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<time begin="00:00:24.51"/><clear/>>> It's such a beautiful
sunny day out there<br/>
and this is such a crowded time of year<br/>
<time begin="00:00:28.82"/><clear/>that we really appreciate you
turning<br/>
out for this the fourth in the series<br/>
<time begin="00:00:33.65"/><clear/>of 4 Voices from the Vanguard
lectures.<br/>
<time begin="00:00:36.75"/><clear/>You know, my partner in
crime, Dan Colley,<br/>
who is the Director of the Center for Tropical<br/>
<time begin="00:00:42.27"/><clear/>and Emerging Global Diseases
here at UGA and<br/>
he is sitting down here in the front row.<br/>
<time begin="00:00:46.95"/><clear/>We really can't thank you
enough for your<br/>
continuing participation in this lecture series.<br/>
<time begin="00:00:51.56"/><clear/>It's been a great reward for
us to<br/>
see you all here and I know some<br/>
<time begin="00:00:54.76"/><clear/>of you have come again
and<br/>
again which is just great.<br/>
<time begin="00:00:58.10"/><clear/>There are few thank you's
that<br/>
I'd like to issue at this last lecture.<br/>
<time begin="00:01:02.31"/><clear/>First of all, to the Office
of the Provost<br/>
<time begin="00:01:04.37"/><clear/>without whose financial
support<br/>
we wouldn't be able to do this.<br/>
<time begin="00:01:07.56"/><clear/>Franklin College, we
appreciate<br/>
being recognized as a blue card event,<br/>
<time begin="00:01:13.40"/><clear/>which I know brings some<br/>
of you here to us tonight.<br/>
<time begin="00:01:15.91"/><clear/>I'd like to thank
Professor<br/>
Julie Moore who's People,<br/>
<time begin="00:01:21.26"/><clear/>Parasites and Plagues course
also<br/>
motivates many of you to join us.<br/>
<time begin="00:01:26.21"/><clear/>That's a great course.<br/>
<time begin="00:01:28.36"/><clear/>These events do require some
technical expertise<br/>
which is certainly not my area and for that,<br/>
<time begin="00:01:33.79"/><clear/>we owe 2 people from Grady
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College who do this<br/>
over and over again and do it so smoothly.<br/>
<time begin="00:01:38.80"/><clear/>Diane Murray, our Director of
External Affairs<br/>
who is down in the front and Anettra Mapp,<br/>
<time begin="00:01:43.42"/><clear/>the administrator for the
Knight Health<br/>
Programs whose watching from up above.<br/>
<time begin="00:01:48.03"/><clear/>If you would just join me for
a minute<br/>
in thanking them for everything they do.<br/>
<time begin="00:01:51.51"/><clear/>[ Applause ]<br/>
<time begin="00:01:56.66"/><clear/>>> I would also like to thank
the Grady<br/>
Ambassadors who time after time hand<br/>
<time begin="00:02:00.42"/><clear/>out the programs and add
a<br/>
note of class to this event.<br/>
<time begin="00:02:05.28"/><clear/>Tonight is really special for
me.<br/>
<time begin="00:02:07.68"/><clear/>It brings together two of the
world's leading<br/>
experts on communicating with journalists.<br/>
<time begin="00:02:14.65"/><clear/>I've been in hundreds of
press conferences<br/>
as a reporter, and you know the difference<br/>
<time begin="00:02:19.55"/><clear/>between the good public
relations or<br/>
news office people and the not so good ones.<br/>
<time begin="00:02:27.27"/><clear/>And we have two of the very
best with<br/>
us tonight, not just Dick Thompson,<br/>
<time begin="00:02:32.81"/><clear/>our featured speaker but also
Dr. Vicki<br/>
Freimuth whose going to introduce him.<br/>
<time begin="00:02:38.84"/><clear/>We're so pleased to have
Vicki here at UGA.<br/>
<time begin="00:02:41.82"/><clear/>She not only has a deep
theoretical<br/>
and academic background in health<br/>
<time begin="00:02:46.25"/><clear/>and risk communication,
but<br/>
she's walked the walk.<br/>
<time begin="00:02:49.82"/><clear/>She was the Director of the
Office<br/>
of Communications at the Centers<br/>
<time begin="00:02:53.53"/><clear/>for Disease Control during
Page 2
Thompson.txt
the<br/>
anthrax attacks, during SARS,<br/>
<time begin="00:02:58.19"/><clear/>and she lived through some
pretty<br/>
exciting times there.<br/>
<time begin="00:03:00.71"/><clear/>So, let's get Vicki out here
and<br/>
she'll tell you something about Dick.<br/>
<time begin="00:03:05.79"/><clear/>[ Applause ]<br/>
<time begin="00:03:11.06"/><clear/>>> Vicki Freimuth: Thank
you.<br/>
<time begin="00:03:12.32"/><clear/>Since tonight is the last in
the<br/>
series of this year's lectures,<br/>
<time begin="00:03:16.55"/><clear/>I'd really like for us to
take a moment<br/>
to recognize the work of both Pat Thomas<br/>
<time begin="00:03:22.25"/><clear/>and Dan Colley who have
been<br/>
organizing this fascinating series.<br/>
<time begin="00:03:26.45"/><clear/>So, if you'd join me in
thanking<br/>
them for their work.<br/>
<time begin="00:03:35.28"/><clear/>[Applause] Thank you.<br/>
<time begin="00:03:35.72"/><clear/>I am particularly pleased
that<br/>
tonight the organizers have chosen<br/>
<time begin="00:03:41.51"/><clear/>to include a risk
communication expert as<br/>
one of the featured speakers in this series.<br/>
<time begin="00:03:47.31"/><clear/>Too often, the communication
is overlooked<br/>
in crisis planning, but it's always to thing<br/>
<time begin="00:03:52.75"/><clear/>that gets blamed in the after
analysis and I<br/>
think once people and organizations have been<br/>
<time begin="00:03:59.44"/><clear/>through a crisis they begin
to recognize what<br/>
the important role that communication plays.<br/>
<time begin="00:04:04.67"/><clear/>And we are very fortunate
that that field<br/>
is very well represented by Dick Thompson.<br/>
<time begin="00:04:10.93"/><clear/>His responsibility is truly
awesome<br/>
and this is from someone who felt<br/>
<time begin="00:04:15.18"/><clear/>like her responsibility was
awesome, but he<br/>
Page 3
Thompson.txt
must break the bad news about infectious disease<br/>
<time begin="00:04:22.08"/><clear/>to the entire world, which
is<br/>
a very challenging activity.<br/>
<time begin="00:04:27.46"/><clear/>I first met Dick in 2001,
right<br/>
after he had taken this position<br/>
<time begin="00:04:32.88"/><clear/>at the World Health
Organization.<br/>
<time begin="00:04:35.20"/><clear/>I was, as Pat told you, then
Director<br/>
of Communication at CDC and we were all<br/>
<time begin="00:04:40.28"/><clear/>in the middle of one of the
series of crisis,<br/>
this time it was SARS and I actually didn't know<br/>
<time begin="00:04:46.14"/><clear/>until today that apparently,
Dick is<br/>
credited with coining the label for SARS<br/>
<time begin="00:04:52.59"/><clear/>and I didn't know that until
I read it today.<br/>
<time begin="00:04:55.85"/><clear/>I especially have appreciated
since that<br/>
time the leadership that Dick has shown<br/>
<time begin="00:05:02.46"/><clear/>by gathering many of the
risk<br/>
communication experts across the world<br/>
<time begin="00:05:07.31"/><clear/>and having them develop a set
of best<br/>
practices for outbreak communication.<br/>
<time begin="00:05:12.68"/><clear/>And these practices are being
used<br/>
and disseminated throughout the world<br/>
<time begin="00:05:16.41"/><clear/>and he is doing a lot of that
work.<br/>
<time begin="00:05:19.00"/><clear/>Before Dick joined WHO, he
was a<br/>
science reporter and war correspondent.<br/>
<time begin="00:05:24.38"/><clear/>He worked for TIME
magazine<br/>
in San Francisco and then<br/>
<time begin="00:05:27.57"/><clear/>in Washington D.C. Dick has a
unique<br/>
perspective of having been a reporter<br/>
<time begin="00:05:33.07"/><clear/>for a major news organization
and now the<br/>
spokesperson for a major international agency.<br/>
<time begin="00:05:39.37"/><clear/>I am really looking forward
Page 4
Thompson.txt
to hearing<br/>
him talk about "Breaking the Bad News."<br/>
<time begin="00:05:43.75"/><clear/>Please join me in welcoming
Dick Thompson.<br/>
<time begin="00:05:46.51"/><clear/>[ Applause ]<br/>
<time begin="00:05:52.70"/><clear/>>> Dick Thompson: Thank you
very much.<br/>
<time begin="00:05:55.71"/><clear/>See if I can get this
off...and turn this on.<br/>
<time begin="00:06:07.37"/><clear/>Thank you all for
coming.<br/>
<time begin="00:06:08.77"/><clear/>It's after midnight in
Geneva, where<br/>
I live and was until yesterday.<br/>
<time begin="00:06:15.54"/><clear/>So I needed a little pick me
up here.<br/>
<time begin="00:06:18.28"/><clear/>It's hard to be described as
a communication<br/>
expert, especially a risk communication expert.<br/>
<time begin="00:06:24.63"/><clear/>I guess that's true, but it
also tells you<br/>
a lot about risk communication experts.<br/>
<time begin="00:06:31.49"/><clear/>We seem to come from very
diverse fields.<br/>
<time begin="00:06:35.18"/><clear/>There is not the kind of
training<br/>
that we would hope to be in place<br/>
<time begin="00:06:39.60"/><clear/>and that we are all moving
for right now.<br/>
<time begin="00:06:42.95"/><clear/>People learn pretty much<br/>
