17th April 2003
This, we are repeatedly told, by those who must be obeyed in the Health Service, is the age where good communication is what matters. We doctors are berated for our allegedly poor powers of communication. But for text book examples of how to confuse the public the efforts by those who spoke for the Department of Health and some of the Health Boards on the SARS issue must be classic.
A delegation from the Department of Health and Children, the Eastern Regional Health Authority, the National Diseases Surveillance Unit and the Irish Medical Organisation appeared before the Oireachtas committee for Health and Children to discuss the SARS International epidemic. I said that I felt their efforts in providing information to the public on SARS were "woeful". The response was that the Department of Health and Children had set up a web site with the answers to the most frequently asked questions on it. This must have come pretty late in the day and from the phone calls I’ve received as a public representative who also happens to be a medical practitioner they might as well have tried to communicate by yodelling or smoke signals.
The media reports on SARS were alarming. On Easter Sunday morning at 9.45 I was called by a man, obviously very concerned not only about himself or SARS but about lack of preparedness, as he saw it, in the nation. He had already been on to St. James Hospital and the Department of Health and neither unsurprisingly given the day could give him information. He was upset and wanted me to "do something about it".
He, at least was civil, as were most other callers, unlike the man who thought he was phoning Mary Harney about SARS (I’m in the phone book and she, probably wisely is not, so I get such calls from time to time).
"Is that you, Mary Harney?" roared the man. After the usual explanations that it was not, no, he had phoned the right number in the book and got onto it, yes it was me Mary Henry, not Mary Harney and so on. He asked me to do something about the Minister for Heath and Children which even if I felt inclined to do it to the poor man is illegal in this country.
"Why", I said "don’t you write a letter to the Irish Times?". This very Dublin 4 response sometimes has the desired effect on such callers but it only enraged this man more. He ended by saying he would join the IRA, get a gun and do the job himself.
At this stage I was pretty confused about SARS myself and not properly prepared to set myself up as a one woman advice centre. The first thing I couldn’t work out was these pronouncements that "the blood tests were negative". This seemed to imply to the general public that the person being tested did not have SARS. Now, seeing that the disease is so new I was amazed that there was a test for it. Well, of course there still is no test for SARS - the tests involved were tests to exclude other conditions which might have similar clinical symptoms. Why was this not made clear to the public early on?
Even after looking at the information on the website I still think it is not clear that the diagnosis of SARS is mainly on clinical symptoms and history. The public is well capable of understanding this if clearly told. The difference between a "suspect" and "probable" case seems to be if made by the chest X ray results of the patient - not a difficult concept either.
There is now a very good announcement on the radio which goes something as follows - "SARS - have you visited China, Hong Kong, Toronto etc. recently? If you have and you have a high fever, cough, shortness of breath or difficulty in breathing, phone your doctor".
The message ends by saying that one is likely to make a full recovery. Why couldn’t we have had this announcement much earlier.
The public health doctors have my support in their efforts to get a proper health structure put in place and proper remuneration for their work. At least, now, the general public knows what public health doctors do and that cannot but be of advantage to everyone. If these doctors weren’t so conscientious about their jobs I’m sure we’d have heard much more about them in the past. It is quite interesting that some commentators are far more excited about the SARS epidemic abroad than the measles one which is taking place in a large primary school in Ireland. With our low MMR immunisation rates, sadly, a death amongst these children is probably more possible but less dramatic than one from SARS here.
People keep asking when there will be a vaccine against SARS. It is amazing how enthusiastic people are to get a totally untried vaccine yet refuse to use those which have been found reliable for decades. Is this poor communication again at a general and personal level?
I’m not a believer in blaming the messenger, frequently being a messenger myself, but some reports on SARS might have been less sensational if as clear information as possible was given to members of the media. Despite complaints about lack of communication by the Department of Health and Children and the Health Boards the actions taken by their staff to date with the Public Health Doctors who came off the picket lines to help, we can hope that SARS will be safely seen off. Then with the public health doctors still on strike we can wait for the next potential epidemic.
Senator Mary Henry, MD
