Here's a small taste of it...
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On February 28, 2003, the Vietnam French Hospital of Hanoi,
a private hospital of about 60 beds, contacted the Hanoi office of the World
Health Organisation. They reported a patient with an unusual influenza-like
virus, and hospital officials suspected an avian influenza virus.
They asked if someone from the WHO could take a closer
look at the case, and Dr Carlo Urbani, a specialist in infectious diseases,
answered that call. In 1999, Dr Urbani was president of MSF-Italy (the Italian
branch of Médecins sans Frontières,
Doctors Without Borders, usually referred to as MSF) and he was a member of the
delegation in Oslo, Norway that accepted the Nobel Peace Prize that year.
Urbani’s courage in dealing with the new disease seems
not to have been given proper recognition, but I would like to list him here as
one of the heroes of 21st century medicine.
The patient he was asked to look at was the first case
of the first recorded outbreak of SARS, and due to the actions that were taken
by the MSF volunteers, quite deliberately and selflessly, Urbani and several
other unnamed health workers died.
That was the cost: the benefit was that the outbreak in
Vietnam was the first to be brought under control, after just 63 cases and five
deaths.
Urbani concluded that the small private hospital was
facing something unusual, and for the next several days, he worked at the
hospital, documenting findings, arranging for samples to be sent for testing,
and reinforcing infection control.
The hospital established an isolation ward that was kept
under guard. Urbani worked directly with the medical staff of the hospital to
strengthen morale and to keep fear in check as SARS revealed itself to be both
contagious and virulent. Of the first 60 patients with SARS, more than half
were health care workers.
The heroism came when many of the staff members made the
difficult decision to quarantine themselves. To protect their families and
community, some health care workers put themselves at great personal risk,
deciding to sleep in the hospital and effectively sealing themselves off from
the outside world.
In some ways, say MSF people who briefed me on this at
the time, the SARS outbreak in Hanoi is a story of what can go right, of public
health coming before politics. First-line health care providers quickly alerted
the WHO of an atypical pneumonia.
Dr Urbani recognised the severity of the public health
threat. Immediately, the WHO requested an emergency meeting on Sunday, March 9,
with the Vice Minister of Health of Vietnam.
By March 19, a team of MSF workers was in place.
Additional specialists from the WHO and the Centers for Disease Control and
Prevention (CDC) arrived on the scene, and MSF provided staff members as well
as infection-control suits and kits that were previously stocked for outbreaks
of Ebola virus.
On March 11, Urbani began to experience symptoms during
a flight to Bangkok. On his arrival, he told a colleague from the CDC who
greeted him at the airport not to approach him.
They sat down at a distance from each other, in silence,
waiting for an ambulance to assemble protective gear. He fought SARS for the
next 18 days in a makeshift isolation room in a Bangkok hospital. Carlo Urbani
died on March 29, 2003.
His decisive and determined intervention bought precious
time and saved lives. Although he would be gratified that so much was
accomplished to beat SARS in such a short time, he would certainly point out
that the other diseases he worked with—such as the human immunodeficiency virus
and AIDS, tuberculosis, and malaria, which kill millions of people each
year—deserve to be treated with similar urgency. Such a man would undoubtedly
have pointed to his colleagues who also died in the battle.
The MSF is a volunteer organisation, but needs funds to
operate, and welcomes donations. Yes, that’s a hint.
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