on the job as it happens.<br/>
<time begin="00:06:47.53"/><clear/>Just to tell you a little bit
about,<br/>
because I'm supposed to talk about myself.<br/>
<time begin="00:06:53.28"/><clear/>About how you get to be a
risk communication<br/>
person, my first professional job,<br/>
<time begin="00:06:59.54"/><clear/>one I had for 10 years was as
a bartender and I<br/>
worked in the restaurant business for a long time,<br/>
<time begin="00:07:07.59"/><clear/>sometimes substituting as
a<br/>
cook and I learned something<br/>
<time begin="00:07:10.23"/><clear/>that was really very
important<br/>
as a communicator.<br/>
Page 5
Thompson.txt
<time begin="00:07:13.10"/><clear/>And I think it's something
that<br/>
is lost on a lot of communicators<br/>
<time begin="00:07:16.16"/><clear/>and that is the ability to
listen.<br/>
<time begin="00:07:18.56"/><clear/>We spend a lot of time
thinking about messages<br/>
but we don't often think about listening.<br/>
<time begin="00:07:23.05"/><clear/>So, being a bartender was my
first life<br/>
and let me see if I can make this work.<br/>
<time begin="00:07:29.88"/><clear/>This was my second.<br/>
<time begin="00:07:31.50"/><clear/>I worked with TIME
magazine<br/>
for a very long time.<br/>
<time begin="00:07:35.22"/><clear/>This was actually the last
cover<br/>
I did about the human genome.<br/>
<time begin="00:07:40.55"/><clear/>I wrote about a book called
Volcano Cowboys<br/>
which I found is not in your bookstore.<br/>
<time begin="00:07:47.36"/><clear/>It's also crossed the one
million mark on<br/>
Amazon, so it may be hard to find anywhere.<br/>
<time begin="00:07:53.24"/><clear/>I was a bureau chief for TIME
in South Asia<br/>
which meant that I covered a number of conflicts<br/>
<time begin="00:08:03.03"/><clear/>in that area including the
fall of Kabul.<br/>
<time begin="00:08:05.69"/><clear/>I covered several
administrations.<br/>
<time begin="00:08:09.32"/><clear/>I worked in the White House a
lot, got to fly<br/>
on both the old and the new Air Force One.<br/>
<time begin="00:08:14.47"/><clear/>So, I had a broad background
as a<br/>
journalist, and that was my second life.<br/>
<time begin="00:08:21.06"/><clear/>It came to an end in 2001
when my<br/>
magazine was acquired by America Online<br/>
<time begin="00:08:28.07"/><clear/>and I entered journalism at a
time<br/>
<time begin="00:08:30.85"/><clear/>when I thought it was a very
robust<br/>
field. It was driven by ideology.<br/>
<time begin="00:08:37.15"/><clear/>I went into journalism and
Page 6
Thompson.txt
I<br/>
went into college in 1971 and,<br/>
<time begin="00:08:44.43"/><clear/>in college during the
Watergate year, and it<br/>
was a time of high ideals and noble purpose.<br/>
<time begin="00:08:51.29"/><clear/>I felt that journalism was
really an<br/>
important function in a democracy.<br/>
<time begin="00:08:57.56"/><clear/>I still feel that way.<br/>
<time begin="00:08:59.35"/><clear/>I'm a little sorry about
what's happen to<br/>
it and I think what has happened to it is<br/>
<time begin="00:09:04.09"/><clear/>that it has become much more
of<br/>
a business than it used to be<br/>
<time begin="00:09:08.80"/><clear/>and this has changed the face
of journalism.<br/>
<time begin="00:09:11.70"/><clear/>But I was fortunate enough in
2001, when I<br/>
was offered early retirement to have a friend<br/>
<time begin="00:09:18.21"/><clear/>of mine who worked at the
World Health<br/>
Organization ask if I wanted to come and work<br/>
<time begin="00:09:22.72"/><clear/>for the World Health
Organization and without<br/>
knowing much more about it then it was<br/>
<time begin="00:09:27.03"/><clear/>in Europe, which I thought
had a<br/>
long vacation, short work weeks,<br/>
<time begin="00:09:34.18"/><clear/>and was a pretty comfortable
lifestyle<br/>
because you could get to Paris in three<br/>
<time begin="00:09:37.57"/><clear/>and a half hours. I decided
to take that job.<br/>
<time begin="00:09:42.34"/><clear/>And this is what I do
now.<br/>
<time begin="00:09:43.97"/><clear/>Uhm, that's not it, this is
it.<br/>
<time begin="00:09:47.90"/><clear/>The idea of breaking bad news
I<br/>
think is contained in this cartoon.<br/>
<time begin="00:09:52.16"/><clear/>I don't know if you could see
this: "as we<br/>
interrupt this emergency breaking news bulletin<br/>
<time begin="00:09:56.50"/><clear/>with an even scarier
emergency breaking<br/>
news bulletin." Ideal in outbreaks,<br/>
Page 7
Thompson.txt
<time begin="00:10:02.99"/><clear/>outbreaks of international
importance.<br/>
<time begin="00:10:05.80"/><clear/>These are of small
epidemics,<br/>
localized epidemics of diseases<br/>
<time begin="00:10:12.23"/><clear/>like SARS, Ebola, plague,
anthrax, Marburg.<br/>
<time begin="00:10:18.39"/><clear/>Usually they erupt in Africa,
parts of Asia.<br/>
<time begin="00:10:23.62"/><clear/>We spend, yeah, I'll get this
right soon.<br/>
<time begin="00:10:26.37"/><clear/>We spend a lot of time
thinking about what<br/>
makes outbreaks special and why do they offer<br/>
<time begin="00:10:35.47"/><clear/>such special communication
challenges because<br/>
a number of countries have found it difficult<br/>
<time begin="00:10:42.47"/><clear/>to announce that they have an
outbreak.<br/>
<time begin="00:10:45.16"/><clear/>This is the very first step
in controlling an<br/>
outbreak, because if countries don't announce<br/>
<time begin="00:10:50.34"/><clear/>that there is a problem
then,<br/>
we can't really respond.<br/>
<time begin="00:10:55.51"/><clear/>We can't begin even the basic
epidemiology.<br/>
<time begin="00:11:00.65"/><clear/>We certainly can't begin
responding.<br/>
<time begin="00:11:04.48"/><clear/>We came face to face with
this after<br/>
our experience with China and SARS<br/>
<time begin="00:11:10.09"/><clear/>in which China delayed for
such a long time the<br/>
very fact that they had hundreds and thousands<br/>
<time begin="00:11:15.49"/><clear/>of cases, hundreds and
thousands<br/>
of cases of SARS.<br/>
<time begin="00:11:20.32"/><clear/>So, we wanted to find out
what is<br/>
it about outbreaks that makes it<br/>
<time begin="00:11:25.63"/><clear/>so difficult for countries to
talk about.<br/>
<time begin="00:11:27.91"/><clear/>And we looked a long time at
these<br/>
Page 8
Thompson.txt
outbreaks and they have, I'll get this right.<br/>
<time begin="00:11:32.89"/><clear/>Outbreaks have several unique
characteristics or<br/>
so we thought at the time. But these are events<br/>
<time begin="00:11:39.89"/><clear/>that begin and we don't
know<br/>
where they're going.<br/>
<time begin="00:11:43.03"/><clear/>They unfold before our
eyes.<br/>
<time begin="00:11:45.57"/><clear/>Is it a single case of
anthrax or<br/>
is it just a first case of anthrax?<br/>
<time begin="00:11:50.32"/><clear/>Is it the first outbreak of
Ebola?<br/>
<time begin="00:11:53.71"/><clear/>Is it localized?<br/>
<time begin="00:11:54.72"/><clear/>Is it spread?<br/>
<time begin="00:11:55.84"/><clear/>So, when outbreaks happen we
really<br/>
don't know the dimensions of the outbreak<br/>
<time begin="00:12:00.57"/><clear/>and it will take sometime
before we know<br/>
that. And there are also unpredictable events.<br/>
<time begin="00:12:08.22"/><clear/>You can come very close to
controlling<br/>
an outbreak, you can be very confident<br/>
<time begin="00:12:13.67"/><clear/>that it is nearly over and
the next<br/>
thing you know, you have a new outbreak<br/>
<time begin="00:12:18.31"/><clear/>of the same disease 10 miles
away.<br/>
<time begin="00:12:20.82"/><clear/>This happened to
Toronto.<br/>
<time begin="00:12:23.84"/><clear/>They thought that they had
SARS under<br/>
control in one area, they came to Geneva,<br/>
<time begin="00:12:28.69"/><clear/>asked us to lift a travel
ban, we<br/>
did and then they had another outbreak.<br/>
<time begin="00:12:33.24"/><clear/>So, they're very
unpredictable and<br/>
these two features being unfolding<br/>
<time begin="00:12:37.78"/><clear/>and unpredictable are
probably<br/>
the most important,<br/>
<time begin="00:12:41.26"/><clear/>there will be a third one
I'll show you in<br/>
a minute, are probably the most important<br/>
Page 9
Thompson.txt
<time begin="00:12:44.72"/><clear/>when it comes to countries
announcing<br/>
outbreaks because even if they want to announce,<br/>
<time begin="00:12:50.10"/><clear/>they want to know that they
have their<br/>
facts in front of them and you can't know<br/>
<time begin="00:12:54.35"/><clear/>that in the beginning of an
outbreak.<br/>
<time begin="00:12:56.10"/><clear/>You cannot know it.<br/>
<time begin="00:12:57.78"/><clear/>And that means that
countries<br/>
have to say, I don't know<br/>
<time begin="00:13:01.99"/><clear/>,but this is where we are at
the moment.<br/>
<time begin="00:13:04.33"/><clear/>This is the information we
have now.<br/>
<time begin="00:13:07.24"/><clear/>And that's very, very
difficult for<br/>
countries to do for lots of reasons,<br/>
<time begin="00:13:12.39"/><clear/>because behavior plays a key
