I try not to use this site to whine about personal stuff (too much), but my shoulder is still a big issue in my life right now, and the doctor has ordered me to get an MRI tomorrow. He thinks when I fell I tore the rotator cuff of my right shoulder, which would require surgery. I wear a sling all the time now and still can’t lift up my right arm nearly two weeks after the big fall.

On a happier note, traffic to my site has tripled in recent weeks, soaring from 6 to 18 viewers, most of whom are sent here by google, thinking they’ll be able to find a recipe for Peking duck. Actually traffic is a bit better than that, and since I started posting about SARS there really was a big spike.

Traffic is sure to plunge again by the end of next week, when I start my 22-day holiday with my favorite person and in all likelihood blogging will come to a complete halt as we peruse South China. Then, immediately after the trip, I move to Singapore. It would be bad form to blog during my first few days at the new job, so the slowdown will most likely continue.

Singapore. It doesn’t quite seem real at the moment. I will be sad, in some ways, to leave Beijing, which I’ve come to enjoy a lot more as the weather’s improved, but I can’t deny that in most ways I feel relieved. In some ways, very relieved.

My big dilemma is this blog’s name. I’ve got a lot invested in the name “The Peking Duck,” but will it be appropriate after I leave China? What about “The Singapore Sparrow”? No, I don’t really think that works…. I’m open to any suggestions readers may have!

Gweilo Diaries has a humorous description of SARS-crazed Singapore. I hope it’s toned down by May 20, when I move there permanently.

In a dramatic turnaround, which I haven’t seen noted anywhere yet, the Central Government is acknowledging the existence of SARS throughout the country, its growing dangers and its geographical spread. This morning on CCTV, for the very first time, the announcers talked about the situation in a helpful and believable manner. No light-hearted sugar-coated testimonials from delighted tourists who love China “now that SARS is a thing of the past.”

Today the message was clear: SARS is spreading rapidly and the number of cases is rising. I was impressed, as it’s a 180-degree turn from their usual (non)”reporting.” I suspect that with the eyes of the world on the country, and with the presence of international investigators, there really was no choice if the government wanted to save even a thread of credibility.

Latest report from the American Chamber of Commerce here:

FROM THE WORLD HEALTH ORGANIZATION:

A reader (I believe she’s native Chinese and living in North America) wrote to me to point out that I may have a gross misunderstanding of the liberation of Tibet, as it’s referred to here. Earlier I had written, “Then again, maybe the Chinese do know more about liberating countries than we do. After all, they liberated Tibet, though, come to think of it, they didn’t call for the UN to step in and handle that liberation, now did they? And anyone who asked, “Liberated Tibet from who? Liberated Tibet from what? is rotting away in a Chinese jail….

The emailer wrote,

“How much you know of that region? Have you ever been there? I met many Americans or westerners who have strong opinion on this topic. But once we started discussion, I found they barely know anything about the issue except Dalai Lama and a general impression of how much tibetan people are suffering from suppression. They don’t know before 1956 (?), tibet had slavery system. Most tibetans were slaves or peasants, owned by monks and aristocrats. They don’t realize that dalai lama was indeed an emperor living in a huge palace, serving as both political and religious leader, enjoying all the luxuries (he had a car disassembled into parts in order to get into Lahsa.) I believe if Dalai never left tibet, he might not allow girls to go to school even up to today.

Fewer people know that as early as 400 yrs ago, then 5th dalai came to beijing to see the mandarin empiror to receive an official title and subsede to central government… I figured it’s getting nowhere to argue with people without these basic knowledge. I’ve been to tibet myself. I’m sure the freedom of religious pratice is limited there. But I also saw the tremendous change the area has embraced. Ask an ordinary tibetan, would he/she choose modernity or primative living condition, you may have very dispersed answers.

I admit I have no formal knowledge of this topic other than what I have learned in school and read in the papers. After reading this email I tried to do some research on the Internet, where I discovered there are two very different schools of thought on the topic, and I have no way of knowing, at least not yet, which is true.

This was a fascinating exercise, because it forced me to consider that fact that I had a very fixed notion about a topic, simply because I had been told that it was so. Maybe America’s propaganda is as bad as that of less free societies, at least in some ways…. I asked several of my colleagues and friends here about the subject, and was shocked to find that virtually all of them agreed with my emailer friend. They all said it was simply a matter of fact that the Tibetans’ lot was improved immeasurably and that it was an act of mercy.

I was shocked because this totally flies in the face of what I — and, I believe, nearly all Americans — know to be “true.” And I must admit that at this moment, I am inclined to say that at least maybe, possibly, we in the West are all under a vast misimpression when it comes to Tibet, and maybe, just maybe, the Dalai Lama is not the saintly, gentle creature who dared stand up to the wicked communists. Maybe.

