The H5N1 Virus [snag]Image by Quiplash! via Flickr


With two pandemics under her belt, few are as qualified

Avoiding open fights is kind of the sine qua non of working for an international organisation. But when it comes to protecting public health, I don't think she would hesitate for a second to do whatever is necessary, including being at odds with a WHO member state.

Dr Jeffrey Koplan, former director of the US Centers for Disease Control and Prevention, on Dr Chan

BORN in Hong Kong in 1947, Ms Margaret Chan never intended to study medicine.

That did not stop her from eventually being appointed Director-General of the World Health Organization (WHO) in 2006, putting her at the frontline of the battle against viruses which have the potential to sweep across the planet and kill millions.

She trained as a teacher at the Northcote College of Education in Hong Kong and then spent a year at the Queen Elizabeth Government High School teaching English, geography, mathematics and home economics to junior students.

She became a doctor out of love, not for medicine but for her then new husband, David Chan.

When he left Hong Kong to study in Canada in 1969, she worried the long distance would end their relationship. Her mother told her to follow her heart.

When he decided to become a doctor, she worried that his medical studies would leave little opportunity for them to spend time together.

So, she enrolled alongside him at the University of Western Ontario.

The couple returned to Hong Kong after graduation, but Dr Chan found few openings in her field of interest, pediatrics, and instead joined the health department. Her rise was rapid, although she modestly attributes her success to luck and the departure of many senior people from the island in the run-up to Hong Kong reverting to China in 1997.

She earned a Masters in Public Health from the National University of Singapore before going to Harvard Business School in 1991 for a three-month management course.

"I learned that there is a cost to every decision, and whether or not you impose a public health order has costs to industry and the public," she said.

"There is also a cost for investing in preparedness (for an outbreak), and a much bigger cost for not investing."

Over this past week, as the world has watched the spread of swine flu, Dr Chan has been holed up in a WHO "war room" at its Geneva headquarters, which is running around the clock to co-ordinate an action plan against the virus.

"Dr Chan is running the show; she is holding morning and evening briefings. She is very much driving the process," said Mr Mike Ryan, the manager of WHO's Strategic Health Operations centre.

Colleagues describe her as relaxed, affable and media-savvy, a "dynamic leader" who can bind together a consensus.

She once reportedly even sang a song from the musical The King and I in front of British civil servants.

From Bird Flu...

But in 1997, Dr Chan's public health career had an inauspicious start.

In May that year, a three-year-old boy in Hong Kong fell sick and died. The laboratory analysis was so surprising that samples were sent to Holland for molecular analysis.

The results came back in August: The boy had died from a virus that ravaged Hong Kong's chicken farms earlier in the year, killing thousands of birds.

No one had ever seen it in humans before. Bird flu had made its first leap over to humans. Over the summer, no new victims emerged and the authorities quietly marked the case down as a one-off.

In November, however, the virus began to spread. By early December, panic was rising.

At the time, Dr Chan was in charge of the island's health department. Her response would catapult her on to the world stage.

As tensions rose in Hong Kong, Dr Chan appeared on local television, advising shoppers that chicken was safe. "I eat it every day, don't panic," she said, perhaps rashly.

Two weeks later, after another 17 infections and five deaths, she realised she had made a mistake. She boldly ordered 1.5 million birds culled, the island's entire population of chickens and ducks. More than 1,000 officials, some of whom had never touched a live chicken before, descended on Hong Kong's markets clad in surgical masks and gloves.

They gassed the birds or slit their throats, dumping them in heavy-duty waste bags. By the end of the week, piles of the bags had built up in the streets and were being torn apart by dogs and rats. "Things could have been done better," Dr Chan admitted.

Despite the botches, her strategy worked. Avian flu was contained and the plaudits poured in.

Thailand gave her the Prince Mahidol award. The Royal College of Physicians gave her the Fellowship of the Faculty of Public Health Medicine and the Queen awarded her an OBE.

To Sars...

Six years after its first pandemic threat, Hong Kong suffered another: Sars.

Severe Acute Respiratory Syndrome, a pneumonia that killed some 300 people in Hong Kong and infected another 1,755, may also have jumped from animals to humans, with the finger being pointed at bats and palm civets in the Chinese mainland province of Guangdong.

Once again, Dr Chan came under fire for her handling of the situation. This time, a Hong Kong government select committee decided that she was responsible for the city's slow reaction to the disease, and for not pushing the Chinese government for details about an outbreak on the mainland.

She said that no one suspected a new virus. "At that time, what concerned us most was influenza. It was the winter peak for flu as well," she said.

Her media performance, however, was dazzling, as she presided over 61 of the 104 emergency press conferences, held each day at 4.30pm.

"What amazes me most is that the media and I have fostered a close relationship," she later said.

She became a public hero through her regular and calming appearances on television.

"New diseases like Sars and bird flu cause anxiety in the community. People get worried, some to the extent that it even affects their health.

"You feel very sad, and yet you must carry on and maintain your cool in very trying and difficult moments. You have to tough it out," she said.

The 62-year-old, who has a son, was later headhunted by the WHO.

Praised for her role in containing the outbreak, Dr Chan caught the attention of the late former WHO chief Lee Jong Wook.

His team recruited Ms Chan to Geneva, where she headed the department responsible for fighting infectious disease threats. She became WHO's director general after Mr Lee's sudden death in 2006.

"She has the courage to make decisions and make the right decisions based on the scientific evidence", recalled Mr David Heymann, a former assistant director-general at WHO.

Agreeing Dr Jim Yong Kim, the incoming president of Dartmouth College who recruited Dr Chan when he worked at WHO, said: "I couldn't imagine the world in better hands."

And with the experience of dealing with two major pandemics under her belt, there can be few people as qualified as Dr Chan to tackle the current crisis. Adapted from The Daily Telegraph


From TODAY, World – Weekend, 02/03-May-2009

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