role in<br/>
transmission, but more importantly,<br/>
<time begin="00:13:17.35"/><clear/>because there are social<br/>
and economic consequences.<br/>
<time begin="00:13:20.36"/><clear/>And that means political<br/>
consequences to announcing an outbreak.<br/>
<time begin="00:13:24.27"/><clear/>So, an outbreak isn't
just<br/>
a public health event.<br/>
<time begin="00:13:27.50"/><clear/>It can be an international
event.<br/>
<time begin="00:13:29.73"/><clear/>It can be an economic
event.<br/>
<time begin="00:13:31.44"/><clear/>It can hurt trade and
tourism.<br/>
<time begin="00:13:32.88"/><clear/>It can hurt the country's
standing,<br/>
how it's seen in the world.<br/>
<time begin="00:13:35.99"/><clear/>And this creates a sense of
anxiety in<br/>
the public and as we've looked at this,<br/>
<time begin="00:13:42.19"/><clear/>what we found was the more
important<br/>
anxiety is in response managers.<br/>
<time begin="00:13:47.92"/><clear/>They become very, very
anxious<br/>
and what they try to do<br/>
Page 10
Thompson.txt
<time begin="00:13:52.47"/><clear/>in their communication
is<br/>
to reassure the public.<br/>
<time begin="00:13:57.97"/><clear/>Yes, we're worried about
this, but<br/>
we don't want to create panic.<br/>
<time begin="00:14:01.00"/><clear/>I can't tell you how many
times we've<br/>
heard that we don't want to create panic.<br/>
<time begin="00:14:06.20"/><clear/>So, we are going to mislead
the public.<br/>
<time begin="00:14:09.05"/><clear/>We are going to say that we
know something.<br/>
<time begin="00:14:11.68"/><clear/>We know the dimensions of the
outbreak or we<br/>
know how to control it, something like that.<br/>
<time begin="00:14:16.87"/><clear/>And then very shortly, it's
seen that<br/>
they don't know how to control it.<br/>
<time begin="00:14:21.45"/><clear/>And so they lose credibility
from the start<br/>
and these are always news worthy events.<br/>
<time begin="00:14:28.14"/><clear/>Very often countries that I
deal with, in<br/>
Africa and Asia, will say they know how<br/>
<time begin="00:14:34.32"/><clear/>to control the press and they
do.<br/>
<time begin="00:14:36.27"/><clear/>There's no doubt about
it.<br/>
<time begin="00:14:37.58"/><clear/>Unless there's an
international event<br/>
<time begin="00:14:39.48"/><clear/>because international
events<br/>
bring in international reporters.<br/>
<time begin="00:14:43.16"/><clear/>And so the normal way that
they've been<br/>
dealing with the press, issuing a statement<br/>
<time begin="00:14:49.51"/><clear/>that may not be right,
whatever,<br/>
this event carried<br/>
<time begin="00:14:53.11"/><clear/>in the press is now subject
to a new scrutiny.<br/>
<time begin="00:14:56.27"/><clear/>So, this would cause them
some problems.<br/>
<time begin="00:15:00.51"/><clear/>[ Pause ]<br/>
<time begin="00:15:06.07"/><clear/>>> Dick Thompson: Okay, so
Page 11
Thompson.txt
this is<br/>
where we begin our day in Geneva.<br/>
<time begin="00:15:10.03"/><clear/>This is the outbreak response
room.<br/>
<time begin="00:15:14.00"/><clear/>It's called the Strategic
Health Operations<br/>
Center (SHOC) and we actually used to meet<br/>
<time begin="00:15:20.84"/><clear/>in a much smaller, more
unpleasant room<br/>
but after SARS, we were given some money<br/>
<time begin="00:15:28.33"/><clear/>to create something like
what<br/>
they have at the CDC in Atlanta.<br/>
<time begin="00:15:34.50"/><clear/>Each morning at nine o'clock,
we'll have disease<br/>
experts sit around this table and they'll go<br/>
<time begin="00:15:40.74"/><clear/>through the over night
reports of outbreak<br/>
confirmation, rumors. We'll understand,<br/>
<time begin="00:15:47.71"/><clear/>we'll get a better
understanding<br/>
of where we are with an outbreak.<br/>
<time begin="00:15:52.68"/><clear/>We'll get reports, at least
once a year and<br/>
sometimes twice a year of a smallpox outbreak.<br/>
<time begin="00:15:59.23"/><clear/>Smallpox has been eradicated
for 30 years or so.<br/>
<time begin="00:16:04.70"/><clear/>Nevertheless, we keep getting
reports.<br/>
<time begin="00:16:06.85"/><clear/>So, what we have to do is to
verify the<br/>
reports and that starts in this room.<br/>
<time begin="00:16:12.35"/><clear/>Each report is assigned
to<br/>
one of the disease experts.<br/>
<time begin="00:16:17.19"/><clear/>They'll contact one of our
country<br/>
offices, they'll ask the Ministry of Health<br/>
<time begin="00:16:21.03"/><clear/>for what's going on, about
what's going on.<br/>
<time begin="00:16:24.23"/><clear/>And then we'll begin a
process<br/>
of either assisting the country<br/>
<time begin="00:16:28.86"/><clear/>or discounting it as false
rumor.<br/>
<time begin="00:16:33.32"/><clear/>So, this is an example of
Page 12
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an<br/>
outbreak that we would get.<br/>
<time begin="00:16:39.01"/><clear/>We began in early 2005.<br/>
<time begin="00:16:42.17"/><clear/>We began hearing reports of a
pneumonic<br/>
plague in a place called Ituri.<br/>
<time begin="00:16:49.86"/><clear/>Ituri is up in the northeast
of<br/>
the Democratic Republic of Congo.<br/>
<time begin="00:16:56.44"/><clear/>There was a large pit not as
large<br/>
as your stadium but a large pit<br/>
<time begin="00:17:03.66"/><clear/>where somebody discovered a
diamond.<br/>
<time begin="00:17:06.36"/><clear/>Over night something like
7000 people<br/>
moved into this pit searching for diamonds.<br/>
<time begin="00:17:12.12"/><clear/>They're in an area about a
quarter<br/>
of the size of your stadium.<br/>
<time begin="00:17:16.55"/><clear/>They're digging around.<br/>
<time begin="00:17:17.86"/><clear/>They spend all day in this
pit.<br/>
<time begin="00:17:21.09"/><clear/>They are coughing, there is
plague in<br/>
the area and plague gets passed around.<br/>
<time begin="00:17:25.55"/><clear/>Now, as soon as it was
confirmed that it<br/>
was plague, 4000 of those people vanished.<br/>
<time begin="00:17:32.47"/><clear/>They just went away.<br/>
<time begin="00:17:35.14"/><clear/>They disappeared back to
their hometown.<br/>
<time begin="00:17:38.52"/><clear/>So, what we had to do was
try<br/>
to try to track down where they'd gone.<br/>
<time begin="00:17:45.39"/><clear/>We had to alert people.<br/>
<time begin="00:17:46.33"/><clear/>We had to let them know if
they were<br/>
sick that this is what they should do.<br/>
<time begin="00:17:49.80"/><clear/>We had to get medicines into
the area.<br/>
<time begin="00:17:51.40"/><clear/>So this is a pretty typical
outbreak<br/>
response. Not the typical outbreak response:<br/>
<time begin="00:17:56.44"/><clear/>This is a picture of
Uige.<br/>
<time begin="00:17:59.34"/><clear/>Uige is in Northern
Page 13
Thompson.txt
Angola.<br/>
<time begin="00:18:02.25"/><clear/>This is an area that has been
pretty<br/>
much devastated by 25 years of civil war.<br/>
<time begin="00:18:11.73"/><clear/>It's close to the border with
DRC.<br/>
<time begin="00:18:14.64"/><clear/>There is something like
10,000<br/>
land mines still in the area.<br/>
<time begin="00:18:18.92"/><clear/>It's a very difficult remote
place.<br/>
<time begin="00:18:23.29"/><clear/>In early 2005, we got a
report<br/>
indirectly from an Italian pediatrician,<br/>
<time begin="00:18:31.36"/><clear/>there was an Italian NGO
working in the<br/>
area and this woman had a number of children<br/>
<time begin="00:18:41.79"/><clear/>who were dying everyday on
her and they were<br/>
dying with unusual fevers and bleeding.<br/>
<time begin="00:18:47.26"/><clear/>She managed to get a sample
out.<br/>
<time begin="00:18:50.09"/><clear/>It was sent to the CDC where
it was<br/>
confirmed to be Marburg hemorrhagic fever.<br/>
<time begin="00:18:56.99"/><clear/>Angola asked for assistance
and it's interesting<br/>
that one of the first types of assistance<br/>
<time begin="00:19:03.63"/><clear/>that they asked for was
communication.<br/>
<time begin="00:19:05.93"/><clear/>And this is something that
happens<br/>
more and more frequently now<br/>
<time begin="00:19:09.90"/><clear/>that countries know that this
is available.<br/>
<time begin="00:19:12.76"/><clear/>They didn't follow much of
the advice that<br/>
we gave them but they recognized right<br/>
<time begin="00:19:16.74"/><clear/>of that they did the
communication assistance.<br/>
<time begin="00:19:21.02"/><clear/>This is Dr. Pierre Formenty,
like many<br/>
people at WHO, he comes to us from MSF.<br/>
<time begin="00:19:28.32"/><clear/>He is probably, I can't think
of<br/>
Page 14
Thompson.txt
anyone else who has more experience<br/>
<time begin="00:19:33.07"/><clear/>in the field dealing with
hemorrhagic fevers.<br/>
<time begin="00:19:36.57"/><clear/>He is a father of two and I
don't think<br/>
he spent a Christmas with his family<br/>
<time begin="00:19:42.66"/><clear/>in the last five years
because for some reasons,<br/>
<time begin="00:19:44.86"/><clear/>hemorrhagic fevers
seemed<br/>
to erupt in the winter time.<br/>
