathers around its neck, was circling the cage, stalking, and then lunging, trying to peck through the bars. The caged veteran watched warily, spinning on his claws, parrying the attacks. For half an hour this dance continued, the young cock exercising his leg muscles. He had already fought twice in the arena and won. A third bout in Chiang Rai was imminent.
Sitthidej lifted the lid of the cage, letting out the old bird, and the two roosters sparred for a few minutes.
“Your cock will do well in Chiang Rai,” Phapart told his friend. “Over there, most of the cocks are very aggressive and like to fight up close. But yours likes to hang back and then kick. It’s a good style.”
Clearly pleased with this endorsement, Sitthidej scooped the young rooster from the ring and placed him in his lap. Then he reached over and grabbed a soft, moist towel, warmed it on a hot plate, and began to scrub the bird feather by feather, rubbing the muscles in the shoulders, back, and stomach. He gingerly held the rooster’s red neck between his thumb and forefinger and leaned back, surveying his condition, and then resumed. It was bath, massage, and sauna rolled into one, and Sitthidej continued meticulously for twenty minutes.
As part of the strict regimen, Sitthidej served the rooster a lunch of champions: the grilled meat of a local mountain river fish called kang, a lean, brawny creature so tough that the villagers of northern Thailand claimed it can survive out of water for an hour. The meat was minced and mixed with honey and herbs, including garlic, pepper, and lemon grass, and then rolled into marble-size pellets. “This is our secret formula,” Phapart offered. “It goes back generations. It makes them strong.” Sitthidej nimbly slipped the food with his fingertips into the cock’s mouth.
After a dessert of chopped banana, Sitthidej walked over to a wooden cupboard to grab the vitamins. The shelves were crammed with little bottles and containers, protein supplements, and various antibiotics. One jar contained yellow paste made from a local root, soaked and ground, used for special massages. Another contained facial cream to prevent skin disease and heal wounds. A third contained a red paste to be applied to the face before matches to toughen the skin. Beside it was a glass jar stuffed with replacement beaks and claws in case the bird’s own cracked or snapped off. Beside that were a needle and thread to stitch wounds closed and eyes open.
Sitthidej returned the rooster to his cage and moved it into the tropical sunlight. It was time for the bird’s daily sunbath before he would retire to his quarters. Phapart teased his friend that there was no music to serenade the bird, recalling that other trainers played Thai country songs while the roosters lounged in the sun. “In truth, the music is for the owners more than for the cocks,” Phapart admitted. He smiled and the corners of his eyes crinkled. “But it makes the birds happy too. Sometimes they even try to sing along.”
Komsan Fakhorm, an eighteen-year-old from the eastern province of Prachinburi, loved his fighting cocks, as Thai men had for generations. He would clear their throats by sucking out the blood, mucus, and spit from their beaks with his mouth. He would sometimes sleep with his favorite roosters.
On the final day of August 2004, the young cock breeder fell sick. He had a fever, a nasty cough, and difficulty breathing. Though Thai officials later faulted his family for waiting too long to get him medical care, by September 4, he had been admitted to the hospital. Three days later, he was dead.
There was no doubt this was bird flu. Thai health officials reported that thirty of Komsan’s hundred roosters had died in previous weeks. But this was the first confirmed human case of the virus in Thailand for months and a jarring setback to Thai efforts at containing the disease. After a series of false starts and premature declarations of victory, senior Thai officials finally had seemed justified when they announced that summer they had turned the corner and quashed the epidemic.
Thailand would continue to struggle with bird flu over the coming months. But by the end of 2005, a massive campaign by health and agriculture officers coupled with thousands of local volunteers had again appeared to banish the virus. It would be déjà vu. In July 2006, after more than seven months without a case, a seventeen-year-old boy from a province north of Bangkok fell ill with a high fever, cough, and headache. He was hospitalized five days later, deteriorated rapidly, and died after another four.
Thai health officials concluded that he, too, had caught the virus from a fighting cock. He had been infected while burying roosters that had died of bird flu. “The victim failed to report the death of his fighting cock because he was afraid the authorities would slaughter his birds,” Thai Prime Minister Thaksin Shinawatra told reporters angrily.
The livestock chief of the boy’s home province, Pichit, alleged an even wider cover-up, saying villagers had declined to notify officials that some of their cocks were dying because the birds were so expensive. Tests by the national livestock laboratory ultimately confirmed bird flu in samples taken from the carcass of a dead cock. When authorities learned of the outbreak and ordered that the surviving roosters be culled, the owners resisted. The livestock chief himself was disciplined for failing to prevent the outbreak, and a complete ban was slapped on cockfighting in Pichit and neighboring Phitsanu lok provinces.
Ever since the virus resurfaced in late 2003, cockfighting has played a role in spreading it around Southeast Asia. At least eight confirmed human cases were possibly caused by infected fighting cocks during 2004 alone.
These roosters have proven to be difficult targets for disease control efforts. Owners have frequently hidden their cocks when officials have ordered mass poultry culls. Others have smuggled the birds across provincial and even national lines to elude the dragnet. Each time they are moved, they risk introducing the virus to new flocks. When bird flu was confirmed for the first time in Malaysian poultry in August 2004, animal-health officers blamed illegal imports of fighting cocks from neighboring Thailand. In turn, several other countries banned imports of all Malaysian poultry, and an area of the northern Malaysian state of Kelantan, where the outbreak occurred, was put under quarantine to prevent further spread. The state’s chief minister, Nik Aziz Nik Mat, who doubled as the spiritual head of Malaysia’s Islamic opposition, slammed local cockfighters. He urged them to give up the sport and repent. While some Muslim clerics opposed the culling of cocks and other poultry as un-Islamic, Nik Aziz endorsed the draconian measure but asked that it be carried out away from villagers so as not to antagonize them.
Some animal health investigators have also suggested that cocks exported from Thailand were behind the far wider outbreak of bird flu in Indonesia. In 2002, the year before the virus swept the region, Thailand shipped nearly six thousand fighting cocks abroad, most of them to Indonesia, according to the Kasikorn Research Center in Bangkok. Later, Thailand may also have been on the receiving end. Health officials speculated that illegal cockfighting tours reintroduced the virus from Laos into the northeast of their country after a long hiatus. Thai cock owners, including a government livestock officer whose own roosters later died, had been stealing across the broad Mekong River to pit their birds against Laotian opponents despite an outbreak on the far side of the border.
The allegation by some Thai officials that cockfighting helped seed the regional epidemic leaves the sport’s partisans seething. “The government is telling lies,” Phapart retorted when I asked him about the claim. He insisted the poultry industry and not fighting cocks was to blame. (Some Thais have also objected to cockfighting on the grounds of animal cruelty, but their calls for prohibition have never gained traction.)
To regulate the movement of fighting cocks, Thai agriculture officials suggested a modern, digital fix for this ancient pastime. They recommended inserting microchips into the roosters. But this prescription was no better received than the diagnosis. “That’s ridiculous,” Phapart scoffed. “They move around. They don’t stand still. How are you ever going to put a microchip into them?” He said a microchip could cramp their agility and leave them vulnerable. “When they fight, they get hit in every part of the body. It might create a weak spot. What if they get hit in the chip? They might run away and you would lose your thousand-dollar bet.” Senior Thai officials ultimately agreed with this widely shared critique and dropped the microchip proposal.
They had only slightly better success with their plan for fighting-cock passports. Local veterinary departments began issuing travel documents for each rooster with its photograph on one side and a register of its movement on the other. Every time an owner planned to take his bird across district lines, he was required first to visit a government veterinarian, who would examine it, record the trip, and stamp the passport. These control measures were to be supplemented with random testing of fighting cocks. Phapart said he personally obeyed the regulations but the whole notion made him chuckle. “Many people don’t use the passports,” he explained. “Less sophisticated villagers don’t care. They just keep breeding and pitting their cocks like they always did. They just tell their friends that they’re going to meet up and hold a fight before the police come. They even have someone to look out for the police.”
