Dr Michael Kai-tsun To is a paediatric orthopaedic surgeon and well-known expert in osteogenesis imperfecta (OI). He received training in orthopaedics at Queen Mary Hospital, where he now offers his expertise; he also serves as a clinical associate professor at The University of Hong Kong (HKU). Since the establishment of the HKU-Shenzhen Hospital in 2012, Dr To has travelled between Queen Mary Hospital and Shenzhen to provide cross-border care for children with bone diseases. Dr To’s dedication to children with rare bone diseases was recognised in 2018 when he received the Hong Kong Humanity Award.

One of Dr To’s most important projects has been the establishment of a rare bone disease centre in Shenzhen, where he provides medical expertise to families from multiple provinces in China. Although it is now a full-fledged specialist service centre, it originated from rather humble beginnings.

Osteogenesis imperfecta is a rare, heritable brittle bone disease with a prevalence of 1 in 10 000. Patients with this disease may exhibit deformities and can easily develop fractures. Although treatment is available, it is prohibitively expensive; because OI is rare, specialists with relevant expertise are often difficult to find. Although relatively few patients with OI attend the Duchess of Kent Children’s Hospital (DKCH) in Hong Kong, one such patient contributed to the establishment of the OI service now thriving in Shenzhen.

Around 2012, while working at the HKU-Shenzhen Hospital, Dr To provided follow-up care for an adult patient with OI. Many years prior, when Dr To was still a medical student, the doctors at DKCH had performed complex surgical treatment of OI in this patient. The patient had presented to DKCH with difficulty walking; after surgery, he regained the ability to walk and subsequently moved to Guangzhou. The grateful patient asked if the new hospital could help other patients with OI as he had been helped in childhood. Through this patient and various WeChat patient groups, numerous families caring for children with OI found their way to the HKU-Shenzhen Hospital.

The rare bone disease centre expanded organically in response to the overwhelming demand. Since then, the centre has gained sufficient recognition that it has been the site of more than 1000 surgical treatments for children with rare bone diseases. When asked how he came to devote much of his career to caring for these children, Dr To jokingly quoted a Hong Kong action movie “Shock Wave”, in which an explosive ordnance disposal specialist (portrayed by Andy Lau) explained that he did not enter into the profession by choice—it was a matter of fate.

Today, the centre is well-known throughout Mainland China for its expert management of OI. The journey from its beginnings in the early 2010s to its present success has been filled with challenges. In particular, substantial time and effort were needed to establish patient trust in a treatment that was relatively unknown. Initially, there were rumours in patient WeChat groups that Dr To was a 'liar' for claiming that surgery can potentially restore mobility in patients with OI. However, the increasing number of patient success stories gradually outweighed the distrust and doubts.

As the service expanded and demand grew, Dr To travelled from Pokfulam to Shenzhen each day before 7 am, returning across the border at 6 pm. Cross-border travel became more difficult during the early portion of the coronavirus disease 2019 pandemic because of lengthy quarantine mandates. To address this situation, Dr To sacrificed time with his family and coordinated with colleagues to ensure that clinical services in Hong Kong continued smoothly in his absence.

Through the OI centre in Shenzhen, Dr To gained knowledge of the unique challenges encountered by patients with OI in Mainland China. Many patients travelled great distances and incurred substantial financial burdens to reach the HKU-Shenzhen Hospital. In one memorable case, a mother with OI (and height of <1 m) and her son with OI travelled for 40 hours to reach the OI centre. Recognising the great need for medical care outside of major cities, Dr To led service trips across the country, including visits to Yunnan, Sichuan and Tibet, to provide medical care and train local medical professionals. Local residents often eagerly waited for the medical team’s arrival, and they offered unexpected tokens of gratitude to the doctors. Dr To recalled that one patient brought a freshly slaughtered chicken to his clinic! He also recalled the story of a 17-year-old boy with OI in Sichuan, who complained of tongue pain refractory to high doses of analgesics. He had not received a proper diagnosis, despite multiple specialist consultations. Upon arrival, Dr To’s team promptly made the diagnosis of basilar invagination as a complication of OI, then obtained funding to help finance the boy’s treatment. After regaining full use of his tongue, the boy greeted everyone by proudly sticking his tongue out.

In addition to providing unforgettable anecdotes, the sincere gratitude from patients during these service trips encouraged Dr To and his team to continue their cross-border efforts. In 2020, Dr To and his team received a special research grant from the Chinese government to support their OI clinical service and research—it was a well-deserved moment of recognition for sustained effort over the past decade.

