SARS lesson: How to address crises

An old Chinese saying goes that "a loss may turn out to be a gain".

And grievous though SARS (severe acute respiratory syndrome) was last year with a big loss of life, one of the major gains was that the central and local governments in China, for the first time, have been working hard to set up comprehensive emergency-response systems to better cope with crises or disasters.

So says Ma Qingyu, a professor at the China National School of Administration (CNSA) based in Beijing and one of the experts in government management from 21 countries and regions who attended an international conference "Crisis Management - Worldwide Experiences and Lessons" in Kunming, capital of Southwest China's Yunnan Province, from January 11 to 13.

Co-sponsored by CNSA, International Association of Schools and Institutes of Administration (IASIA) and the Asian Development Bank (ADB), the forum offered a platform for about 30 scholars, mainly from Asia-Pacific countries, "to share experiences they have had in establishing emergency networks in their own countries," says Allan Rosenbaum, president of IASIA.

SARS was the hottest topics among the participating scholars of all the subjects which also involved economic crises and natural disasters such as floods and earthquakes.

The flu-like disease first surfaced in southern China in November 2002 before it spread to almost 30 countries and regions, infecting more than 8,000 people (5,327 on the Chinese mainland) and killing nearly 774, 349 of them on the mainland.

When the battle against SARS' first onslaught was over at the end of last June, the research group Ma works with in CNSA was designated to assess government actions during the battle. They were also asked to offer suggestions to establish a national emergency scheme, according to Ma.

Although several confirmed and suspected cases of SARS have been reported in Guangzhou, Hong Kong and Taiwan this winter, Chinese scholars from the mainland, Hong Kong and Taiwan are showing great confidence in tackling any major outbreak. Don't worry. We can do much better this time, they say.

Crisis management
"Crisis management, although important, was a field that scholars or governments paid less attention to before," says Chen Fujin, executive vice-president of CNSA. "SARS was the best and the most timely reminder that an effective system is desperately needed in China to reduce loss caused by disasters to the greatest extent.

"The system will enable us to be prepared not only for crises like SARS, but for other natural disasters, such as floods or earthquakes."

It's not just government response to the crisis that has attracted attention; the role of the community is also under the spotlight.

Dong Ruihua, professor from the Shanghai Administration Institute, says the reason he initiated the study of the role of the community in the battle against SARS was because he was one of the beneficiaries of community action.

"I didn't realize that SARS would be a problem in our daily life until an elderly woman, who is the head of the neighbourhood committee, knocked on my door last April," Dong recalls.

Dong says the woman was bustling around offering useful tips on the prevention of SARS to residents. She and her co-workers on the neighbourhood committee knocked on the door of every household on Caohejing Street in Xuhui District of Shanghai, where Dong lives.

And the neighbourhood committee, with fewer than 10 staff members looking after 2,000 residents, took upon themselves the tasks of SARS prevention such as distributing masks, disinfectants and leaflets about prevention, buying daily supplies for those in quarantine and keeping a sharp eye out for those coming from high-risk areas such as Beijing and Guangzhou.

"The old woman and her colleagues started earlier than the local district and municipal governments required," Dong says.

"That was one of the major reasons that there was no large outbreak of SARS in Shanghai when a few other big cities in China were hit."

The first case in Shanghai was discovered on April 4 last year and altogether eight cases had been reported by June 24, when the World Health Organization (WHO) declared the whole country safe for outside travellers.

Role of communities
"It's amazing to think that there were so few SARS cases among Shanghai's 13 millions residents and 3 million migrant population," says Dong.

"However, the contributions made by neighbourhood committees are almost forgotten since the media focused on medical workers and hospitals.

"I heard some complaints and realized it was a topic deserving of research," he says.

Started on July 15 last year, Dong investigated over 10 communities in Xuhui, Changning and Yangpu districts of Shanghai and discovered that the role they played in crisis management was so vital that their work should not be forgotten.

One of the "sensational" things that the neighbourhood committees did was to track down three persons who possibly had come in contact with a SARS patient and whom even the local police had no way of tracing, he recalls.

