EFTHA congradulates scientists of Taiwan CDC and Austrian AGES for importnat scientific findings

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18922

Eurosurveillance, Volume 13, Issue 28, 10 July 2008

Rapid communications

Isolating Asian enterovirus 71 subgenogroup C4 in two Austrian clinical samples from 2004

H. P. Huemer^1,2, B Ortner¹, C-W Huang³, D Schmid¹, I Mutz⁴, G Wewalka¹, J-Y Yang³, F Allerberger ()¹

1. Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
2. Department of Hygiene, Microbiology and Social Medicine, Medical University Innsbruck, Innsbruck, Austria
3. Viral Enteric and Emerging Diseases Laboratory, Center for Disease Control, Taipei, Taiwan
4. Department of Paediatrics, Regional Hospital Leoben-Eisenerz, Leoben, Austria

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Citation style for this article: Huemer HP, Ortner B, Huang C, Schmid D, Mutz I, Wewalka G, Yang J, Allerberger F. Isolating Asian enterovirus 71 subgenogroup C4 in two Austrian clinical samples from 2004. Euro Surveill. 2008;13(28):pii=18922. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18922
Date of submission: 04 July 2008

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Hamaguchi et al. recently reported on the on the occurrence of enterovirus type 71 (EV71) subgenogroup C4 in Japan [1]. According to the authors, this strain may have emerged in mainland China and in Taiwan. EV71 subgenogroup C4 has recently gained public health interest following reports of an ongoing outbreak in China and Vietnam in 2008: In June 2008, more than 176,000 cases of hand, foot and mouth disease (HFMD) were reported in China alone, and at least 24 deaths have been attributed to EV71 [2,3]. In the largest and most severe EV71-associated HFMD outbreak in Taiwan in 1998, 405 children had severe neurological complications and/or pulmonary oedema; 78 children died [4].

The genus enterovirus comprises poliovirus, coxsackievirus, echovirus, and enteroviruses 68-71. Based on molecular classification, human enteroviruses (HEV) are divided into groups A-D. There are now in excess of 100 types of EV. EV71 has been allocated to the group HEV-A (together with coxsackievirus A16 and some other coxsackie A-viruses) [5]. Both EV71 and coxsackievirus A16 virus can cause HFMD and herpangina, but only EV71 frequently leads to severe diseases, such as aseptic meningitis or poliomyelitis-like paralysis; fatal cases due to pulmonary oedema have been reported in neonates [6].
By molecular typing EV71 can be divided into three genogroups (A,B,C), the latter two being further sub-divided into B1-5 and C1-5 [7,8]. Currently genogroups B and C are co-circulating worldwide. Genotype C1 is predominating in Europe, but it can also be found in Australia, Malaysia and Singapore [9,10]. In China, Taiwan and Japan, the other genotypes are dominant, obviously replacing each other in circulation every one or two years [9,10].

Laboratory investigation in Austria
In Austria, the Agency for Health and Food Safety (AGES) serves as the national reference centre for laboratory diagnosis of poliomyelitis [11]. Between 1999 and 2007, 1,388 stool specimens from patients with acute flaccid paralysis (AFP) or aseptic meningitis were voluntarily submitted by hospitals, none of them yielding polio virus.
The number of reported AFP-cases in patients under 15 years-old per year was 12 in 1999 (0.87/100,000/year), 13 in 2000 (0.95/100,000/year), nine in 2001 (0.66/100,000/year), eight in 2002 (0.62/100,000/year), two in 2003 (0.16/100,000/year), seven in 2004 (0.53/100,000/year), three in 2005 (0.23/100,000/year), and nine in 2006 (0.69/100,000/year) [11]. The WHO requirement of testing two stool specimens (gained within two weeks after onset of paralysis) for enterovirus in at least 80% of AFP-cases was fulfilled in 2002 (88%) and in 2003 (100%).

Stool specimens were processed according to recommendations from the World Health Organization (WHO) listed in the WHO’s 'Polio laboratory manual' [12]. In brief, samples were treated with chloroform and antibiotics to remove bacteria and fungi. Cell cultures were inoculated, incubated at 36°C and observed for cytopathic effect (CPE) daily. When complete CPE was obtained, the infected cells were harvested and stored at -20°C until serological typing by neutralisation tests using a kit provided by the National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
Of the 1,388 stool samples, 201 yielded non-polio enteroviruses. A total of 181 viruses were available for molecular typing as described by Nix et al. [13]. For EV71-positive isolates, extended length VP1 gene sequences were amplified as described by Oberste et al. [14].

Retrospective analysis of enterovirus samples
On the basis of a general cooperation agreement signed between AGES and the Center for Disease Control (CDC) in Taipei in fall 2007, AGES decided to screen retrospectively Austrian enterovirus isolates collected in its acute flaccid paralysis surveillance programme for EV71. Molecular typing was performed by an AGES employee in February 2008 during a three week stay at the Viral Enteric and Emerging Diseases Laboratory at the CDC in Taipei, Taiwan. Analysing enteroviruses cultured from 181 clinical samples collected between 1999 and 2007, we detected EV71 in specimens from 16 patients (8.8%): EV71 genotype C1 was found in 14 cases, and genotype C4 in two cases.
In the Austrian province of Lower Austria (1.5 million inhabitants), an eight year-old boy of Vietnamese descent (born and raised in Austria) and an eight month-old female breastfed infant, were hospitalised in October 2004 at different institutions for respective aseptic meningitis and aseptic meningitis plus diarrhoea. The two children lived in villages approximately 270 km apart, without any known common contacts; they were not known to have traveled abroad.
Table 1 summarises demographic data of the 16 patients with EV71 infection. No signs of HFMD were documented in any of them. All 16 Austrian patients with EV71 infection recovered completely.

Table. Patients with aseptic meningitis due to enterovirus 71 infection, Austria, 1999-2007

Discussion and conclusions
The discovery of two EV71 subgenogroup C4 isolates in Austria was an unexpected finding, as was the obvious occurrence of a cluster of infection with EV71 subgenogroup C1 in the years 2001-2003 in the province of Styria (1.2 million inhabitants). The fact that one of the two Austrian children suffering from EV71 subgenogroup C4 infection was of Vietnamese descent suggests that independent introduction of Asian strains may occur in Europe.

Several EV71 outbreaks have been documented throughout the world and clinical manifestations of EV71 infections can be diverse, including HFMD, herpangina, central nervous system (CNS) disease, and pulmonary oedema [1]. In children, the CNS diseases associated with EV71 manifest clinically in various ways, such as aseptic meningitis or acute flaccid paralysis, symptoms previously well known for infections with poliovirus. After the eradication of wild poliovirus from most parts of the world, EV 71 must be regarded as one of the most dangerous neurotropic enteroviruses. The well established WHO PolioLabNet may be well advised to upgrade for surveillance of EV71. Enterovirus surveillance is already an integral activity in some European polio laboratories.

