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American Morning

Stateside Doctors Prepare for Anthrax while Doctors in Afghanistan Conduct Relief Work

Aired November 23, 2001 - 07:32   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
LEON HARRIS, CNN ANCHOR: Well you know up until about two months ago, some doctors might have had to think long and hard about how to diagnose an anthrax infection. But as our Dr. Sanjay Gupta reports this morning, doctors on the front lines of this war against bioterrorism are having to learn on a fast track now.

(BEGIN VIDEOTAPE)

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: As a doctor, when I recall my own medical school days, I remember we only glossed over anthrax, and I think that's true of many of my colleagues. But now doctors all over the country have had to become instant anthrax experts. They know, for example, that the symptoms of inhalational anthrax closely resemble the flu. And with flu season approaching, I sat down and spoke to some of my colleagues to see if they were ready to test their newly found expertise.

So do you feel prepared now to possibly deal with anthrax infections?

UNIDENTIFIED DOCTOR: I don't think I'll be absolutely fully prepared to see or treat a patient with anthrax until I have seen a patient with anthrax.

UNIDENTIFIED DOCTOR: I think as prepared as we can be.

UNIDENTIFIED DOCTOR: I feel prepared intellectually that I understand the disease, inhalational anthrax. Unfortunately that understanding is that the disease is very much like flu.

GUPTA (voice-over): The real question is flu versus anthrax, how do you tell the difference?

UNIDENTIFIED DOCTOR: If a patient comes to me with a runny nose, with sneezing, with some drainage down the back of their throat but they feel otherwise OK, that reassures me I don't think that they have anthrax.

GUPTA: Reassures him because inhalational anthrax does not typically cause a runny nose.

UNIDENTIFIED DOCTOR: Chest X-ray, looking for enlargement of the middle part of the chest what's called the media-stinum. GUPTA: A check X-ray could be valuable because anthrax infects the lymph nodes in the middle of the chest, flu does not.

UNIDENTIFIED DOCTOR: Now that we do have good tests for influenza, one strategy that we could use is to start someone on antibiotics for a day or so, and if we find out that it's the flu, stop the antibiotics.

GUPTA: Now if a flu test indicates the infection is not influenza, it still probably won't be anthrax, but you could keep the patient on antibiotics until more tests were done.

(on camera): Do you think we're going to see more patients that actually get blood tests and are started on antibiotics this season?

UNIDENTIFIED DOCTOR: I think we're bound to see a lot more patients that are both tested and started on antibiotics. Yesterday I worked a shift here at Emory in the fast track for the more minor emergencies, I saw 17 patients and 4 of them have symptoms that they were concerned about anthrax.

UNIDENTIFIED DOCTOR: I will take a thorough history documenting that exposure. I will also do a nasal swab or nasal culture and depending on the other symptoms involved, put them on antibiotics or potentially just follow them without antibiotics until the culture comes back.

UNIDENTIFIED DOCTOR: I suspect, as is usually the case, we err on the side of caution. So I suspect there will be people getting antibiotics this flu season.

GUPTA: What reassuring words can you give us and give your patients about this?

UNIDENTIFIED DOCTOR: Well, there's a few things. One is, you mentioned before, there will be 10 or 20 million cases of flu this season and so far there have been 10 cases of anthrax. So just looking at the odds like a gambler, they weigh in all of our favor against getting anthrax.

GUPTA (voice-over): Dr. Sanjay Gupta, CNN reporting.

(END VIDEOTAPE)

HARRIS: And while that goes on stateside, doctors and aid workers overseas are among those who are putting their lives at risk on the front lines in Afghanistan every single day. Francois Calas is the head of the Kabul mission for Doctors Without Borders, and he is our guest this morning in Kabul.

Dr. Calas, thank you very much for your time today. Can you give us an idea right now of how things are for you and for the other aid workers who are helping the Afghan natives right now? Are things getting better?