<time begin="00:19:49.33"/><clear/>So, he is often in the
field.<br/>
<time begin="00:19:51.25"/><clear/>He looks a little
concerned<br/>
here but I think he is trying<br/>
<time begin="00:19:55.92"/><clear/>to impress upon these people
the<br/>
importance of wearing this equipment.<br/>
<time begin="00:20:00.87"/><clear/>This is personal protection
equipment.<br/>
<time begin="00:20:04.64"/><clear/>Whenever a person is infected
with a<br/>
hemorrhagic fever, they become more infectious,<br/>
<time begin="00:20:11.51"/><clear/>the sicker they get and they
are<br/>
most infectious at the time they die.<br/>
<time begin="00:20:15.79"/><clear/>This is a problem especially
for families<br/>
that go through traditional burials of people<br/>
<time begin="00:20:24.14"/><clear/>because they'd spend a lot of
time touching<br/>
the body and preparing the body for burial.<br/>
<time begin="00:20:28.97"/><clear/>In some cultures in Africa,
it is important that<br/>
everybody who knows this person touches the body<br/>
<time begin="00:20:36.55"/><clear/>because that shows that they
didn't<br/>
place a curse on that person.<br/>
<time begin="00:20:40.17"/><clear/>That wasn't the case in
Uige.<br/>
<time begin="00:20:43.79"/><clear/>In Uige there was a
ritual<br/>
pouring of water over the body<br/>
<time begin="00:20:50.05"/><clear/>and then those people
attending<br/>
Page 15
Thompson.txt
the funeral would drink this water,<br/>
<time begin="00:20:53.75"/><clear/>thus, spreading the
disease.<br/>
<time begin="00:20:57.54"/><clear/>And this Uige eventually<br/>
became the largest outbreak<br/>
<time begin="00:21:01.21"/><clear/>of hemorrhagic fever that
we'd ever seen.<br/>
<time begin="00:21:05.87"/><clear/>This is what happens in the
field.<br/>
<time begin="00:21:10.83"/><clear/>You see a person here
who<br/>
has just taken a throat swab<br/>
<time begin="00:21:14.86"/><clear/>from, this person just died
recently,<br/>
<time begin="00:21:19.08"/><clear/>he's taken a throat swab
from<br/>
this body and he is preparing it.<br/>
<time begin="00:21:24.35"/><clear/>Canada had set up a mobile
field hospital<br/>
which is probably unique in the world I think<br/>
<time begin="00:21:33.19"/><clear/>because it requires a
safety<br/>
level that is a very high level<br/>
<time begin="00:21:37.86"/><clear/>and it is hard to deploy in
the field.<br/>
<time begin="00:21:40.29"/><clear/>So, this person will take a
sample, as you'll<br/>
see the body has to be carefully cared<br/>
<time begin="00:21:45.89"/><clear/>for and especially during
burial.<br/>
<time begin="00:21:49.25"/><clear/>We bring an
anthropologist<br/>
to these kinds of situations<br/>
<time begin="00:21:53.23"/><clear/>so we can understand what the
burial<br/>
rituals are and offer substitutions in areas<br/>
<time begin="00:21:58.98"/><clear/>where people have to touch
the body.<br/>
<time begin="00:22:02.62"/><clear/>We can say that the spirit of
this<br/>
person has been transferred to a tree<br/>
<time begin="00:22:08.78"/><clear/>and if you touch the tree
it's the same thing.<br/>
<time begin="00:22:11.32"/><clear/>And this actually works.<br/>
<time begin="00:22:12.63"/><clear/>It's a kind of
communication<br/>
Page 16
Thompson.txt
challenge that, you get a range<br/>
<time begin="00:22:17.49"/><clear/>of communication challenges
in my job.<br/>
<time begin="00:22:20.37"/><clear/>Another communication
challenge is<br/>
that these people are wearing white.<br/>
<time begin="00:22:27.22"/><clear/>We didn't realize it at the
time,<br/>
but white is a symbol of witchcraft.<br/>
<time begin="00:22:33.93"/><clear/>And this created a huge
problem.<br/>
<time begin="00:22:37.97"/><clear/>The other problem here and we
jump ahead is<br/>
<time begin="00:22:43.39"/><clear/>that this is how people
would<br/>
leave the WHO Emergency Center.<br/>
<time begin="00:22:51.23"/><clear/>It was very important that we
would<br/>
confirm that everybody had put<br/>
<time begin="00:22:55.92"/><clear/>on their personal protection
equipment<br/>
properly even though it was 105 degrees<br/>
<time begin="00:23:01.50"/><clear/>and that they would be driven
out to the site.<br/>
<time begin="00:23:03.18"/><clear/>Actually, it wasn't very long
before<br/>
people started stoning these trucks.<br/>
<time begin="00:23:08.82"/><clear/>And it became very dangerous
for them and we<br/>
had to stop our work and it didn't happen here<br/>
<time begin="00:23:15.68"/><clear/>but in other places
hemorrhagic<br/>
fevers can be very dangerous<br/>
<time begin="00:23:20.47"/><clear/>for healthcare workers,
they've<br/>
actually been killed.<br/>
<time begin="00:23:24.41"/><clear/>And the reason being is
that<br/>
families are encouraged<br/>
<time begin="00:23:30.34"/><clear/>to send their sick loved<br/>
one to the local hospital.<br/>
<time begin="00:23:34.43"/><clear/>That person would go in the
hospital and die.<br/>
<time begin="00:23:39.43"/><clear/>And people naturally start
thinking that<br/>
something is happening in this hospital,<br/>
<time begin="00:23:44.21"/><clear/>it's killing my family, and
Page 17
Thompson.txt
the people doing<br/>
the killing are the people who work there.<br/>
<time begin="00:23:49.19"/><clear/>So, it is not usual
that...I'm<br/>
sorry it is unusual<br/>
<time begin="00:23:54.51"/><clear/>but it does happen that
people get killed.<br/>
<time begin="00:23:58.25"/><clear/>Healthcare workers are
killed<br/>
during hemorrhagic fever outbreaks.<br/>
<time begin="00:24:01.55"/><clear/>Emotions run very high.<br/>
<time begin="00:24:03.57"/><clear/>This is a new and extremely
difficult<br/>
way, difficult disease that people have<br/>
<time begin="00:24:12.51"/><clear/>but by listening to what's
going on<br/>
between now I think is extremely important.<br/>
<time begin="00:24:18.92"/><clear/>We can respond to factors
that most<br/>
people would consider irrational<br/>
<time begin="00:24:26.12"/><clear/>and that's an important thing
about<br/>
listening and about communicating.<br/>
<time begin="00:24:29.65"/><clear/>And you often hear things
that won't<br/>
make sense to the technical side.<br/>
<time begin="00:24:35.75"/><clear/>During SARS, a lot of
people,<br/>
especially in Asia started wearing masks.<br/>
<time begin="00:24:41.02"/><clear/> And we were asked to comment
about that and<br/>
I went to our technical group and I said,<br/>
<time begin="00:24:45.26"/><clear/>what do you think about these
surgical<br/>
masks that are open on the side<br/>
<time begin="00:24:48.99"/><clear/>and have cute drawings on the
front.<br/>
<time begin="00:24:51.11"/><clear/>Are these actually preventing
any illness?<br/>
<time begin="00:24:55.52"/><clear/>The answer was, no certainly
not.<br/>
<time begin="00:24:57.67"/><clear/>I mean there's no
eyewear.<br/>
<time begin="00:24:58.70"/><clear/>There's nothing.<br/>
<time begin="00:24:59.37"/><clear/>The masks are open.<br/>
<time begin="00:25:00.85"/><clear/>It's not good thing to do and
Page 18
Thompson.txt
so as the sound<br/>
technical person following our technical<br/>
<time begin="00:25:06.85"/><clear/>guidance I went out and said,
you know<br/>
you're really not protecting yourself.<br/>
<time begin="00:25:12.06"/><clear/>I hope I wouldn't do that
again<br/>
because it was a huge mistake.<br/>
<time begin="00:25:16.56"/><clear/>What people were saying and
what<br/>
I wasn't listening to was the fact<br/>
<time begin="00:25:19.72"/><clear/>that people wanted something
to do, but<br/>
I'll talk more about SARS in a minute.<br/>
<time begin="00:25:24.39"/><clear/>They wanted something to<br/>
do to protect themselves.<br/>
<time begin="00:25:27.55"/><clear/>So, once we finally figured
out that this<br/>
kind of scene was frightening the people.<br/>
<time begin="00:25:33.49"/><clear/>We had them dress in their
personal<br/>
protection equipment outside the home<br/>
<time begin="00:25:38.99"/><clear/>that they were visiting.<br/>
<time begin="00:25:40.28"/><clear/>So, you would show up, you
would see<br/>
somebody that looks like your neighbor<br/>
<time begin="00:25:43.19"/><clear/>and you'd see them put this
on and<br/>
things got much better from that point.<br/>
<time begin="00:25:48.71"/><clear/>Well, things got a
little<br/>
bit better from that point.<br/>
<time begin="00:25:51.67"/><clear/>There were traditional
healers who actually<br/>
began selling a potion that would protect people<br/>
<time begin="00:25:59.23"/><clear/>from Marburg and if your
family member<br/>
had it and if you thought you had it,<br/>
<time begin="00:26:05.43"/><clear/>you could go to this
traditional healer and buy<br/>
this potion. But the trouble was that in Uige,<br/>
<time begin="00:26:13.94"/><clear/>this isn't true in all of
Africa but<br/>
certainly in this corner of Africa,<br/>
<time begin="00:26:18.00"/><clear/>it was felt that the
only<br/>
good medicine was injected.<br/>
<time begin="00:26:23.14"/><clear/>So, this potion which I don't
Page 19
Thompson.txt
think<br/>
was helping people very much was given<br/>