Phapart urged that cock owners be left to regulate themselves. In this age of cell phones, he said an outbreak in one village is instantly flashed across the district through text messages, and owners effectively quarantine the infected area themselves. No owner would want to see bird flu spread among his own prized roosters.
“The decision makers analyze the situation just on paper,” he said, growing agitated again. “Their feet aren’t on the ground. They don’t really know how we treat the cocks and don’t really share our feelings. We care more for the fighting cocks than the health officers do.”
But for a growing minority in Thailand, the debate keeps coming back to the basic question of whether it is time to ban the pastime altogether. Phapart leaned forward intently and vowed, “They’ll never be able to stop us from doing cockfighting.”
In contrast to the brawny, exquisitely groomed gladiators of the cockpit, the vast majority of Asian chickens are scrawny, sorry creatures. In Indonesia they’re known as kampung chicken, or village chicken. They root around in the dust and slime, often living off discarded rice, fallen leaves, morsels of overripe mango, and whatever else they happen across. So when Indonesians are given a choice between dining on these vagabonds of the backyard and on their plumper distant cousins raised commercially for the market, the response is unanimous, and surprising. “It’s obvious,” Ketut Wardana, a Balinese villager with a shock of dark hair and droopy mustache, confirmed for me. “Kampung chicken is healthier, tenderer, and much more delicious. Our kampung chicken is raised on natural food, not those chemicals like the broiler chickens in the market.”
In Bali, as throughout the Indonesian archipelago and much of the region, a home is not a home without a chicken, or several dozen. They pretty much come and go as they like, sleeping as often in trees and under beds as they do in their own cages. The Indonesian government estimates that 30 million households raise poultry. It is their intimate presence in the lives of so many Asians coupled with the near-total absence of safeguards against contagion that makes backyard poultry farming what the U.S. Agency for International Development has called “the greatest single challenge to effective control of the spread of the virus.”
Wardana raises twenty-five chickens behind the ornately sculpted walls of his family’s traditional compound on Bali’s lush east coast. When he invited me inside the courtyard, the air was fragrant with frangipani blossoms and the grounds tranquil, shaded from the sun’s midafternoon rays by a stand of palms. At his feet, a black hen cackled. “It would be hard to imagine life without chickens,” he said, nodding with a laugh. “Life would lose its flavor without chickens.”
Yet culinary concerns are the least of it. Chickens are central to home economics, he continued, taking a seat on the wooden floor of his bale dangin, the raised pavilion at the heart of most every Balinese compound. They are a way out of poverty. If the family is hungry, they can always sup on chicken. If they’re short of cash, they can hawk them in the market and earn a premium over the price for commercial poultry. When the new school year began and his brother needed shoes for his two children, Wardana sold several chickens to raise the money, and chicken paid the doctor’s bill when his wife got sick. “They’re our living wallet,” he quipped.
Chickens also constitute part of the social contract binding communities together, providing what Wardana’s matronly neighbor Made Narti described as the “solidarity of the centuries.” Though her good fortune has translated into a flock of several hundred chicks, she recalls a time when she was hungry and had to turn to her fellow villagers of Tegal Tegu for chicken. She said she has reciprocated countless times. “For generations, chickens have lived very close in the lives of us Balinese,” she recounted. The elderly raise chickens as a hobby. The devout raise them as a matter of faith. Four times a month, Narti slaughters a bird and carries it with a plate of fruit and flowers down the narrow, walled alley to a Hindu temple. It’s an offering to the gods.
Some public health officials have urged an end to backyard farming. But it is so tightly stitched into the cultural fabric of Asian life that the prescription is sure to fail. “If you seriously proposed eradicating backyard poultry farming, you would get a lot of undesirable outcomes,” said Jeffrey Mariner, a veterinary professor at Tufts University dispatched to work with the UN Food and Agriculture Organization in Indonesia. Senior FAO officials have cautioned that a ban would simply force poultry farming underground. This could also alienate villagers from other programs to control the virus, for instance notifying authorities of outbreaks, Mariner explained.
Mariner is not one to underestimate the threat of flu. In early 2006, he helped set up and train teams of inspectors to uncover outbreaks that had gone undocumented. “We thought at the time we’d find that bird flu is underreported. We never imagined the extent to which this is true,” he said. They started with twelve districts on Java, then twenty-seven districts, then the outer islands. Everywhere the teams looked, they found the virus. Even on training exercises they found it. “It’s very widespread, and it’s difficult to address the disease, since it’s in the backyard system.”
In the two months before my visit to the village of Tegal Tegu, Mariner’s teams had confirmed a dozen different outbreaks in Bali, including a pair just days earlier. Animal-health officials had burned more than a thousand chickens in a bid to contain the epidemic in one location on the resort island. Though Narti had heard about bird flu on television, she remained oblivious. “Bali is safe. There’s no bird flu here,” she assured me. Her warm eyes, full cheeks, and thick lips offered a mother’s comforting smile. “It happened on Java. The chickens that got bird flu on Java had white feathers. My chickens mostly have green feathers.”
Researchers elsewhere in Southeast Asia have found that villagers are widely cognizant of bird flu’s perils yet continue to take risks with their own backyard birds. As they have for generations, they handle sick and dying fowl, butcher and eat birds that have died of illness, and even let their children play with infected livestock. The contradiction is not surprising. For years, long before the disease struck, they have seen their own relatives and neighbors engage in these practices and rarely come to harm. As a precaution, Narti volunteered she was in the habit of separating out any of her birds that seemed sick and fortifying the rest with vitamins, including a supplement to combat depression and stress. “But there’s really nothing to worry about,” she added. “I don’t think it could happen here.”
Asia’s live poultry markets leave many Westerners queasy. Deep inside the cavernous Orussey Market in the Cambodian capital, Phnom Penh, a short walk from the fairy-tale spires of the royal palace, scores of live chickens and ducks are crammed together, legs bound, on wood pallets speckled with droppings. Shoppers stoop over to scrutinize the birds like customers examining cantaloupes in a Safeway, then hang the beleaguered creatures upside down from hooks to measure their weight. Some shoppers carry off their cackling purchases to finish them off at home. Others turn them over to butchers, who hunch on the muddy floor, slitting throats and plucking feathers. So, too, in the dim light of Jakarta’s Jatinegara Market, one of more than thirteen thousand live poultry markets in Indonesia, a dozen boys squat amid stacks of pungent cages on a tile floor slick with death. With swift slices of the knife, these barehanded youths dismember the chickens and then tug out their entrails, heaping them up for waiting customers. Blood trickles down ruts in the floor and spills into the alley outside.
Many Asians swear by freshly killed chicken, duck, and goose, insisting they are tastier and more nutritious. But Robert Webster has vigorously argued that “wet markets” represent a perilous nexus where flu viruses can amplify, swap genetic material, and spread. WHO’s expert committee on avian flu has endorsed this view. Each morning, live markets are restocked with birds, and with them new microbes. They can infect merchants, customers, and other animals, who by day’s end may carry the contagion onward to new frontiers. Researchers in the early 1990s identified live markets as a “missing link” to explain flare-ups of a low-pathogenic strain among poultry in the United States. After the 1997 human outbreak in Hong Kong, investigators ultimately traced six of the deaths back to wet markets. The city instituted new safeguards, including the screening of poultry from mainland China and a ban on the sale of live ducks and geese. But the virus nonetheless returned to Hong Kong’s markets five years later. On the mainland, where an even wider array of flu strains has continued to circulate amid the poultry stalls, Chinese researchers concluded that six city dwellers who came down with bird flu had likely caught it during recent market visits. These patients had no other known exposure to sick poultry.
