SARS in China

Abstract

Arthur Kleinman, James L. Watson (eds), SARS in China, Houndmills, Palgrave Macmillan, 2004, 219 pp.As memories of the 2003 SARS outbreak slowly fade away, SARS in China is an invitation to revisit the days of anxiety, their legacy and the paradigms that were arguably turned upside down during this episode. SARS was unusual in many ways. First, and importantly, it was brief. But it was nonetheless challenging, intense and global, thanks to air travel. The book captures aspects of life under SARS through several lenses. The authors write that it became rather unintentionally a transdisciplinary project.The study highlights governance aspects of the response to the outbreak and is a useful reminder that SARS was a reality check, a wake-up call that put to test global systems in response to epidemics. With avian flu close on the heels of SARS, lessons must not go unlearned, as the authors rightly point out.The first part of the book maps the epidemiological and public health background. Alan Schnur, at the time team leader for communicable diseases at World Health Organisation's (WHO) Beijing office, gives a tactful account of China's interactions with WHO and carefully avoids highlighting the fault lines, tensions and conflicts that paved the road to disclosure by the Chinese authorities.Social anthropology and psychology are the best researched themes in the book. In particular, stigmatisation is put into perspective. An important point made by Arthur Kleinman is that discriminatory attitudes were compounded by the fact that the clinical features of SARS infection were highly non-specific. One may wonder, though, what is specifically attributable to Chinese characteristics, such as Confucian values, and what would have been relevant anywhere, had the epidemic struck non-Chinese communities around the world on a large scale.Economic issues, addressed in the second part of the book, quickly turned out to be relatively unimportant, as it became obvious that global or regional growth would only be temporarily and rather marginally affected by the outbreak.In terms of political analysis, the book is somewhat disappointing. General aspects of bureaucratic control and, in particular, the potential adverse impact of quarantine policies on human rights are discussed. Otherwise, the main focus is on the response or responses of the PRC authorities. To an informed observer, though, the issues discussed are not really new. In her chapter on China's healthcare response, Joan Kaufman rightly notes that the Chinese authorities have been in denial mode for a long time, in particular with regard to the HIV/AIDS pandemic and more generally the appalling state of public healthcare provision in rural areas. But the analysis provided in the book in terms of before and after disclosure appears simplistic. …