Organizing for Crisis

Bekedam had to reorganize the office to deal with the overwhelming public interest. Starting in March, he instituted an hour-long staff meeting from 8-9 a.m. each morning, to touch base and coordinate activities. Every day, he left participants with specific action items—information or permissions or contacts that WHO needed—to give all employees the ability to answer questions. “I ended up having no more than three or four key messages for that day or for that week… At least [staff] didn’t need to make up points,” he laughs. It was also important, he says, “for them to understand the larger picture within the group, and for me to be able to direct the whole team.”

As the disease outbreak snowballed, the office also needed more personnel: experts in epidemiology, surveillance/response, infection control, laboratory work and research. For missions, it needed travel advisors, plus administrators to manage the extra staff and consultants. It took several weeks to bring in the necessary people; the office came up to speed only in mid-March.[11]

Embassies. Then there were the embassies. Not only the media, but the diplomatic corps turned to WHO-Beijing for news. “If you have information, people are going to listen to you. Information is gold,” recalls Bekedam. “We had here embassies; their headquarters wanted to know what was happening in China. Their embassies were asking our office what was happening.” In late February, he and his staff began to brief the diplomatic corps, at first once a week and, as demand increased, twice. A rotating group of some 30-40 individuals attended each briefing, from ambassadors to first and second secretaries. Bekedam instructed his staff that all calls from embassies were to be answered immediately.

As with the staff meetings, Bekedam used the briefings to convey “three or four simple messages—what are the next things that need to be done? We always made it something not too confusing.” For example, if China had provided the number of cases in a locality, WHO told the embassy reps that it needed to know how (or whether) those people were related. If it got the answer to that, it asked where they were from, or how they contracted the disease. The result was that Chinese government officials heard a uniform message from the diplomatic community on next steps.

For the missions, Bekedam decided that only senior WHO-Beijing international officers could be team leaders and negotiators. In his experience, visitors had scientific expertise but confronted with Chinese officials, “sometimes they’re completely overwhelmed and they don’t dare to say anything. And sometimes they are completely culturally insensitive, and start talking in a relatively rude manner, and then people start focusing not on what they say, but how they say it,” says Bekedam.[12] As negotiators, he designated himself, Schnur and Chin.

Bekedam also realized that appearances were important—especially what he personally did or did not do. One goal was to minimize panic. So, for example, he never donned a mask. But he also never went to a hospital, so that he would never need to wear a mask. “As long as I know what my environment is, I can make that decision. But I also said if I were to go to a hospital, I would wear a mask,” he remembers. Avoiding hospitals also minimized the danger that he would fall ill himself. His role was too important to risk being sick. He says:

There was agreement that I would be the chief negotiator. And the chief negotiator could not change. If I wasn’t protected well enough, I would have had to put myself in isolation for 10 days, and we couldn’t afford that.

Dr. Bekedam explains staff organization.

National People’s Congress. Meanwhile, official China was much preoccupied with a major upcoming leadership change. Every 10 years, the Communist Party proposed in November a new slate of top leaders, which was endorsed the following March by the National People’s Congress (NPC).[13] The NPC, with nearly 3,000 delegates in 2003, was China’s legislature and its highest state authority. About 70 percent of delegates were also members of the Communist Party. In November 2002, the Party had endorsed the transfer of power from General Secretary (and President) Jiang Zemin to Hu Jintao, and announced members of a new 400-member Central Committee as well as the nine members of the ruling Politburo Standing Committee. The transfer would be completed during a 10-day People’s Congress from March 5-14, 2003.

[11] Arthur Kleinman and James Watson, eds. Prelude to Pandemic: SARS in China. (Stanford; Stanford University Press), 2006. p.46.

[12] Bekedam adds that the office could not ask its Chinese staff to conduct negotiations—“that’s impossible... because they’re talking to their superiors.”

[13] The congress was held every five years, but most leaders held two, consecutive, five-year terms. China had some 82 million Party members, from a population of 1.4 billion.