THE WOMAN DELIVERING the software sales pitch is in full flight. The audience is hanging on her every word when suddenly, she stops. The silence is only broken by the nervous shuffling of those watching and waiting. She has forgotten the rest of her spiel. Shortness of breath, loss of memory and frequent fainting are now part of the life of Ching, a name chosen to keep her anonymity. One of the survivors of severe acute respiratory syndrome, or Sars, she is in constant pain. 'I feel so frustrated,' the 33-year-old says. 'I could carry out lots of management roles before, but now I can't even handle basic tasks and always forget things. I feel so useless.' It has been more than two years since Sars swept through Hong Kong, killing 351 people and causing one of the city's biggest crises in recent years. To compensate for loss of income, Ching received $30,000 a month from the $150 million Sars Fund set up by the government in November 2003 to help survivors and the families of those who died. But with a $500,000 limit for each recipient, Ching's payments ended last month. Many others who receive set amounts based on previous income and extent of their illness and who rely on the fund for their living and medical expenses, are now in a similar position. 'They started reducing my payments in January, with the last payment last month. That was it,' says Ching, who contracted the virus on a flight to Beijing with her boss, who died from the disease. Two years ago last month, Ching was released from Queen Elizabeth Hospital, happy to be alive, but unaware that her life would never be the same again. Before she could return to work, she was fired from her job as a marketing director for a computer software company without explanation or compensation. Out of work and getting weaker, Ching survived on her savings. From earning up to $60,000 a month, she now makes as little as $5,000 working part time for another software company. 'I'm so worried,' she says. 'How can I support myself and my parents who are retired and have no income? My parents also worry about how I will support myself for the rest of my life.' Hundreds of Sars victims still suffer side effects from the high doses of steroids used to treat the disease. The effects can range from memory loss, joint pain and osteoporosis, to the bone degeneration condition known as avascular necrosis, or AVN, caused when the flow of blood to the bones is disrupted. Many also suffer lung damage from scarring left by the virus. There are concerns that the government's rigid conditions for qualifying for fund payments - based on medical and financial considerations - deny many others in need of help. 'The Hospital Authority has rejected [some applicants], but many are still weak, have heart problems, respiratory and joint pain,' says Ms Chan, who contracted Sars as a resident of Amoy Gardens, the scene of a major outbreak that infected 329 residents and killed 42. 'We feel that because Sars happened so long ago, people have forgotten it, giving the government a chance to prevent us from drawing from the fund.' Sars, a coronavirus, first emerged in southern China in November 2002 and was brought to Hong Kong by a mainland doctor before spreading to 29 other countries around the world. By the end of the outbreak in June 2003, 1,755 people had been infected in Hong Kong, and 351 had died. Of the 1,404 survivors - 832 females and 572 males - most were given high doses of steroids as part of their medical treatment. The use of steroids has come in for criticism from both patients and doctors due to the severe side effects. Canada, which only used low dosages, and Taiwan, which used none at all, had no recorded cases of such complaints. 'Steroid treatment is a well-recognised major risk factor for nontraumatic osteonecrosis [AVN],' said James Griffith, a professor at the department of diagnostic radiology and organ imaging at the Chinese University of Hong Kong, in a recently published report on the relationship between AVN and steroids. According to experts, the chance of recovery from such an ailment is slim. 'Unlike many other side effects (such as immunosuppression, myopathy, and reduced bone density), osteonecrosis, once established, does not regress after discontinuation of steroid therapy,' Griffith said in the report. According to Hospital Authority records, 158 survivors - 11 per cent - have contracted AVN. However, a Peking University report published last year says AVN can be contracted up to 10 years after the use of steroids. And then there is the damage from the virus itself. David Hui Shu-cheong, head of respiratory medicine at Chinese University, who is studying a group of Sars patients with lung dysfunctions, says 16 out of 110 victims suffered a reduction in lung functions to 80 per cent or less six months after being discharged. 