Washington Post: A Mistrust of Government Undercuts China's Effort

April 29, 2003, Tuesday, Final Edition

By: John Pomfret, Washington Post Foreign Service

Chen Qisan came to Beijing looking for justice. Then he caught a cold.

Chen, a 30-year-old farmer from central China, traveled here last week with fellow farmers to ask the government to help retrieve money they said was stolen by local officials. After they had visited several offices to plead their case, the police moved in and threatened to arrest them.

By then, Chen was suffering from a dry cough and fever, and worried not only about being thrown in jail, but also about being quarantined on suspicion of having the SARS virus. Instead of seeking medical treatment, he went underground. "I don't know what I fear more," he said. "The disease or the officials."

Chen's story illustrates the dilemma faced by China as it combats the spread of SARS, or severe acute respiratory syndrome. Government officials, who initially covered up the severity of the epidemic, are now struggling to gain the trust needed to effectively implement measures to fight the disease. Faced with a government they think has routinely lied to them, Chinese are now being told by Premier Wen Jiabao, "We are all in the same boat." But for many people, such declarations don't inspire confidence.

Throughout the country, Chinese are violating the letter and the spirit of government regulations. Hundreds of thousands have fled Beijing, despite orders and pleas for them to stay in the city, because they don't believe the government can control the illness in the capital. Doctors say many people are not informing them that they have symptoms because of fears they will be sent to hospitals. Over the weekend, thousands of farmers in the village of Chagugang outside Tianjin, 90 miles east of Beijing, ransacked a school that was being prepared for suspected SARS patients because they said the government had not informed them of its plans.

Officials are trying to institute a strict quarantine regime to control the rapid spread of SARS, which has infected at least 3,106 people in China and killed at least 139, a higher incidence of the virus than in any other country.

Chen, who arrived from his home in Gaoyang township, along the banks of the Yangtze River, believed being quarantined in an infected hospital would be a death sentence. So he evaded the police and fled the hotel he had been staying in. With just the clothes on his back and his mobile phone, Chen said, he spent several days at flophouses around Beijing, sleeping one night in the open air. His cold worsened and his fever rose.

"I don't want to give myself in," he said, hacking into a ragged shirt, acknowledging that he didn't know if he had SARS. "I just don't trust the government. Do you think they will actually give me, a poor peasant, free treatment? I don't believe them."

The issue of public trust is cited by international health officials as key to the fight against SARS. In a recent report on the virus and China's economy, the World Bank concluded that "it is clear that frankness and transparency in public information will be critical in building public trust and minimizing the economic costs of SARS."

Right now, however, the government is trying to recover from a series of admissions that officials had covered up the extent of the disease in Beijing and around the country.

"The fundamental problem here is that people don't have faith in the government," said Kang Xiaoguang, a leading social scientist.

Tonight, for example, at Kunming airport in the southwest, authorities checked temperatures of passengers traveling from Beijing on Air China Flight 4172. Two people were found with low-grade fevers and were escorted from the plane. Then authorities blocked the rest of the passengers from disembarking, keeping them in the plane for four hours, some of those present said. Finally, several passengers at the front of the plane forced the door open, allowing others to run down the aircraft stairs and onto the runway. Police arrived and surrounded the passengers in a standoff that continued into the evening.

"There were no rules to follow. The government has no idea what it's doing," said a passenger who said his surname was Xu, speaking by mobile phone from the tarmac. "So, of course, we didn't listen to them. If they had a semi-reasonable plan, we would have followed it. But locking us in a plane where potential SARS patients had been? What kind of plan is that?"

The use of the state-controlled news media also has damaged whatever trust there was in the government. At the beginning of the year, authorities suppressed news about SARS. Then the government ordered China Central Television to do a series of reports attacking rumors about the virus. The reports were intended to denigrate pharmaceutical and herbal drug companies, suggesting they were fomenting worries about SARS to increase sales in Guangdong province, the southern region where the virus originated. Only when the outbreak hit Beijing did the government begin to disclose the scope of the disease.

But now that it has, officials are finding that citizens are reluctant to follow their orders. They say that people who appear to have SARS symptoms should be treated and monitored by doctors and that those who have been in contact with potential SARS victims need to respond to government calls so they can be isolated. They also say people need to heed the government's advice.

For at least a week, the central government has been encouraging and, finally, ordering people to stay within Beijing's city limits in an effort to keep SARS from spreading across the country. But a government health official said an estimated 1 million people have already defied those orders and left the capital.

More than 1,000 students have arrived in Ningxia, a western province that is among the poorest in the country, and an official there said they constituted a "latent source of infection for the whole region." An estimated 10,000 workers and more than 1,000 students have arrived in the southern province of Hunan from Beijing, undermining preventive measures there. And today provincial authorities in the eastern province of Zhejiang announced that a student who had returned home from Beijing was suspected of having SARS.

"The government has said the people are panicking because they don't understand SARS, but that's wrong," said Kang, the social scientist. "They are panicking because they don't know who to rely on. The migrant workers in Beijing are afraid that if they are quarantined they won't get treated, just left there to get sick and die. Their flight is actually a rational response."

Kang has his own experience with such fears. When several cases of SARS popped up inside the compound where he lives in Beijing, Kang flew with his wife and 3-year-old to Kunming.

In the past week, government and party organs have issued a series of inducements that indicate that they are having a hard time getting people to follow their program. The Communist Party's Discipline Inspection Committee warned party members, especially doctors and nurses, that they would be forced out of the party if they left their posts. The government also announced that health care workers dealing with SARS would be given an extra $ 36 a day, a sign that officials realize propaganda is not enough incentive to gain better cooperation.

China has also ordered hospitals to treat or at least hold potential SARS patients until better-equipped hospitals can admit them. And it has told the poor that they will be given free treatment if they are infected.

Many people do not seem to believe that.

"Free medical care for me?" laughed Huang Dongshan, a 28-year-old laborer who left his job as a house painter to head back to his home in Guangxi, 1,000 miles to the south. "No one has ever given me anything for free. If I'm going to die, I want to die in my home. I don't trust the hospitals."

Indeed, some 20 SARS patients in Taiyuan, the capital of Shanxi province, recently fled their hospitals because they didn't trust government promises that they would be given quality treatment for free, sources in the city said. Police were given photographs and addresses of the patients and ordered to round them up, the sources said.

In other regions, villages are taking matters into their own hands. On the outskirts of Beijing, the village of Jiankou put up checkpoints and blocked outsiders. Jiankou, which sits at the foot of a section of the Great Wall, is a favorite for day hikers.

"Outsiders keep out," yelled a villager, manning a fence. "Don't come near me."

Asked if he trusted the government, the man responded, "We trust ourselves!"

On Sunday night, Chen, the farmer from Gaoyang, surrendered to police in Beijing. They had called him on his mobile phone and threatened to harm the villagers who came with him to the capital, he said. Today they put him on a train for the western city of Chongqing. Chen hadn't told them about his symptoms. They didn't check. On the train, he sneaked a call to a reporter.

"Who knows where they'll put me in Chongqing?" he said. "The hospital could be worse than the jail. I know I should have told them about this in Beijing. But I just didn't believe they would really help me. My life means nothing to them."