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Following is the full text of a letter by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, on RTHK Radio 3 Programme "Letter to Hong Kong" this June 27) morning:

A year has passed since SARS was finally brought under control in Hong Kong after a hard-fought, 15-week battle against the disease. I remain immensely saddened whenever I think of the families who lost loved ones to SARS. For them, and patients still recovering, the past year must have been a most trying time.

The SARS experience was emotionally highly charged and psychologically extremely demanding. The ferocity of the outbreak and the deadly nature of the illness ignited waves of deep-seated fear within the community. I hope none of us ever have to endure anything like that ever again.

It only seems like yesterday that events of the epidemic unfolded. I can vividly remember the heightened tensions, and the look of anxiety on even the most seasoned and experienced clinicians who were facing a situation for which no amount of training and experience could have prepared them. As medical doctors, we are trained to regard every single life as precious and worth saving with all our might. So, one can imagine our anxiety and anguish as we witnessed the number of SARS cases rising exponentially and healthcare workers falling sick by the dozen. However, like every medical doctor, I knew that I had to keep calm and remain strong in the face of a deadly and mysterious enemy. The words of wisdom from Sir William Osler, one of the greatest medical teachers, reminded me at the time of the importance for physicians, in the face of such a circumstance, to display calmness amidst the storm, because the fear and panic experienced by patients or a community as a whole can be worse than the disease itself.

What we were facing at the time was a disease about which all of us knew very little. The situation unfolded from hour to hour; knowledge about SARS changed from day to day. The unknown nature of the disease, and the magnitude and speed of the outbreak, all played a part in requiring a response from our public healthcare system that was unprecedented in Hong Kong's modern history. Although the Department of Health has the primary role to prevent and control outbreaks of infectious diseases, as the epidemic progressed, my medical training as well as my background knowledge and understanding of the health system enabled me to participate in the control of the outbreak at the operational level.

As a medical doctor, I understand very well the immense pressures faced by healthcare workers in the Hospital Authority, the private sector and the Department of Health as they worked under the most difficult and extremely stressful of situations to fight SARS. In my direct contacts with our healthcare workers, both in the frontline and at management level, I witnessed, and was deeply moved by, their professionalism, selfless dedication and hard work. They were often physically and mentally drained from working extended hours because of enormous workloads and pressure. For many, the experience of seeing colleagues come down with the illness, become breathless and then develop life-threatening conditions, and then having to care for them in the same environment, was indeed highly psychologically and emotionally demanding. Many healthcare workers even volunteered to work in the SARS units, while management did not shy away from making hard and often very difficult decisions.

In the fight against SARS, there were many battlefronts. Many people played a part and contributed to the effective control of the epidemic. For example, when I visited the Prince of Wales Hospital and the Princess Margaret Hospital, I witnessed how everyone - supporting staff, professionals, frontline staff, management - how they were united in their outbreak control efforts, and tackled the disease with the same spirit of dedication and professionalism. I remember a visit to the Princess Margaret Hospital when a security guard told me, in a resolute manner, that he would stand guard to protect the doctors and nurses who were working tirelessly to take care of SARS patients. There was also a healthcare assistant who assured me she would continue to provide the best care for the sick. I was deeply touched by their sincerity, dedication and attention to duty. Indeed, besides clinical staff, other healthcare workers such as managers, attendants, cleaners and security guards were also among the many unsung heroes and heroines in our battle against SARS. They demonstrated the highest form of professionalism as they discharged their duties with dedication and compassion despite the difficult situation and the enhanced risk to their own health.

The SARS epidemic was a time of great personal sacrifice for our healthcare workers and their families. They feared not just for their own safety, but also the possibility of bringing the disease home to their loved ones. However, despite these fears, they did not waver from their dedication to duty. Despite the daunting risk, they did what they knew was best for the patients. Despite seeing colleagues fall to SARS, they lay their lives on the line to make a difference to SARS patients. Their dedication, steadfast commitment and self-sacrifice was truly exemplary.

I am immensely proud of all our healthcare workers, both in the frontline and management, supporting or professional personnel, for the way they rose to the challenge. They have, through their resilience, selfless service and self-sacrifice, shown everyone the true meaning of professionalism and care. We remain in their debt. Although most healthcare workers do not think about dying in the line of duty, some, sadly, gave their lives so that others may live. It was only because of the heroic efforts of everyone involved that SARS was eventually brought under control.

I salute all our healthcare workers for, together, they have made Hong Kong a safer place. To commemorate their contributions, we intend to dedicate the new infectious disease block of the Princess Margaret Hospital to the healthcare workers who died in fight against SARS and to other healthcare workers who contributed to the fight against SARS. A plaque will be laid at a prominent place inside the new building to commemorate their fighting spirit.

Many lessons have been learnt from the SARS epidemic. By putting the recommendations of the SARS Expert Committee into practice, we have since made significant progress to improve our infrastructure and enhance our system capabilities. Although we should continue to remain vigilant and not be complacent, it is perhaps no coincidence that Hong Kong has been free from avian flu this year when our neighbours were adversely affected, and that SARS has not reared its ugly head again. The preventive and detection measures we have put in place have worked. However, there are still many challenges ahead. Stepping into the summer months, we have to be vigilant and keep at bay food-borne diseases such as EV71, and diseases spread by mosquitoes, such as dengue fever and Japanese encephalitis.

It is my sincere wish that the community in Hong Kong can pool our collective knowledge and the lessons we have learned from SARS, and move forward together. It is not just for the benefit of Hong Kong, but also the rest of the world - in this age of globalisation and rapidly growing air travel, our health system is an important line of defence against the outbreak of new infectious diseases.

Ends/Sunday, June 27, 2004

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