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References

1. Hamaguchi T, Fujisawa H, Sakai K, Okino S, Kurosaki N, Nishimura Y, et al. Acute encephalitis caused by intrafamilial transmission of enterovirus 71 in adult. Emerg Infect Dis. 2008;14(5):828-30.
2. Chinese Center for Disease Control and Prevention and the Office of the World Health Organization in China. Report on the Hand, Foot and Mouth Disease Outbreak in Fuyang City, Anhui Province and the Prevention and Control in China. May 2008. Available from: http://www.wpro.who.int/NR/rdonlyres/591D6A7B-FB15-4E94-A1E9-1D3381847D60/0/HFMDCCDC20080515ENG.pdf
3. United States Centers for Disease Control and Prevention (CDC). Hand, foot and mouth disease – asia (19): CDC Notice. ProMED-mail. 4 July 2007. Archive no. 20080704.2037. Available from: http://www.promedmail.org/pls/otn/f?=2400:1202:2646754013195931::NO::F2400_P1202_CHECK_DISPLAY,F2400_ P1202_PUB_MAIL_ID:X,73018
4. Ho M, Chen ER, Hsu KH, Twu SJ, Chen KT, Tsai SF, et al. An epidemic of enterovirus 71 infection in Taiwan. Taiwan Enterovirus Epidemic Working Group. N Engl J Med. 1999;341(13):929-35..
5. Wu TC, Wang YF, Lee YP, Wang JR, Liu CC, Wang SM, et al. Immunity to avirulent enterovirus 71 and coxsackie A16 virus protects against enterovirus 71 infection in mice. J Virol. 2007;81(19):10310-5.
6. Ho M. Enterovirus 71: the virus, its infections, and outbreaks. J Microbiol Immunol Infect. 2000;33(4):205-16.
7. Mizuta K, Abiko C, Murata T, Matsuzaki Y, Itagaki T, Sanjoh K, et al. Frequent importation of enterovirus 71 from surrounding countries into the local community of Yamagata, Japan, between 1998 and 2003. J Clin Microbiol. 2005;43(12):6171-5.
8. Tu PV, Thao NT, Perera D, Huu TK, Tien NT, Thuong TC, et al. Epidemiologic and virologic investigation of hand, foot, and mouth disease, southern Vietnam, 2005. Emerg Infect Dis. 2007;13(11):1733-41.
9. Cardosa MJ, Perera D, Brown BA, Cheon D, Chan HM, Chan KP, et al. Molecular epidemiology of human enterovirus 71 strains and recent outbreaks in the Asia-Pacific region: comparative analysis of the VP1 and VP4 genes. Emerg Infect Dis. 2003;9(4):461-8.
10. Sanders SA, Herrero LJ, McPhie K, Chow SS, Craig ME, Dwyer DE, et al. Molecular epidemiology of enterovirus 71 over two decades in an Australian urban community. Arch Virol. 2006;151(5):1003-13.
11. Strauss R, Sagl M, Wewalka G, Dierich M, Baumhackl U, Holzmann H, et al. WHO Polio Eradication Programme: Status quo and implementation in Austria. [In German]. Wien Klin Wochenschr. 2008;120(7-8):210-6.
12. World Health Organization. Polio laboratory manual. 4th edition. Geneva; 2004. Available from: http://www.who.int/vaccines/en/poliolab/WHO-Polio-Manual-9.pdf
13. Nix WA, Oberste MS, Pallach MA. Sensitive, seminested PCR amplification of VP1 sequences for direct identification of all enterovirus serotypes from original clinical specimens. J Clin Microbiol. 2006;44(8):2698-704.
14. Oberste MS, Maher K, Kilpatrick DR, Pallansch MA. Molecular evolution of the human enterovirus: correlation of serotype with VP1 sequence and application to picornavirus classification. J Virol. 1999;73(3):1941-8

陽明大學與義大利國立柏魯加大學締結姊妹盟校

陽明大學與義大利國立柏魯加大學締結姊妹盟校

陽明大學與義大利國立柏魯加大學締結姊妹盟校

陽明大學與義大利國立柏魯加大學於六月26日締結姊妹盟，將推動多項雙邊的交流與合作計畫，以擴增兩校學生的視野及加強學術交流與合作。

締盟儀式是在柏魯加大學校本部舉行，由本校副校長徐明達教授與柏魯加大學副校長畢耶瑞帝教授代表雙方在盟約上簽字。中華民國駐義大利代表鄭欣應邀到場觀禮。

柏魯加大學負責國際關係的醫學院教授馬妮表示她很高興柏魯加大學能與陽明大學締結為姊妹校，並希望此一盟約能有助於擴大兩校學生的視野。

她說，柏魯加大學與全球各地一百五十多所大學締盟，主要都是為學生的交流與研習，擴大學生的視野。陽明大學是柏魯加大學在台灣的第一所姊妹校，她希望從今年起雙方就能展開交換學生計畫。

柏魯加大學是義大利最古老的大學之一，今年適逢建校七百週年慶，目前全校設有十一所學院，包括碩士與博士研究生在內，學生總數達三萬五千人。

EFTHA joins the online petition to say no to child sex tourism from Europe

Online petition www.sayno.eu to fight child sex tourism

Every year thousands of European tourists go to countries in Southeast Asia, South America and Africa seeking sex with minors. The chance that offenders get caught is almost zero. This has to change. European Liberals and Democrats have launched an online petition www.sayno.eu to fight child prostitution. The online petition pleads for more powers for Europol to fight sexual exploitation of children by Europeans travelling abroad. The citizen's based campaign is initiated by Jules Maaten (VVD, Netherlands) in cooperation with his parliamentary colleagues from ALDE: "Child prostitution has to stop. We want to collect a million signatures from people who say no to child prostitution. Enough is enough." "The EU cannot close its eyes to sexual exploitation abroad committed by its own citizens. The Council has to give Europol the means to fight these appalling crimes." The online petition includes three concrete proposals. 1) The Member States should give Europol a stronger role and receive the powers and the means to train police, prosecutors and judges in Southeast Asia and South-eastern Europe on the subject of sexual exploitation of children. 2) The EU should improve the exchange of information with third countries in order to help identify possible suspects as well as prosecuting perpetrators. 3) The EU should enter those suspected of child sex tourism, also outside of the EU, into the Schengen Information System. Apart from ALDE the online petition is sponsored by Terre des Hommes, Plan International, ECPAT International and Save the Children.

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Une pétition en ligne www.sayno.eu pour lutter contre le tourisme sexuel d'enfants

Les milliers de touristes européens se rendent chaque année dans des pays d'Asie du Sud-Est, d'Amérique du Sud et d'Afrique à la recherche de relations sexuelles avec des mineurs. La probabilité d'arrestation de ces criminels est quasi nulle. Ceci doit changer. Les démocrates et les libéraux européens ont lancé une pétition en ligne www.sayno.eu afin de lutter contre la prostitution enfantine. La pétition en ligne réclame davantage de compétences pour Europol afin qu'il puisse lutter contre l'exploitation sexuelle des enfants par des ressortissants européens voyageant à l'étranger. La campagne centrée sur le citoyen a été lancée à l'initiative de Jules MAATEN (VVD, Pays-Bas) et de plusieurs membres de l'Alliance des démocrates et des libéraux pour l'Europe: "La prostitution enfantine doit cesser. Nous voulons rassembler un million de signatures de personnes qui disent non à la prostitution enfantine. Cela suffit." "L'UE ne peut pas fermer les yeux sur l'exploitation sexuelle commise par ses propres citoyens à l'étranger. Le Conseil doit donner à Europol les moyens de lutter contre ces crimes horribles." La pétition en ligne comprend trois propositions concrètes. 1) Les Etats membres devraient octroyer à Europol une compétence plus large et doter l'Office du pouvoir et les moyens de former la police, les procureurs et les juges en Asie du Sud-Est et en Europe du Sud-Est en ce qui concerne l'exploitation sexuelle des enfants. 2) L'UE devrait améliorer l'échange d'informations avec les pays tiers afin d'aider à identifier les suspects possibles et poursuivre les auteurs. 3) L'UE devrait encoder ces suspects du tourisme sexuel d'enfant, même en dehors de l'UE, dans le système d'information Schengen. Indépendamment de l'ADLE, la pétition en ligne est parrainée par Terre des Hommes Plan International, ECPAT International et Save the Children.

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For more information, please contact: Pour de plus amples informations, veuillez contacter: Neil Corlett: + 32-2-284 20 77 ou + 32-478-78 22 84 Courriel: neil.corlett@europarl.europa.eu Jeroen Reijnen: +32-2-283 25 18 ou +32-473-39 47 10

Web: http://www.alde.eu

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Taiwan's way with dignity

Monday, June 30, 2008

Taiwan's way with dignity

By HISAHIKO OKAZAKI

The inaugural address that Taiwan President Ma Ying-jeou gave was titled "Taiwan's Renaissance." It was well-composed, reflecting the president's views clearly while not evoking excessive alarm or expectations on complex and sensitive issues. These include the future of Taiwan's democracy, relations with the United States, cross-strait relations and relations between Chinese- Taiwanese — those who came to Taiwan from China after the Nationalists (KMT) were defeated in the civil war with the Communists, and their descendants — and Taiwanese-Taiwanese.

