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SARS: A tale of three cities
Xiaoxia Gong, Ph.D.
11/28/2003

In February, merchants in Shanxi Province in northern China found a new way to make quick money. A whisper of the good news flowed around town: a mysterious flu-like disease was spreading in Guangdong, the richest province in the country. This disease could be prevented, or even cured, by a common product: vinegar. The price of vinegar, as a result, went skyrocketing.

Shanxi, a poor province in the west, produces plenty of vinegar. In fact, the Shanxi brand of vinegar, Shanxi Chencu, is the best known in China. Grasping the opportunity, merchants traveled between Guangdong and Shanxi, more frequently than ever, with vinegar and with other goods. Few people from Shanxi cared about the disease, since the media were reporting only that the epidemic was under control.

In late February, Ms. Yu, a jewelry merchant in the Shanxi capital, Taiyuan, had a bad fever. Ms. Yu had recently returned from a business trip in Guangzhou, the capital of Guangdong. She visited several local hospitals but found no cure. So she did what the well-heeled in Taiyuan often do when they fall ill: She took a taxi 350 miles to Beijing.

Beijing has the best-equipped hospitals in the country, and its military hospitals are the cream of the crop. Under Mao Zedong, only privileged cadres and military officers were admitted to such hospitals. But times have changed, and now anyone who can afford the fees is admitted to these top-notch hospitals. So Ms. Yu checked herself into the No. 301 Military Hospital on March 1. A week later, doctors were convinced she had SARS.

After a lengthy investigation, a Chinese magazine Finance concluded that Ms. Yu was the first SARS case in Beijing. She infected approximately 20 people in Shanxi, including her own parents, both of whom died. Doctors and nurses who treated her, five in Shanxi and unknown number in Beijing, were also infected.

Spreading from Guangzhou to Taiyuan and then to Beijing, SARS began to take a heavy toll—initially in China and then worldwide. And Guangzhou and Beijing are now the Chinese cities no one wants to visit.

The speed of this turnaround is stunning. Guangzhou has long been a Chinese Mecca of economic reform. It has over the years drawn a “floating population” of millions: money-hungry northerners, desperate migrant laborers, international speculators, and officials.

This Gold Rush lasted for two decades, until SARS—traveling in from the nearby countryside—cast a pall over the southern port city in early 2003.
Beijing’s tale is more overtly political.

The central government had pooled the best resources from all over the country to turn the Chinese capital into a showcase—with the best medical facilities, the best specialists and equipment, and the best access to the global medical information network.

Moreover, most of the great facilities here were not even subjected to the authority of the Beijing municipal government, as most hospitals in the rest of the country would be under their own local governments. No. They all answered to higher authorities in the ministries of the central government. The military, of course, took the best. The education ministry also had the advantage of utilizing the best medical-faculty brains to establish its own facilities. It was a privilege, even an honor, to be admitted to such a facility. No wonder the wealthy people in Taiyuan sought treatment in Beijing—this would telegraph their wealth and social status for all to see.

When the now fired Beijing mayor claimed that the municipal government didn’t cover up the SARS epidemic, he might not be telling a lie. It’s quite possible that he didn’t know of the actual figure. Hospital cadres may not have been reporting to the mayor’s office. But who would believe him? Top Communist Party leaders might also genuinely have been in the dark—mainly because the Party has cultivated a subordinate workforce that prefers to suppress bad news.

The irony of dictatorship is that while the “iron fist” can ably persecute dissidents, it’s never managed the affairs of the nation with any great degree of effectiveness or efficiency. During Mao’s Great Leap Forward, it took top party leaders two years to learn that 40 million people had already starved to death. When the World Health Organization criticized China for hiding the truth about SARS, they might have gotten it wrong: Maybe top leaders just weren’t told what was really going on. As far as which looks worse—hiding the truth, or simply being ignorant of it—it may be a wash.

China at the dawn of the 21st century is a study in jarring contrasts.

In the big port cities of Shanghai and Guangdong, college students chat on mobile phones while their parents dash from high-rise offices to Starbucks and then to the gym. In the central and western regions, meanwhile, millions still don’t have running water. And the capital, Beijing, is struggling to keep a lid on dissent and discontent from the hundreds of millions of workers for whom economic modernization has meant only misery and pain.
The tale of SARS in three cities—in three distinct regions of China—doesn’t end here, with hundreds of deaths in Guangzhou, Taiyuan, and Beijing.

Terrified workers trying to avoid the virus were suddenly as eager to flee Beijing and Guangzhou as they once were to migrate there. Rumor said that anyone with a fever would be sent to a SARS hospital, where he would definitely contract SARS if he wasn’t already infected. Once again, people boarded trains, this time heading home.

But their hometowns didn’t welcome them back. At every stop, local police would get on the train and ask: “Anyone coming from Beijing or Guangzhou?” No. They were not wanted.

*Xiaoxia Gong comes originally from the People's Republic of China. She holds a Ph.D in sociology from Harvard University, and is currently a free-lance columnist.

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