The OI service in Shenzhen has also delivered unexpected gains in Hong Kong. Because of the high patient volume in Shenzhen, the HKU team has become internationally renowned, leading to multiple research and training opportunities. At the time of writing, Dr To and his team are preparing to host the 2025 OI conference in Hong Kong—the first OI conference outside of Europe and North America. This great honour is expected to inspire further developments in OI research and treatment in Hong Kong.

Professor George Woo, the ‘father of optometry’ in Hong Kong, began his career by establishing the first optometry programme in Hong Kong, and his tale is a valuable lesson in commitment, perseverance, and resourcefulness. In 1973, Prof Woo approached The Hong Kong Polytechnic University (PolyU) with the idea of setting up the first optometry school in Hong Kong. After many years, it has evolved from a certification course in 1978 into a five-year degree programme, granting students the degree of Bachelor of Science in Optometry.

One can attribute this evolution to Prof Woo’s continued commitment to healthcare in Hong Kong. His years of working with and nurturing the next generation of clinicians are a compelling reminder that healthcare professionals are leaders, servants, and pillars of their communities.

Prof Woo is humble about his contributions to the Faculty of Health and Social Sciences at PolyU; he recalls his happiness at seeing the first cohort from the Professional Diploma in Optometry graduate in 1987, witnessing the fruit of the faculty. He humourously recalls how he swore he would retire after helping the faculty transition to a fleet of Bachelor of Science programmes in different disciplines; he laughs when he admits he did not retire.

Prof Woo has been advocating for improvements in the Hong Kong healthcare system for the past 30 years, focusing on the limited availability and scope of primary care. While he acknowledges the government’s strides in improving the availability of primary care within District Health Centres, their narrow scope led to severe underutilisation. He firmly believes in expanding the District Health Centre’s purview to allow for the provision of a more comprehensive range of primary care services, such as traditional Chinese medicine practitioners, full-time pharmacists, optometrists, dentists, occupational therapists, and physiotherapists. On-site holistic healthcare can relieve the burden on primary care doctors, improving the distribution of resources and manpower. Better usage of all dimensions of primary care can also enhance the professional-patient relationship; rather than shuttling a patient between various doctors and referrals, a single professional with the relevant expertise, and who could track patient progress, would significantly improve the primary healthcare experience.

Prof Woo laments that little change has been achieved over the years due to rigid rules and regulations, and despite him actively passing 17 items for legislation while serving on the Supplementary Medical Professions Council for 10 years. He raised continuing medical education as an example, where the lack of training for primary care physicians overshadows Hong Kong’s robust training for specialists. Other countries have been pursuing continuing education for 60 to 70 years but Hong Kong’s efforts have fallen behind. A gleam of hope appeared in 2021, when compulsory continuing education was required for optometrists. However, due to the complexity of the healthcare system, change in Hong Kong is hampered by political and professional interests, as well as the divide between the public and private sectors. With the current trajectory, Prof Woo mournfully states that he doubts meaningful change will come in his lifetime.

In addition to being a leader in his field, Prof Woo continues to be an avid hotline volunteer for the Samaritans, which he has done for over 20 years. The Samaritans is a non-profit organisation offering a 24-hour multilingual hotline service run by volunteers who provide emotional support to people who are in distress or suicidal. Prof Woo realised the importance of personal, human-to-human interactions for one’s wellbeing early on; he recalls how, as a student, he would volunteer to provide health services at an elderly care home. At the time, he noted that the older adults were less concerned about their health complaints, but instead treasured the chats and personal time spent with them. It was then that he realised a caring, empathetic touch was just as important to wellbeing as the scientific aspect of healthcare. He was first inspired to join the Samaritans when he understood that helping patients was beyond just medicine and surgery. As he began to identify the link between mental health and visual problems, he knew it was his duty as a practitioner to help patients to heal physically and mentally. Over the years, Prof Woo felt a sense of gratitude towards the hotline as it helped him gain a deeper understanding of the complex issues regarding mental health in the city. With over 2000 hours of volunteer work under his belt, it broadened his horizons and helped him empathise with and understand his patients better. In 2015, Prof Woo became the chairman of the Samaritans Board of Directors, where he expanded their services beyond hotline help and lent support by introducing many outreach programmes, such as the Supporting the Aged Responsibly Programme, or STAR, aimed at improving the mental health of the elderly population.

To this day, Prof Woo continues to don his headset and answer phone calls for the hotline with the hopes that providing a listening ear can help people rise above difficult moments in their lives. In 2020, Prof Woo was awarded the Hong Kong Humanity Award, bestowed upon those who exemplify the very spirit of humanity in service and commitment to their community by putting it into action and practice. ‘I will walk with them as long as they want to walk further to improve their quality of life,’ affirms Prof Woo, as he continues his mission of curing wounds invisible to the eye. He hopes that as he continues to serve in the future, more academics and medical professionals will step out of their comfort zones and volunteer to help.