'Those whose lungs have been left with a lot of scar tissue can't recover,' he says, adding that even less severe cases haven't shown signs of improvement. One of dozens of doctors at the Prince of Wales Hospital who treated Sars victims, Hui says the decision to use steroids was taken by individual hospitals following a class held by mainland professor Zhong Nanshan, head of the Guangzhou Institute of Respiratory Disease, on March 15, 2003. 'Professor Zhong said steroids could kill the virus, but didn't mention when to introduce the drug,' Hui says. There appears to have been some confusion about at what stage of the illness the steroids should have been administered, resulting in heavy bouts of dosages. 'It was a mess at the time. It was not possible to do tests ... with hundreds of people in hospital, some dying,' Hui says. 'How could we not give them the drugs?' Social worker Tim Pang Hung-cheong, of the Patients Rights Association for the Society for Community Organisation, says many victims will never recover or work again. 'How can [the government] set a limit [on the fund] when they don't know the outcome?' he says. 'What is their future when the money is gone?' The Health, Welfare and Food Bureau - under which the Hospital Authority, which decided policies in the fight against Sars, operates - says the Sars Fund 'is not a compensation fund'. 'The ceiling of $500,000 may be able to help most of the patients for a few years as tide-over assistance,' a bureau spokesman says, adding that people who require long-term support should apply for social security assistance. Former taxi driver Ah Man, released from hospital two years ago this month, says he constantly worries about the half-yearly assessments for eligibility and reaching the payout ceiling, on top of his associated disabilities. Married with a teenage son, he is one of 80 people in Hong Kong who were wrongly diagnosed as having Sars and treated with steroids. He was admitted to Queen Elizabeth Hospital with a fever in April 2003. Now suffering from AVN, he lives with constant pain in both hips and needs a walking stick to get around. 'I often just sit at home all day,' the 42-year-old says. He tried going back to his old driving job, but quit when he found he couldn't concentrate for more than 10 minutes and often forgot his clients' destination. The establishment of the Sars Fund didn't initially help Ah Man, because he wasn't deemed to be a Sars patient. It was only after complaints from others in a similar situation and help from legislator James To Kun-sun's that he and others started to receive money from the fund. He now receives $10,500 a month. He worries about when the fund payments will eventually stop, and of being screened out for eligibility. 'No doctors have said that I will recover,' he says. 'If they stop the payments, I don't know how I'll live.' When first released from hospital, ward assistant and cleaner Ms Fong was grateful doctors had saved her, but today suffers from depression. 'I wouldn't need to suffer the daily pain if I had died,' says the 48-year-old, in a quiet corner on Tuen Mun pier. 'I feel like I've fallen into a bottomless hole and cannot climb back up.' With aching bones and only 40 per cent of her lungs functioning, Fong is reduced to spending her days inhaling oxygen through a nose tube. 'I feel pain with each breath,' she says. 'It is so painful that sometimes I want to end my life.' Fong contracted Sars while working with victims in a public hospital without knowledge of the illness or adequate protection. She is one of 340 government health care workers who contracted the virus. On sick leave, she is paid her $6,000 monthly salary from the Hospital Authority, and relies on the Sars Fund to hire a domestic helper to care for her. She worries about being screened out of the fund and that the authority will one day stop her salary. Fong and two nurses from the same ward are considering legal action against the Hospital Authority, hoping to get damages for losses they say were incurred due to a lack of training and protection. Solicitor Lau Kar-wah, who is helping them, along with Ching, Ah Man and 20 to 30 medical workers, knows it's an uphill battle. Many applications for legal aid have been rejected because of difficulties in establishing a viable case. Lau, one of several lawyers helping the victims, says the Hospital Authority and the Department of Health is reluctant to give them information, making a case for negligence hard to prove. 'As long as there was a reasonable amount of medical opinion that believed it was acceptable to use steroids to treat them, it will be difficult to say there was negligence.' While Ah Man considers it unrealistic to ask the government to support victims for the rest of their lives, he is at a loss as to an alternative. 'If we don't ask this, we can't survive,' he says.