<time begin="00:26:31.63"/><clear/>to people with dirty
needles.<br/>
<time begin="00:26:34.47"/><clear/>So somebody who is a little
sick or may have<br/>
been infected with Marburg would come along<br/>
<time begin="00:26:39.05"/><clear/>and get his shot of Marburg
protection<br/>
drug and the next person would come along<br/>
<time begin="00:26:44.68"/><clear/>who maybe wasn't infected and
they<br/>
would get a shot in the same needle,<br/>
<time begin="00:26:49.06"/><clear/>thereby exchanging blood<br/>
and spreading the disease.<br/>
<time begin="00:26:52.16"/><clear/>This was another
communication<br/>
challenge that we had.<br/>
<time begin="00:26:55.44"/><clear/>I like this picture because I
think it<br/>
shows exactly how the population felt about us<br/>
<time begin="00:27:01.94"/><clear/>for the first three weeks we
were there.<br/>
<time begin="00:27:04.55"/><clear/>This little guy was being
taken to a hospital.<br/>
<time begin="00:27:09.37"/><clear/>He'd been in contact with
Marburg victim<br/>
and he was being taken for testing.<br/>
<time begin="00:27:15.95"/><clear/>He would be isolated in the
hospital<br/>
and the way he is looking at the<br/>
<time begin="00:27:22.52"/><clear/>WHO worker I think says
a<br/>
lot how they felt about us.<br/>
<time begin="00:27:27.03"/><clear/>This is a bad photograph
because this<br/>
healthcare worker should be better protected.<br/>
<time begin="00:27:35.91"/><clear/>He certainly should be
wearing mask.<br/>
<time begin="00:27:38.85"/><clear/>But I think what this says is
that in these<br/>
kinds of situations when a child is crying,<br/>
<time begin="00:27:45.39"/><clear/>when they've lost their
family, it is very,<br/>
very hard to maintain that equipment.<br/>
<time begin="00:27:52.43"/><clear/>This now is...you can see
this people<br/>
Page 20
Thompson.txt
dressed in personal protection equipment.<br/>
<time begin="00:27:57.84"/><clear/>This is now our major
concern, a virus H5N1.<br/>
<time begin="00:28:05.52"/><clear/>This is a highly
pathogenic<br/>
avian influenza virus.<br/>
<time begin="00:28:10.95"/><clear/>I spend my life talking
about<br/>
this now and I don't know<br/>
<time begin="00:28:14.32"/><clear/>if it is actually something
that you've<br/>
spent much time thinking about or hearing about<br/>
<time begin="00:28:20.14"/><clear/>but for the last three years
we've been<br/>
talking a lot about how this virus is a virus<br/>
<time begin="00:28:31.49"/><clear/>which can ignite the next
pandemic.<br/>
<time begin="00:28:34.51"/><clear/>This is a scene that, it's a
picture,<br/>
a classic picture that usually goes<br/>
<time begin="00:28:40.73"/><clear/>in every pandemic
presentation that I've<br/>
been to, anyways. It's a makeshift hospital<br/>
<time begin="00:28:49.92"/><clear/>from the 1918 Spanish flu
pandemic.<br/>
<time begin="00:28:54.46"/><clear/>1918 was actually the single
most deadly<br/>
infectious disease event in history.<br/>
<time begin="00:29:05.95"/><clear/>For that short of period of
time,<br/>
nothing, not the Black Death,<br/>
<time begin="00:29:10.05"/><clear/>nothing killed more people
than this pandemic.<br/>
<time begin="00:29:14.56"/><clear/>And so what we hear a lot now
is, you know<br/>
the pandemic's coming, the pandemic's coming,<br/>
<time begin="00:29:20.30"/><clear/>and then they show this
picture.<br/>
<time begin="00:29:22.62"/><clear/>This is a huge communication
challenge.<br/>
<time begin="00:29:25.88"/><clear/>It's a communication
challenge for us<br/>
<time begin="00:29:28.47"/><clear/>because we really don't know
what<br/>
the next pandemic would look like.<br/>
<time begin="00:29:33.78"/><clear/>We don't know how deadly it
Page 21
Thompson.txt
will be.<br/>
<time begin="00:29:36.82"/><clear/>We have lots of ideas, we
have a<br/>
couple of nightmares but we don't know<br/>
<time begin="00:29:43.59"/><clear/>when the next pandemic will
start.<br/>
<time begin="00:29:45.04"/><clear/>There certainly will be a
pandemic,<br/>
<time begin="00:29:46.61"/><clear/>there's no reason to
believe<br/>
that there won't be a pandemic.<br/>
<time begin="00:29:49.78"/><clear/>They've occurred,<br/>
<time begin="00:29:50.56"/><clear/>they've been documented since
the 1500s and<br/>
really there will be another pandemic.<br/>
<time begin="00:29:56.90"/><clear/>We don't know if it'll come
from the virus<br/>
that we're monitoring but this virus has two<br/>
<time begin="00:30:01.91"/><clear/>of the three characteristics
of pandemic virus.<br/>
<time begin="00:30:06.31"/><clear/>It jumps from animals to
people<br/>
and it causes severe disease.<br/>
<time begin="00:30:12.26"/><clear/>It causes severe disease
because this is a<br/>
virus entirely new to the human immune system.<br/>
<time begin="00:30:17.68"/><clear/>Should this virus acquire the
third<br/>
characteristic and that is easily moving<br/>
<time begin="00:30:23.45"/><clear/>from one human being to
another in the<br/>
same way that seasonal influenza moves,<br/>
<time begin="00:30:28.94"/><clear/>that would ignite a pandemic.
And what that<br/>
pandemic would look like, nobody can say.<br/>
<time begin="00:30:36.78"/><clear/>Many of you may have lived
through one<br/>
pandemic, the 1968 pandemic. And when you tell<br/>
<time begin="00:30:45.07"/><clear/>that to people at my age,
anyways,<br/>
they will certainly not remember<br/>
<time begin="00:30:49.99"/><clear/>that as a major public health
event.<br/>
<time begin="00:30:52.45"/><clear/>That's because fewer than
a<br/>
million people died in that pandemic<br/>
Page 22
Thompson.txt
<time begin="00:30:55.55"/><clear/>an excess number of deaths
worldwide that is.<br/>
<time begin="00:30:58.05"/><clear/>So it was a very, very mild
pandemic.<br/>
<time begin="00:31:01.54"/><clear/>So all pandemics are not
like<br/>
1918, but they're certainly not all<br/>
<time begin="00:31:06.33"/><clear/>like 1968, so how do we
communicate?<br/>
<time begin="00:31:10.64"/><clear/>How do we talk about what the
pandemic<br/>
that people should prepare for?<br/>
<time begin="00:31:15.68"/><clear/>That nationas should prepare
for?<br/>
<time begin="00:31:16.99"/><clear/>How do we tell them
about<br/>
what they should prepare for?<br/>
<time begin="00:31:22.73"/><clear/>And so, this is where I want
to jump back to<br/>
SARS because it was SARS actually that allowed<br/>
<time begin="00:31:33.49"/><clear/>WHO to develop the
foundation<br/>
for how it talks about outbreaks<br/>
<time begin="00:31:40.52"/><clear/>and other events, other
public<br/>
health emergencies.<br/>
<time begin="00:31:47.32"/><clear/>When I came to WHO there<br/>
was a lot I didn't know,<br/>
<time begin="00:31:51.06"/><clear/>but the most important thing
I didn't know<br/>
was there was no real communication structure.<br/>
<time begin="00:31:55.33"/><clear/>Not, only was there no
risk<br/>
communication structure and there was none,<br/>
<time begin="00:32:00.77"/><clear/>there was no communication
structure at all.<br/>
<time begin="00:32:04.67"/><clear/>
<time begin="00:32:06.13"/><clear/>The new Director General<br/>
had decided that divisions,<br/>
<time begin="00:32:11.21"/><clear/>departments could have their
own communication<br/>
personnel, although they didn't give them terms<br/>
<time begin="00:32:16.57"/><clear/>of reference so they would
know<br/>
what their job was. And people<br/>
<time begin="00:32:21.74"/><clear/>who were running these
departments thought<br/>
Page 23
Thompson.txt
that the best communicators were reporters.<br/>
<time begin="00:32:26.64"/><clear/>I don't think that's
true.<br/>
<time begin="00:32:28.27"/><clear/>I think reporters spend most
of<br/>
their careers being used by communicators<br/>
<time begin="00:32:34.46"/><clear/>and so those are the
people<br/>
they should have been hiring,<br/>
<time begin="00:32:36.99"/><clear/>what they went out on hired
people like me.<br/>
<time begin="00:32:39.62"/><clear/>And then SARS came
along.<br/>
<time begin="00:32:42.30"/><clear/>This is a sketch of an event
that<br/>
occurred in Hong Kong in February of 2003.<br/>
<time begin="00:32:52.93"/><clear/>A man staying in the
Metropole Hotel,<br/>
he was a physician from the province<br/>
<time begin="00:32:59.86"/><clear/>of Guangdong which is above
Hong Kong.<br/>
<time begin="00:33:04.16"/><clear/>He came to this hotel, he
stayed one night, he<br/>
stayed in Room 911 and all of the little figures<br/>
<time begin="00:33:14.52"/><clear/>that you see, the boxes are
rooms on that floor,<br/>
<time begin="00:33:17.13"/><clear/>but the figures you see are
the<br/>
people he infected in that one night.<br/>
<time begin="00:33:22.90"/><clear/>The next night he was in a
hospital.<br/>
<time begin="00:33:25.01"/><clear/>The night after that he was
on a<br/>
respirator and shortly he died.<br/>
<time begin="00:33:29.79"/><clear/>Nevertheless, these people,
very few of them<br/>
lived in Hong Kong, why would they be, they're staying<br/>
<time begin="00:33:36.00"/><clear/>in a hotel, and they began
