Letter to Editor

Abstract

Dear Dr Farhud

Editor in Chief

It is a well-known fact that in our daily life we can learn from everything including the good com­munica­tion practices among health professionals.                                                               

Delayed communication is a challenge for effective health management in many parts of the world in par­ticular the developing countries.                                                                              

Sometimes we learn lessons from a simple exchange of emails between a national public health officer and a WHO program manager. As an example, few weeks ago I sent the following email message to Dr Keiji Fukuda the Special Adviser on Pandemic Influenza to the Director General, World Health Organiza­tion as follows:

Dear Dr Fukuda   

First of all I should  congratulate you for your excellent work including valuable information being con­veyed to the Member States through the WHO Site concerning  the most recent developments in the area of the new Influenza A (H1N1) so called Pandemic (H1N1) 2009. However, sometimes there is contra­dictory information placed on some of the popular sites of the world which is misleading .As an exam­ple, I would like to refer to the Yahoo News which refers to the interview of the Director General in Paris. I am sure the text published by the (AFP) is at least to some extent manipulated. Also the text of the Article is somehow different with the title. This is in contrast with the excellent document placed on the WHO site under the Global Alert and Response (GAR) entitled "preparing for the second wave: les­sons from current outbreaks of Pandemic (H1N1)2009, briefing note 9. Whereas I have no doubt about the fast and extensive spread of the pandemic. I personally disagree with the exaggerations being made by the media/press concerning the intensity and the dangers of the pandemic which creates a lot of tension among the populations and results in a great deal of unnecessary expenses due to over doings by the Member States. I believe, while we should closely and seriously continue to monitor the spread, trend and intensity of the pandemic and its impact on the health system, at the same time we should miti­gate its harmful effects on the populations and be prepared for unusual /unexpected changes of the vi­rus. In my view, we should not overestimate the magnitude of the problem as it may result in overspend­ing of the limited resources which are badly needed for other priority problems of the coun­tries. Furthermore, we may lose the trust and confidence of the decision makers and the communities, should we commit mistakes in our judgments or make unjustified recommendations. Although I have a lot more to say and share with you, I stop here and look forward to receiving your comments and guid­ance on the subject. Last but not least, may be because of the same reasons, as a member of the National Technical Committee on Influenza. Most of the times I have different views on the issues. That is why sometimes, I think either I am "Dumb" or others are "Deaf" or both.                 

With best wishes                             

Bijan

Surprisingly, I received the following response from Dr Fukuda the same day in two hours:

Dear Dr Sadrizadeh

Thank you for your note. I think we are now entering into the most difficult period so far in terms of commu­nications. There is so much second guessing going on. Plus there is the usual reporting in which the reporters did not get it right. For example, after the Le monde article I believe the DG was quoted in some places as saying "unbelievable" rate when she said that the speed of spread is unprecedented, and that this H1N1 virus spread further in 6 weeks than in 6 months with previous pandemics. We are also see­ing stories which are simply a manipulation.

Some of the issues, however, are also extremely difficult to explain. The spread has been very fast. Most people develop self limited illness. However, there is still much concern because those who die are more likely to die from an unusually rapid and severe respiratory failure, thought to be initiated by pri­mary viral pneumonia, rather than the causes usually seen with seasonal flu and those dying are also much younger. Finally, many countries have been able to function during the pandemic. However, some countries and their health systems have undergone extreme stress. Finally, we need to know what is going on now but must be prepared for the future- which could be a less severe disease, the same thing, or a more severe disease.                                                                                                                              

Putting this all together in a way the regular person can understand has not been easy, so typically, a re­porter stresses one or another aspect and we often see imbalanced stories.         

anyway I believe the answer is not to try and correct all of these stories one by one-an endless task-but to further develop our communications and information strategy so that WHO is more consistently put­ting out accurate information on a regular basis. We will step up.                                                                                                                                              

It is very good to hear from you and best regards.

Keiji

The interesting point in the above exchange of emails is the fact that somebody in WHO has the respon­sibil­ity of dealing with the fourth global influenza pandemic, so called "Pandemic (H1N1) 2009" finds him­self under obligation to respond to somebody else who may not be even known to him, in a transparent, fast and  comprehensive manner.

I firmly believe that the same type of communication should exist between the health professionals and man­agers everywhere, both within the countries and between the countries and the WHO, if we are go­ing to tackle the health problems of the world today successfully.

Yours sincerely

Bijan Sadrizadeh

President of Iranian Public Health Association