An attendant on the train from Guangzhou to Shanghai was found to have been infected with the SARS virus when the train arrived in Shanghai last June. The man was immediately sent to the hospital while hundreds of the passengers on that train who were in contact with the patient had to be quarantined for further observations.

However, three passengers seemed impossible to locate because their addresses were fake and their mobile phones were always off.

It was two staff members working with Dongan Xincun neighbourhood committee in Xuhui District who found the three "mysterious" travellers.

The neighbourhood committee workers were so familiar with the community that they were on full vigilance and able to detect any changes, said Dong.

They found a house which had been empty for a long time recently rented by four people, who seldom stepped out. So they reported it to the local police and after investigation, two of them admitted that they were on that train; and the third person had gone back to his hometown.

More support needed
"The chance of finding the three persons was the same as looking for a needle in a haystack in such a huge metropolis like Shanghai. It was a mission impossible without the assistance of neighbourhood community workers," says Dong.

However, Dong adds, there are still many things that the government can do to improve the effectiveness of neighbourhood committees in crises like SARS, such as giving them more financial support, training more staff in public management and empowering the neighbourhood committees with more authority.

The story in Beijing is relatively more complicated than in Shanghai, says Dong Wu, professor at the Beijing Administration Institute.

"But one thing is for sure, Beijing should not make the same error again," he stresses.

According to Dong, the Beijing municipal government has taken stock of lessons learned from last year. It has also worked out a comprehensive emergency response, which guarantees an effective response and management if, by any chance, SARS makes a comeback.

Beijing released on September 12 the city's meticulous emergency scheme that involves plans down to minor details in battling the deadly disease, says Dong.

Hospitals in Beijing belong to different institutions; for example, some are managed by the local government, some under the jurisdiction of the Ministry of Health and some managed by the military. So medical supplies are gathered and distributed through different channels.

"When there is an emergency, such a diversified management system will greatly reduce the effectiveness of hospitals," Dong says.

According to the emergency scheme, Ditan Hospital, You'an Hospital, Xiongke Hospital and Xiaotangshan Hospital - with 1,540 beds - are the four designated hospital to treat SARS patients.

SARS prevention
And 16 other hospitals and medical research centres, including Union Hospital, Chaoyang Hospital, Anzhen Hospital and Youyi Hospital, are designed to be back-ups both in treatment, medical workers and supplies.

The scheme also stipulates detailed standards in SARS prevention for people in different walks of life.

For example, the living space per person cannot be less than 3 square metres for construction workers. No bedroom should house more than 10 workers and the apartments should be disinfected regularly.

Although three confirmed SARS cases have been reported in Guangzhou, Beijingers have remained calm, says Dong.

He said he would not cancel his travel plan to southern China during the Spring Festival because of the SARS news in Guangzhou. "I know similar emergency schemes are now available in Shanghai and Guangzhou as well as in other major cities in China," Dong says.

However, Dong agrees that the peak travel season during the Spring Festival will bring some challenges.

"But I believe the government can handle the challenges easily with the help of past experience and the emergency systems in big cities."

Ma Qingyu says he is glad to see that the local government of Guangzhou doing a good job since the first suspected case of SARS was reported on December 27.

The emergency system has been on full alert ever since the local disease control department reported the case to the Ministry of Health and the World Health Organization.

Those with contact with the infected patient were put under quarantine. Any the new developments about the case were reported to the public in a timely fashion.

"This kind of action can reinforce public faith and trust in the government," says Ma.

Public information
When SARS appeared early last year, Chinese people in hard-hit cities started panic buying, emptying shop shelves of food and medicine. Some were holed up at home, others fled to the countryside.

But when the government showed both courage and effectiveness in correcting the initial statistical confusions and gave daily reports of the incidence via TV, newspaper and radio, the panic subsided quickly.

"We could not have overcome the threat of SARS without an open public information system last year," says Ma. Transparency is the most powerful 'weapon' to curb public panic and the spread of rumours, which could have stirred more panic," Ma stresses.

To date, almost all central government ministries and more than a dozen provincial and municipal governments, including Beijing, Shanghai and Guangdong, have established a news-release mechanism, according to Ma.

Source: China Daily



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