It is noteworthy that the address uses the expression "Taiwan's dignity," and premises the advance of cross-strait relations on whether international dignity is accorded to the island.

While I have pointed out in the past the danger of Taiwan's being dragged into unification by China's strategy of accepting Beijing-proposed peace agreement talks, I have also written that I would be comfortable with such talks if the KMT pursued them on the condition that Taiwan would be accepted into the United Nations.

Ideally, Taiwan should be admitted into the U.N. At the very least, it may be reasonable today to expect Chinese President Hu Jintao to be flexible enough to let Taiwan join international economic, social and health-care organizations to keep its dignity.

In reality, Taiwan is a full member of the World Trade Organization and the Asia-Pacific Economic Cooperation (APEC). If APEC extends an invitation to President Ma for a summit meeting, how would China react to it? It would be a test of Hu's flexibility.

Behind Ma's policy of acknowledging "one China under respective interpretations" lies his thinking that Taiwan is part of the Chinese community. That thinking runs through his inaugural address. He said Taiwan is the only Chinese society in which power has shifted peacefully twice. This is significant in pressing China for democratization and emphasizing that Taiwan is more democratic than Singapore.

This may embarrass the Taiwan's Democratic Progressive Party (DPP), which places high priority on the identity of the Taiwanese people.

However, if the one-China policy is defined as loosely as the Commonwealth of Nations, in which India acknowledges the crown of Britain as a symbol of the free bond, any interpretation is possible. In fact, Pakistan has repeatedly left and joined the Commonwealth.

Thus the establishment of the Ma administration may provide a chance to break the diplomatic gridlock in East Asia.

In a sense, China is caught in its own trap. During the DPP era, Beijing often invited KMT leaders to China and treated them respectably for the purpose of impacting Taiwan's political balance. To try to explain now that that was because the KMT was not in power is unreasonable. Beijing will have to formally contact the KMT's leader, who is Taiwan's president, in some way or another — possibly at an APEC summit.

This would be a chance for Japan as well. With its hostile policy toward the DPP president of Taiwan, China used to stiffly oppose Japan's attempts to make contacts with Taiwan. Since the U.S. was also cold toward the DPP for some unexplainable reason, Japan had to pay heed to both China and the U.S. in dealing with Taiwan.

Japan may no longer have to care about either's reaction. Since Taiwan and Japan have strong historical and economic ties, to treat Taiwan coldly in disregard of those ties is unnatural. Japan might now be freed from this bind.

The DPP might be unhappy with Japan's about-face to establish friendly ties with the Taiwanese government under the control of KMT. Nevertheless, deepening relations with Japan would bring benefits that would be an asset for Taiwan when the DPP returns to power in the future — possibly four, eight or more years from now.

When conducting cross-strait talks, the Ma administration must never give in on Taiwan's sovereignty and security. Any kind of "one country, two systems" formula is designed to set a time limit on Taiwan's freedom regardless of whether it is for half a century or a century.

Again, Taiwan must not accept neutrality or any unilateral arms restrictions. There is no comparison between China and Taiwan in terms of size. Once security measures are abandoned, there will be none to defend Taiwan if the situation changes. Taiwan must keep this in mind.

Hisahiko Okazaki is former ambassador to Thailand. This article originally appeared in the June 13 Seiron column of Sankei Shimbun.

從台大「醫用台語」課說起

從台大「醫用台語」課說起

醫用台語教學

向呵護台灣文化的年輕人致敬

■ 賴其萬

幾個星期前我看到兩位台大醫學系四年級學生朱子宏、張之嚴主編的一本《醫用台語教學》的教科書，心裡感到莫大的振奮。

根 據他們的自序，我才了解這些醫學生在系學會的主導與台大醫學院老師們的幫忙下，恢復了停止多年的「醫用台語」課，而這兩位同學更主動地將老師的授課講義錄 音、騰稿，並用心地編寫第一章「台語拼音教學」，以幫忙讀者透過台語注音，學會正確的發音，而後再以不同的臨床科別分開章節，將每位老師在其專科所常用到 的病名、症狀、徵候，以及對病人說明病情時需要用上的台語詳盡列出。

編者之一的朱子宏同學，更坦承他父親是「所謂外省第二代」，所以家中自 小都用國語，但在精通台語的張之嚴同學幫忙下，在之前的暑假學會了台語的正確發音與拼音。醫學院陳定信院長與醫學系黃天祥主任都在序言中盛讚學生重視如何 與病人以母語溝通的能力，而這正是我們這些關心台灣醫學教育者所樂見的醫學生開始重視病人的文化背景及其想多了解病人的誠意。

幾天前，我有 幸在國家戲劇院，聆聽由台灣名作曲家鄧雨賢先生的生平故事改編而成的音樂劇。經過精心的編劇，鄧先生最出名的四首曲子「四季紅」、「月夜愁」、「望春 風」、「雨夜花」，透過演員獨唱或合唱，唱出了這位享年僅有三十九歲的「台灣舒伯特」的一生，編劇者更獨具匠心地以這四首曲名的第一個字為名，將這部台灣 人的經典音樂劇命名為《四月望雨》。穿插於劇中的多首年輕作曲家冉天豪的優美歌曲都是我生平第一次聽到的，生動的劇情加上這些年輕藝術家的載歌載舞，使得 台下觀眾如醉如痴，而在謝幕時贏得全場的起立鼓掌。

當我聽到飾演鄧雨賢的台柱歌星江翊睿道出「希望大家能夠共同支持保留台灣文化」的一席 話，我不禁激動得熱淚盈眶。特別值得一提的是鄧雨賢先生是客家人，而劇中有些他與家人的真情對白與歌曲，均以客語道出。雖然我不諳客語，但配合著字幕，我 領會到句句真情，同時也使我有機會享受到摯友朱真一教授常告訴我的「客語之美」。

在新政府加速進行親中政策下，有心人都對於台灣的前途憂心不已，而最近觀察到的這兩件事，使我對年輕一代的台灣子弟呵護台灣文化的能力重新燃起希望。但願新政府不要忘記競選時「我是台灣人」的承諾，而能夠在政策上多多支持年輕人這方面的努力。（作者為醫師）

World Medical (Association) Journal introduces Taiwan Medical Association

Dear EFTHA friends,

The World Medical Journal, official journal of the World Medical Association, has a full-page coverage of the Taiwan Medical Association in the issue of May, 2008. We are pleased to share this with all.

http://www.wma.net/e/publications/pdf/wmj18.pdf

Th e Taiwan Medical AssociationTh e Taiwan Medical Association (TMA)was established in 1930 to advance medicalknowledge, to uphold members’ rights,to strengthen physician-patient relations,as well as to advocate social services. Th eTMA is composed of regional medical associationsfrom 23 counties around Taiwan.Its membership is compulsory for everypracticing physician. Among the total 36991 TMA members (fi gure for the end of2007), 30% practice in medical centres, 13%in regional hospitals, 18% in local hospitals,and 39% in private clinics. Th e physicianpatientratio is 1:653.Th e TMA has formed ten committees tocarry out its various missions and duties.Th ese include Health Care Policy Committee,National Health Insurance Committee,Health Industry Advisory Committee,Medical Laws and Regulations Committee,Academic Committee, Member WelfareCommittee, Medical Ethics and DisciplineCommittee, International Aff airs Committee,Public Relations Committee, and PublicationsCommittee. In many areas, ad hoctask forces are set up to study relevant issuesand to provide policy suggestions for theExecutive Board.For more than a decade, the TMA has activelyparticipated in several key areas topromote the health of all Taiwanese, includingthe formulation and revision of apatient-centred National Health InsurancePolicy in Taiwan, the advocacy of qualityof care and patient safety, the implementationof continuing medical education, andthe uplift of moral standards of health careprofessionals. In the international forum,the TMA joins forces with the rest of theworld through the World Medical Associationand CMAAO to increase its visibility,and to express Taiwan’s good will to servethe international community. In time of disastersand emergency around the globe, theTMA has taken little time in mobilising itsmembers to provide emergency relief andmedical aid to people in need.Th e TMA has established close interactionwith the WMA in recent years by participatingin various programs and activities.Th e translation and publication of “Manualof Medical Ethics” of WMA enables TMAmembers to share WMA’s policy changes,its functions and the contribution to allphysicians around the world. By workingwith the WMA in devising declarationsand policies, the TMA acquires updated informationon medicine, ethics, and medicaleducation.Th e TMA strongly believes in the collaborationamong all national medical associationsunder the auspice of the WMA.Th e sharing of information and resources,and the joint eff ort in international medicalassistance will enable us to create a trulyglobal village.Dr. Ming-Been Lee, the President of TMATaiwan Medical Assembly in 2007