Yet despite these scientific warnings, Asian governments have been hard-pressed to break people of their longtime passion for freshly butchered meat. Some countries, notably Vietnam, have begun phasing out wet markets and building modern slaughterhouses. But Webster counseled that, as with backyard farming, a complete ban on wet markets would simply drive this commerce underground. Demand would remain strong and prices high while monitoring for disease would become far more difficult.
Among Southeast Asians, it is Vietnamese who take fresh furthest, with a delicacy called tiet canh vit. This popular pudding is traditionally prepared from raw duck blood and served at meals to mark the anniversary of a death in the family, the celebration of Tet, the lunar New Year, and other special occasions. It is typically washed down with rice wine. Tiet canh vit is also sold widely in the market. Health investigators suspect that at least five people from two families in northern Vietnam contracted bird flu after feasting on the dish. After hearing this, I told a Vietnamese friend in Hanoi that I simply had to have the recipe. She e-mailed the following.
1. Cut a small incision in the duck/chicken to get the blood in a bowl. Pour some drops of lime into the blood bowl.
2. In a separate bowl, mix chopped bowel and stomach together.
3. Mix the blood liquid (the first bowl) and the stock (the second bowl) with the ratio of one spoon blood to two spoons stock. You will also put some fish sauce in, as much as desired.
4. Set aside for about half an hour. The mixture will form a texture like pudding cake.
For many in Asia, birds are an essential element of everyday life, synonymous with sustenance, commerce, companionship, and even national identity. Moreover, for some, they are also linked to aspirations not just for this life but for the life to come.
Over the centuries, Buddhists across much of Asia have released the sorrows born of sickness, hunger, and war through the simple, cathartic act of buying caged birds and setting them free. In front of the shimmering gold pagoda of Wat Phnom, erected on the wooded knoll that lent Phnom Penh its name, Cambodian devotees reach inside the metal and wire mesh cages, draw out sparrows, swallows, munias, and weavers, often in pairs, and raise them in cupped palms to their lips. The adherents mumble a prayer and, often with a kiss, set them free into the warm, still air. But this tradition, in which devotees seek blessings for this life and the next, could now prove to be a curse. The lethal flu strain has been isolated from some of the wild species most commonly peddled outside the shrines of Buddhist Asia from Thailand to Taiwan. The hazards posed by the collection and release of these so-called merit birds is akin to that of live poultry markets.
Kong Phalla has been selling merit birds from the cobblestone sidewalk at the base of Wat Phnom since she was eight. A slight woman in her twenties with small brown eyes, she had the familiar look of those who trade their childhood for the hustle of the street: a thin veneer of smarts overlaid on innocence. She approached me with a lotus stem in one hand and a cage crammed with birds in the other. She said the birds had been shipped into the capital overnight by riv erboat. She had already sold nearly three dozen to worshipers. “They want to free their depression, free their sadness and illness with the birds,” Kong Phalla explained. Her dark hair was tucked under a red knit cap despite the day’s gathering heat. She rested her load in the shade beside a table of incense sticks and flashed a weak smile, saying she had brought five cages to the pagoda that morning and was confident all one thousand birds would be sold by nightfall. The birds went for about fifty cents each, good money in Cambodia, though Kong Phalla got to keep only a tiny fraction. On holidays like Cambodia’s New Year, when business was especially brisk, she said, prices could triple.
Bird flu was of no concern, Kong Phalla continued, patting the cage. It’s only the foreign tourists who fret. She snickered. “They’ll only open the doors of the cages and ask me to release the birds myself so they don’t have to touch them,” she said, adding with a boast, “Bird flu has never happened to me.”
Kong Phalla spied one of her frequent Cambodian customers drive up to the curb in a new Toyota sedan and get out. She instantly abandoned her thought, grabbed the cage, and gave chase. She followed him up the long brick staircase, past the statues of lions and pink balustrades of mythical serpents and beyond the stone stupas above, beseeching him at each step to purchase some of her birds. He acceded just before vanishing into the sanctuary on the crest of the hill. Kong Phalla put down her cage on a stone bench beside those of other peddlers and waited for her next chance.
To understand this Buddhist custom, I sought out a monk named Khy Sovanratana. I found him at his monastery in the center of Phnom Penh, a once romantic city of French colonial villas still trying to collect its thoughts three decades after Pol Pot’s reign of terror. The Khmer Rouge had abolished religion, decimating the country’s Buddhist institutions. Since then, Buddhism has revived, monks bearing alms bowls have returned in large numbers to the early morning streets, and Khy Sovanratana has emerged as a commentator on morality and social issues. Though his close-cropped hair was still black with youth when I met him, his learning had already elevated him into the ranks of senior clergy. When he received me, he was seated cross-legged on a thin cushion, his orange monk’s robe draped over his left shoulder.
The monk started by recounting a legend of Prince Siddhartha, the Indian nobleman who would later attain enlightenment and become the Supreme Buddha. The young prince and his cousin were walking through the woods when they spotted a swan. The cousin drew his bow and shot the swan with an arrow. Siddhartha raced to the injured bird, refusing to relinquish it. His cousin grew furious. But Siddhartha caressed the swan, eventually nursing it back to health before setting it free.
“This kind of conduct has had a big impact on Buddhist practices,” the monk said softly. “Giving life is very much extolled in Buddhism.” He explained that the simple gesture of releasing birds is rich in significance, and he slowly explicated the different layers of meaning. First, by giving life, a devotee follows in the footsteps of the Buddha. Second, the act of releasing the bird helps to cast off the “torments and tortures” of everyday life. And third, the act of liberating a living creature earns devotees religious merit toward reincarnation into a better life. For a person with financial means, the only limit on the number of birds to be released is his kindness. Sometimes, the monk said, adherents have been known to free not only birds but fish, turtles, and even cows and buffalo that are tied up awaiting slaughter.
But setting aside the sublime, Khy Sovanratana acknowledged that believers should not be blind to the dangers of this tradition. “There’s no point if you don’t get benefits but instead catch a virus,” he counseled. “Monks should be given this kind of awareness and pass it on to devotees when preaching.”
That’s a tall order in Cambodia, where this tradition is intertwined not only with religion but national identity. The king himself frees doves, pigeons, and other wildfowl about four times a month—in especially generous numbers to mark royal birthdays—and this has complicated efforts to regulate the practice. Its adherents rarely comment on the contradiction of trapping birds only to set them free, an irony compounded by the success of some boys in catching fowl moments after their release so they can be sold yet again. Not long before my audience with the monk, an environmental group based in the United States had tried to curtail the practice on the grounds that the sale of merit birds represented illegal trade in wildlife. The organization, WildAid, had established a rapid-response unit that included Cambodian military police and forestry officials and carried out several raids on bird peddlers. The campaign culminated in the confiscation of birds sold at Wat Phnom and elsewhere. But this provoked a religious and political backlash. The government suspended further raids.
Even in Hong Kong, which so successfully overcame public opposition in its decisive response to the initial bird flu outbreaks, officials have been reluctant to tackle this revered ritual. Nearly ten years after the virus first jumped to humans, fears of a new outbreak in Hong Kong surged when several dead birds recovered from city streets tested positive for the lethal strain. Among these were munias, which are not native to urban Hong Kong but imported by the tens of thousands from mainland China each year for Buddhist rites. The discoveries prompted Richard Corlett, an ecology professor at the University of Hong Kong, to publicly warn that bird releases posed the principal threat of reinfection in the city. Agriculture officials urged people to refrain from freeing captive birds and asked religious organizations to make a similar appeal to their members. But while the government ultimately suspended trading at Hong Kong’s famous Bird Garden market after an infected starling was discovered there, a similar ban was not imposed on merit-bird releases. The cultural sensitivities were too great.
