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.