Unmasking A Crisis

This is the hospital ward China's Ministry of Health doesn't want you to see. There are more than 100 Severe Acute Respiratory Syndrome (SARS) patients crammed into tiny rooms in the infectious diseases section of Beijing's You'an Hospital. "Every single one of us in this building is a SARS patient," says a nurse surnamed Zhang who worked at the People's Liberation Army Hospital (P.L.A.) No. 301 until 11 days ago, when she was diagnosed with the disease and admitted here. "There are at least 100 SARS patients here, if not several hundred. The conditions here are really bad. We're not allowed out of this room. We piss in this room, crap in this room and eat in the room. As far as I know, at least half of the patients here are doctors and nurses from other hospitals." As a Time reporter continued through the ward, another nurse who wouldn't give her name stopped him and explained, "Look, I'm not pushing you away. I do this for your own good. It's too dangerous here. It's really a terrible disease, even we who work here don't know when we'll get it. No place is safe in this hospital. All of these wards are full of SARS patients, there are over 100 at least. Don't believe the government—they never tell you the truth. They say it's a deadly disease with 4% mortality? Are you kidding me? The death rate is at least 25%. In this hospital alone, there are over 10 patients dead already."

According to the Chinese government, most of these patients—and perhaps hundreds or even thousands of others across the nation—simply do not exist. Before the reporter is hustled out of You'an's teeming isolation ward, nurse Zhang warns, "Never believe what the Health Ministry tells you."

China, flush from having won the right to host both the Beijing 2008 Olympics and the 2010 Shanghai World Expo, may be presenting a rosy, reformist face to the rest of the world. But the country's handling of the deadly SARS epidemic, which is believed to have originated in the southern province of Guangdong last November, shows that behind closed doors Beijing can be as inscrutable and secretive as ever. Numerous reports from local doctors over the past week suggest that the nation's health-care system remains hostage to a government that values power and public order before human lives. "You foreigners value each person's life more than we do because you have fewer people in your countries," says a Shanghai-based respiratory specialist, who sits on an advisory committee dealing with epidemic diseases. "Our primary concern is social stability, and if a few people's deaths are kept secret, it's worth it to keep things stable."

The question is: Just how many deaths can be kept secret before the health epidemic itself becomes a threat to social stability? For decades, China's Ministry of Health has deliberately kept killer outbreaks hidden, hoping that deadly diseases will burn out on their own without interference, or scrutiny, from the international medical community. After all, China is a big country, it says, and it's natural for a case or two of plague or rabies to pop up; why worry the populace unnecessarily? But Beijing's emergency plan may be backfiring with SARS, which has burst out of the mainland's national boundaries to kill 116 people and infect 2,890 worldwide as of last weekend. Yet even as the deadly pneumonia proliferates around the world—Africa is the latest continent afflicted with the bug—China continues to massively underreport its own SARS epidemic. In the metropolises of Beijing and Shanghai, local doctors and nurses whisper of hundreds of cases piling up in epidemic wards. And citizens who have put faith in China's health-care system for decades are beginning to wonder whether their long-held trust has been dangerously abused.

Even as late as last Saturday, China's health authorities continued to stick to an accounting of 60 SARS deaths and 1,300 cases—even though China's Premier Wen Jiabao visited You'an Hospital, where medical staff say the full caseload there has not been incorporated into the figures. In an effort to ease an increasingly worried populace, Beijing's recently appointed Mayor Meng Xuenong claimed last Thursday that Chinese health officials have "full control over atypical pneumonia." Meanwhile, medical authorities maintained that most SARS cases in China outside of Guangdong were "imported," proving that cities such as Beijing and Shanghai were not themselves breeding grounds for the disease.

But even as the government continued its policy of denial, a number of whistle-blowers began contesting Beijing's numbers. On Tuesday a retired military hospital surgeon alleged that in one Beijing hospital there were more than 60 SARS patients and seven deaths from the disease. A local cadre from Shenzhen told Time that during an internal meeting last week, a city health official spoke of at least six deaths there so far while still publicly denying any cases. And in Shanghai, local doctors spoke of 14 cases at one hospital, while Dr. Li Aiwu of the Shanghai Pulmonary Hospital confirmed that seven foreigners were being treated for the disease—contradicting the city's previous claim that no foreigners were suspected of having SARS. "I guess that means I don't exist," jokes a middle-age Englishman who has been confined to its 14th-floor isolation ward for a week.

The Manchester native connects with the outside world by cell phone. "The care here is good, but I must admit I'm feeling a little cut off from the real world."

China's continued obfuscation contributed to the U.S.'s issuing a travel advisory warning against nonessential trips to China. At about the same time, Malaysia barred all tourists from mainland China and Hong Kong. In Hong Kong, the government reacted to the continued increase in local SARS cases and criticism it had been slow in dealing with the disease by finally ordering household contacts of confirmed patients to stay in home quarantine. Travelers wishing to fly from Hong Kong's Chek Lap Kok airport would also have their temperature taken before they were allowed to board their flights. In the mainland, luxury-hotel occupancy in Shanghai has slipped from the usual overbooked 120% this time of year to 30%. High-level trips by former U.S. President George Bush, Singaporean Prime Minister Goh Chok Tong and a World Economic Forum event have been postponed or canceled. "The drop-off in visitors is worse than in 1989," grumbles a Shanghai foreign-affairs official, referring to the foreign exodus after the Tiananmen crackdown.