Recommendation of a website

Dear EFTHA website readers, and those concern about Taiwan, a website/blog by a Belge gentleman who now teaches in Taiwan, will be a very interesting one for all of you,

http://johangijsen.blogspot.com/

推薦文章: 我讀歐巴尼／林衡哲

我的私房書

我讀歐巴尼

文／林衡哲

在 我一生的讀書經驗中，我的私房書似乎不斷地在改變中。在小學時代，我最愛的讀物是《學友》與《東方少年》這二本雜誌。到了初中時代，傳記文學變成了我的文 學初戀情人，例如居禮夫人傳、林肯傳、華盛頓傳、富蘭克林傳、畢斯麥傳等都是在初中時代看的，同時也看了不少梁啟超、胡適和林語堂的作品，莎士比亞的羅密 歐與茱麗葉中譯本是引領我進入西洋文學的第一本書。

高 中在建中時，頗受羅曼羅蘭的《貝多芬傳》、《約翰．克利斯多夫》、托爾斯泰的《戰爭與和平》、歌德的《浮士德》、但丁的《神曲》以及朱生豪翻譯的莎翁劇本 的影響。因為對文學的興趣，而保送東海外文系。後因看了協志叢書《史懷哲傳》，而「棄文從醫」，考取台大醫學院。在台大時代，我頗受史懷哲「尊重生命」的 精神以及羅素的「懷疑精神」底影響，培養我獨立思考的能力，加上卡薩爾斯的「理想主義」和反抗獨裁者的精神，也深深地影響我的一生，另外愛因斯坦以知識份 子的良知，去反抗龐大的極權專政，這種知其不可為而為之的精神，對我也頗有影響。因此基於「有第一流的文化才能創見第一流的國度」的信念，我在1967 年催生了「新潮文庫」，並譯出了《羅素回憶集》及《羅素傳》，同時也請林宜勝先生譯出《白鳥之歌：卡薩爾斯自述傳》、張聖輝譯出菲利蒲．法蘭克所寫的《愛 因斯坦傳》，並由曹永洋先生編出一系列的「史懷哲叢書」，讓羅素、史懷哲、愛因斯坦和卡薩爾斯的精神，在台灣這塊土地上開花結果。

1968 年出國之後，我由台灣文化的文盲變成台灣文化的奉獻者，因為我到美國之後，我才讀到真正的台灣歷史以及認識多采多姿的台灣文化，其中吳濁流的《無花果》、 彭明敏的《自由的滋味》、柯喬治的《被出賣的台灣》以及黃煌雄的《蔣渭水傳》和李南衡的《賴和全集》對我都有深遠的影響，因此1983年我在美國創刊「台 灣文庫」時，馬上推出《無花果》與《自由的滋味》等，希望這些書能讓台灣人覺醒認同自己的國家與土地，在美國出版的42部「台灣文庫」建立了台灣傳記文學 的新傳統，1998年我終於落葉歸根，返台後成立了望春風出版社，繼續出版傳記名著及台灣文化名著，同時也在去年推出了「望春風世界文學名著」，其中最感 動我的一本書是：《卡羅．歐巴尼醫師傳奇》。

我第一次聽到歐巴尼醫師是在2003 年4月，那時我正擔任衛生署顧問，為台灣加入WHO而努力，同事蘇金鳳女士提供我不少有關歐巴尼為SARS而「燃燒自己、照亮全世界」的英勇事蹟，不久在 《自由時報》上看到一篇有關歐巴尼的報導，於是我整理出一篇紀念歐巴尼的文章五千字，發表在《新台灣》雜誌上。不久我去日內瓦參加第五十六屆WHO大會 時，本來想大會結束後親自坐火車去拜訪歐巴尼夫人茱莉安妮，為歐巴尼寫出一本書，想不到義大利台商會會長莊振澤及衛生署派駐日內瓦代表張武修，已經邀請歐 巴尼夫人及16歲的大兒子來參加我國在紅十字會總部主辦的「SARS國際學術研討會」，張武修臨時要我介紹歐巴尼夫人，這是我這次瑞士之行最大的光榮與收 穫，歐巴尼夫人是一位非常單純而誠樸的人，她顯得很堅強，認為她丈夫的犧牲是有價值的，他求仁得仁無怨無悔。歐巴尼16歲的大兒子已經是一位小大人，他說 他將追隨他爸爸的理想，將來也要作醫師，繼續服務人群。

能 夠出版《歐巴尼醫師傳奇》，是我一生出版事業的高潮，作者貝美穗是義大利名記者兼名作家，漢譯者古桂英，譯筆流暢，在信、雅、達三方面均達完美之境。此書 透過作者親自訪問歐巴尼的母親、家人、心靈知己及朋友、同事們，把他多采多姿的一生及內心世界娓娓道來，確實是一部動人的文學傳記，這是我在大學時代看 《史懷哲自傳》之後，令人印象最深刻也是最感人的一部醫師傳記。如果史懷哲「尊重生命」的精神和歐巴尼「視病如親」的精神，能在台灣的醫界與社會發揚光 大，相信一個充滿愛心的現代化社會便會慢慢地在台灣形成。如果每一個醫生都看過此書，也許「邱小妹事件」就不會在台灣發生，歐巴尼醫師的存在，不僅是義大 利的榮耀，也是全球醫界的榮耀，我的很多朋友包括陳永興院長、賴其萬教授、廖運範醫師等人都看了此書，而流下了感動之淚；我的眼睛雖然沒有流淚，但在我內 心的深處，我也感動得在內心流淚。

聯合國秘書長安南在為此書作序時說：「卡羅．歐巴尼醫生，一生以致力於救護他人生命為使命，然而無常的命運，殘酷弄人，竟在他盡力挽救他人性命於SARS病患時，讓病毒奪走了生命，他站在最前線對抗病毒，我們要以英雄的形象紀念他，因為他的確是名符其實的真英雄。」

我深信《歐巴尼醫師傳奇》是一部永恆價值的書，值得每一位讀者的一再閱讀與珍藏。（2005年12月10日於台北關渡）

林衡哲　小檔案

1967年畢業於本校醫學系。大學期間為了賺取學費，以筆名「林衡哲」譯介外國文史哲叢書，其主編之「新潮文庫」（志文出版社），曾激勵了無數的年輕學子，影響極為深遠。

1968年赴美，在醫師本業之外，仍不忘情文化事業，1983年創辦「台灣文庫」，先後出版近40本傳記及文化叢書。1997年回台，在花蓮門諾醫院擔任小兒科主任，不改「文化醫師」本色，成立「望春風」出版社，繼續為發揚台灣文化而努力，曾任台南市文化局局長。

Source: http://www.alum.ntu.edu.tw/read.php?num=43&sn=913

Share this Summer Program in Taiwan

Introduction
1.Aims
		The National Yang-Ming University TMTCA program is a short-term program to introduce to international students with traditional medicine and Taiwanese culture and art. This program is to accept students for 2 weeks during summer and winter break. Courses are taught in English and on-site visits after lessons. Students can benefit from this program on: overall knowledge of Chinese culture and arts, ex. Pottery, literature, history, etc. basic knowledge of traditional medicine, especially acupuncture and Chinese herb therapy.
2. Requirements
		To apply for the NYMU TMTCA program, applicants must meet all the following requirements: Applicants must be full-time students. Applicants must be proficient in English.
3. Number of Students Accepted
		20 students for each program
4. Program Calendar
		Term 1：July 21 – August 1st 2008 Term 2：August 4 – August 15 2008 *We also offer an optional 2 days culture program to east coast and Taroko Gorge National Park. Students could experience nature beauty and aboriginal culture of Taiwan. (NT$5,000 for 2 days’ program)
5. Tuition
		Tuition will be waived for students from the universities that have the formal academic exchange agreement or memorandum with National Yang-Ming University. The list can be found through http://issue.ym.edu.tw/cia/new/fundingfaq/sister_universities.php Students from the universities that have no agreement or memorandum with National Yang-Ming University are obliged to pay the registration fee NT$15,000 (US$500) for two weeks program. The registration fee is included the in-campus dormitory, lessons materials and site visit traveling fee.
6. Certificate of Completion
		Students who complete all programs could obtain a certificate issued by National Yang-Ming University.

