Managing SARS

Managing SARS

Initially, there were the usual official denials: Severe Acute
Respiratory Syndrome (SARS), the newest "mystery" disease to
threaten the world, was not in Indonesia, public health officials
in Jakarta said. Ordinary Indonesians were skeptical from the
start. The World Health Organization (WHO) announced the
discovery of the "mystery disease" in Hanoi, Vietnam, as early as
Feb. 26 while earlier cases were first recorded in southern
China. From that moment on, similar cases emerged in rapid
succession in Hong Kong, Singapore and several other areas in the
region.

So despite the official assurances that Indonesia remained
unaffected, the unspoken public feeling was that the country
would be unusually lucky to escape this disease for which no
known treatment as yet exists. After all, Indonesia is an
archipelagic country, many of whose ports are potential entry
points for the disease.

The country's coastline is one of the longest -- and most
inadequately guarded -- in the region, if not the world. In
addition, Singapore and Hong Kong are places where thousands of
Indonesians find employment. The island of Batam in the Riau
islands buzzes daily with traffic to and from Singapore. From the
start, there was little doubt in the public's mind that sooner or
later the dreaded SARS would arrive in Indonesia -- if it had not
already done so.

That moment of truth came earlier this week when officials
made it known that at least five "alleged" cases of the disease
had been reported in Jakarta and Semarang in Central Java. All
five, the government said, had all recently arrived back from
SARS-affected countries and displayed flu-like symptoms, though
they had no known history of contact with SARS patients.

That set the authorities scrambling to contain the disease
before it could grow into epidemic proportions. The disease was
declared an epidemic threat and state hospitals in Jakarta and in
the provinces were appointed to serve as emergency SARS clinics.

Minister of Health Achmad Sujudi was scheduled to issue a
ministerial decree on Thursday invoking Law No.4/1984, which
gives the minister of health the authority to take the necessary
steps to contain the disease. This includes providing the
necessary facilities and personnel for health institutions, and
directing the public in helping to fight the disease.

Obviously, all of these measures are welcome, though they come
somewhat belatedly. Preventive measures should have been taken at
seaports and airports, at border crossing points and hospitals as
soon as the first cases were discovered in the region. It should
never have been expected that Indonesia would escape the
outbreak, given the close social, political and economic
relationships between Indonesia and its neighbors, and given the
high degree of mobility of people in this part of the world.

Now that the first substantial step toward dealing with the
problem has been taken by invoking Law No.4/1984, the government
should go all out to provide everything, including money, needed
by those workers and institutions involved in the effort in
contain the disease. Obviously, this brings with it the need for
transparency and accountability in the management of the
resources involved.

Clearly, serious efforts are needed to deal with the disease.
As the initial indicators and forecasts show, the current SARS
outbreak is nothing to trifle with. Already, the travel industry,
including airlines and hotels, is suffering because of SARS,
which could turn out to be even more harmful than the war in
Iraq. This is not to mention the social costs the nation will
have to shoulder if the disease is allowed to run out of control.

Much of the success in fighting SARS will depend on the
support of the public. But it is the government's leadership that
in the end will determine whether the current SARS threat can be
managed and contained, or whether what we are seeing is a new
crisis in the making.