traveling.<br/>
<time begin="00:33:39.25"/><clear/>They went to Hanoi, they went
to<br/>
Canada, they went to Singapore.<br/>
<time begin="00:33:46.06"/><clear/>They just started
spreading<br/>
the disease all around<br/>
<time begin="00:33:49.47"/><clear/>and it wasn't very long
Page 24
Thompson.txt
before we<br/>
had reports of a very large outbreak.<br/>
<time begin="00:33:58.01"/><clear/>We'd actually had
reports<br/>
coming in about this time.<br/>
<time begin="00:34:03.28"/><clear/>We didn't know.<br/>
<time begin="00:34:04.05"/><clear/>Certainly, it took us months
to piece<br/>
together this information, but about this time,<br/>
<time begin="00:34:08.90"/><clear/>we were getting reports into
that<br/>
nine o'clock meeting that I showed you<br/>
<time begin="00:34:12.91"/><clear/>of strange events,
strange<br/>
happenings in Guangdong,<br/>
<time begin="00:34:16.70"/><clear/>the province of Guangdong in
southern China.<br/>
<time begin="00:34:19.03"/><clear/>There was a big run on
vinegar.<br/>
<time begin="00:34:24.04"/><clear/>Vinegar is thought to be a
disinfectant<br/>
and it's something that the Chinese buy<br/>
<time begin="00:34:30.24"/><clear/>in great quantities when
they're<br/>
concerned about flu or whatever.<br/>
<time begin="00:34:35.29"/><clear/>So, there was a big run on
vinegar.<br/>
<time begin="00:34:36.58"/><clear/>We began getting e-mails and
SMSs.<br/>
<time begin="00:34:40.03"/><clear/>SMSs are a very important
communication<br/>
tool in Asia, especially in China,<br/>
<time begin="00:34:46.23"/><clear/>about strange infectious
disease events.<br/>
<time begin="00:34:49.89"/><clear/>There was one report which
turned out to<br/>
be true of a patient who was transferred<br/>
<time begin="00:34:58.75"/><clear/>from one provincial
hospital<br/>
to a large central hospital.<br/>
<time begin="00:35:04.19"/><clear/>The people who
transferred<br/>
him in that ambulance, the nurse,<br/>
<time begin="00:35:08.62"/><clear/>doctor and driver all
became<br/>
infected and they all died.<br/>
Page 25
Thompson.txt
<time begin="00:35:15.33"/><clear/>So, we'd been picking up
these reports, we<br/>
were asking the Ministry of Health of China<br/>
<time begin="00:35:19.20"/><clear/>about them, and we were
not<br/>
getting any information at all.<br/>
<time begin="00:35:23.70"/><clear/>And then this event
happened.<br/>
<time begin="00:35:25.23"/><clear/>We were completely unaware of
it until we<br/>
began getting reports first from Hanoi.<br/>
<time begin="00:35:34.40"/><clear/>One of the people who had
gone to the<br/>
Metropole Hotel, a New York businessman went<br/>
<time begin="00:35:42.88"/><clear/>on to Hanoi, became very
sick,<br/>
and was put in a hospital.<br/>
<time begin="00:35:50.80"/><clear/>He didn't respond to
antibiotics<br/>
and his condition declined.<br/>
<time begin="00:35:55.98"/><clear/>That's when this man in the
brown suit,<br/>
<time begin="00:35:59.73"/><clear/>Dr. Carlo Urbani who was
our<br/>
Infectious Disease person in Hanoi,<br/>
<time begin="00:36:07.51"/><clear/>was called to the hospital to
look at this guy.<br/>
<time begin="00:36:11.62"/><clear/>He was concerned, very
concerned<br/>
actually. He looked at the test results.<br/>
<time begin="00:36:18.45"/><clear/>He gathered samples from this
person<br/>
and had them sent again to the US CDC.<br/>
<time begin="00:36:24.42"/><clear/>Dr. Urbani was a very
interesting guy.<br/>
<time begin="00:36:29.70"/><clear/>He worked, like a lot of
people,<br/>
he had worked at MSF and<br/>
<time begin="00:36:37.90"/><clear/>he was head of the Italian
MSF.<br/>
<time begin="00:36:40.89"/><clear/>He was part of the small
group<br/>
who picked up the Nobel Prize<br/>
<time begin="00:36:48.67"/><clear/>that was awarded MSF I think
in 1999.<br/>
<time begin="00:36:54.84"/><clear/>Dr. Urbani became sick
Page 26
Thompson.txt
himself<br/>
and he would within a month<br/>
<time begin="00:37:03.39"/><clear/>of visiting the hospital he
was dead himself.<br/>
<time begin="00:37:13.05"/><clear/>So shortly after Dr. Urbani
was hospitalized, we<br/>
realized and the government of Vietnam realized<br/>
<time begin="00:37:22.84"/><clear/>that they needed assistance,
and so there<br/>
is a global network that we have at WHO.<br/>
<time begin="00:37:28.22"/><clear/>It sort of like a group of
volunteer<br/>
fire department people and they work<br/>
<time begin="00:37:36.30"/><clear/>at different institutions all
around the world<br/>
and we can say that we need an epidemiologist<br/>
<time begin="00:37:43.84"/><clear/>who speaks Portuguese for a
place like<br/>
Uige. We'll put out that alert<br/>
<time begin="00:37:48.79"/><clear/>and then will get that,
volunteers,<br/>
people who fill the requirement.<br/>
<time begin="00:37:55.25"/><clear/>This is the team that
assembled in Hanoi.<br/>
<time begin="00:37:58.81"/><clear/>This happened at a time when
there<br/>
was a lot of global bitterness<br/>
<time begin="00:38:08.45"/><clear/>about what was going to
happen in Iraq.<br/>
<time begin="00:38:11.69"/><clear/>There were arguments in the
UN in New York<br/>
and globally about what was going to happen<br/>
<time begin="00:38:18.59"/><clear/>but this is truly an
international team.<br/>
<time begin="00:38:21.55"/><clear/>We have people from France,
here, from Italy,<br/>
the woman I care for dearly Dr. Eileen Plant is<br/>
<time begin="00:38:30.32"/><clear/>in red and she was the team
leader.<br/>
<time begin="00:38:34.11"/><clear/>All of these people received
and responded<br/>
to a notice that said, "We have an outbreak<br/>
<time begin="00:38:40.87"/><clear/>of an unknown disease and it
is so infectious<br/>
that it's claimed our infectious disease expert,<br/>
<time begin="00:38:49.03"/><clear/>and do you mind giving up
Page 27
Thompson.txt
everything your doing<br/>
and going off and responding to this outbreak?"<br/>
<time begin="00:38:54.83"/><clear/>And we had number of people
who replied. And<br/>
it was a good thing that we have a large number<br/>
<time begin="00:39:00.45"/><clear/>of people who replied because
these<br/>
people all needed to be changed out,<br/>
<time begin="00:39:03.92"/><clear/>the outbreak went on for such
a long time.<br/>
<time begin="00:39:07.62"/><clear/>
<time begin="00:39:09.93"/><clear/>This is another spreading
event.<br/>
<time begin="00:39:12.35"/><clear/>And this is an image that
actually, I'm not a<br/>
comfortable flyer and so this is something else<br/>
<time begin="00:39:20.85"/><clear/>that adds to the things I
think<br/>
about when I'm on an airplane.<br/>
<time begin="00:39:26.49"/><clear/>Anyways, I don't know if you
can make<br/>
it out but the man in red is the person<br/>
<time begin="00:39:30.92"/><clear/>who is infected when he got
on this plane.<br/>
<time begin="00:39:33.62"/><clear/>All the other colors are
people who were<br/>
infected when they disembarked from the plane.<br/>
<time begin="00:39:40.54"/><clear/>So, this was a spreading
event<br/>
that occurred on an airline.<br/>
<time begin="00:39:46.05"/><clear/>This too, actually there is
another story<br/>
about this and that is that one of the people<br/>
<time begin="00:39:52.46"/><clear/>on this airplane was a
Chinese official.<br/>
<time begin="00:39:57.18"/><clear/>He became somewhat sick, but
he<br/>
goes on to a meeting in Bangkok.<br/>
<time begin="00:40:04.41"/><clear/>This is a flight from Hong
Kong to Beijing.<br/>
<time begin="00:40:07.61"/><clear/>This person goes on to
Bangkok shortly<br/>
after this flight and on the flight back,<br/>
<time begin="00:40:12.43"/><clear/>he seats next to an
(ILO)<br/>
International Labor Organization official<br/>
Page 28
Thompson.txt
<time begin="00:40:18.20"/><clear/>and he infects him and that
person dies.<br/>
<time begin="00:40:21.69"/><clear/>So, this is what we think
about when we<br/>
think about disease spreading events.<br/>
<time begin="00:40:27.05"/><clear/>When we think about how H5N1
would spread<br/>
we think about situations like this,<br/>
<time begin="00:40:39.03"/><clear/>the Hotel Metropole and this
Air China flight.<br/>
<time begin="00:40:43.79"/><clear/>Actually, SARS was not that
easily spread.<br/>
<time begin="00:40:49.30"/><clear/>It was what we call short
distance droplet,<br/>
so, about three feet or so, two, three feet.<br/>
<time begin="00:40:55.88"/><clear/>If you are in coughing range
you<br/>
might become infected and that's why a lot<br/>
<time begin="00:41:01.06"/><clear/>of hospital healthcare
workers<br/>
became infected because they worked<br/>
<time begin="00:41:05.36"/><clear/>around patients often without
protection.<br/>
<time begin="00:41:10.60"/><clear/>Pandemic influenza will
spread<br/>
in an entirely different way.<br/>
<time begin="00:41:15.82"/><clear/>It'll be much easier to
spread.<br/>
<time begin="00:41:18.41"/><clear/>Many people in this room
would<br/>
become infected if I were infected.<br/>
<time begin="00:41:22.13"/><clear/>It isn't just three feet
away.<br/>