Taiwan's scientists made great breakthrough on degue fever!

Breakthrough in hunt for dengue treatment

By Roger Highfield, Science Editor

Last Updated: 6:01pm BST 21/05/2008

A way has been found to fight a mosquito-borne virus that infects 50 million people annually, and puts another half a million in hospital, some with a lethal fever.

	Dengue is carried by mosquitos and infects 50 million people worldwide every year.

Some 2.5 billion people – two fifths of the world's population – are now at risk from dengue, an infection that causes a severe flu-like illness, and sometimes a potentially lethal complication called dengue haemorrhagic fever.

The World Health Organisation estimates there may be 50 million dengue infections worldwide every year. An estimated 500 000 people require hospitalization, mostly children, and 2.5 per cent die. There is no specific treatment for the virus.

Now, in the journal Nature, Dr Shie-Liang Hsieh of National Yang-Ming University, Taipei, Taiwan, and colleagues have identified a molecule targeted by the dengue virus in mice that brings about the haemorrhagic fever associated with lethal disease.

The virus hijacks the CLEC5A molecule on immune cells to cause a massive release of potent inflammatory agents known as cytokines. TThe storm of these cytokines is are probably responsible for the extreme inflammation that causes haemorrhagic fever.

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Using antibodies to block the interaction between CLEC5A and dengue virus, the team found they could prevent inflammation without affecting the normal immune response to virus infection.

What's more, half of mice treated with these antibodies managed to clear the virus. This ability to control inflammation and simultaneously maintain natural viral immunity makes CLEC5A an exciting prospect for the development of new treatments, says the team.

The current antibody has to be "humanised" so it is not attacked by the body. "It is estimated to take two years to enter phase I clinical trial, after the humanization of the current antibody for toxicology and preclinical study," says Dr Hsieh.

He adds: "The technology we develop can also be used to identify therapeutic targets of other viruses, including members of flaviviruses, such as West Nile Virus and Japanese Encephalitis Viruses."

The spread of dengue is attributed to expanding geographic distribution of the four dengue viruses and the mosquitoes that carry them, the most important of which is the predominantly urban species Aedes aegypti.

Midday article: Royal care for some of India's patients, neglect for others

Royal care for some of India's patients, neglect for others

By Somini Sengupta

Sunday, June 1, 2008

BANGALORE, India: "To get the best care," Robin Steeles said gamely, "you gotta pay for it."

Steeles, 60, a car dealer from Daphne, Alabama, had flown halfway around the world last month to save his heart, at a price he could pay. He had a mitral valve repaired at a state-of-the-art private hospital here, called Wockhardt, and for 10 days, he was recuperating in a carpeted, wood-paneled room, with a view of a leafy green courtyard.

A dietician helped select his meals. A dermatologist came as soon as he complained of an itch. His Royal Suite had cable TV, a computer, a minirefrigerator, where an attendant that afternoon stashed some ice cream, for when he felt hungry later. Three days after surgery, he was sitting in a chair, smiling, chattering, thrilled to be alive.

On his bed lay the morning's paper. Dominating its front page was the story of other men, many of them day laborers who laid bricks and mixed cement for Bangalore's construction boom, who had fallen gravely ill after drinking illegally brewed liquor. All told, more than 150 died that week, here and in neighboring Tamil Nadu State.

Not for them the care of India's best private hospitals. They had been wheeled in by wives and brothers to the overstretched government-run Bowring Hospital, on the other side of town. Bowring had no intensive care unit, no ventilators, no dialysis machine. Dinner was a stack of white bread, on which a healthy cockroach crawled while a patient, named Yelappa, slept.

Wockhardt has 30 ventilators, including some that are noninvasive, so the patient does not have to have a tube rammed down his throat. At any one time, a half-dozen are in use. An elderly woman had been in its intensive care unit for a week, on dialysis; her family wanted to do whatever possible to keep her alive, no matter the cost.

At Bowring, one of the young doctors, named Harish, said a ventilator and a dialysis machine would have allowed him to keep half of his patients alive. The most severe case, Mohammed Amin, was breathing with the aid of a hand pump that his wife squeezed silently. Harish sent the relative of one man to get blood tests done at the nearest private hospital; there was no equipment to do the test here. Then the doctor rushed to the triage section in Bowring's lobby, where the newest patient, writhing, resisting, disoriented from the poison in his gut, had to be tied down with bedsheets.

Where you stand on the Indian social ladder shapes to a large degree what kind of health you're in, and what kind of health care you receive. The beds in Bowring were taken up by small skinny men. One of Wockhardt's most popular offerings is a weight loss program, and the majority of walk-ins at its outpatient clinic suffer from diabetes, closely linked to obesity.

This is no anomaly. A government-sponsored National Family Health Survey released last fall says a woman born in the poorest 20 percent of the population is more than twice as likely to be underweight than one in the richest quintile, and 50 percent more likely to be anemic.

For children, the gap is equally stark. The poorest quintile is more than twice as likely to be stunted, a function of chronic malnutrition, and nearly three times less likely to be fully immunized.

It is not as if the poor do not seek treatment, Jishnu Das, an economist who studies health and poverty for the World Bank, points out. They do, and sometimes more often than the rich. It is just that they are more likely, Das says, to land at the doorstep of a caregiver who is incompetent, ill-trained or indifferent to their needs.

"The poor are not dying and sick because they do not go to seek medical care," he said. "In fact, the poor are going to doctors in droves. There are no good options for the poor. The private hospitals and care they are able to access is of very low quality, and when they try and access government care, they receive no attention whatsoever."

The survey found that two-thirds of Indian households rely on private medical care when sick, a preference that cuts across class. Asked why they don't use public facilities, the most common answer was poor care.

India has a countrywide network of government-funded primary health centers and hospitals, but staffing, medicines and resources vary widely. Some, especially in rural India, are notorious for having staff doctors on paper at best. This is only beginning to change. The government has increased health spending in recent years, and this year began a health insurance program that would allow people in poverty access to a hospital of their choice.

The Planning Commission of India this year found that in government-run health centers, 45 percent of gynecologist posts and 53 percent of pediatric posts went unfilled, and that salaries for government doctors are a fraction of those at new private hospitals like Wockhardt.

Wockhardt struggles to fill its slots, too, but its facilities allow it to aggressively recruit, including from among Indian doctors who have worked abroad for years.

The morning papers did not let Steeles forget the vast gulf between his predicament and that of the hooch drinkers fighting for life at Bowring. Yet as far apart as they were, their tales followed a somewhat parallel plot. The American health care system could no more care for Steeles than the Indian system could for Amin.

Steeles came here because he is uninsured, and could not afford heart surgery in the United States, he said, without liquidating most of his assets. After five months of research and e-mail messages to doctors worldwide, he chose a heart surgeon here in Bangalore. "I'm over here for a fraction of what I would have paid in the United States," he said. "In my personal situation, I'm just delighted I took the road that I did."

Steele's Royal Suite, incidentally, is available to anyone, Indian or foreigner, who can pay for it. After his stay here, he would move to a room at a private club for 16 days of further recovery, before flying home. All told, he said it cost him about $20,000, a tenth of what he would have paid at a private American hospital.

Across town, among the hooch drinkers, a few of the worst cases had been transferred to private hospitals that had agreed to take them, at the government's expense.

