April 24, 2003

(Clearwisdom.net) China's health care system, already suffering from a shortage of funds and resources, is facing significant challenges in coping with SARS, experts warned Thursday.

But as the deadly disease spreads rapidly across the country, the most important task in fighting Severe Acute Respiratory Syndrome, ironically, requires no more than people, notebooks and pens, they said.

"There's really no magic treatment for SARS. All the hospitals can do is keep you hydrated and keep your fever down, so the treatment is not as important," said Ray Yip, a Beijing-based United Nations health expert.

What is more important is tracking down people who had contact with SARS patients and quarantining them.

"This is disease control 101. This is not difficult. All you need is a body, notebook and pen. You ask patients 'Where did you go?' 'Who did you see?' 'Who did you shake hands with?' 'Did you take a taxi?'" Yip said.

"This is a highly controlled society. They should do what they're good at -- tracking down people and telling them 'You should not do that.'"

Individual cases show China is not doing enough of that. As a result, the disease has spread to the hinterlands and to people who could have avoided it.

In Inner Mongolia, an Air China flight attendant who contracted SARS went home and spread the virus to several others, giving the northern province its first few cases.

In Beijing, entire families got SARS after taking care of their SARS-infected loved one because no one isolated them.

"That's evidence of sloppiness," Yip said. "How are people getting the disease? From a lot of carelessness."

For the small percentage of SARS patients who develop severe breathing trouble, China's hospitals may not be able to offer help. Many lack isolation wards, intensive care units and respirators.

"The hospitals have enough beds, but they are turning away patients because they don't have infectious disease wards. It's dangerous for other patients," said Hu Yonghua, director of Beijing University's Public Health Department.

Even Beijing, which has far better medical facilities than other cities, has this problem, he said.

Funding for hospitals has dropped over the years as China weens its public from once free healthcare.

In one of Beijing's largest medical facilities, You'an Hospital, two to three patients are crammed into small rooms in the infectious disease ward.

Masks seemed in short supply. Trees near the ward were strewn with washed cotton masks to be dried and reused.

Nurses, doctors and even cleaning ladies were working overtime.

"I don't speak to the patients," said a hospital worker surnamed Wu who refills hot water flasks in patients' rooms.

"I wear two masks and change all my clothes when I get off work. But we don't go home anymore. We live in the hospitals. We don't want to transmit this disease to our family."

The healthcare system in rural areas would be put under even greater pressure.

"If you think it's scary in Beijing now, wait till you see what can happen in rural areas," said Hu Jia, executive director of the Aizhixing Institute of Health Education, an AIDS prevention group that works in the countryside.

"Many places do not have hospitals, just clinics. And even the hospitals are poorly equipped and the staff poorly trained," Hu said.

"Awareness among farmers is low. Not a single person in a village of several thousand subscribe to newspapers. Many people don't have televisions and even if they did, they can't afford to pay for electricity. So they don't know how to protect themselves."

Hygiene standards are poor and farmers have a habit of not seeing the doctor if they are sick because they cannot afford hospital bills.

So far there is no concrete evidence SARS has spread to large parts of rural areas, but lack of awareness and precautionary measures can change that fast.

Already, migrant workers afraid of SARS are fleeing places like Beijing and Guangzhou for the countryside and no one is checking them for symptoms first.

To head off a SARS nightmare in the countryside, people leaving Beijing should have their temperatures checked, Hu said.

But with tens of thousands flooding each of Beijing's railway stations daily, this seems a massive task.

[...]

http://sg.news.yahoo.com/030424/1/3abqg.html

Posting date: 4/25/2003
Original article date: 4/25/2003
Category: News & Media Reports

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