In the busy corridor of the hospital emergency department, nurse Dong Wei stands out among her colleagues walking briskly past her. Her pace is slow her gait cautious. Her sky blue uniform looks too big for her thin frail frame. Dong works here from 8 to 11 AM.

Dong contracted SARS (severe acute respiratory syndrome) in April 2003. At the time, she was working in the hospital's emergency rooms. After she recovered from SARS, she noticed an increasing pain on the inside of her right leg, but she did not see the need for alarm at the time as she thought it was demineralization. Unfortunately, a subsequent health check showed that she had developed bone or avascular necrosis.

Dong's hopes for a normal life after SARS were dashed.

"I could have avoided all this if I had died from SARS. Now I am destined to be a cripple for the rest of my life," Dong lamented. Her condition prohibits her from doing many things, simple things like window-shopping with friends and sports.?

Life dealt Dong another blow when her boyfriend of seven years abandoned her on the advice of his parents who believed Dong and her condition would prove to be too much of a burden.

Life is very mundane for Dong. She works three hours at the hospital, but is not given very major responsibilities. Despite this, she is exhausted by the time she gets home and has to be in bed by nine every evening.

In another month, Dong will resume working a full eight-hour day and she is thinking of transferring to another position. "Every nurse in the emergency except me is a fast walker. I can at best walk steadily," she explained.

Dong just hopes that the hospital will continue to employ her. It would certainly help her to cover the cost of medical treatment. She has changed the major she planned to take from nursing to medical information management. "I will be satisfied working in the hospital library," she said.

"I hope society doesn't forget us"

Liu Mei, also a nurse, said that after she recovered from SARS, the thought of avascular necrosis never crossed her mind.

Three months after she recovered, she started to suffer from frequent aches in both her legs. She was later diagnosed as having developed avascular necrosis in both sides of her body.

"There was no organized collective treatment (for the medical staff who contracted the disease) at that time so I had to manage all necessary health checks and treatments myself. I really felt abandoned," Liu recalled.

It was only later that organized treatment and group specialist consultation was arranged for medical workers who had contracted SARS in the line of duty. But Liu felt that little progress was being made with the treatments.

In March 2005, she had a bone graft. Three months later, she was delighted to learn that she no longer needed crutches. But just three months after that, she was told that her surgery was in fact a failure.

The ups and downs of the last two years have made Liu very wary of her future. She is currently unable to work.

"There is so much that a SARS survivor has to bear, things that are inconceivable to the common person. To me, the four steps of stairs at the entrance of the hospital is a real problem if I go back there to work," Liu said softly.

Liu is most worried about her health and medical treatments, and could not help it when she said to the China Youth Daily reporter: "Can you send out an appeal for us?"

She put her head down and whispered: "I don't' know what to do. I hope society doesn't forget us."

Staying positive

Liu Yuan, who is in his forties, said he has "no time" for tears and despair. "I have my family and my daughter to look after."

On December 10, Liu cut short his first course of treatment. Ten days of treatment left him with a bill of about 7000 yuan (US$870). A normal course of treatment required by the hospital is three months. "I will have to negotiate with my company for the reimbursement of such a big sum of money."

Liu began to feel pain in the inside of his left leg in September 2005, more than two years after recovering from SARS. He was then diagnosed as having developed avascular necrosis in both sides. He understands that merely ten days of treatment is insignificant, but he was afraid of being left behind in his work. He plans to return for treatment after the Spring Festival. However, treatment might mean his losing his position as production manager at the company. Yet, Liu tries to keep a positive outlook on things: "What's the use of worrying? Just take it easy."

Huang Yufen, 50, has been in and out of hospital for the last two years. Dr Cai, Huang's attending physician, said: "Huang was a prominent figure in her unit before the SARS epidemic. She was on the road to promotion. But she contracted SARS and her health deteriorated."

After two years' treatment, Huang's health has improved remarkably and is almost as good as it was before SARS. But she knows that mental and emotional health might be harder to regain. "After all, it is hard to retrieve all the beads of a broken necklace," she explained.

The scars of SARS

In November 2003, China Daily reported that high doses of corticosteroids were widely used by doctors in the first half of that year in China to save the lives of many SARS patients. Months after the patients recovered from SARS, some of them developed avascular necrosis, especially in the hips.

It is estimated that of the medical staff of the main hospitals in Beijing who had recovered from SARS, about 33 to 50 percent of them suffer from avascular necrosis.

Dr Julie Hall, leader of the World Health Organization (WHO) SARS Response Team in China, told China Daily on November 25, 2003 that avascular necrosis was a known side effect of high doses of corticosteroids. However, doctors had no alternative at that time if they were going to save people's lives, Dr Hall added.

In addition, the SARS virus itself is a possible cause of avascular necrosis, according to Han Demin, deputy director of the Beijing Health Bureau.

On the Chinese mainland, a total of 5,327 people contracted SARS, 4,959 of whom have recovered.

In Beijing, 2,521 cases were reported, with a total of 193 deaths.

(Survivors' names have been changed.)

(China.org.cn December 20, 2005)