DR. FRANCOIS CALAS, DOCTORS WITHOUT BORDERS: Well I must say that in Kabul we have resumed our presence in smalls (ph) in one week and we are now extending our activities to Kabul. The population in various areas of the city and most vulnerable population were in the Perif (ph) area of Kabul and also to -- south to us populations who were -- who were stopped to -- to come back to the former front line north of Kabul where everything has been destroyed. And there is an urgent need to restart medical activities, to bring relief good, to bring food so that's presently what we are doing and we are quite operational. But I must say that we have a lot of concerns for other regions of Afghanistan where there is still no -- not yet accessibility.

HARRIS: Where are those areas right now where you have no accessibility, is it in the south where the Taliban still control the area or is it someplace else?

CALAS: Well among these areas there is still Ahzar-Akshat (ph), the central mountainous region which is, for the moment, not accessible because we'll say the access roads are still troubled or unsecure. And there are southern regions like the province of Kandahar or Ghazni which are, of course, still troubled and they're not yet accessible for relief workers.

HARRIS: A couple of weeks ago, I talked with someone else with Doctors Without Borders about the prospects for winter and there was much concern about that and the fact that there would -- you would not be able to get all of the assistance to people who direly needed it. Have things changed in that regard now that the Northern Alliance has taken control of most of the country?

CALAS: Well today we cannot say that they have yet taken control of most of the country. I mean -- I mean this may happen in the next future. There are still some areas which will be very difficult to access in the -- in the future. As I was speaking you before, Ahzar- Akshat, this region will be very difficult to travel in because of winter conditions. And it will need, of course, to have a new transportation means and to think about the airlift operations because now we need to bring in a lot of food, a lot of relief and medical aid. Various areas will remain inaccessible during winter and that's a major concern right now.

HARRIS: What is being done right now to coordinate any of your efforts with the U.S. or with the coalition that the U.S. is using to drop bombs and other assistance as well into Afghanistan?

CALAS: May you repeat? I' sorry.

HARRIS: I'm sorry. What is being done right now to coordinate your efforts with the U.S. coalition right now? Are -- is the U.S. coalition going to provide you any help in transporting assistance over land or by air drops?

CALAS: We know that the coalition has stated to have a clear intention to bring humanitarian relief. Well there are a lot of needs to cover and we guess that they're in a position to achieve part of these goals. But we must make clear also that many organizations have been working in the country for the past years have been negotiating with different leaders with different local warlords and they could get access to the local communities. What we see nowadays is that southern regions of Afghanistan are troubled areas and there is not yet a sufficient security for relief workers. There are difficulties of access.

We don't know exactly how the international coalition will be felt by local population, local commanders in southern areas of the country. And for us, it's important to say that while there is today an international aid, humanitarian aid which will be delivered by the coalition, but in parallel there is still an independent aid relief which will be provided by organizations like Doctors Without Borders, other organizations. And we intend to work still independently to keep on having the confidence of the local population, of the local leaders. That's important conditions to be sure that the aid will access to every remote part of the country and we cannot ensure today that the coalition will be eager to cover all this inaccessible areas all over Afghanistan.

HARRIS: Francois, we have been watching the reports of journalists who have been killed in the last couple of weeks in Afghanistan. That has got to be very, very troublesome for you and for your colleagues to hear those sorts of reports. Are you concerned about the safety of yourself and your colleagues who are out there working on the front lines?

CALAS: Of course we are very much concerned because this kind of threat, this kind of incident has happened very rarely inside Afghanistan in the past. And we believe that while it can be a new kind of threat for humanitarian workers and journalists and all foreigners who will travel inside the country and a threat which will be very difficult to foresee, to understand. We have been used to work in a war situation with front line with a movement of troops and something which was visible. And right now, yes, there is this threat. It puts a major obstacle on our security assessment and our relief operations and for in the future, we'll have, of course, this incertitude to travel in different areas and the risk has increased definitively.

HARRIS: Francois Calas, I hope you understand just how much many people around the world are wishing you and your colleagues good luck. We understand that what you're doing is very, very special work, and we will continue to watch it and we wish you luck as you continue your endeavors.

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