Amin was too frail to be transferred. He died at Bowring, leaving behind a wife and two young children.

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Notes:

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Copyright © 2008 The International Herald Tribune | www.iht.com

Recommendation: "當達文西遇見華陀"

2004-09-14 02:40:23 | 人氣(48)

當 達文西遇見華陀 ---神乎其技的手術機器人配合針刺麻醉進行心臟手術側記

莊振澤

2000 年11 月23日

電子科技進步日新月異，外科醫生為重症病患進行重大手術時在開刀房裡開胸剖腹之場面將不復再現。最先進的第三代手術機器人--達文西，日前在義大利巴維亞大學附屬的聖馬竇醫院為來自台灣的貴賓展示了一場神乎其技之精彩表演。

台灣輔仁大學醫學院暨耕莘醫院陸幼琴院長，偕同台東聖母醫院鄭雲院長，在梵諦岡出席國際醫學會議之後，經由中華民國駐教廷大使戴瑞明之安排，前來米蘭巴維亞大學聖馬竇醫院觀摩難得一見的機器人開刀手術。

這部最先進的手術機器人被命名為達文西，藉以紀念義大利文藝復興時期這位集建築、雕塑、繪畫、機械、水利工程、解剖醫學等傑出科學藝術成就於一身的不世出天才( Leonardo da Vinci , 1452 – 1519)。造價約四千萬台幣的達文西機器人目前全義大利僅此一部，它大約分為三部分： 手術台邊矗立著伸出三支複雜構造機械手臂的座台，一旁是上接監控Monitor的主控電腦，另有一座外觀看來好似電動遊戲機亦附有Monitor的操作台。

利用機器人開刀，避免了傳統開刀手術之開胸剖腹； 以心臟血管繞道(Bypass)手術為例，僅在左胸側穿刺三個小洞穴供機器人手臂伸入進行手術：中間洞穴插入探照燈及微型攝影機，以將手術操作過程完整呈現於Monitor。右洞穴插入手術刀，左洞穴則是夾鉗，就如同外科醫生的左右手般靈活操作。 ”主刀”的醫生則端坐在一旁的操作台，眼觀Monitor，手腳並用熟練操作，看起來就好比把玩電動遊戲機一般，實在神奇 !

除了避免開膛破肚，機器人開刀亦免除了繁複的血液體外循環設備，開刀房助手亦大大減少，確是好處多多 !

當天的Bypass心臟手術特別安排了針刺麻醉配合機器人開刀，中西醫學之頂尖技術合作無間，可謂是世紀創舉 !

中華醫學技術最精華之針刺麻醉術，其高度鎮痛效果能完全取代強烈的麻醉藥物，應用在大型而須長時間的外科手術中，能免去麻醉劑對人體免疫系統的抑制作用，手術後病體恢復極快。上述作Bypass手術病人只需三天即可出院。

這項手術負責針麻任務的潘賢義醫師來自台灣屏東，旅居義大利三十多年，目前任教於巴維亞大學醫學院外科研究所，是著名的器官移植與實驗外科權威，其參與的醫療團隊在心臟手術、肝臟自體移植手術方面居世界領導地位。

(莊振澤會長在潘賢義醫師指示下，亦獲准進入開刀房全程拍攝，留下珍貴的紀錄，可供日後教學觀摩之用。) 2000 年11 月23日

http://mypaper.pchome.com.tw/news/italy329/

EFTHA invites readers' interest to read the live address by Deemond Tutu in 61th World Health Assembly

EFTHA invites readers' interest to read the live address by Desmond Tutu in 61th World Health Assembly, in Geneva, May 20, 2008

http://video.who.int/streaming/wha61/wha61_desmond_tutu.wmv

Chinese earthquake exposes deep social divide

As death toll climbs, Chinese earthquake exposes deep social divide

By John Chan
15 May 2008

http://www.wsws.org/articles/2008/may2008/chin-m15.shtml

Use this version to print | Send this link by email | Email the author

The major earthquake that hit China’s Sichuan province on May 12 is a huge human tragedy. The official death toll is now almost 15,000 and is expected to rise. At least 26,000 people are believed to be buried in the debris and many of those may be dead. According to estimates from Premier Wen Jiabao’s working meeting yesterday, the affected area is 65,000 square kilometres, with 6 cities and 44 counties. Half the 20 million residents in the area have been directly affected by the earthquake.

Although Chinese troops and armed police have begun to reach the most isolated areas, including the town of Wenchuan at the epicentre, severe weather and damaged roads have prevented the transport of bulldozers and other heavy equipment. Wen has ordered parachute drops into the worst-affected counties and the deployment of 90 more helicopters. So far, the aid supplied by 20 helicopters has been insufficient. The number of soldiers mobilised has increased to 100,000. However, time is running out as soldiers and civilians use primitive tools and their bare hands to try to locate and extricate trapped victims.

TV footage has shown the flattened town of Yingxiu, which has been virtually wiped off the map. Rescuers found only 2,300 people alive—out of a population of 10,000. Half the survivors are seriously injured. Apart from the difficulties facing the rescue effort, tens of thousands of homeless people lack shelter and emergency supplies. Yesterday afternoon, the Mianyang city government ordered 700,000 residents to evacuate all buildings after warnings of a sizeable aftershock.

The Associated Press reported: “Homeless victims begged for aid on roadsides, and people settled in for a third night in a growing sprawl of refugee camps littered with garbage. In Hanwang, a town in one of the hardest-hit counties, survivors stood hoping for handouts from cars, jostling with each other to reach one vehicle where a passenger handed bottled water out the window.”

Hanwang Hospital, a seven-storey building, collapsed. The surviving medical staff set up in a tyre factory driveway to provide basic care. Zhao Xiaoli, a 25-year-old nurse, told the Associated Press: “I’m numb. The first day, hundreds of kids died when a school collapsed. The rest who came in had serious injuries. There was so little we could do for them.”

There has been an outpouring of sympathy throughout China and internationally, and offers of assistance for the earthquake victims. Ordinary working people in many Chinese cities have lined up to donate blood or money to assist the survivors.

Although the earthquake is a natural disaster, the extent of the destruction and death has exposed the monstrous reality of an irrational social order that puts private profit ahead of the safety and well being of people. Anger is mounting at the shoddy character of the buildings in the impoverished towns and villages and the stark inequality between rich and poor.

At least nine schools and two hospitals were flattened in Sichuan. The death of school children has focussed resentment on “tofu” buildings—substandard constructions that look good on the outside but are like soybean curd on the inside. Limited safety regulations are often subverted by corrupt collusion between developers and government officials. An online comment cited in the Los Angeles Times yesterday asked: “Why did so many schools collapse but all the government buildings were fine? It’s outrageous!”

Dr. Tian has been treating the injured from Juyuan Middle School in Dujiangyan city, where collapsed buildings buried 900 students. He told today’s Australian newspaper: “It’s nothing but corruption—they must have used substandard cement and steel...The morgue is full of children’s bodies. It’s hell on earth.”

A teacher who was lucky to escape explained: “The school has been sending requests, at least since 2000, to the local government asking for it to rebuild more safely, but it took no action.” Another staff member said: “They [the two main buildings] were constructed from prefabricated cement boards that were inserted between steel poles to create walls. They were very fragile compared with concrete walls made of cement poured on site.”

By contrast, major transnational and Chinese corporations operating in Sichuan have survived largely intact, except for mining operations and power supplies. Japanese plants in Chengdu, such as the Toyota auto factory and the Yamaha electronic components facility, have been shut for the safety concerns, but suffered little damage. US operations, including the Intel assembly plant, did the same. Wal-Mart closed three stores. Microsoft and Motorola reported minor damage. China’s largest rice cake manufacturer, Want Want China Holdings, shut seven plants, but none were damaged.

The presence of these well-known corporations in Sichuan demonstrates the growing penetration of foreign capital into China’s inland regions, although the investments are still relatively small compared to coastal regions. Building codes have been enforced to protect the property of large investors, while other constructions have been ignored.