Anyway, I am holding off any final judgment until I have a better grasp of the facts, but this really did get me thinking. I looked back at my education during the height of the Cold War and all the vile things we were taught about Red China and its partner in crime, The Evil Empire (most of which were grounded in fact), and I just have to wonder, were we duped, at least in this case?

Sorry to make so much about this, but it was like having cold water thrown on me. The crushing of freedom in Tibet — a liberation? Okay, I’ll let it go at that for now.

John Pomfret at the Washington Post again provides excellent coverage of the SARS travesty here in the People’s Republic. Be sure to check it out to see just how vulnerable some parts of this vast country are, and how irresponsible the Wise and Magnanimous Central Government can be when it comes to protecting its citizens. (Courtesy of Ole Eichhorn.)

As so many people say over here, “We love our country, but our country doesn’t love us.”

As the war began, members of the House of Representatives gave speech after speech praising our soldiers, and passed a resolution declaring their support for the troops. Then they voted to slash veterans’ benefits.

So begins Paul Krugman’s scathing column on the hypocrisies of the Republicans. His conclusions are scary. America doesn’t seem to be the country it was just a few years ago. While George Senior called for a kinder, gentler nation, it seems Junior’s America is meaner, more predatory and greedy — unabashedly so.

What that scene demonstrated was the belief of the Republican leadership that if it wraps itself in the flag, and denounces critics as unpatriotic, it can get away with just about anything. And the scary thing is that this belief may be justified. For the overwhelming political lesson of the last year is that war works — that is, it’s an excellent cover for the Republican Party’s domestic political agenda. In fact, war works in two ways. The public rallies around the flag, which means the President and his party; and the public’s attention is diverted from other issues.

This coming Saturday (April 19) I will be singing in a chorus at the Forbidden City concert hall. At last night’s rehearsal, the choir director told us that he was considering canceling the entire thing due to SARS, which has caused many multinationals to send their expat staffs packing. Nearly all concerts have been cancelled in Beijing, it appears, due to SARS fears. We discussed it and agreed that there would be no sense cancelling; there is no way to predict when the city will get back to “normal,” if ever. We will be discreetly offering surgical masks to any attendee who would like one. If you’ll be in Beijing and want to hear some amazing music let me know.

Yesterday afternoon I spoke with the CEO of a well-known Hong Kong company who told me that the city has in recent weeks become an utterly surreal place. It is virtually SARS City, and the media, he said, have made the situation far worse than it is. He cited reports in Fortune magazine and other international publications that “restaurants are empty” and “everyone on the street is wearing a face mask.” These are gross exagerrations, he said, and they are only helping to destroy the city’s economy unjustifiably. What is true, he said, is that the city’s anxiety level is being stretched to the limit. He described how prank emails about SARS disasters are circulating at a fever pitch, and at least one (on how Cathay Pacific was terminating most of its flights) was picked up by a local newspaper, increasing the general spirit of fear and misery.

So SARS is still alive and well here in Asia, no matter what the Chinese Minister of Health says, and it is top of mind with everyone I know, local or expat. The panic seems slowly to be shifting to a mood of grim resignation as people adjust to the fact that SARS may never be cured, and that it is something we may simply have to get used to.

Jon Udell at Infoworld responded to some of my and fellow bloggers’ recent remarks on how PR people might try to take advantage of blogging to benefit their clients.

In general, I think Udell is too magnanimous toward PR people, almost naive. While acknowledging that they (“we,” I’m aftraid) may be hired to ghost-write “an executive’s or architect’s blog” to make them and/or their firms look good, he says this won’t go too far, as the connection between bloggers and their readers are founded on a deep authenticity that is “hard to fake.” I don’t know about that last part. I have seen some PR people who can fake just about anything (it’ll all be in my book).

Once we have people who command a large audience (“transmitters”), we have PR people fluttering like moths around a light bulb. I would be very surprised if the mega-bloggers do not begin to get “pitched” blog ideas from PR hawkers (posing as dedicated fans who “want to share an idea” with them). We have already seen how Dr Pepper plans to create a “blogging network” to help hype its new product. Blogs are a rich and untapped market, and there is no way PR people will be able to ignore them.

As Udell goes on to say, there really is a helpful, justified side to PR in terms of brokering and facilitating smooth connections, to the benefit of journalist and spokesperson alike.

