© Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
DOCTOR FOR SOCIETY
The vanguard of integrative medicine: Dr Vivian Wong Taam’s visionary work in evolving Hong Kong’s healthcare paradigms
Zareen Chiba, KS Eu, Edward Tam
Year 3, Faculty of Medicine, The University of Hong Kong
The work of visionaries is often sown into society generations before the profound results are appreciated. This is often the case when these contributions are ahead of their time. Dr Vivian Wong Taam, at first glance, is a motherly figure with a piercing visage, who does not openly proclaim the multitude of contributions she has amassed that range from Chief Executive of the Hospital Authority (HA), Public Health Specialist of The World Bank, Chairman of the Safe Motherhood Initiative of International Federation of Obstetricians & Gynecologists, and current Chairman of Friends of the Earth (HK).
A Fellow of three Colleges (FRCOG, FFH, FRCP), her claim to fame was discovering the perinatal transmission of hepatitis B, paving the way for prevention of liver cancer in the next generation. Another lesser-known fact is that Dr Wong was instrumental to the founding of the local Prenatal Diagnosis Service at Tsan Yuk Hospital (TYH) and pioneering thalassaemia research. Nonetheless, her métier has been to impeach the dichotomy of traditional versus western medicine, and in its stead vitalise the role of integrative medicine using policy and practice.
The Eureka moment
It was in the vestiges of the Cultural Revolution when Dr Wong, as a resident at TYH, was inspired by the philosophies of traditional Chinese medicine (TCM) practitioners (in particular acupuncture) and began her academic contributions to integrative medicine. Conducting the first randomised controlled trial for comparison of intravenous oxytocin with electrical acupuncture stimulation, she demonstrated that both were equally effective in the induction of labour. Nonetheless, “the climate was not right for Chinese Medicine. The paper could not be published—we were too much ahead of time.” This heralded a Eureka moment, calling to question whether scientific documentation and trials of the practice of TCM could be standardised. Dr Wong, in her capacity as Chief Executive of Queen Mary Hospital 20 years later (and subsequently the HA’s Director of Professional Services and Advisor in Integrative Medicine) would go on to establish the Research Ethics Committees across all clusters in HA, covering both dichotomies of medicine. By using the ‘evidence-based medicine’ approach for the two, TCM clinical trials were ensured to be subject to the same standards of ethics and care as western medicine, heightening the public perception of TCM and integrative medicine through the years. For this she has inaugurated an endowed professorship in integrative medicine to her name.
“A Collaborative Approach”
Touting the philosophy of 醫、教、研 (to heal, teach, and research), Dr Wong played a crucial role in building a tripartite model of modernisation and collaboration for Chinese medicine. With the establishment of one Chinese Medicine Centre for Training and Research (CMCTR) in each of the 18 local districts, graduates of three local universities are provided with a formal clinical training in Hong Kong, with scholarships for ancillary training in China. In her tenure as President of the Hong Kong Association for Integration of Chinese-Western Medicine (香港中西醫結合醫學會), Chinese medical practitioners themselves benefitted under the organised structured instruction of the bases of primary care western medicine. Withal, to combat the great concern of drug-herb interaction, the HA has, under her strong guidance, established a drug-herb interaction database available on the electronic Knowledge Gateway, inadvertently sparing morbidity, mortality and raising the standard of personalised care. Her uncomplicated motivation for the above work was that “If we do not integrate TCM with our practice, the patients will integrate it themselves.”
Ethnopharmacological endeavours 地道藥材
Her work on Rural Health Manpower Development and Maternal & Child Health under WHO, UNICEF and World Bank projects, culminated in the improvement of rural healthcare, ethnopharmacy, women’s rights and women’s education in China. She described with fervour her work 25 years ago for the 30 poorest counties in China, refining systems that were in place and founding them when there were none. She laboured to upgrade rudimentary healthcare facilities and developed geopolitically relevant training material, with a pan-climatic emergency call and transport method. Dr Wong vividly depicted the challenges in replacing the ‘barefoot doctor’ by empowering village girls with only 9 years of education, to become birth attendants and village doctors. These contributions would trickle down to future generations of rural populations in the quest for modernised healthcare and equal opportunity.
On this tangent, she cites the term ‘ethnopharmacology’ and its application in the context of rural healthcare: a notion that encompasses culture, ecology, and anthropological pharmacy. This exemplified the fluidity that characterises TCM, which has become a firm representation of holistic care and cultural integration. Those without the means have to adapt to whatever resources available locally, fortifying the relevance of ‘local herbal pharmacology’, personalised medical care and interprofessional work in today’s healthcare paradigm.
Aside from her substantial career, Dr Wong has never lacked energy, evident to this day in her enduring involvement in advocacy work. Dr Wong also crosses boundaries of different media and target audience in health education. Her current ventures include a tri-weekly column in Hong Kong Economic Journal and a weekly RTHK talk show 精靈一點: 中醫循證醫學, flexing the public’s mind beyond their preconceived notions of healthcare to embrace everyday applications of Chinese medicine. Not constrained by the boundaries of her profession, she is also an enthusiast of environmental work, and is currently the elected Chairperson of Friends of the Earth (HK), a locally based charitable organisation active in environmental campaigns and education, all while maintaining a brimming schedule for family time, and to be an athlete and an aesthete of the performing arts.
She imparts to us a final lesson, one that she has consistently demonstrated during her life. “Start dreaming and you’ll see things differently. Be open-minded and allow yourself to dream. Things that you don’t know may still exist; you just haven’t found it yet”.
For the first HKMJ issue of 2015, we have been taken on an odyssey of four decades of medical inspiration, and arrive in a century interconnected and globalised like no other. Dr Vivian Wong’s conviction that “the medicine of the twenty-first century is integrative medicine” may well be predictive of the pivotal shifts in UN developmental frameworks and healthcare goals to come. Only time will tell if her visions will be embraced wholeheartedly in the timbre of medical practice and the public voice.
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