William Gormley, a former China manager of the US-based aircraft engine manufacturer Pratt & Whitney, told the Los Angeles Times that when its joint venture was built in Chengdu in 1996, Chinese officials insisted that the size of the piers was doubled and the foundations dug deeper to meet the seismic codes. As a result, the factory withstood Monday’s earthquake. Gormley, who is still working in Chengdu as a business consultant, added that there were lots of “unregulated” buildings in Sichuan. “You don’t find out how many until a tragedy like this happens,” he said.

The Wall Street Journal yesterday contrasted the new high-rise buildings and office towers in Chengdu, equipped with anti-quake technology, with the flattened towns and villages. “Despite the recent growth of these outlying areas, the imbalance persists, as the rich get richer and the poor struggle to make ends meet. There is so little work in many of Sichuan’s rural areas that it is one of China’s biggest sources of migrant labour.”

The newspaper said the massive migration of rural labour into urban areas—15 million people every year—has created the world’s largest construction zone. China built 1.8 billion square metres of property in 2006 and another 4.1 billion square metres are under construction. Thousands of little-known towns and cities have sprouted up, but many buildings have been built cheaply and quickly, with little concern for safety. Construction in Sichuan ranked fifth among China’s provinces in 2006, with almost twice as much property completed as in Beijing.

Poor planning and corruption associated with frenzied, often speculative construction has had other consequences. The Chinese government is relieved that the Three Gorges Dam, the world’s largest, has no reported damage. However, according to the Ministry of Water Resources, 391 mainly small dams have suffered quake damage that could produce more disasters.

Some 2,000 troops have been sent to the two-year-old Zipingpu Dam in Sichuan, where cracks have appeared, threatening downstream communities, including the city of Dujiangyan. During a government meeting in 2000, seismologists opposed the plan to build the dam as it is close to a known fault line. However, as with other infrastructure projects, the overriding preoccupation of Chinese authorities was to rush to provide power for rapidly expanding industry.

The Chinese government has been attempting to present a humane image, appealing to the broadly felt shock and sympathy. Premier Wen has been at the heart of this carefully managed PR operation. He has toured the worst-hit areas and spoken of the need for a “united” effort behind the Communist Party leadership. He wept before the cameras. He slipped due to the rain on May 13, but stoically refused to be treated by medical staff. Authorities have even scaled back the Olympic torch relay inside China so as to not appear indifferent.

In the age of the Internet, the Chinese leaders are aware that the old methods of blanket censorship are not effective. A similar PR operation took place in February when anger threatened to erupt over the “snow havoc” that left millions of rail passengers stranded and many areas without power. Senior Politburo members were dispatched to all affected areas to make a show of concern. In the midst of the crisis, the Los Angeles Times reported that the Chinese leadership had employed a US public relations firm to provide top-level schooling in crisis management.

So far, the latest campaign appears to be working. The New York Times noted: “Commentary on Chinese Web sites and in chat rooms has been full of praise for the government’s emergency response. On Tianya, a popular forum where antigovernment postings sometimes find a home, users have been quick to shout down those who criticise Mr. Wen and the military’s delay in reaching some quake victims. ‘Those who can only do mouth work please shut up at this key moment,’ says one posting.”

The Beijing bureaucracy, however, is concerned that the mood could change if stories of incompetence, corruption and callous indifference for the suffering of victims begin to emerge. The propaganda bosses have issued an instruction to the state media to report developments “positively”. The massive deployment of troops is not just for rescue efforts, but to prevent any protests breaking out.

See Also:
Death toll, economic consequences mount from China earthquake
[14 May 2008]

EFTHA Midday Express: Beijing says it will accept foreign aid and has agree to Taiwan help to China's victims

Page last updated at 14:44 GMT, Thursday, 15 May 2008 15:44 UK

China quake toll 'to top 50,000'
http://news.bbc.co.uk/2/hi/asia-pacific/7402460.stm

More than 50,000 people may have died in the earthquake that devastated parts of China on Monday, state media say.

The warning came after the government confirmed the death toll had risen to 19,500, as rescue efforts continue to search for thousands still trapped.

About 10 million people across Sichuan province have been directly affected by the 7.9 quake, Chinese media said.

The country is sending 30,000 extra troops to Sichuan to help the 50,000 already involved in rescue efforts.

Beijing says it will accept foreign aid and has agreed to help from rescue teams from Japan and its rival Taiwan.

Rescue teams pull woman from rubble of collapsed building

Correspondents say the death toll, which rose from 14,866 on Wednesday, is expected to rise further as rescue workers dig more victims out of collapsed buildings.

People are still being found alive - an 11-year-old girl was pulled from the rubble of a school in Yingxiu 68 hours after it was destroyed.

Desperate search

The BBC's James Reynolds, in Hanwang, says rescuers and relatives of those trapped reject suggestions time has run out for finding survivors.

At Juyuan Middle School, near Dujiangyan about 50km (32 miles) from the epicentre, parents were trying to reach 900 children still trapped in the rubble.

"It's not that we don't trust the rescuers," local resident Deng Yuehong told Associated Press Television on Thursday.

See a detailed map of quake zone
In pictures: Quake recovery
Dams pose flooding risk
"They have done a lot of work to search for survivors but they couldn't search all the places in such a large area here and there may be some places that they ignored.

The Chinese government has appealed for basic equipment to help in the rescue operation. It said hammers, cranes, shovels and rubber boats were urgently needed.

The health ministry says there will also be an increasing demand for medicines and sophisticated medical equipment as survivors are treated for bone fractures, crushed internal organs and kidney failure.

More than 10,000 medical workers, police and volunteers have been sent to Beichuan County, one of the hardest-hit areas in Sichuan province, where up to 5,000 are thought to have died.
But there were suggestions that some of those trying to help bring relief were actually hindering the rescue effort, blocking roads to the worst-hit areas.

"Passionate but inexperienced volunteers have brought little food and their vehicles are blocking roads," the Chengdu chapter of the Young Communist League said in a statement read out on local TV.

Meanwhile 17 people were disciplined for allegedly spreading "malicious rumours" about the earthquake, two of whom were put in custody, AFP news agency quoted state media as saying.
Appeal

Deputy Health Minister Gao Qiang says more than 64,040 people have been treated since Monday's earthquake - 12,587 of them are seriously injured, Xinhua reports.
RECENT CHINA QUAKES

March, 2008: 7.2 quake in Xinjiang - damage limited
February 2003: 6.8 quake in Xinjiang - at least 94 dead, 200 hurt
January 1998: 6.2 quake in rural Hebei - at least 47 dead, 2,000 hurt
April 1997: 6.6 quake hits Xinjiang - 9 dead, 60 hurt
January 1997: 6.4 quake in Xinjiang - 50 dead, 40 hurt
Send us your comments
Life in tent city

How earthquakes happen
Officials say about 10 million people have been affected by the quake. Many are in refugee camps, without proper shelter, food or clean water.

The International Federation of Red Cross and Red Crescent Societies has issued an emergency appeal for medical help, food, water and tents.

Gu Qinghui, a member of the Red Cross assessment team told AP television: "I just came back from Beichuan County this morning, basically the whole county has been destroyed, there is no Beichuan County anymore.

"No-one knows what has happened in particular areas, in the villages. I am sure that the numbers [death toll] will just go up continuing day by day."

EFTHA concerns about the death and injuries in China from earthquake

The EFTHA is very much concerned about the death tolls and tens thousands of injured and homelessness in the aftermath of recent earthquake in China.

The EFTHA is extremely sympathetic to the situation on Chinese people in the rampaged region. EFTHA also witnesses immediately massive donation in medicines, foods, and goods from Taiwanese people in the last few days to China, and EFTHA supports the good wills of the Taiwanese to the Chinese suffering from this casualty. This reflects what had happened to Taiwan in 1999 for a detrimental earthquake in Nan-tou, which killed more than 2,000 citizens and students, while China blocked the international aids to Taiwan by all her means.

However, while Taiwanese are doing all they can to help China in recovering from the earthquake, EFTHA urges China's government be realistic and share their humanitarian concerns on the health rights, the rights to access better health care, and the rights to access to the World Health Organization and the global health network for all people in Taiwan.