My gripe with my own industry is how this legitimate role can be abused. For example, a PR guy in one of the multi-national mega-PR firms (not my company here in China) recently put out a company-wide email asking everyone in the firm to go to a website where a poll was being held on which Widget has the best features; there, we were told to “vote” for the client firm’s Widget. This raises a slew of ethical questions that this emailer apparently never considered: it’s ballot stuffing; it destroys any possibility of a credible poll; it’s not the PR person’s role to tamper like this; it’s utterly stupid — the email is red-hot evidence of dirty tricks, etc., etc. But this is how a PR person responds: Opportunity; exploit it at any cost. It’s Pavlovian. The Opportunity bell rings, the PR person salivates.

The PR person who acts as a true coach and mentor is the exception, though that’s not necessarily our fault. The bottom line is that clients’ measure our success generally by a single criterion, i.e., column inches or other “measurable results.” (Many of them have no interest in our service as coaches/mentors.) Is it any wonder that we’ll go to nearly any extreme to obtain them? And that driving force will, I am afraid, end up contaminating the blogosphere, at least to some extent. It’s just too irresistible. Someone has a captive audience of a quarter-million readers a week, then someone somewhere is brainstorming on how to subtly use that blogger to get their client’s message across, be it on political affairs/legislation, a product, a company, whatever. Very low-hanging fruit in the eye of the PR shark.

I have been working on a report on AIDS in China. As I read the latest UN materials, I have to admit that even I was startled at just how awful the situation has become and how atrociously the government has dealt with it.. Equally startling are the reasons AIDS has had such an easy time spreading, basically unchallenged, throughout the country. It all goes back to the government and its obsession with “looking good.” The parallels with the current SARS crisis are abundant and rich.

Below are some of the paragraphs I’ve written over the past few days (an ideal cure for insomnia). This was a true “learning experience,” one that gave me a new and deeper understanding of this mysterious land that I am getting ready to leave….
AIDS in China

As this document is being prepared, China finds itself embroiled in controversy over the way that it has handled the outbreak of SARS (Severe Acute Respiratory Syndrome). The New York Times has written, “China’s Ministry of Health still says that there is no evidence that the disease can be acquired in Beijing. What is clear, though, is that Chinese doctors knew a lot about SARS long before it had a name or had left China’s borders, and chose not to share that information for many months.”

Unfortunately, this scenario more or less mirrors the way China has handled its AIDS crisis, the process being denial, resistance, grudging acceptance of the need to cooperate, followed by the nightmare of a full-blown health crisis that could have been lessened had the government taken action earlier.

All indicators show that China is on the brink of an unprecedented explosion of the AIDS epidemic. The latest data, prepared by UNAIDS, the Joint United Nation Program on HIV/AIDS, indicate there were well over 1 million cases of AIDS at the end of 2001 and that this number will most likely mushroom to 10 million by 2010. About 70 percent of those infected are peasants living in rural areas.

Only in the mid-1990s did China start to acknowledge the worsening crisis, and the central government has been slow to take action. Currently only a few Chinese hospitals, all in the big coastal cities and far from the vast majority of infected citizens, are equipped to treat AIDS, and the cost of treatment is far too high for average citizens to afford. These factors, combined with the unwillingness of the government at the local level to take actions such as prevention awareness, converge to increase the likelihood of a future AIDS tragedy in China.

The main cause of AIDS in China has not been sexual transmission but contaminated needles, mainly those shared by injection drug users, but also needles used in unsanitary ways during paid plasma collection. In poorer parts of China, selling blood is a common way to earn extra money, especially for drug users and commercial sex workers. Tragically, many of the blood-collecting companies are unlicensed and illegal, and their use of contaminated needles has been a major factor in spreading the disease. Furthermore, those who sell blood to these companies are often in the most high-risk groups and have already been infected with HIV. Their blood is not tested, and is mixed into the blood pool and sold. Most of this occurs in poor, remote areas of China where there is less likely to be interference from authorities.

The epidemic is worse in provinces with a higher level of commercial sex and intravenous drug abuse. It is not surprising that the most severely affected area is along China’s southwest territory, bordering “The Golden Triangle” along the Myanmar, Laos and Thai borders, a region famous for its heavy trade in heroin, methamphetamines and other illegal drugs. In the northwest province of Xinjiang there has also been a huge outbreak due to prostitution, sharing of needles for drug injection, and little to no awareness of AIDS and its prevention.

AIDS in China has been a taboo topic for years, and to a large extent it remains so today. This is key to understanding the evolution of the AIDS epidemic in China, and why confronting it is so challenging.

The Chinese culture and government tend to frown on sex education and to discourage open dialogue on controversial subjects like AIDS, which has made it difficult to raise awareness, especially in the rural parts of the country. Most Chinese citizens, especially in rural areas, are frightened to discuss sex-related topics, and have a hard time gathering the courage even to purchase condoms. Their local governing officials usually harbor the same fears.