<time begin="00:41:24.11"/><clear/>It is a much greater
distance.<br/>
<time begin="00:41:26.94"/><clear/>There is an argument
there.<br/>
<time begin="00:41:28.33"/><clear/>It's unclear what that
distance<br/>
is and what the spread is like<br/>
<time begin="00:41:32.58"/><clear/>but it's certainly spread
much easier.<br/>
<time begin="00:41:35.38"/><clear/>So, when we think about how a
pandemic<br/>
virus would spread, we have an indication<br/>
Page 29
Thompson.txt
<time begin="00:41:42.62"/><clear/>of how it might spread from
these spreading<br/>
events but it would be much more severe.<br/>
<time begin="00:41:48.42"/><clear/>So, the life as a
communicator<br/>
during an outbreak is well,<br/>
<time begin="00:41:56.25"/><clear/>especially a global health
event.<br/>
<time begin="00:42:00.69"/><clear/>In journalism they say if you
go to work in<br/>
public relations like I did, I left journalism<br/>
<time begin="00:42:06.65"/><clear/>and I became a flack
[assumed] for the<br/>
World Health Organization,<br/>
<time begin="00:42:10.40"/><clear/>they call that crossing the
street.<br/>
<time begin="00:42:12.55"/><clear/>At least they used to
call<br/>
it crossing the street.<br/>
<time begin="00:42:14.37"/><clear/>You work on the other side of
the street.<br/>
<time begin="00:42:16.51"/><clear/>I don't think that's right,
you<br/>
work on the other side of the wall,<br/>
<time begin="00:42:19.77"/><clear/>because it's very hard to see
what's going on.<br/>
<time begin="00:42:25.29"/><clear/>I realize now that a lot of
what I did<br/>
<time begin="00:42:27.59"/><clear/>as a reporter was a
gross<br/>
approximation to what was going on.<br/>
<time begin="00:42:32.46"/><clear/>If I worked very, very, very
hard on something<br/>
as I did with the Clinton Healthcare Plan,<br/>
<time begin="00:42:38.47"/><clear/>I worked three months inside
the White<br/>
House while they were developing that plan.<br/>
<time begin="00:42:43.55"/><clear/>It's still an
approximation.<br/>
<time begin="00:42:46.11"/><clear/>But what you don't know is on
the other side<br/>
<time begin="00:42:48.05"/><clear/>of that wall that's also
an<br/>
approximation of what's going on.<br/>
<time begin="00:42:51.90"/><clear/>They don't know, they've got
Page 30
Thompson.txt
an idea, they<br/>
may have, they certainly have a better idea<br/>
<time begin="00:42:57.68"/><clear/>than any reporter would have
but there are<br/>
lots of things they don't know, nevertheless,<br/>
<time begin="00:43:05.08"/><clear/>we began getting hundreds of
calls,<br/>
hundreds and literally thousands of e-mails.<br/>
<time begin="00:43:13.98"/><clear/>So, I was pretty much alone
and we went out<br/>
and I made a case for hiring another person.<br/>
<time begin="00:43:20.97"/><clear/>So, we doubled our
communications<br/>
staff and very quickly learned<br/>
<time begin="00:43:26.54"/><clear/>that there's no way we can
respond to this.<br/>
<time begin="00:43:29.80"/><clear/>I was taking calls at three
a.m. from reporters<br/>
in Hong Kong and they would go right on through<br/>
<time begin="00:43:37.56"/><clear/>into midnight or later from
reporters<br/>
in Toronto or on the East Coast.<br/>
<time begin="00:43:44.19"/><clear/>It just kept going on and on
and on and<br/>
initially, I thought it's important to respond<br/>
<time begin="00:43:51.72"/><clear/>to as many people as
possible, big mistake,<br/>
but I thought that what we should do is just be<br/>
<time begin="00:44:00.74"/><clear/>out there and answer
every<br/>
question so we can answer questions.<br/>
<time begin="00:44:04.17"/><clear/>The problem is that you just
physically<br/>
can't do that so we have to develop a couple<br/>
<time begin="00:44:08.40"/><clear/>of ways of responding to
questions.<br/>
<time begin="00:44:11.44"/><clear/>We developed a web update in
which we<br/>
<time begin="00:44:16.62"/><clear/>from the day before we
thought we were<br/>
hearing the same questions over and over,<br/>
<time begin="00:44:20.68"/><clear/>so we would do a web update
the<br/>
following day answering those questions<br/>
<time begin="00:44:24.57"/><clear/>and that went out
everyday.<br/>
<time begin="00:44:27.18"/><clear/>We also developed something
Page 31
Thompson.txt
we<br/>
called a virtual press conference<br/>
<time begin="00:44:30.19"/><clear/>which is something else we've
stole from<br/>
CDC and that is because Geneva is actually<br/>
<time begin="00:44:36.10"/><clear/>in a little remote corner of
Europe, it isn't<br/>
a big news hub. We set up a way for reporters<br/>
<time begin="00:44:45.04"/><clear/>to call in and we had a video
feed going<br/>
out and radio quality sound and we would sit<br/>
<time begin="00:44:51.00"/><clear/>down for an hour or 45
minutes usually, the<br/>
best expert that we could find on our team<br/>
<time begin="00:44:58.61"/><clear/>who had some time to talk and
that<br/>
usually no one really had any time<br/>
<time begin="00:45:03.86"/><clear/>because we were all working
very long hours,<br/>
we were working everyday, seven days a week.<br/>
<time begin="00:45:11.97"/><clear/>We had this emotional
blow<br/>
over losing Carlo Urbani.<br/>
<time begin="00:45:17.29"/><clear/>We didn't really know, is
this just the<br/>
beginning>? It seems to be limited to hospitals<br/>
<time begin="00:45:23.57"/><clear/>but then there was an
apartment<br/>
building in Hong Kong, Amoy Gardens,<br/>
<time begin="00:45:27.84"/><clear/>where a number of people were
became<br/>
infected as the virus changed.<br/>
<time begin="00:45:30.62"/><clear/>So, there were lots of
things<br/>
that kept us on edge.<br/>
<time begin="00:45:35.65"/><clear/>It was a very, very tense
time but<br/>
one of the interesting things is<br/>
<time begin="00:45:39.74"/><clear/>that there were no big
shouting<br/>
matches inside, internally.<br/>
<time begin="00:45:45.07"/><clear/>There was a lot of
pressure,<br/>
there were certainly a lot<br/>
<time begin="00:45:49.08"/><clear/>of emotion, but it didn't
spill out.<br/>
<time begin="00:45:51.21"/><clear/>Actually, it did when it was
Page 32
Thompson.txt
over and it was<br/>
kind of unpleasant for a while but during<br/>
<time begin="00:45:57.27"/><clear/>that time, people just kept
working.<br/>
<time begin="00:46:01.51"/><clear/>Our lead influenza person,
Dr. Klaus<br/>
Stohr, his mother became very sick.<br/>
<time begin="00:46:10.05"/><clear/>She was taken to the
hospital.<br/>
<time begin="00:46:11.63"/><clear/>She lingered in the
hospital<br/>
and she eventually died.<br/>
<time begin="00:46:15.93"/><clear/>He never attended the
funeral.<br/>
<time begin="00:46:18.00"/><clear/>He didn't go to the
hospital.<br/>
<time begin="00:46:19.87"/><clear/>I think that's the most
extreme example<br/>
of personal pressure but there was a lot<br/>
<time begin="00:46:25.94"/><clear/>of personal pressure on this
very small team.<br/>
<time begin="00:46:29.76"/><clear/>I heard that CDC at that time
had something like<br/>
33 communication people working, is that right?<br/>
<time begin="00:46:36.09"/><clear/>Something like that?<br/>
<time begin="00:46:38.44"/><clear/>We had 42 people in our
entire<br/>
group, we counted everybody.<br/>
<time begin="00:46:44.23"/><clear/>We had 42 people so it was
a<br/>
lot of work for a lot of people.<br/>
<time begin="00:46:52.13"/><clear/>We learned a few things,
[laughter] I like this<br/>
because it's TIME, it has no real meaning in here.<br/>
<time begin="00:46:57.74"/><clear/>One of the things we wanted
to<br/>
know was how honest should we be?<br/>
<time begin="00:47:02.83"/><clear/>I felt that we were doing
great work.<br/>
<time begin="00:47:07.56"/><clear/>We were small team working
hard and I thought<br/>
all we had to do was throw the door open,<br/>
<time begin="00:47:13.25"/><clear/>allow people to come in,
say<br/>
what we thought at the time,<br/>
<time begin="00:47:17.84"/><clear/>just to be a good
Page 33
Thompson.txt
source,<br/>
this is what I thought.<br/>
<time begin="00:47:19.98"/><clear/>And one spokesperson at WHO
said this,<br/>
this appeared in the Associated Press,<br/>
<time begin="00:47:25.43"/><clear/>it ran worldwide, said
"people are not<br/>
responding to antibiotics and antivirals,<br/>
<time begin="00:47:31.10"/><clear/>it's a highly contagious
disease and it's<br/>
moving by jet, until we can get a grip on it,<br/>
<time begin="00:47:36.42"/><clear/>I don't see how it will slow
down.<br/>
<time begin="00:47:38.76"/><clear/>It's bad." I think that now
is not a<br/>
very good quote and why isn't it good?<br/>
<time begin="00:47:52.78"/><clear/>I think it is accurate,
it's<br/>
how I felt, that's me.<br/>
<time begin="00:47:58.44"/><clear/>It's how I felt.<br/>
<time begin="00:48:00.79"/><clear/>It's how many of us
felt.<br/>
<time begin="00:48:03.31"/><clear/>We were very, very anxious
about this.<br/>
<time begin="00:48:06.20"/><clear/>I think what's wrong with
this quote is<br/>
the line I don't see how it will slow down<br/>