By the banks of Phnom Penh’s Tonle Sap River stands an ornate, carnival-colored shrine called Preah Ang Dang Ker. Under its steeply pitched roof rests a likeness of the Buddha gazing across the broad gray waters. Around the outside linger peddlers surrounded by cooing and chirping. “I have no concern about getting sick with bird flu, and the buyers have no concern,” offered Srey Leap, a stocky woman in a sweat-stained shirt keeping vigil from the shade of an umbrella. “They never worry about this. It is our Cambodian tradition.” When a family approached, Srey Leap and the other hawkers converged. The five visitors paused to haggle, then purchased an entire cage frenetic with the flapping of about a hundred pairs of wings. They carried it to a low stone wall above the water’s edge. They pulled the birds two by two from behind the mesh and, with the occasional whisper of a prayer, set them loose, casting a line of silhouettes down the ancient river until the entire contents of the cage and whatever contagions it concealed had disappeared along the banks.
To thwart a gathering pandemic, the perimeter must hold. Once it is breached, there’s no turning back. This precarious frontier, the first and last line of defense separating the pathogen’s animal hosts from the human race, runs through thousands of remote Asian villages. These outposts are vulnerable and often unsuspecting, like the Javanese hamlets that scale the lush, terraced slopes of the Mount Lawi volcano. There, an Indonesian animal-health officer who goes only by the name Suparno had been drafted into keeping the virus in check before it crossed to people. But the day I met Suparno, he preferred to go to lunch.
It was late one morning in May 2005 when this lanky, good- humored veterinarian arrived at an elderly woman’s farmhouse partway up the slopes. Clad in the tan uniform of a civil servant, Suparno announced he’d come to inoculate her chickens against bird flu. While a human vaccine had so far proven elusive, workable poultry vaccines were already in production, and several Asian countries, including Indonesia, had made them the centerpiece of their efforts to contain the virus. Suparno knew the woman kept some chickens. Nearly every family in her village did.
“How many do you have?” he asked her.
“Twenty-five,” she answered. The woman motioned initially toward a low, concrete barn out back where she kept some of them. Then she swept her right arm in front of her, indicating the rest were wherever he might find them.
Suparno led his team around the side of the house into the cramped backyard. Crouching on the dirt, he set down the small, pink pail that held his gear. He took out a plastic bottle of vaccine, then slowly drew the fluid through a tube into an automatic needle. His colleagues produced five black hens from the barn, one by one, and clasped their wings and legs tightly while Suparno injected half a milliliter of vaccine into their breast muscle.
After only a few moments, he rose to his feet and got ready to leave.
“What about the rest of the birds?” I asked him.
“Too hard to catch,” he responded. They might be hiding in the trees or in the crawl space beneath the house.
Then, changing the subject, Suparno and his fellow officers agreed it was time to eat. He invited me to join them. With no irony intended, they suggested a local joint specializing in chicken.
I had come to the province of Central Java to spend several days observing Indonesia’s much-publicized effort at fighting the infection that had been coursing through the country’s flocks for more than a year. Central Java, as its name implies, is at the center of Java island, which, in turn, is home to the majority of Indonesians and has always dominated the country’s politics. My base would be the old royal city of Solo, host to one of Java’s two main sultanates. Solo remains the premier seat of Javanese culture and tradition. So I’d figured, given the political, cultural, and geographic centrality of the city, that the surrounding countryside would be at the forefront of the national campaign to root out the disease.
At first I was encouraged. The chief livestock officer in one nearby district, Sragen, told me how she’d set up a twenty-four-hour bird flu command center. Sri Hardiati, a gregarious yet autocratic woman with a stylish haircut and piercing dark eyes, described how her office monitored poultry outbreaks and even had a small diagnostic lab for dissecting stricken birds. But as I toured the countryside with my assistant, we discovered that containment efforts were just public relations. We had asked to see the vaccination campaign at work. Yet in district after district, livestock officials declined. They said they had none to show us. Finally, after some pestering on our part, Hardiati asked us to accompany her chief vet, Suparno. He made only one stop, pausing long enough to vaccinate the woman’s five black hens. When he bypassed all the other homes in the village, I realized the outing had been simply for my benefit, little more than a photo op.
Over the coming days, we would learn the extent of the ruse. Indonesia’s central government was claiming it provided millions of free vaccine doses for small and midsize Javanese farms and that 98 percent of these had already been used. But local officials and peasants told us this was fiction. “Maybe the farmers get the vaccine. The percentage who use it is small,” said the chief livestock officer in neighboring Karanganyar district. In Boyalali district, the chief livestock officer told me he had a hundred thousand doses in a refrigerator, but no one had asked for any in months. He was content to let them sit there.
As we continued to drive the narrow byways of the Javanese countryside, we were also starting to learn from villagers and local veterinary officers that die-offs among chickens had been occurring much longer than we’d believed. Indonesia had officially confirmed its first poultry outbreak in January 2004, not long after Vietnam and Thailand initially reported theirs. But the local accounts we were hearing contradicted the version we’d been provided back in the Indonesian capital, Jakarta. We were fast realizing that Indonesia’s central government had covered up the mounting epidemic for almost half a year, since mid-2003, until it was too late to reverse the tide.
Now, as we explored Central Java in May 2005, Indonesia had still to confirm its first human cases. But that too would change within months when death struck a suburb of Jakarta and Indonesia joined the growing list of countries with casualties. It wouldn’t be long before the death toll in Indonesia outstripped that of anywhere else on Earth.
Yet Indonesia wasn’t alone in concealing the disease. I would come to learn that every Asian country with major outbreaks in livestock had hidden them from view, for months or even longer. The fatal strain’s progress across East Asia had been a journey veiled in secrecy and blessed with neglect. This microbial killer, born in the deep south of China, had repeatedly slipped across international borders over the previous decade, evolving and increasing its virulence until the toll on both people and poultry could no longer be denied.
But even then, when it became untenable for governments to keep up the lie, they often chose to discount the danger rather than mount a serious campaign to defeat it. Instead of attacking the virus, they too often went after the scientists, journalists, and other whistle-blowers who tried to reveal the threat.
The virus exploited this opportunity to put down roots. It became entrenched in Asia’s poultry, thus posing a long-term menace to humanity. While some Asian governments eventually intensified their efforts to contain the disease, total eradication was now a distant prospect at best. Not a single one of these frontline countries—China, Indonesia, Thailand, and Vietnam—had adopted the most powerful disease-fighting weapons: truth and transparency.
Later, when I arrived on my first trip to Geneva, a senior WHO official gave me a piece of advice. He counseled me that influenza is all about politics. And those antiquated politics have proven every bit as intractable as the virus itself.
This tale of death and deception begins in the coastal Chinese province of Guangdong, close to where the first human cases were confirmed in Hong Kong back in 1997. The H5N1 flu strain, which went on to ravage farms on at least three continents, infect hundreds of people, and pose the most serious threat of pandemic in a generation, was first isolated in a sample taken from a sick goose during a Guangdong outbreak in the summer and early fall of 1996. That was more than seven years before China first acknowledged any infection in its flocks. By the time Chinese officials went public in early 2004 and stepped up efforts to contain it, the virus had already seeded outbreaks in the country’s neighbors.
