In the SARS crisis people must be told by every medium possible what to look out for and what to do, writes Mark Hennessy.
Three thousand children a day die in Africa because of malaria. Over three million people died from AIDS last year. Over 120,000 people died from cholera. Tetanus killed 270,000 children. Thirty million people, mostly children, were infected with whooping cough last year. Nine hundred thousand died.
The number of cases of Dengue haemorrhagic fever multiplied sixty-fold in Latin America between 1989 and 1993, as compared with the previous five years. These disturbing figures should make us all pause and reflect, as panic spreads throughout the world about the impact of Severe Acute Respiratory Syndrome.
All of them have one thing in common. They kill vastly more of the Third World's poor than they do those living comfortably in the First World, including Ireland. So far, SARS has killed 256 people. The virus responsible has already been identified. Some researchers believe that a treatment could be available in months.
This is not to argue that SARS is not a threat. Clearly it is. However, panic, aided by truckloads of the most crassly irresponsible reporting imaginable, achieves nothing. And certainly none of it excuses the handling of the issue by the Department of Health, the Minister for Health, Mr Martin, and other elements of the health service.
The Minister cannot behave like a latter-day King Canute holding back a tide of illness, real or imaginary, in a globalised world. And it is silly to believe that he could.
However, he must ensure that responses are quick and adequate and that information flows rapidly and accurately through the system. This does not seem to be happening.
So far, he has not been in control. When he did emerge in a rush of radio and television interviews he did so only to take a rollicking. The plan was absent.
However, ministers often get blamed for the blunders of a system. Here, he bears a heavy cross. The Department of Health is unreformable and dysfunctional. He has not been helped by leading Health officials, particularly the Chief Medical Officer, Dr Jim Kiely, who has failed miserably to calm nerves.
Yesterday Dr Kiely said details about the Chinese woman treated by St Vincent's Hospital could not be revealed because her privacy had to be protected.
Fair enough, most people would agree. But who revealed her condition, her sex and her nationality? The Department and the Eastern Regional Health Authority share the blame. Either her case is confidential, or it is not.
The release of her nationality has raised unnecessary fears about and for Chinese people living here, since most of them were here long before SARS ever became a problem.
The Government's information campaign has emerged haltingly. People must be told by every medium possible what to look out for and what to do if they find something. All incoming travellers must be put on notice. Leaflets to emphasise hygiene should be sent to homes and posted up everywhere else, from shops to toilets.
The public needs to be assured that someone is in control, and that each citizen has a role in limiting the spread of the disease should it emerge here. Simply put, people must be given something to do. Medics must know who to inform.
Given the delays so far, some clearly have still not have got the message. And they must agree about a patient's condition if they find one. Contradictory diagnoses, as we have had, do not inspire confidence.
The flow of information through the health service is hindered by the plethora of structures that now make it up. Riven by factionalism and turf wars, it is one of Europe's most sclerotic.
One of the difficulties facing Mr Martin and his international counterparts is that information flows more quickly than bureaucracies can cope with.
But global illness means a global response. In the beginning China tried to hide SARS or at least tried to convince itself that it did not have a problem. Now Beijing, stung by international criticism, has gone to the other extreme, sending people into forced quarantine, which may drive cases underground.
If SARS spreads, the problem will worsen. If it spreads in the Third World, poorer countries - unable to treat worse diseases - will certainly not be able to cope.
And they may carefully note the damage that has been inflicted on the economies of Toronto, Hong Kong, China and other parts of south-east Asia.
The world's poor have, too often, had experience of disproportionate responses by richer countries, which have been quick to pull up the drawbridges.
In 1998, for example, the European Commission banned fresh fish imports from four east African countries during a cholera epidemic there. Despite WHO and UN declarations that the fish was safe, the restrictions remained for six months, causing significant harm to the local economies.
In future countries must be legally obliged, and financially helped, to report disease outbreaks promptly. But, equally, they must not be victimised if they do so. Otherwise we will all lose.
Back home, the Minister is faced with the public health doctors' strike. But now is not the time for a strike. They should get back to work, even if only temporarily, until the worst is over. Otherwise, frankly, they should be sacked.
mhennessy@irish-times.ie