중국 SARS 위기와 의료적 대응: ‘분절된 의료’를 중심으로

Abstract

Generally, during infectious disease outbreaks, healthcare workers are exposed to the greatest risks of harm, but it was particularly so in the case of the 2003 SARS outbreak in China. It is understandable that in the initial phase of a previously unknown epidemic outbreak it is rather unavoidable; however, in the case of China’s SARS crisis, even after the identification of the virus, the healthcare workers were severely affected because they had not been properly informed. This was because of the restrictive structure of Chinese medical system: “bureaucratization” and “fragmentation.” “Bureaucratization” here means that healthcare workers are controlled by the government like other civil servants rather than deal with situations based on “professionalism”; and “fragmentation” here refers to the situation where China’s medical institutions cannot be integrated because, like other lower-level institutions in the nation, hospitals are subjugated to different upper-level authorities. Beijing, its capital, was the place where this “medical fragmentation” was most serious. Beijing medical department could not get enough information about such medical units as military and armed police ones, and so the information flow between hospitals in the city was blocked. This was temporarily solved as the China’s communist party came to the front and made an effort to integrate medical institutions, but the cost was not small. Without resolving the problem of this medical bureaucratization and fragmentation, it is likely that there will break out another social and political crisis caused by an infectious disease like SARS crisis.