Molecular biologists were later able to identify the Guangdong pathogen as the common ancestor of all subsequent H5N1 viruses by analyzing the eight segments of RNA that all flu viruses contain. Each of the segments in a single virus has its own signature, a specific sequence of basic building blocks called nucleotides that make up the RNA. As viruses evolve, these segments mutate. They can even be completely replaced as the promiscuous flu strains swap genetic material. In the lab, genetic genealogists determine the pedigree of viruses by looking for similarities in their RNA. Isolates that share the same pattern are often related and descended from the same specific virus.
A combined team of researchers from the U.S. CDC and China’s official National Influenza Center reported in 1999 that the virus that had killed people in Hong Kong two years earlier was related to the Guangdong goose isolate. The specific H5N1 subtype was identified at the Chinese influenza center. At least three other academic papers written in Chinese by Chinese researchers also reported in 1998 and 1999 that H5N1 had been isolated in Guangdong in 1996, disclosing in one instance that up to 40 percent of the geese on a farm stricken by the outbreak had died. These findings had been reported by Chinese government researchers in government publications. Yet for years, senior Chinese officials continued to deny publicly that Guangdong had been struck by bird flu in 1996 or that it had spawned the wider epidemic.
Over the coming years, Chinese and foreign scientists continued to report periodic outbreaks in southern China, including a large poultry die-off in Guangdong just months before the Hong Kong cases in 1997. A series of research articles published between 2000 and 2002 further documented that H5N1 viruses were continuing to circulate in southern China, for instance in geese and ducks exported from Guangdong to Hong Kong. The virus was also isolated in a specimen taken from frozen duck meat exported from Shanghai to South Korea in 2001. A team composed primarily of mainland Chinese researchers later reported that tests on ducks from southern China between 1999 and 2002 had repeatedly come back positive.
The most damning evidence came in a study published in 2006 by scientists from China, Indonesia, Malaysia, Vietnam, and the United States, which identified China as the wellspring of the international epidemic. “We have shown that H5N1 virus has persisted in its birthplace, southern China, for almost 10 years and has been repeatedly introduced into neighboring (e.g., Vietnam) and distant (e.g., Indonesia) regions, establishing ‘colonies’ of H5N1 virus throughout Asia that directly exacerbate the pandemic threat,” the researchers wrote. They concluded that addressing the “pandemic threat requires that the source of the virus in southern China be contained.”
Chinese initiatives to tackle the disease may have only fueled its spread and honed its lethality. Just days after the government first disclosed in January 2004 that it had detected the disease, New Scientist reported that Chinese poultry producers had been vaccinating their flocks against it for years. But the vaccination campaign may have been mishandled, obscuring the usual symptoms without eradicating the virus itself. “The intensive vaccination schemes in south China may have allowed the virus to spread widely without being spotted,” the magazine alleged.
Animal-health experts later told me about an even riskier strategy that China had adopted to suppress the spreading virus years before officials publicly disclosed its presence. Acting with the approval and encouragement of the government, Chinese farmers had tried to douse major outbreaks among chickens with amantadine, an antiviral drug meant for humans. As a result, international researchers concluded that this drug might no longer protect people in case of a flu pandemic. The H5N1 subtype circulating in Vietnam and Thailand had become resistant to the drug, which is one of two types of medication for treating human influenza, though another viral subtype found elsewhere was still sensitive to it.
China’s use of amantadine violated international livestock regulations. It had long been barred in the United States and many other countries. But veterinarians and executives at Chinese pharmaceutical companies said farmers had been using the drug to contain the virus since the late 1990s. “Amantadine is widely used in the entire country,” confirmed Zhang Libin, head of the veterinary medicine division of Northeast General Pharmaceutical Factory in Shenyang. He added, “Many pharmaceutical factories around China produce amantadine, and farmers can buy it easily in veterinary medicine stores.” Zhang and other animal health experts said the drug was used by small private farms and larger commercial ones. China’s agriculture ministry had approved the production and sale of the drug, and local government veterinary stations instructed Chinese farmers on how to use it by adding it to the chickens’ drinking water—and at times even supplied it.
One veterinarian steered me toward a popular Chinese handbook, titled Medicine Pamphlet for Animals and Poultry, which provided farmers and livestock officials with specific prescriptions for amantadine use to treat chickens and ferrets with respiratory viruses. The manual, written by a professor at the People’s Liberation Army Agriculture and Husbandry University and issued by a military-owned publishing company, prescribed 0.025 grams of amantadine for each kilogram of chicken body weight. Farmers also used the drug to prevent healthy chickens from catching bird flu, giving it to their poultry at least once a month and often mixing it with Chinese herbs, vitamins, and other medicine.
After China’s misuse of amantadine was first reported in the Washington Post in June 2005, the Chinese government angrily denied the account. “This is groundless and isn’t in accordance with the truth,” the agriculture ministry said in a statement. “The Chinese government has never permitted farmers to use amantadine to treat bird flu or other virus-related disease.” But the government-owned China Daily acknowledged in a front-page article that some farmers had in fact used the drug in poultry. The newspaper said the agriculture ministry planned to send inspection teams across the country to halt the practice. I was never able to determine whether it was indeed brought to an end nor the extent to which it had been part of a concerted Chinese effort to conceal the outbreaks. In private, officials at WHO had also been asking the Chinese government about the improper use of antiviral drugs in livestock. They, too, were never given a satisfactory answer.
From China, the virus had ventured south. It stole across the border to Vietnam and began infecting poultry there no later than 2001, more than two years before the children in Hanoi’s National Pediatric Hospital started succumbing to the mysterious outbreak of respiratory disease in late 2003.
Vietnamese scientists knew the truth about the early poultry infections. These researchers had participated in a study that the CDC’s intrepid investigator Tim Uyeki had helped put together sampling various species of poultry in the live bird markets of Hanoi. Uyeki had suspected that the novel flu strain was still circulating in China even after Hong Kong’s mass cull of 1997 had expunged the virus from that city. But mainland China was, for all practical purposes, off-limits for the kind of scientific study he envisioned. So he tried the next-best thing: peering in from the distance by sampling birds south of the Vietnamese border. In the fall of 2001, the researchers discovered two geese with H5N1 in a pair of Hanoi markets. This strain was closely related to the isolate from the Guangdong goose. Lab tests revealed that this pathogen was devastating for chickens, killing every single bird inoculated with the agent within forty-eight hours.
Sometime in 2002 or the first half of 2003, a new variant of the H5N1 virus again slipped across the border from China. This one was later traced to China’s Yunnan province, just north of Vietnam. It was even more virulent. Veterinary officers working in the rural districts outside Hanoi later recounted how it decimated poultry in the province of Vinh Phuc half a year before the government first announced Vietnam’s outbreaks in January 2004.
Among the first farms stricken was a commercial operation run by Japfa Comfeed, an Indonesian conglomerate with operations in four Asian countries and whose president commissioner, a retired general, would later become Indonesia’s director of national intelligence. The die-off was never publicized. But Japfa’s annual corporate filings later disclosed that bird flu had been discovered in June 2003 and severely affected the company’s Vietnamese operations.
The first outbreak killed twenty thousand of Japfa’s chickens. The company suspected from the symptoms that it was bird flu and sent samples to the agriculture ministry’s veterinary department for testing. Government officials hushed up their findings, informing the company that the deaths were due to an “unknown agent.” But Van Dang Ky, an epidemiologist in the veterinary department, later admitted that “the first signs of an epidemic” were found in Vinh Phuc in July 2003. The timing was inconvenient. “Vietnam was preparing activity for the Twenty-second Southeast Asian Games, and we did not announce it for political and economic reasons,” Ky said.
