Abdicating responsibilities

Rivers in the central area have dried up thanks to an extreme drought. Rice paddies are parched and the worst-ever outbreak of an imported infectious disease has sent much of the country into a panic.

Droughts and epidemics were considered ominous signs by ancient monarchies, and they felt their destinies could be affected by them. During the Joseon Dynasty (1392-1910), the onus of droughts and epidemics fell on the monarch. When a severe drought struck the country in 1882, King Gojong blamed himself for bringing about the suffering of his people. He held rituals atop mountains in April of that year praying for rain. He bowed in front of the Han River and before tombs and shrines of ancestors. When rain still didn’t come, he and his subordinates held another ritual before the altar at the royal court in May. Less than a month later, his palace was breached by Japanese invaders. On the following day, a muddy rain came down. The king could not have had a drink to congratulate or comfort himself under such chaotic circumstances.

In 1895, cholera broke out in the capital. Corpses formed a chain along the hill of Seodaemun. Two Western doctors opened an outdoor hospital to help fight the contagion, but could not stop an outbreak that killed tens of thousands. King Gojong again performed a ritual to pray for the withdrawal of the spirits that were spreading the disease. Under a royal ordinance established in 1474, the ritual to chase away the specter of disease was to be held three times a year and at any time in case of an epidemic. The tradition lasted for 500 years until the last cholera outbreak during the Joseon Dynasty in 1902. With or without deep medical knowledge, fighting an epidemic was the responsibility of the state.

Protection of the people against natural disasters and contagious diseases is still an important national responsibility in today’s world. The government is responsible for irrigation and water supplies as well as quarantines against outbreaks. As the ancient court ordinance made rituals a duty for the monarch and rulers of a province, the responsibility for a contemporary outbreak goes to the president, politicians, cabinet members and local government heads.

While a patient who was not aware of the potential danger of his infection innocently roamed around the emergency ward of Samsung Medical Center, politicians were busy wrangling over revision to legislation that would give them more power to kill presidential and government ordinances. After Patient No. 14 in the current outbreak did his deadly work - spreading the disease to everyone in the emergency ward and some outside as well - the government issued a warning on May 29 to be cautious about the communicable disease.

Samsung Medical Center, which claims to have the best medical equipment and human resources, began to panic on the night of May 29 after realizing the dire consequences of casual routines in its emergency room. If it had come clean immediately and worked closely with the government, we may have seen a different outcome. But the government was too laid-back and Samsung was overly confident. Dr. Song Jae-hoon, who heads Samsung Medical Center as well as the Korean Society of Infectious Disease, was the person to recognize Middle East respiratory syndrome (MERS) in the first patient. He followed the protocol of the World Health Organization (WHO) and confirmed everyone who had been within 2 meters (6.56 feet) of the first patient to segregate them. He had 600 of his 2,000 medical staff isolated and immediately transferred patients in critical condition to safer wards. He released a list of 3,000 people who could have been exposed.

But he was not completely thorough. He did not know the virus was capable of spreading beyond a 2-meter threshold. He did not check doctors, nurses or visitors. He did pay heed to the ambulance staff. As a result, the virus was carried to as far as the southern cities of Busan and Changwon. While the state was negligent, Samsung Medical Center was named the major culprit in the outbreak.

How about the local governments? Seoul Mayor Park Won-soon emerged as a kind of hero by holding an emergency press conference to break the news that a doctor at Samsung Medical Center attended a public event carrying the virus. His action was a wake-up call to the political sector. But despite his public display, Seoul’s government was poor in follow-up actions. The city of Seoul has not made a single call for comfort and aid to people forcibly isolated upon coming in contact with an infected patient. Gyeonggi Governor Nam Kyung-pil quietly cooperated with the government and worked to help fight the contagion. What is needed now is the government and private sector working quietly but thoroughly.

After his evaluation of the outbreak, WHO Assistant Director General Keiji Fukuda said that Korean medical professionals had not been knowledgeable about the MERS virus and could not anticipate its outbreak. The health ministry in April held a meeting on MERS. There are only two professionals familiar with the MERS virus in the country. The headquarters of national disease control is mostly staffed by public health doctors who are trying to fulfill their compulsory military service.

There is no sign of taming the contagion while state engagement is less vigilant than in the ancient days. Our only hope hinges on the medical professionals working around the clock to fight the disease. The value of alertness to maintaining public health is the painful and shameful lesson the MERS outbreak has taught our society.

Translation by the Korea JoongAng Daily staff. JoongAng Ilbo, June 16, Page 31

*The author is a professor of sociology at Seoul National University.

by Song Ho-keun