Sat, May 17, 2003 - Page 8 News List

Editorial: A war that words alone won't win

When suspected cases of SARS were reported at a public housing complex in Taipei's Wanhua District, people were worried that local transmission might have finally broken out. But no mass infection was found at the complex. Instead, SARS has attacked several hospitals -- Kaohsiung Chang Gung Memorial Hospital, Mackay Memorial Hospital in Taipei and National Taiwan University Hospital.

Even Lee Ming-liang (李明亮), convener of the Cabinet's SARS prevention and relief committee, said the hospital outbreaks had surprised experts. The fact that infections have so far been limited to inside hospitals is somewhat of a consolation. But such outbreaks have also raised concerns about systemic problems in the health-care establishment.

One longstanding problem is that the plan to classify and allocate different types of patients to different levels of medical institutions around the country has not been implemented effectively. The lack of front-line clinics to screen patients has meant, with the arrival of SARS, that everyone arriving at major hospital to seek treatment -- whatever their ailment -- is a potential SARS risk. On top of this, most Taiwanese have the habit of going to different hospitals or clinics instead of sticking to one doctor or facility during a course of treatment. As a result, it is extremely difficult to trace patients' medical histories and their records.

More critical to the current crisis is the inequitable distribution of medical resources and inadequate supplies. It is a long-standing problem but one that has proven deadly now. Front-line health-care workers have been exposed to unnecessary risks because of a shortage of protective gear. When the Taipei Municipal Hoping Hospital was sealed off on April 24, its medical staff protested that they didn't have enough masks and protective suits and that sealing off the hospital without giving them sufficient protective gear was tantamount to sending them to the grave. We heard similar pleas when National Taiwan University Hospital closed its emergency depart-ment. Now there are reports of staff at some hospitals having to make do with one N95 mask per week.

A shortage of face masks on the market is a public relations problem for the government, given that the World Health Organization says the average person on the street doesn't need to wear one. The lack of sufficient supplies of protective gear for medical personnel -- face masks, gowns, goggles, gloves and caps -- is a national catastrophe. The Executive Yuan finally ordered a crackdown on hoarders of face masks and requisitioned imported masks that have been sitting in customs warehouses to be claimed by importers. A more important question is what it is doing to ensure health workers get what they need.

Department of Health Director-General Twu Shing-jer (涂醒哲) tendered his resignation yesterday, saying he had to take responsibility for the SARS outbreaks among medical workers. He will be replaced by Chen Chien-jen (陳建仁), head of the Cabinet's special anti-SARS task force. Hopefully the change will reinvigorate the government's battle against the virus -- a fight President Chen Shui-bian (陳水扁) has compared to a war.

Two months after SARS spread to this country, the public is now quite aware of the dangers of the disease, but no one wants treatment centers dedicated to SARS cases in their neighborhood. The government says the SARS outbreak is a national security threat. Well, words are not enough. The government must demonstrate that it can respond quickly and act decisively. It must stand tough when controversial measures are needed and do what is best for all of the people of this country, without regard to how such tactics will play in terms of next year's elections. This is a war that no one can afford to lose.

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