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Xiaotangshan Hospital -- Noah's Ark

With everybody moved out -- the savers, the saved, and the deceased, Xiaotangshan Hospital isn't the focus of public attention any more. It's reported that the hospital has become a scenic spot along a tourist route. People from all over go there to take pictures, sightsee, and meditate on those fearful days under the shadow of severe acute respiratory syndrome (SARS).
After complete sterilization, all isolation wards at Xiaotangshan were closed down on June 22, and the day after the whole hospital -- the world's largest medical complex devoted solely to SARS patients -- was taken over by the Beijing municipal government. However, until now, what happened at the hospital remains a mystery.
Of 680 SARS patients hospitalized at Xiaotangshan only eight died, a mortality rate of merely 1.18 percent. More surprisingly, not a single medical worker was ever infected. Nonetheless, people are more curious about the true story behind these incredible figures.
Situated in Changping, on the northern outskirts of Beijing, Xiaotang Hill (Xiaotangshan) was known only for its hot springs. The first workers' sanatorium in China was built there. What made it world famous over night was the construction of the Xiaotangshan Hospital, a Noah's Ark made to brave the storm of SARS.
Starting from April 23, the construction of the Xiaotangshan Hospital took six days and seven nights. There was a maximum of 7,000 construction workers working at the site. Meanwhile, a total of over 1,300 medical workers from major military regions were deployed to immediately work at Xiaotangshan.
Nonetheless, the newly completed Xiaotangshan looked more like a field hospital. Facing rows of simply-equipped houses, many people had doubts in their mind about medical conditions and technology possibly provided by Xiaotangshan. When receiving the first batch of SARS patients at midnight on May 1, Xiaotangshan was awaiting an unknown fate.
Actually, in the beginning, Xiaotangshan was only expected to serve as a "pressure reducer," since an orange alert was declared everywhere at that time. China-Japan Friendship Hospital was reported to be in an emergency state. Beijing You'an Hospital and Ditan Hospital were asking for emergency help also. Almost all SARS designated hospitals in Beijing were running in excess of their abilities, without enough beds to admit more patients for treatment. To make things worse, a number of doctors and nurses came down with SARS. At a critical juncture, Beijing municipal government made the decision to construct the Xiaotangshan Hospital and requested assistance from the military.
Of course, competent authorities didn't expect Xiaotangshan to create a medical miracle. So initially only patients whose conditions were already improving were transferred there. However, as medical equipment went through trial runs successfully, and medical workers transferred from major military regions were in position promptly, the epidemic was kept under control steadily. SARS-stricken Beijing began to place greater confidence in Xiaotangshan. In fact, from the initial "pressure reducer" to the backbone of the later stage of the epidemic, Xiaotangshan Hospital not only treated a total of nearly 700 SARS patients within 50-odd days but helped rebuild public confidence in combating SARS.
Besides SARS, doctors and nurses at Xiaotangshan had to fight different kinds of weaknesses of human nature, including fear, anxiety, occasional laxity, and the idea of leaving things to chance, which had all been experienced by both patients and medical workers.
Even today, it's hard to say that Xiaotangshan had created a medical miracle. Honestly speaking, what was done there was to enforce rules and regulations to the letter based on a military routine. It's not an overstatement to say that the whole Xiaotangshan Hospital had been "guarded" heavily. As if shut out by an invisible protective screen, even a willow catkin could not have flown between the infection, sterilization and living zones, all of which had been put under strict surveillance.
On the other hand, quarantine and stringent protective measures had not hindered the patients and medical workers from having intimate exchanges. During his hospitalization at Xiaotangshan, Wang Daping, a SARS patient of Beijing, had cherished a desire to know the exact look of the doctors and nurses who were treating him everyday wearing thick protective clothing. Wang didn't have his wish fulfilled until his discharge. On that very day, among the crowd who had come to see him off, Wang recognized those medical workers treating him from their voices, with which he had been so familiar.
As a makeshift hospital, Xiaotangshan is unable to function as a permanent infectious hospital. Completed within one week, Xiaotangshan is not in a favorable situation with its far-from-perfect facilities, and the basic maintenance expenses are very high. In fact, internationally, the construction duration of a standard infectious hospital with more than 500 beds is usually no less than two years.
Since the founding of the People's Republic of China in 1949, the nation has established a large number of infectious hospitals to deal with the outbreak of serious contagious diseases such as the plague, malaria and pulmonary tuberculosis (TB). Following reduction in the incidence of afore-mentioned diseases nationwide, those infectious hospitals are now in a difficult position for survival. In view of this, experts have said, "Sooner or later Xiaotangshan Hospital will be dismantled."
Nonetheless, the other side of the coin is that human beings have not mastered adequate and accurate knowledge of SARS yet. The Centers for Disease Control and Prevention (CDC) of the United States warned that SARS might be a seasonal disease, and it might recur this fall and winter. In case of the recurrence of SARS, after heated argument, the parties concerned came to a tentative conclusion that it was necessary to keep Xiaotangshan Hospital for six months more up to one year as Beijing's dedicated SARS facility. 

The Ministry of Health of Singapore confirmed September 9 that a 27-year-old Singaporean man -- a post-doctoral student working on the West Nile virus -- contracted SARS. Immediately 25 people who came in contact with the man were ordered into home quarantine. This is the first new case of the contagious disease since it was contained two months ago. The World Health Organization (WHO) urged caution, saying more tests were needed.
Today Xiaotangshan Hospital is still lying quiet in the middle of a wheat field. No matter whether or not it will have to assume the mission of Noah's Ark once again this fall and winter, Xiaotangshan has left a rich experience in dealing with the unexpected emergencies and large-scale outbreak of an unknown infectious disease.
(China.org.cn, translated by Shao Da, September 17, 2003)

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