<time begin="00:48:11.62"/><clear/>and I would not say that
again because<br/>
I do know how things slow down now.<br/>
<time begin="00:48:18.61"/><clear/>This is just a lack of
experience.<br/>
<time begin="00:48:21.78"/><clear/>The other outbreaks I showed
you,<br/>
the plague outbreak in a diamond mine<br/>
<time begin="00:48:28.78"/><clear/>and the Marburg in Uige, they
all used the<br/>
same basic techniques of contact tracing,<br/>
<time begin="00:48:37.54"/><clear/>isolating people, pretty<br/>
rudimentary stuff, but it works.<br/>
<time begin="00:48:44.70"/><clear/>And it worked for SARS and it
worked<br/>
for those other diseases as well.<br/>
<time begin="00:48:48.32"/><clear/>How am I doing?<br/>
<time begin="00:48:49.40"/><clear/>Not too well.<br/>
<time begin="00:48:50.09"/><clear/>Okay, so after SARS, we
developed,<br/>
Page 34
Thompson.txt
<time begin="00:48:54.29"/><clear/>we decided that we better
have a more solid<br/>
intellectual foundation for what we were going<br/>
<time begin="00:48:58.87"/><clear/>to say with our communication
and<br/>
we developed something I'm very,<br/>
<time begin="00:49:03.70"/><clear/>very proud of, although
I<br/>
played a minor role in it,<br/>
<time begin="00:49:06.34"/><clear/>and that was to develop
outbreak<br/>
communication best practices.<br/>
<time begin="00:49:10.38"/><clear/>We spent a year going through
the literature<br/>
<time begin="00:49:13.01"/><clear/>and we found what we
thought<br/>
were five important features<br/>
<time begin="00:49:17.73"/><clear/>that influence communication
during an outbreak.<br/>
<time begin="00:49:21.96"/><clear/>We took those five features
to a meeting of<br/>
85 outbreaks managers that we brought together<br/>
<time begin="00:49:28.16"/><clear/>in Singapore and we asked
them to look<br/>
at these features and get their feedback.<br/>
<time begin="00:49:34.05"/><clear/>They endorsed these features
and now<br/>
these are what we're telling countries,<br/>
<time begin="00:49:39.32"/><clear/>this is the guidance that
we're giving countries<br/>
about how to communicate during outbreaks.<br/>
<time begin="00:49:44.09"/><clear/>And it is interesting, the
number one feature,<br/>
<time begin="00:49:47.40"/><clear/>"the over-arching
communication goal during an<br/>
outbreak is to communicate with the public<br/>
<time begin="00:49:52.04"/><clear/>in ways that build, maintain
or restore trust."<br/>
<time begin="00:49:56.24"/><clear/>I thought the outbreak
managers<br/>
themselves would not agree with that.<br/>
<time begin="00:50:00.02"/><clear/>I thought the most important
thing they thought<br/>
was that we got to control the outbreak.<br/>
<time begin="00:50:06.08"/><clear/>But as you saw in Uige, you
have to be able<br/>
Page 35
Thompson.txt
to listen to people, to build their trust,<br/>
<time begin="00:50:10.69"/><clear/>to relate to them in a way
that<br/>
they'll actually do what you say<br/>
<time begin="00:50:15.15"/><clear/>so they endorsed this trust
feature.<br/>
<time begin="00:50:17.51"/><clear/>This first announcement is
something<br/>
that troubles a lot of countries.<br/>
<time begin="00:50:21.83"/><clear/>We encourage them to go
out<br/>
as rapidly as possible.<br/>
<time begin="00:50:24.36"/><clear/>It is very difficult to do
because<br/>
the information at the beginning<br/>
<time begin="00:50:27.90"/><clear/>of an outbreak is uncertain,
it's incomplete.<br/>
<time begin="00:50:30.34"/><clear/>They're very likely to be
wrong.<br/>
<time begin="00:50:31.88"/><clear/>New York, when it announced
West Nile virus<br/>
said that this was St. Louis encephalitis.<br/>
<time begin="00:50:39.54"/><clear/>And they were wrong about it
but they were<br/>
right about how it was transmitted and so going<br/>
<time begin="00:50:46.19"/><clear/>out early allowed people to
take<br/>
measures that protected them.<br/>
<time begin="00:50:50.50"/><clear/>Even though they were
wrong<br/>
they did the right thing.<br/>
<time begin="00:50:53.46"/><clear/>We encourage transparency
that<br/>
communication should be "easily understood,<br/>
<time begin="00:50:58.74"/><clear/>complete and free of
deceit."<br/>
<time begin="00:51:00.05"/><clear/>That's an important phrase
and very<br/>
difficult for some countries to do.<br/>
<time begin="00:51:05.03"/><clear/>We now call listening,
communication<br/>
surveillance because it sounds technical<br/>
<time begin="00:51:09.29"/><clear/>and all of this has to be
planned in advance.<br/>
<time begin="00:51:14.22"/><clear/>Essentially, and what I don't
tell people is<br/>
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that this is all adds up to tell the truth<br/>
<time begin="00:51:18.65"/><clear/>as fast as you can and
then<br/>
listen to what people say.<br/>
<time begin="00:51:21.92"/><clear/>This is my boss now, Margaret
Chan.<br/>
<time begin="00:51:24.58"/><clear/>Margaret was Head of the Hong
Kong Department<br/>
of Health during the first H5N1 outbreak in 1997.<br/>
<time begin="00:51:32.15"/><clear/>And she and I have talked a
long time<br/>
about how we communicate about the pandemic,<br/>
<time begin="00:51:38.56"/><clear/>and the best thing we can
say<br/>
really is that, we don't know.<br/>
<time begin="00:51:42.52"/><clear/>We've gone three years<br/>
now without a pandemic<br/>
<time begin="00:51:46.18"/><clear/>that we've been warning
about,<br/>
is this Y2K of public health?<br/>
<time begin="00:51:50.07"/><clear/>The answer is we don't
know.<br/>
<time begin="00:51:53.66"/><clear/>When is the next pandemic
going to start?<br/>
<time begin="00:51:55.24"/><clear/>How bad is it going to
be?<br/>
<time begin="00:51:56.43"/><clear/>We don't know.<br/>
<time begin="00:51:57.22"/><clear/>It's the most honest answer
we can give.<br/>
<time begin="00:51:59.00"/><clear/>It is unsatisfactory, but
that's where we are.<br/>
<time begin="00:52:03.85"/><clear/>This slide is supposed to
tell<br/>
you that we've been teaching countries<br/>
<time begin="00:52:09.57"/><clear/>to follow these best
practices<br/>
and actually Egypt is one<br/>
<time begin="00:52:14.40"/><clear/>of the best countries to
employ this.<br/>
<time begin="00:52:16.72"/><clear/>Egypt has a very, very bad
problem with H5N1 now.<br/>
<time begin="00:52:21.20"/><clear/>It actually had a
cluster<br/>
cases of a Tamiflu resistant<br/>
<time begin="00:52:27.33"/><clear/>and that's the only drug
really<br/>
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that works against the H5N1.<br/>
<time begin="00:52:31.20"/><clear/>People actually developed a
resistance to<br/>
this drug and it was very difficult position<br/>
<time begin="00:52:36.07"/><clear/>for Egypt to talk about
because Egypt<br/>
is especially dependent on tourism.<br/>
<time begin="00:52:41.66"/><clear/>So, to talk about having the
next pandemic<br/>
in your country and that it's now resistant<br/>
<time begin="00:52:48.42"/><clear/>to Tamiflu is very difficult
for them<br/>
to do and nevertheless they've done it.<br/>
<time begin="00:52:52.13"/><clear/>I put this up because I
think<br/>
it's the best example<br/>
<time begin="00:52:55.69"/><clear/>of country using
outbreak<br/>
communication techniques right now,<br/>
<time begin="00:52:58.36"/><clear/>but the same time I've
worked<br/>
with a government in Africa<br/>
<time begin="00:53:02.16"/><clear/>that had a hemorrhagic fever
outbreak, was in<br/>
a meeting with the Ministry of Public Health<br/>
<time begin="00:53:09.41"/><clear/>in which they had planned in
detail how to<br/>
get rid of the bodies using the military<br/>
<time begin="00:53:15.32"/><clear/>to move bodies and bury
them<br/>
in the middle of the night<br/>
<time begin="00:53:18.16"/><clear/>so that people wouldn't be
afraid and panic.<br/>
<time begin="00:53:21.97"/><clear/>So, we're making some
advances<br/>
but you move ahead and you slip back.<br/>
<time begin="00:53:25.57"/><clear/>As I was preparing for this,
I read through<br/>
again, Carlo Urbani, The Viet Nam Journal,<br/>
<time begin="00:53:33.02"/><clear/>and in it he writes that "the
joys of<br/>
life: to savour what each horizon brings,<br/>
<time begin="00:53:43.49"/><clear/>to offer this to your
children, to get excited<br/>
with new discoveries, to rejoice in sharing.<br/>
<time begin="00:53:48.82"/><clear/>This fills my heart with
energy and<br/>
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allows for the work that one does<br/>
<time begin="00:53:52.44"/><clear/>to improve some small corner
of<br/>
the world. This is productive.<br/>
<time begin="00:53:57.41"/><clear/>More than worrying about how
much I will<br/>
earn, I will worry about how well I work<br/>
<time begin="00:54:01.93"/><clear/>in the movement towards
poverty<br/>
alleviation and the access to health care<br/>
<time begin="00:54:08.11"/><clear/>for the forgotten." And
that's Carlo.<br/>
<time begin="00:54:11.65"/><clear/>Thank you very much.<br/>
<time begin="00:54:19.82"/><clear/>[ Applause ]<br/>
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