The Southeast Asian Games came and went that fall, with the prime minister opening the sporting competition at Hanoi’s new national stadium and Vietnam racking up the mother lode of gold medals, and still there was no announcement of the outbreak. Vietnam wanted no rerun of the SARS drama earlier that year, which had tripped up the country’s humming economy. Senior Vietnamese officials hoped to quietly contain this latest epidemic before it delivered a new blow to tourism and trade. But the virus refused to cooperate. It quickly spread to other commercial farms in Vinh Phuc and then to neighboring Ha Tay province, the heart of Vietnam’s poultry industry.
Early on, disease also struck the Vietnamese flocks of the Thai conglomerate Charoen Pokphand. The first outbreak eventually confirmed by the government was a massive die-off of chickens at one of the company’s industrial farms in Ha Tay. CP, as it’s commonly known, is Thailand’s largest business enterprise. Started by a family of poor Chinese immigrants, it grew from a small Bangkok seed company into a sprawling multinational, with operations in twenty countries ranging from agribusiness and retailing to telecommunications. The family’s connections to Thailand’s senior ministers are legend, prompting allegations from critics in Thailand that CP used these to cover up flu outbreaks on its farms. (By November 2003, the virus had begun devastating flocks in Thailand itself, though the government in Bangkok concealed this until late January 2004.) The company’s chief executive denied that CP had helped spread the disease across Southeast Asia or cover it up.
During one of several trips to Ha Tay, I heard an alternate explanation. Nguyen Xuan Vui, the deputy director of a local animal-health office, described how tens of thousands of chickens were hauled every day from China into the markets of northern Vietnam by small-time traders. Family farmers also drove up to China and brought back nutrients to fatten up their flocks. These imports could easily have been contaminated. Vui’s account appeared to dovetail with the findings of microbiologists, who analyzed the genetic fingerprints of the virus circulating in northern Vietnam and concluded that it had been introduced from China on at least three separate occasions between 2001 and 2005. A single, even massive introduction by a multinational company would have left a different signature. But although the culprits were minor-league merchants, the impact was tremendous. Vui told me that 2 million chickens had been culled in his province at more than 175 different locations over the course of 2003 before the central government ever got around to acknowledging the first outbreak in January 2004.
For a brief period when the initial human cases were confirmed in early 2004, Vietnam opened its doors to dozens of WHO disease specialists. But after the first wave of human cases ebbed, Vietnam closed back up. This was a country that for years had depended mostly on its own wits and was finally discovering a modicum of prosperity after more than a generation of war and deprivation. Senior officials were deeply suspicious of foreign meddling. Dr. Hans Troedsson, WHO’s chief representative in Vietnam, publicly complained in the summer of 2004 that the government had not responded to a new offer of outside expertise nor provided virus samples for analysis. In private, he fretted that his telephone calls and urgent faxes to the health ministry were going unanswered.
WHO officials in Asia and Geneva acknowledged they were completely in the dark about the details of Vietnamese cases, how they arose, and even how many there were. “So basically, bugger all, we still don’t know what the numbers are,” wrote one agency official. The frustration would continue to mount through early 2005 as the rate of human infection in Vietnam accelerated and a pandemic seemed to grow closer. WHO’s office in Hanoi repeatedly tried to raise its “grave concerns” with the government but was again met with silence.
In Geneva, senior officials debated whether to admit in public that they were flying blind. They had neither accurate information from Vietnam nor the freedom to conduct their own field investigations. But WHO did not want to jeopardize its relationship with Vietnam’s health ministry, since they collaborated on a raft of public health issues. “We cannot openly blame Vietnam (at least not yet) but cannot also let people believe that we have access to all the data we need,” one senior WHO official said at the time. “At some point in time we may have to make a radical choice.” A second senior agency official warned that nothing less than the world’s ability to contain a global epidemic was at stake. “I am concerned,” he stressed, “that we are pretending to our Member States and also internally in WHO that we can assess the situation, are capable of detecting the emergence of a pandemic virus and initiating early interventions.” Without transparency, there could be no hope of containment.
Duc Trung and Hoai Nam aspired to be Vietnam’s Woodward and Bernstein. Duc Trung, at age thirty-four, was the senior member of the team. He was a university journalism graduate who had been working at the Thanh Nien newspaper in Ho Chi Minh City for five years when I met him. He had been attracted by the paper’s reputation for investigative reporting. Lanky, with large, soft eyes and smooth skin, his tastes ran to pastel designer shirts, teal on the day we were introduced. He sported a gold watch, and his shoes were impeccably polished. He was well spoken and did most of the talking for the pair, choosing his words carefully.
Though a year his junior, Hoai Nam looked far older. He never reached university, instead spending five years in the Vietnamese army, retiring as a sergeant major. He was short and skinny with an uneven haircut, white sleeves rolled up to his elbows, shoes old and scuffed. He was quick to smile, a broad disarming smile, and when he did, the crow’s-feet would deepen around his eyes and the creases multiply on his cheeks.
“This guy looks like a chicken trader,” Duc Trung told me, patting his partner on the back. “I don’t look the part but he does. That’s why he was chosen for the project.”
A few months earlier, in the summer of 2005, the pair had swapped their office clothes for the soiled shirts and shorts of poultry traders and loitered around the livestock markets until their disguises soaked up the odor. Duc Trung poked a hole in his shirt, near the waist, affixing a tiny video camera barely an inch wide to the inside. Hoai Nam did the same. Posing as novice chicken sellers, the two men repeatedly filmed the illicit, predawn commerce at a Ho Chi Minh City slaughterhouse where merchants bought and sold forged health documents certifying that their birds were free of avian flu. Through these nearly invisible punctures, the reporters offered Vietnamese an education in the corruption and governmental misconduct that would continue to bedevil the country’s battle with the disease.
By the fall of 2005, it looked as though Vietnam had turned a corner. After a long internal debate and repeated delays, the agriculture ministry launched a campaign to vaccinate about 250 million chickens and ducks in all sixty-four provinces. New restrictions were imposed on the breeding, movement, and sale of poultry. To win more cooperation from farmers, the government promised to pay them greater compensation when their birds were culled. As the months passed, poultry outbreaks and human cases declined. Vietnam was widely praised by UN agencies. The U.S. Agency for International Development called its performance “remarkable.”
Yet if not an illusion, this judgment was certainly premature. The virus remained entrenched in the Vietnamese countryside. And every time Vietnam thought it had finally put out the fire, new outbreaks flared, first in ducks and then chickens in the Mekong Delta. “The situation is alarming,” reported Hoang Van Nam, a senior agriculture official. Soon the disease returned to farms across the country and eventually Vietnamese again fell sick. Hoang Van Nam attributed the resurgence to the failure of local officials to carry out the vaccination campaign and enforce a ban on hatching ducks.
Even during the brief lull in outbreaks, Duc Trung and Hoai Nam were documenting the rot inside Vietnam’s control efforts. Their reporting, which illuminated the disconnect between national policy and officials on the front lines, left little doubt the virus would resurface.
Their editors at Thanh Nien had decided to tackle bird flu soon after the government announced its new drive against the virus in 2005. Though the country’s television stations and 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 explanation, some WHO officials concluded that his remarks had contributed to his ouster.
A similar fate befell Naipospos, the country’s animal-health director. Commonly known as Dr. Tata, she was passionate and opinionated, with dark eyes that seemed both probing and vulnerable behind her thick glasses. She was a rare professional in the ranks of the agriculture ministry. She had earned a master’s degree from England, a doctorate in veterinary epidemiology from New Zealand, and widespread respect from disease experts at WHO and other international agencies. Naipospos first disclosed the government’s cover-up in an interview she gave me in early 2005 for the Washington Post. She repeated her allegations five months later but this time in Indonesian, in an interview with the Kompas newspaper. A day after the article was published, the agriculture ministry fired her.