It will be amazed to all to see that, while Taiwanese are doing as much as they could to help China, China's government might still make all the efforts to kill or eliminate the basic rights of Taiwanese to join the WHO in the coming week in Geneva.

Please write to EFTHA to express your concern and comments. ***

EFTHA recognizes the Early Day Motion by UK Parliament

EDM 1415

TAIWAN'S PARTICIPATION IN THE WORLD HEALTH ORGANISATION
23.04.2008

Winterton, Nicholas
33 signatures
Anderson, Janet
Bottomley, Peter
Breed, Colin
Clarke, Kenneth
Conway, Derek
Cook, Frank
Corbyn, Jeremy
Curtis-Thomas, Claire
Davies, Philip
Dean, Janet
Dodds, Nigel
Donohoe, Brian H
Dowd, Jim
Evans, Nigel
Hamilton, David
Hancock, Mike
Harvey, Nick
Hemming, John
Holmes, Paul
Horam, John
Jenkins, Brian
Kumar, Ashok
Laxton, Bob
McCafferty, Chris
Pugh, John
Robinson, Iris
Rosindell, Andrew
Spink, Bob
Viggers, Peter
Vis, Rudi
Williams, Betty
Winterton, Ann

That this House regrets that the World Health Organisation (WHO) has opposed including Taiwan's participation as an observer to the World Health Assembly (WHA) on its agenda since 1997; notes that the 61st WHA will convene between 19th and 24th May 2008; recognises that disease knows no boundaries or politics and there should be no gap or weak spot in the world's disease prevention network; contends that Taiwan should not become the only gap in the global public health network; applauds Taiwan's strong desire to work with international health institutions through medical co-operation and emergency humanitarian work; further applauds the valuable medical assistance and humanitarian aid provided by Taiwan's public and private sectors worldwide exceeding US$450 million over the last decade; further notes that Palestine, the Holy See, the Sovereign Military Order of Malta, the International Red Cross, the International Federation of Red Cross and Red Crescent Societies, and the Inter-Parliamentary Union have been granted observer status to the WHA; regrets that the Government has not supported Taiwan's WHA observer status or WHO membership; welcomes the fact that Taiwan would be willing to accept an arrangement to be a WHA observer so as to engage in direct access to and communication with the WHO before attaining WHO membership; strongly encourages the UK Government to support Taiwan's justifiable bids for WHO membership and preliminary WHA observer status; and urges the WHO Director-General to invite Taiwan as a WHA observer before granting WHO membership to ensure no gap in the global public health network.

歐台醫事聯盟抗議台未獲通報中國腸病毒疫情[中央社]

歐台醫事聯盟抗議台未獲通報中國腸病毒疫情 【19:50】

〈中央社記者黃礦春羅馬四日專電）歐洲台灣醫事聯盟三日致函世界衛生組織秘書長陳馮富珍女士，抗議世衛組織及中國均未及時向台灣通報最近在中國爆發的腸病毒疫情，同時籲請世衛組織及中國尊重全人類共享健康的原則。

歐洲台灣醫事聯盟在信函中指出，過去十年來在東南亞及西太平洋地區曾爆發過數次七十一型腸病毒流行，一九九七年及一九九八年更分別在馬來西亞與台灣造成數以百計的十五歲以下兒童死亡案例，但世衛組織與中國並未正視此一疾病。

中國一直到現在才與世衛組織及其他有關國家合作，但進展還是很慢，做法也不適當。

更有甚者，當此一波腸病毒疫情於三月下旬在中國爆發之後，世衛組織及中國都未將此一重要的疾病訊息及時通知台灣。世衛組織則在五月一日發佈的新聞稿中錯誤及不負責任地宣稱，中國將會把此一緊急的健康照護事件通知台灣。

歐洲台灣醫事聯盟在信中並對腸病毒可能影響今年八月北京奧運會表示關切。信函中說「我們不希望屆時再有更多的人罹病或死亡。」

歐洲台灣醫事聯盟期盼世衛組織與中國政府尊重全人類共享健康的原則，及承認享受健康的權利是基本人權之一，與台灣的衛生主管機關與職業醫護人員合作與互動。

歐洲台灣醫事聯盟是由在歐洲從事醫事相關工作的台灣人，於公元二零零二年成立的公益事業團體。成立的宗旨是：將台灣在醫事上成功的經驗回饋國際社會，尤其是那些開發中或未開發的國家；促進台灣成為世衛組織會員或觀察員，以便由世衛組織獲得必要的資訊，讓台灣二千三百萬人民更能提昇健康與福祉，並能藉由世衛組織的功能將台灣之經驗回饋給其他的會員國；以及為僑居各地之鄉親提供醫事諮詢及服務。

聯盟目前有會員三百多人，分別在德國、英國、法國、義大利、瑞士、荷蘭、奧地利、丹麥與比利時等國。

EFTHA submits a question to the Douglas Alexander, Secretary of State for International Development, UK

Moderator says: Douglas Alexander, Secretary of State for International Development, will take part in a live webchat in Downing Street on Wednesday 7 May at 13:00 BST.

The webchat will take place in the same week as the launch of the Business Call to Action, an initiative aimed at bringing the private sector on board to boost economic development

==============
Dear Secretary Douglas,

After many years in establishing and strengthening health care services to the northern Mzuzu province in Malawi, Taiwan's Pingdong Christian Medical Mission was called in early February to suspend health service to the impoverished 2M people in Malawi, including leaving more than 7,000 HIV patients who were under the anti-retroviral treatment by the Taiwan medical mission since 2000. China was to establish the diplomatic tie with Malawi and depart Taiwan’s doctors. UK has been a close allay of Malawi, and offered strong support for health care program there. Can UK government continue the medical program in Mzuzu, which has not been possible by China’s diplomats there. Donald Luchen, MD, EFTHA, London

	LIVE web chat with Douglas Alexander Douglas Alexander, Secretary of State for International Development, will take part in a live webchat on the Downing Street website on 7 May from 13:00 BST. Log in at the Number 10 website and post your question to Douglas on a number of issues including the progress being made in reaching the Millennium Development Goals, especially the drive to achieve universal education and reductions in maternal mortality. This is your chance to find out what the government is doing to fight poverty in some of the world's least developed countries, what difference the UK is making in tackling climate change in Africa and how ethical consumers can make a difference through their weekly shop. In the week the Business Call to Action launches you can ask Douglas Alexander how this will help bring the private sector on board to boost economic development. Douglas will also take questions on the wider development agenda. Number 10 website
	Business Call to Action | Millennium Development Goals Call to Action | How we fight poverty | Developments magazine Want to unsubscribe? If you no longer want to receive the e-bulletin, you can click Unsubscribe me to be removed from our mailing list.

EFTHA's letter to the WHO to corrent its wrong message

Dear Director-General Dr. Margaret Chan
The World Health Organization
Geneva, Switzerland

The WHO carried a press release at May 1st, 2008, regarding the outbreak of Enterovirus 71 in some of China's provinces. There have been more than 20 children died of this new outbreak, and many thousands people admitted to the hospitals.

There had been several EV71 outbreaks occurred in south east Asia and western pacific regions in the past decade. WHO and China failed to recognize this diseases continuously, and the outbreaks in Malaysia and Taiwan rendered hundreds of death in those less than 15 years old, respectively, in 1997 and 1998.

Until now, China started to corporate with WHO and others responsible countries, but the progress is too slow and inadequate, even in this Olympic year. We do not wish to see more death and illnesses in coming August.

Moreover, WHO did not send such important disease information to Taiwan, to the health care professionals, as well as Taiwan's health authority timely in late March, when the outbreaks already occurred in China. Nor did the health authority in China. The press carried by WHO was a mistake and irresponsible one that lied on China to inform Taiwan for such urgency for health care.

The EFTHA wishes WHO and China's government respect the principle of health for all, and health rights (to know) as one of the fundamental human rights, to interact and corporate with Taiwan's health professionals and health authority timely in this emergency.

May 3rd, 2008


Ref: http://www.who.int/csr/don/2008_05_01/en/index.html