As the current SARS crisis demonstrates, both the central and provincial governments are highly reluctant to discuss anything that might reflect poorly on the image of China, as this might have an adverse effect on tourism and/or foreign investment. Officially there is still no prostitution, no drug abuse, and no blood donation scandal in China.

While in recent years the central government has become more involved in raising awareness of AIDS and taking steps to prevent and contain it, the local and provincial governments have been slow to follow suit. Often they make the situation more difficult by refusing to acknowledge the AIDS crisis as it might reflect poorly on them. It is at the local/provincial level that most of China’s 1.2 billion citizens deal with their government, and where they turn for help.

Because of the government’s avoidance of the issue, the general public has little knowledge of AIDS and how it is affecting China. This in turn creates fear of AIDS patients, who are often fired from their jobs or banned from attending school. This contributes to a vicious circle, where the AIDS victims chooses not to seek help for fear of losing their job or facing public disgrace.

Even today AIDS has “no face” in China; it was only in 2001, at the Beijing International AIDS congress, that the first infected man was allowed to speak to a public audience. This was after the central government had implemented its “Five-year Plan of Action to Contain and Control of HIV/AIDS” with a set of specific goals for grappling with AIDS. Since that time, in 2002, there was actually a public wedding of an AIDS-infected couple, indicating a further shift toward coming to terms with the disease.

Still, the five-year plan continues to present AIDS strictly as a medical problem without considering the broader social-economic implications of the crisis. Thus, public awareness remains low. Some of the legislation has actually made the situation worse, especially at provincial and local levels. Many local governments simply do not want to know or let others know about AIDS in their respective regions, as it might make them look bad. So information is suppressed. In addition, local officials worry that an honest assessment of prostitution, illegal plasma collection and drug abuse in their region would lead to their being accused of incompetency.

Laws based on prejudice and fear exacerbate rather than curb the epidemic. Employers in Beijing, for example, are required to report “suspected AIDS patients” to local health authorities, reinforcing the notion that AIDS victims will be punished. In Hebei, all citizens with STDs are banned from entering school, getting married or working in service-related fields. Local and provincial laws are frequently in direct contradiction to national AIDS guidelines prepared by the central government’s Ministry of Health.

International experience shows that restrictive laws and punitive measures have little effect in curbing AIDS, while there is no question that they can have a negative impact on both prevention and care. In a punitive environment, vulnerable people will be more inclined to avoid preventive outreach, and people will decline getting tested for HIV for fear of punishment and/or stigmatization.

At the heart of the entire problem is awareness. When AIDS first surfaced in the US, the mantra for years was “Siilence equals death.” Sadly, that formula has proven to be totally correct when it comes to China. Keeping silent and ignoring the reality of AIDS has made the situation in China infinitely worse than it could/should have been.

Simply acknowledging the existence of these issues, let alone taking bold action on them, is challenging in a cultural environment that is inclined to minimize or ignore its problems, especially those related to traditionally “untouchable” topics like drugs, prostitution and homosexuality. Let us hope that the small steps China is only just beginning to take continue to accelerate, gathering increased momentum and determination. There is no time to waste.

Don’t miss this excellent article by The Washington Post’s China correspondent John Pomfret on how SARS patients who don’t have enough cash are being tossed onto the street by China’s capitalist hospitals. Snippet:

Several days after Chen Jianchang checked into Guangzhou’s No. 8 Hospital with what appeared to be severe acute respiratory syndrome, officials ordered one of his roommates to check out. The man, who was also exhibiting symptoms of SARS, owed the hospital $250, said Chen’s daughter, Chen Lili, who was visiting her father at the time. “They made him pack up and go,” she said. “Who knows what happened to him? He had no money and he was sick.”

The SARS epidemic has hit China at a time of turmoil in its health care system. Once the pride of this nation, the country’s socialist health care system, with its “barefoot doctors” and free clinics, has collapsed. In its place has emerged a dog-eat-dog medical system that benefits the rich and generally hurts the poor, Chinese economists and public health researchers say.

The picture Pomfret paints is bleak, and you have to ask, If they are doing this to SARS patients, are they treating AIDS patients any differently?

He goes on to describe just how nasty things here can get:

The Chen family found that out. When Chen Jianchang, 78, died on Feb. 22, his body lay at the hospital for two days because the family owed the hospital $750 in medical fees, including charges for immune-system boosters and antiviral and steroid medications, which are widely used in China to treat SARS. “The hospital wouldn’t release him to us for cremation until we came up with money,” said his daughter, Chen Lili. “They just kept his corpse in a room, waiting for the cash.”

Pomfret also points out how the abuse of antibiotics in China (you can buy them at any 7/11-type shop) is messing up people’s immune systems here….
[Courtesy of SARSWATCH and a fellow blogger via email)