Agriculture Minister Anton Apriyantono told me he dismissed Naipospos because he was not happy with her handling of bird flu and her working relationship with top ministry officials. This explanation outraged Naipospos. She countered that she had been sacrificed by the ministry not only because of her candor but because of party politics. With the minister’s upstart party trying to cast itself as a force for government reform, Apriyantono sought to tar her with the failures of his department, even accusing her of corruption. That charge was never pursued by prosecutors. And UN officials publicly criticized the government for ousting its most respected animal-health expert at the height of a crisis.
Naipospos alleged that bird flu had never been a priority in the agriculture ministry. Agriculture officials had not even tapped available emergency funds to pay for disease control. “I talked to the minister about it many times,” she recalled. “He said a disease outbreak is not a national emergency, not a disaster.”
Naipospos was ultimately vindicated when she was named to a new presidential commission established in 2006 to oversee the government’s avian flu policies. The body’s primary charge was to coordinate the efforts of rival ministries, in particular health and agriculture. But it, too, proved impotent. The commission received little support from the ministries, and even its own director was just a part-time appointee. Indonesia would continue to be singled out by senior UN officials for “the lack of a national strategy, the lack of political involvement.” Still, the avian flu commission made a small contribution to setting the record straight. In a press release three years after the disease erupted, the commission formally acknowledged that the virus had indeed first made landfall in Indonesia in the middle of 2003, many months before the government had admitted.
The trip that took Margaret Chan to Beijing’s Great Hall of the People was a delicate mission. Just three weeks before, in early November 2006, the former Hong Kong health director had been elected WHO’s new director general. She was to replace Lee Jong Wook, who had died suddenly after brain surgery. Chan’s election had been hotly contested, with the former Hong Kong public health director besting ten other candidates. China had sponsored Chan’s candidacy, lobbying hard for her, and saw the contest as a measure of the country’s growing clout on the world stage. When months of quiet pressure and diplomatic horse trading were finished, the Chinese government had lined up far more than enough votes, including crucial backing from the United States, and Chan became the first Chinese national ever to hold such a high post at a United Nations agency. Now she was visiting China’s monumental seat of government to personally thank President Hu Jintao. “I will remember the support given to me by the country in my heart forever,” Chan told him.
But she also had more sensitive matters to raise. Beijing had stopped supplying flu samples to WHO’s affiliated labs. No human specimens had been shared since the spring, and the most recent was from a year-old case. The newest samples from infected birds were also a year old. Flu viruses are notoriously mercurial, and China’s defiance of repeated international appeals was keeping WHO from staying abreast of the virus’s twists and turns. This was undercutting international scientific efforts to understand the behavior of this unusual virus and anticipate its further evolution. At stake was the timely development of vaccines and drugs tailored to the prevailing strains.
In the days after Chan was elected, reporters had pressed her on whether she would stand up to the Chinese government. One commentator in her hometown of Hong Kong even asked whether she’d be simply a “foot soldier for Beijing.” Chan insisted that her allegiance was to WHO. “First and foremost, now that I have been elected as director-general, I will no longer wear my nationality on my sleeve. I’ll leave it behind,” she replied. As she met with Hu, skeptics were watching for a sign of such independence.
Chan told the president it was vital for China to disclose its outbreaks and share samples. She urged him to speed up the process of providing specimens to WHO. She pressed the same points with Premier Wen Jiabao.
“The president and premier have a very good understanding of the potential impacts, on the health of the people, and also on the economy,” Chan told me later. “They understand the importance of being transparent.” In meetings with the leaders, she had made sure to praise China for strengthening its disease monitoring system since SARS. But she also reminded them that the country still had a hard time staying on top of emerging threats in the provinces. “China has a challenge, being a vast country,” Chan continued. “The importance is to make sure that policies go down to the lowest possible level so that the implementation is not impeded.”
That point was not new for either Hu or Wen. “They understand the challenge,” she put it to me. “But you know…” Her voice trailed off. It was a tacit acknowledgment of her own doubts about the potential for change.
After she exited the meeting in the Great Hall of the People and was asked by waiting reporters about the prospects for cooperation between China and her agency, Chan offered a diplomat’s assessment:
“We will have to look at the actual situations, but we all agree with it in principle.”
In one of Chan’s first speeches as the world’s top health official, she outlined in 2007 what she called an unwritten code of conduct requiring governments to tell the truth about infectious disease. “No nation has the right to conceal an outbreak within its territory,” she declared. Chan didn’t mention China by name. But Beijing’s handling of SARS had clearly been the most flagrant breach.
Now China was again a cause for concern. It wasn’t just that China was still failing to provide virus samples. People were continuing to get sick from bird flu, but Chinese authorities were not confirming any related outbreaks in the birds. Investigators were being robbed of crucial details about how people were contracting the virus.
In an e-mail to WHO headquarters in early 2006, one of the infectious-disease experts in the agency’s Beijing office noted a series of recent human cases that had all occurred in the absence of any reported poultry outbreaks. “What on earth is going on with the animals and the virus?” she wrote. The health ministry, though repeatedly pressed for an explanation, offered none. By the middle of 2007, cases in China had reached twenty-five, and only one could be explained by a related outbreak in poultry.
One possibility was that China’s hugely ambitious campaign to vaccinate its entire population of chickens, ducks, and geese was hiding outbreaks by keeping birds from getting sick, without fully disarming the virus. A second explanation, put to me by influenza researcher Robert Webster, was that the poultry might be receiving a kind of natural inoculation from another, less lethal flu strain that was prevalent among the birds. He suggested that exposure to this second strain, H9N2, might offer limited protection to poultry when infected by H5N1. The birds would carry the virus and spread it but not show symptoms.
Yet in some instances, birds were indeed dying and agriculture officials were not reporting the fact. China’s agriculture ministry has long denied details of livestock diseases, even to officials at China’s own health ministry, claiming that animals are none of their business. When the two ministries clash, as they have repeatedly since the 1990s, the agriculture ministry inevitably prevails. It is far more powerful and prestigious because China’s senior leaders place their top priority on development, and agriculture is a central part of that, according to Yanzhong Huang, a professor at Seton Hall University specializing in the politics of China’s public health system.
Huang explained that China’s mishandling of the SARS outbreak had transformed the country’s health sector. Chastened, China invested heavily in disease surveillance and laboratories and lifted the ban on disclosing infectious diseases, which had been considered state secrets. But these advances did not extend to the agriculture ministry, where the prevailing view was that any candid discussion of animal diseases would only undercut productivity.
Equally vexing is the divide between China’s central government and local officials. A week after China confirmed its first outbreaks in birds, Vice Premier Hui Liangyu admitted to WHO that the central government wasn’t sure what was transpiring in the provinces. For local officials, career advancement hinges on success in promoting economic development. Better to keep quiet about infectious diseases that could deter investment and scare off tourists. So it’s little surprise that Chinese local officials look unkindly on journalists and whistle blowers who publicize these outbreaks, even arresting and expelling them.
Qiao Songju was a simple farmer in Jiangsu, a coastal province just north of Shanghai, when the young man heard a piece of gossip that changed his life. Qiao’s father told him that more than two hundred geese had died a mysterious death at a friend’s farm in the next province. Afraid that local officials were covering up a bird flu outbreak, Qiao called all the way to Beijing and notified the chief of animal husbandry at the agriculture ministry. That in turn prompted a formal investigation, which soon found that at least 2,100 geese and chickens in the village could have the virus. The suspect birds were all slaughtered. Chinese media dubbed Qiao the “farmer hero.” China’s state-owned television nominated him to receive its award for economic figure of the year.
