CHI Media Statement The Art of Information (Mis)management: It is ironical that Science, Environment & Technology Minister Law Hieng Ding (as well as his other Cabinet colleagues) justifies the secrecy over the Air Pollution Index (API) readings by invoking the interests and "health" of the tourism industry. But in that other instance of deliberate obfuscation - the infamous "JE/Nipah" joint epidemic - the interests of the tourism industry seem to have been sacrificed to maintain the fiction of an accentuated JE (Japanese encephalitis) epidemic concurrent with the Nipah eruption of 1998/1999. We now know that the Nipah epidemic, which devastated a billion ringgit pig-farming industry and caused untold misery and death to communities directly or indirectly dependent on pig-rearing, is caused by a newly recognised paramyxovirus. This paramyxovirus is transmitted from live pigs to humans through close, physical proximity (aerosols, physical contact with bodily fluids), and not by mosquitoes or other insect vectors. There is no evidence whatsoever of a dual epidemic in the encephalitic deaths and illness centred around Ipoh and the Bukit Pelanduk vicinity. After sifting out unsubstantiated assertions and equivocal data, the remaining solid, definitive evidence has, at least in scientific circles, laid to rest the dual epidemic fiction. Immunofluorescence staining of brain autopsy specimens (performed at the Centers for Disease Control (CDC) in Atlanta) has confirmed the findings (from in situ hybridisation to detect for presence of viral sequences in autopsy tissues): All brains available from autopsies of encephalitis patients during this outbreak (about a third of the known fatalities) showed evidence of Nipah antigens. None was positive for JE virus antigens (included among them the earlier "confirmed JE" cases). In persisting with the fiction of a "JE/Nipah" dual epidemic, our pliable and undiscriminating media managers have inevitably garbled and peddled a hopelessly confused version to the Malaysian public. Hitler's propaganda czar Goebbels had it about right: an outrageous lie, repeated often enough, begins to appear as truth. How effective this has been is revealed by the fact that even as discerning a commentator as Amir Muhammad has recently conceded to this relentless propagandising of a "JE/Nipah" epidemic in 1998/1999. (No letup in this propaganda is to be expected, in view of pending lawsuits over the misdiagnosis and mishandling of the Nipah epidemic). The irony now: JE virus (a flavivirus) is typically transmitted from pigs (and wild birds) to humans via a Culex mosquito vector. Nipah virus is not mosquito-transmissible. Continuing to harp on a JE/Nipah theme (often referred to as our "JE problem") sends out an alarming message to less-than-discriminating casual outsiders (discriminating enough to know that JE virus is transmitted by mosquitoes; not well-informed enough to pierce through the fog of disinformation generated and repeated ad nauseam by our media czars) that we have a highly lethal strain of endemic virus in Malaysia that is mosquito-transmissible. It is difficult to imagine a more fearsome scenario with which to frighten any intending visitors. Responsible Malaysians understand and accept that in an emergency situation of outbreak investigation and control, the government in principle should have the discretion for timely and responsible release of information. Having said that, CHI (Citizens' Health Initiative) would add that the government must sustain the confidence of the public that it is doing a competent, just and credible job in the broader interests of the entire community. In confronting national emergencies, we expect the government to exercise accountable, exemplary leadership in implementing well-considered and firm but necessary measures in a difficult situation, and in ensuring that these are equitably borne as a national, social compact. There is no other way to sustain confidence, broad-based support and unity in facing such challenges. Gag orders on public and professional discourse, and media blackouts fail miserably in averting disquiet and panic—this can only be achieved by accurate, timely information from a credible, competent and responsible source. In its handling of information dissemination in two disastrous epidemic outbreaks (Sarawak 1997 and Ipoh/Negri Sembilan 1999), and in these recurrent seasonal smogs, the government has repeatedly transgressed the reasonable limits of responsible information management. Its mindset of obsessive, unwarranted secrecy and its unwillingness to divulge legitimate information to the Malaysian public is reprehensible and totally unacceptable. Dr Chan Chee Khoon
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