© Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
DOCTOR FOR SOCIETY
Breaking down frontiers through medical humanitarianism: an interview with Prof Emily Chan
Caitlin HN Yeung1; Natalie KW Cheuk2
1 Year 2 MBBS, The University of Hong Kong
2 Year 3 MBBS, The University of Hong Kong
In this issue of Doctor for Society, we interviewed Prof Emily Chan, a doctor with international public health experience whose career has been fuelled by a passionate humanitarian spirit that has allowed her to utilise hands-on skills, knowledge, and opportunities—all culminating in numerous accolades and numerous lives transformed.
Prof Emily Ying-yang Chan is the current and founding director of the Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC) under the Jockey Club School of Public Health and Primary Care at The Chinese University of Hong Kong (CUHK). She was the former president of Médecins Sans Frontières–Hong Kong (MSF-HK), assuming the position in 2001 after 3 initial years of service at MSF-HK. After graduating with an MBBS from The University of Hong Kong (HKU) in 2003, she worked as a public health doctor at the Hong Kong Department of Health, and soon after joined the CUHK Faculty of Medicine with a focus on global health.
Journey into humanitarian medicine and beyond
In retrospect, Prof Chan’s career path has been straightforward, as her passion for humanitarian work is the apparent link that unifies most of her projects. In reality, it would be more accurate to characterise her professional career as a self-discovery process, combined with a dedication to medicine and to having an impact on the lives of other people, especially those who are disadvantaged.
Prof Chan was born and educated in Hong Kong; she went to the United States to continue her high-school education. She actually took her first step towards medicine when she graduated with a BSc in Biomedical Engineering at Johns Hopkins University. She jokingly explained that her undergraduate degree, intended as preparation for entry into an MD programme, was the obvious choice for an Asian living in the United States with scientific interests. She fared well in her course, which had a strong focus on laboratory research. But she knew it was not her calling. “My mentor advised me that my personality is a better fit for working with people, outside the laboratory,” said Prof Chan—so off she went: during the summer break of her junior year, she spent 2 to 3 months in Zimbabwe with a multidisciplinary team of nutrition and public health experts. It was a key experience.
“I was enchanted by humanitarian work,” said Prof Chan, reflecting on her Zimbabwe trip. It kindled a lifelong passion for public health. After finishing her undergraduate degree at Johns Hopkins University, she attended Harvard University to study for a Master of Science in Population and International Health. Shortly after she returned to HKU to start an MBBS for family reasons, she also began working with MSF-HK.
Many people were curious about Prof Chan’s long career with MSF-HK, especially about her participation before qualifying as a medical doctor. “I was able to join MSF-HK early on, even without a medical degree, because of my public health skills,” explained Prof Chan. The combination of skills and needs enabled her to continue to pursue her interest in humanitarian medicine. She joined MSF-HK in 1998, initially as part of its flood-relief missions in Guangxi Province, and subsequently was pivotal in helping MSF put down deeper roots in Hong Kong.
A global career makes a childhood dream come true
Prof Chan enjoys both teaching and learning, and has an inquisitive and explorative mind. On the recommendation of a mentor, she began her academic career as a scholar in global health at CUHK in 2006. She continued juggling her humanitarian work with her work at CUHK, which focused on global health in times of climate change. At the beginning of her academic career, she collaborated with a team based in Oxford University to investigate the area of public health in the Asia-Pacific region.
“My childhood dream was to be an explorer,” quipped Prof Chan. Although it was not planned that way, her global career proved to be a good fit for someone who loves to travel. Her multidisciplinary expeience influenced her approach to her humanitarian work, and the advances she led in humanitarian medicine locally and globally also saw her breaking down frontiers with MSF. Subsequently, she was able to fulfil her childhood dream by winning the National Geographic Chinese Explorer Award in 2016, for her role in bridging and breaking frontiers among academia, frontlines, and professional practice in the fields of science, medicine, humanities, and education.
A rewarding career on many levels
Prof Chan was also an awardee of the Ten Outstanding Young Persons of the Year of the World and Hong Kong Outstanding Young Persons and Leader of the Year in 2015. Her long career in academic and field medicine for global health and disaster and humanitarian response established her as a leading advocate and scholar in the area, with a formidable wealth of experiences and accomplishments. However, the most memorable moments in her career were the many times when she was deeply humbled by her team members, especially when realising her limits in the face of new challenges.
“I wanted but never expected my humanitarian work to flourish,” Prof Chan said. When she first returned to Hong Kong, Disaster and Medical Humanitarian Response was a relatively undeveloped field of medicine in Hong Kong. Over the years, her hard work and contributions to the field has allowed her to rally many meaningful team members and inspire the next generation of doctors to participate in humanitarian aid and disaster relief. She has also been actively transferring her knowledge to institutional and government partners to broaden their participation in disaster and humanitarian work and to provide opportunities to the Hong Kong Academy of Medicine’s specialists to train in the field. Since 2 years ago, she has even been able to reach beyond China to establish field training in the Democratic People’s Republic of Korea, Myanmar, and Nepal.
Making an impact through humanitarian medicine in rural China
Making a lasting impact on humanitarian trips to remote locations is a difficult feat, yet Prof Chan has been able to achieve this. This year marks the CCOUC’s 160th humanitarian field trip that Prof Chan’s team has returned to Ma’anqiao Village of Sichuan Province, their first site in rural China. When the team first visited the village, they faced many difficulties—once the car suddenly broke down and the team had to carry their belongings and walk for 11 km. Despite returning to the field sites every year, new challenges arise each time, which have sharpened Prof Chan’s problem-solving skills. Over the years, she has adapted field sites into teaching classrooms for students who want to train in disaster and humanitarian response, so much so that the villagers have even supported the students in training. Prof Chan’s commitment and determination to build long-term relationships with service sites have truly allowed her to realise her dream of making a lasting impact in underprivileged areas.