A month later, Qiao blew the whistle again, this time reporting a suspected outbreak in his own home county of Gaoyou in Jiangsu. The police came for him a day later. They arrived at midnight and asked him to accompany them to the station for a “chat.” They made the arrest formal on the following day. Qiao was charged with blackmail and extortion. The accusation was that he had wrung thousands of dollars out of veterinary institutes by threatening to report them for manufacturing bogus flu vaccines. His lawyer called the charges fabricated. His family and supporters, including scores who recorded their outrage over the Internet, questioned the timing of his detention.
But few sympathizers were found among his fellow farmers. The price of eggs in Gaoyou had fallen by half after he’d raised the alarm. The price of chicken meat had tumbled even more. “Qiao Songju is a sinner to all Gaoyou farmers,” said Chen Linxiang, an official in Gaoyou’s agriculture and forestry bureau.
Five months after he was detained, Qiao went on trial in the Intermediate People’s Court of Gaoyou. His lawyer complained that not one of the agriculture ministry officials who could have testified in his defense had chosen to do so. After another three months, in the summer of 2006, the court handed down its verdict and convicted Qiao on six counts. He was fined nearly four thousand dollars and sentenced to three and a half years in prison.
Deep in the interior of China, more than a thousand miles from Gaoyou, in the midst of the great green grasslands of the Tibetan Plateau, is a vast body of salt water called Qinghai Lake. Many in the region consider the lake, China’s largest, to be sacred, and pilgrims still circumambulate its 220-mile shoreline. Sheep and yaks graze on its banks, distant mountains reflected in its azure waters. In the north west corner is Bird Island. Though this rocky outcropping is technically more of a peninsula than an island, the first part of the name is apt. Each spring, thousands of geese, swans, cormorants, and other wildfowl from 189 species congregate here, migrating over the Hima layas and from Southeast Asia to lay their eggs. By the time the rapeseed of summer has turned the pastures a brilliant yellow, the birds have continued on their way.
In late April 2005, something stunning occurred at Qinghai Lake. The birds began to stagger around like drunks. They became paralyzed, their necks trembling, contorted. Then they would die. This was not supposed to happen. Sure, birds were dying elsewhere in Asia, but those were chickens and other domestic poultry. These victims were wild birds, mostly bar-headed geese and some gulls. For millennia, migratory waterfowl had been nature’s reservoir for flu viruses, meaning these birds could carry the pathogen without getting sick themselves. But now they were dropping at a rate of hundred or more a day. By the time the full numbers were tallied, at least five thousand had perished from what Chinese authorities confirmed was bird flu. The novel strain had abruptly turned its fury on its own natural hosts. Equally alarming was the fear that the birds at this major migratory hub might now carry the infection on with them, speeding its spread westward through the network of overlapping flyways.
WHO officials had been clamoring for details about the Qinghai outbreak since they first heard about it. They were appalled to learn that Chinese authorities had sampled only twelve of the sick birds at the lake and checked no healthy-looking ones for signs of infection. Though China finally allowed a team of investigators from WHO and FAO to visit Qinghai, the government continued to refuse them access to samples, test results, and the sites of related outbreaks. “They’re doing all they can to block information from us,” WHO’s Beijing office reported to headquarters.
Yi Guan, the maverick microbiologist in Hong Kong who had been amassing bird flu samples across southern China, was not to be denied. One of his former students headed to Qinghai, surreptitiously collected nearly a hundred specimens, and sent them on to Guan for analysis. Barely two months after the die-off on Bird Island began, Guan’s team had published its findings in Nature. By comparing the genetic material in these samples with others taken in live poultry markets of southern China, the scientists were able to establish a similarity between the Qinghai virus and two others previously isolated in Shantou, a city on the Guangdong coast. “This indicates the virus causing the outbreak at Qinghai Lake was a single introduction, most probably from poultry in southern China,” the team concluded.
The Chinese government was infuriated by the claim that the virus had spread from southern China to Qinghai. This made China the source of the global threat rather than an innocent victim of someone else’s birds. No sooner had the Nature article appeared online than China’s official Xinhua news agency fired back, quoting Jia Youling, the ministry’s animal-health director. No bird flu has broken out in southern China since the previous year, Jia claimed.
Government officials had been monitoring Guan’s research for more than a year. His genetic detective work was steadily unraveling their deceit. “They were very unhappy,” he recalled. “This is supposed to be a black box. Nobody is supposed to know what is going on. Now I’m opening the door and I have a strong case.”
The article about Qinghai was too much for the government. Jia went on the attack. He announced that Guan’s team had fabricated the data, saying the researchers had lied about taking samples at Qinghai. Soon after, Jia suggested that the team’s lab was so poorly equipped that the tests could have been contaminated and the results meaningless. He further alleged that the scientists had failed to apply for government approval to conduct their research and that the Joint Influenza Research Center at Shantou University Medical College, which Guan helped set up four years earlier, lacked adequate safeguards for doing the tests.
The government ordered the Shantou research center shuttered immediately. Virus samples were to be destroyed or turned over to the ministry’s official animal-flu lab in Harbin, one of only three institutes in China that would now be allowed to conduct this research. Jia later denied any political motive, saying the Shantou lab was one of four around the country that had been closed because it failed standard inspections. But to be sure Guan understood how severely they viewed his activities, agriculture officials accused him of the cardinal sin of disclosing state secrets.
“It was a lot of pressure,” Guan admitted, baring his still-fresh wounds. “Doing the science is simple. The big problem is that people try to stop you from writing.” As he recounted the incident, his voice rose an octave and he sputtered, almost spitting out his grievance as he struggled for the right words in English. “They tell me, ‘You’re a human doctor and this is an animal matter. Don’t interfere in my animal issue. It’s none of your business.’ ” He paused and caught his breath. Then, filling his lungs with the smoke of a freshly lit cigarette, he continued, “Working on this, I’m not sure how far I can go, how safely I can go. They kept saying I’m leaking state secrets.”
Yet Guan kept going, and his network kept collecting samples even after Shantou’s front doors were closed. That fall, his team published another piece of disturbing research. It documented a new wave of disease that had appeared in China’s poultry and had already spread elsewhere in the region. After sampling more than 53,000 birds at live poultry markets in six southern Chinese provinces, the scientists discovered that a new H5N1 subtype, which they labeled “Fujian-like” because of its similarity to an earlier isolate from Fujian province, had rapidly squeezed out its predecessors. In just a year, the rate of infection in China’s poultry had nearly tripled. This new wave of transmission had renewed poultry outbreaks in at least three Southeast Asian countries and sickened people not only in China but also in Thailand. The scientists said China’s massive campaign to vaccinate all its poultry was possibly to blame for stimulating the emergence of this resistant subtype.
The government responded by calling a press conference to belittle the findings and impugn Guan’s ethics. “The data cited in the article was unauthentic and the research methodology was not based on science,” Jia said. “In fact, there is no such thing as a new ‘Fujian-like’ virus variant at all. It is utterly groundless to assert that the outbreak of bird flu in Southeast Asian countries was caused by avian influenza in China and there would be a new outbreak wave in the world.”
A month later, Guan shut down his research network in mainland China and told his army of sample takers they would have to find other work. Over the previous eight years, Guan and his “thankless heroes” had sampled more than two hundred thousand birds. Many of the virus samples available to researchers and vaccine developers around the world had come from work done by Guan and his Hong Kong University colleague Malik Peiris. Time and again, they had alerted the world to crucial turns in the behavior of the virus.
But now he was switching off the radar, pulling the plug on the world’s early-warning system. “Let Dr. Jia Youling come and find a solution,” Guan told me in late 2007. “Let him clarify that I didn’t make a mistake or make up the data so I can recover my honor. Why should I sacrifice my honor?”
“Malik and I did a lot of work for the world,” he continued, his voice rising again. “Who continued on a weekly basis to do sampling for eight years? Anybody else? No. We are second to none in the world. What more can we do?”