The government has been quicker to respond to the threat of a Bird Flu outbreak than the reality of the coutry's MRSA epidemic. Sarah McInerney reports IN2003, bird flu broke out thousands of miles away in southeast Asia. In 2005, it started to spread. Immediately, the Irish government began to plan for a pandemic. Just two years on, stringent measures are in place for an outbreak that hasn't hit us yet.

Last year, almost 600 Irish people contracted bloodstream MRSA. In Holland, when one person is found with MRSA on their skin, they regard it as an outbreak. They inform the media immediately. They isolate the individual. They do everything in their power to make sure the disease doesn't spread. The Dutch react to humans like the Irish react to birds.

"Go to the Department of Agriculture website and you'll get any information you need about avian flu, including a freephone number, " says Dr Teresa Graham from the MRSA and Families group. "Go to the Department of Health website and there's no number or information about MRSA. None on the HSE website either. It's indicative of the general attitude of the government.

They just keep hoping it will go away."

Our failure to deal with MRSA has become, literally, the biggest dirty secret in the Irish health system. Yet again, last week, evidence of hospital negligence reared its head. A consultant microbiologist braved the wrath of her colleagues and announced that MRSA is "endemic" in every hospital in Ireland. We had two more inquests of two dead men. Two more cases in which patients were admitted to hospital to be cured, and left with a disease that became - at the very least - a contributing factor in their deaths.

People are scared and outraged. Pressure is growing from the public. The Health Research Board announced three weeks ago that they were going to put Euro1.5m into research in Beaumont hospital to tackle the problem. That is, not money to actually solve the problem, but money to find out how.

'No more reports - we need action' "We know how, we've known how for years, " says Graham. "To say that it is a total waste of time is an understatement. They're looking at whether it is a good idea to sterilise - we know that it is.

They're looking at how useful early detection is - we already know that it's vital and we know that the rapid-detection machine is already being used in the States. They're looking at how to enforce handwashing - and we wonder why they don't go down to the nearest meat factory and ask the manager, rather than having the best brains in the country working on it. It's not rocket science."

According to Graham, the national guidelines drawn up by the government in 1995, if implemented, would go a long way towards solving the MRSA outbreak in Ireland. "We don't need any more reports or research, we need action, " she said.

"It's also an incredibly unfair research project because it means that Beaumont is now going to be safer than any other hospital in the country.

Everywhere else is going to be the 'control' in the government's experiment. Everyone who doesn't go to Beaumont will still have reason to be scared."

It's a baffling response to what is quite clearly a deadly crisis in the health service. While the Department of Agriculture have implemented tight biosecurity measures at the 1,000 commercial poultry farms in the country, the nation's hospitals remain infested with this disease. Flock owners have been strictly advised to only allow essential visitors access to their poultry sites and to provide them with disposable overalls and footwear. Hospital visitors roam the building freely, often bringing in food and taking away clothes to be washed.

Flock owners are told to provide disinfectant footbaths outside each poultry house. There are no such precautions in hospitals.

Flock owners are told to only allow equipment that has been cleaned and disinfected into poultry houses. But a 2004 survey of Irish medics found that fewer than one in 10 cleaned their stethoscopes once a day and almost two-thirds wore the same unwashed white coat for longer than a week.

The Department of Agriculture knows the location of every one of the 80 million birds in the state and yet we still have no idea how many people have died from MRSA. The message seems clear. If there was any political will to sort out our MRSA crisis, then it could have been done. They've managed it with the birds.

"It's a rhetorical question to ask how the government has dealt with MRSA in this country, because it simply hasn't, " said John Devane, a Limerick solicitor who contracted the disease five years ago.

"I went into hospital to get better and came out with a potentially fatal disease. My entire life has been destroyed. I was meant to be getting married in August but my doctor told me at Christmas to 'get my affairs in order' because there is a considerable chance that I will not make it that long. So I've moved the wedding forward to the end of next month so that my partner and children will be provided for."

'They knew what to do to stop it' Devane went into hospital with a mild case of pneumonia. He left so sick that last March he tried to kill himself. "Mentally, I just couldn't take the suffering any longer, " he said. "I'm a 44-yearold man and I'm afraid to hug my children in case I make them sick. I sleep with two nasal plugs in my nose so that I will be able to breathe the next day.

I take 10-15 tablets and use a nebuliser three times every day. It's like living in hell. Honestly, if an animal was as sick as I am, they'd put him down.

The only reason I'm still going is for my family."

Devane spoke of the dirt that he witnessed in the hospital where he was treated. He spoke of overflowing sanitary bins, blood-splattered toilets, and hairs clogging the showers. His story is depressingly similar to so many sufferers of MRSA.

No hygiene in the one place where it is so vitally necessary.

According to another MRSA victim, Tony Kavanagh from Tuam in Galway, patient safety has been completely compromised by the sub-standard hygiene conditions in Irish hospitals. Kavanagh was admitted to hospital in 2004 for a simple operation to improve blood circulation in his leg. The operation was a success but four days after he was discharged he found himself in intensive care, fighting for his life, with a 30% chance of survival. "I'm 57 and I've spent the last two years learning how to walk again, " he said. "I haven't been able to go back to work, so I've devoted myself to studying a kaleidoscope of contradictions in the health service - there's a civil war going on between the unions and the HSE and because of it, patient safety has been 100% compromised."

For Kavanagh, the most difficult thing to accept is the knowledge that government-issued guidelines from 1995 - if implemented - could have prevented what happened to him. "They knew what to do to stop it, " he said. "They still know. That's what really gets to me. And they're still doing nothing."

WHAT IS MRSA?

MRSA stands for Methicillin-Resistant Staphylococcus aureus. MRSA is a subgroup of Staph aureus that is resistant to a range of antibiotics, including penicillin antibiotics. MRSA first appeared in 1961 soon after the introduction of the antibiotic methicillin (an antibiotic that is no longer in use). Since then MRSA has spread widely in many countries and has been particularly associated with hospitals and other healthcare facilities. The infection can leave patients seriously ill with permanent health defects and can sometimes be fatal.

Between 30%-40% of healthy people can be 'colonised' by MRSA and in the majority of cases it is harmless. However, when it enters open wounds it can lead to septicaemia, serious infections of bones, joints and heart valves and, in some cases, death.

Ireland has one of the highest incidences of MRSA in Europe. To put it in context:

MRSA currently accounts for about 1% of all Staphylococcus aureus infections in Dutch hospitals; the equivalent figure for Ireland is 42%.