In her capacity as the director of the CCOUC, she has been able to extend her impact in humanitarian work by sharing the joy and rewards of field work. It has also given her the opportunity to take on new challenges in the field as a teacher. Once, she led a group of students to a field site in rural China. Despite warnings about the local food, a few students got food poisoning and were taken to a nearby hospital. In this moment of crisis, as the team leader and teacher, Prof Chan deployed team members to various positions and closely followed up the laboratory tests and treatment of her students. It was a new challenge, even with her years of experience as a disaster-response doctor in the field.
Likewise, it has been a challenging experience for her students. A PhD student, “usually quite proud of himself,” commented Prof Chan, was asked to keep an eye on the bags of the sick students. After 3 hours, she was shocked to find the student in tears. He confessed that he was unable to do anything for the other students and felt useless in the field. It proved to be a transformative experience for the student. “It shows how going into the field is always a deeply humbling experience,” added Prof Chan.
The field, which Prof Chan sees as her own “teacher”, is an environment impossible to simulate. That is one of the reasons behind her regular teaching-cum-service trips with CUHK students with the CCOUC. Her role as a teacher has given her new perspectives regarding the field, as she has realised that relief work, however challenging, is not the only type of frontier that one can encounter. Prof Chan has not only been crossing geographical borders throughout her career, but she has also been breaking down walls between different professions. Personally, she is a wearer of many hats, combining her skills as a medical doctor, scholar, teacher, and humanitarian worker. Furthermore, through her humanitarian fieldwork, Prof Chan has gained a profound appreciation for multidisciplinary collaboration among both medical and non-medical members of her team.
Humility as a doctor through service in unlikely corners of the world
Many people may believe that they need to travel to warzones or disaster areas to provide humanitarian aid. Yet, the worst humanitarian crises may not be very far from people’s affluent metropolitan lives, where the haves and have-nots live side-by-side. Back in the days when the cocktail therapy for HIV/AIDS was still not available and palliative care was the only intervention offered to AIDS patients, Prof Chan embarked on one of her first service trips to Bangkok to observe an outreach team for AIDS patients. The team brought her to the slum area at the outskirts of the bustling city centre, where cramped huts were built on stilts above the sewage-filled canals. As she stood at the banks of the slums, the field nurse gave her a plastic bag. She initially thought that it was to protect her shoes, but instead the nurse asked her to tie it around her head as the team began to wade into the murky water beneath the stilt houses. The stench was nauseating and rats scurried around her in the turbid waters. Then, in the darkness beneath the huts, she caught a glimpse of a human shadow. Curled up on a stack of sodden cardboard was a half-naked, rail-thin man with cockroaches and fleas swarming around him—this was the patient they were meant to visit.
The patient had been abandoned by his family after contracting HIV by having unprotected sex with HIV-positive men, and he was unable to seek help at care facilities owing to the high medical costs. The field nurse brought him food, listened to what he had to say and cleaned his ulcers and wounds on his body, while singing with her soothing voice like an angel.
“Doctors play a very important role in humanitarian medical missions, yet the best doctoring and humanitarian spirit is not always best exemplified by doctors,” said Prof Chan. It was the nurse who truly exemplified what it means to support human dignity with a humanitarian spirit, and that was when Prof Chan learnt how to cherish the contributions by other professionals.
Doctors for humanitarian medicine
Prof Chan believes that “humanitarian work experience is useful not only for young, aspiring students but also experienced doctors.” Being a good doctor in the field has important differences from everyday clinical work. Doctors with experience can share their life stories in the field with trainees so as to transfer knowledge to them, but experienced doctors also benefit from field work, as the landscape is fast evolving. Humanitarian work may not be enjoyable for everyone, but the cost of participating in a humanitarian response team is more than outweighed by the development gained in one’s personal life.
Although she has been able to handle the rather tiring moment-to-moment problem-solving required for fieldwork, travelling has become exhausting with age. Prof Chan describes the present as a period of transition, as she gradually moves away from the frontline in the field towards a greater focus on her academic work. However, this shift does not mean that she will stop engaging herself with the humanitarian work that has enchanted her from the start. “Reading and learning from books alone is not sufficient for teaching in my field,” remarked Prof Chan. She demands herself to be able to foresee developments and see through trends related to her teaching and research interests in order to provide timely preparation for her students’ career after graduation. As a result, she plans to remain an active participant in humanitarian work and disaster response to keep tabs on ongoing trends in these areas.
All photographs, except the last one, were kindly provided by CCOUC and were reproduced with permission. (© CCOUC. All rights reserved.)
Prof Chan conducted basic health examinations for Tibetan women in Qinghai in November 2013 (© CCOUC)
Prof Chan conducted post-earthquake assessment in Nepal, June 2015, where she met Topalo, the village representative and a teacher who endeavours to educate children on the knowledge and awareness of disaster preparedness (© CCOUC)
Prof Chan (back row, fifth from right) led a group of students from the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, to a field site in Datan Village, Zhangjia County, Tianshui City, Gansu Province, China, during a snowstorm in January 2011. The visit aimed to educate and promote public health and disaster preparedness (© CCOUC)
Emergency kits were distributed to villagers when Prof Chan’s team visited Hongyan Village of Sichuan Province in March 2014 (© CCOUC)