Those who decide to bear the Hippocratic Oath will find no shortage of mentors, especially Prof Woo, who will shape them and provide them with the skills, knowledge, and insight needed to one day enter the field and serve the community.

Prof Woo continues to come to PolyU to mentor students and perform research. Regarding his students as blank sheets of paper, he believes it is his duty both to shape the way that they see the world and to teach them about the healthcare system that they will one day work in and, hopefully, transform for the better. His establishment of the field of optometry is only the first step in what he sees as a mission to improve Hong Kong’s healthcare systems and prepare those who serve within it.

Recently, there has been extensive news coverage of the ongoing coronavirus disease 2019 (COVID-19) pandemic and current geopolitical conflicts in Eastern Europe. Although they often seem far from Hong Kong, human conflicts and infectious diseases have always been major causes of suffering around the world. Dr Shannon Melissa Chan, an upper gastrointestinal surgeon and assistant professor from the Chinese University of Hong Kong, exemplifies what doctors can do to provide help and a glimmer of hope to those experiencing such humanitarian crises.

Since completing her general surgery fellowship in the Prince of Wales Hospital, Dr Chan has been closely working with Doctors Without Borders (Médecins Sans Frontières; MSF) to provide surgical care globally. When asked about the reasons behind her joining MSF missions, Dr Chan expressed that it has always been a pursuit for her to serve the less fortunate, and she felt that she could do more on top of her usual duty of surgery, endoscopies, and clinics. It was also to remind herself to reconnect with her passion to help patients and save more lives.

The application process into surgical missions was not an easy one. Even as a young Fellow trained in general surgery, Dr Chan initially did not fulfil the technical requirements, as MSF expects a very broad surgical exposure including orthopaedic procedures, obstetric and gynaecological operations, simple neurosurgical procedures, such as Burr hole, and even nephrectomy. Dr Chan was not deterred, and arranged a 1-month rotation to the obstetrics and gynaecology department where she put in great effort to gain as much knowledge and acquire as much operative experience as possible. “I was learning from trainees who taught me Caesarean sections.” Dr Chan recalls. She even went to help neurosurgeons and orthopaedic surgeons on her call nights, assisting with emergency surgeries. With the necessary experience completed, and annual leave saved up, she was ready for her first mission.

Dr Chan’s first 3-month MSF mission was to South Sudan in 2016. In addition to the usual surgical conditions seen in Hong Kong, she was exposed to a variety of new scenarios not previously seen, ranging from arrow injury to schistosomiasis. Creative thinking was also often required because of the limited available resources; she had to use kitchen pots as surgical step stools during operations, and created a make-shift ileostomy bag using a coffee jar lid. During the 3-month mission, Dr Chan was able to help many patients with her surgical skills. Even the local witch doctor, who was initially sceptical and discouraged patients from seeking help from Western medicine, grew to respect her work and the effective interventions. “The patients were also very grateful,” Dr Chan explains, “and I would know that because the next day I would find them self-discharged from the hospital, leaving a chicken in their stead as a token of appreciation.”

In late 2019, Dr Chan went on her second MSF mission, this time to Mocha in Yemen. Mocha is situated only 2 hours from an active war zone, and Dr Chan experienced the ugly and destructive power war up close. Every night, she could hear explosives and gunshots, and injured civilians would be transferred to her centre to be stabilised and treated. She had to perform amputations for many patients with non-salvageable limb injuries due to landmines, and damage control operations for those with multiple gunshots wounds. Dr Chan also recounted how some patients succumb and others who get caught up repeatedly in the armed conflict. While as doctors we can heal individuals of their medical conditions, we are unable to heal the larger circumstances. However, Dr Chan does not believe that the clinical efforts under these situations are futile. Instead, the fact that there are doctors available at all is already an act that preserves human dignity. These efforts represent a message of hope to the community. After all, to the war-torn region, the beacon of hope is vital.

For her brave service with MSF, Dr Chan was awarded the Hong Kong Humanity Award in 2021. When congratulated, she merely said “It was volunteering work to help people, and I never expected there would be awards.” In a way, the best reward has been the hope that she was able to sow in those who she aided.

The deep care Dr Chan has for those in need is not only limited to the overseas missions, but also extends to those closer to home. Just the weekend before our interview with her, she was busy coordinating and participating in the first part of a community COVID-19 vaccination programme in Kowloon. The programme is targeted mainly at kindergarten and primary school students, improving the accessibility of COVID-19 vaccinations and protecting this vulnerable group from the pandemic. For 2 days, Dr Chan and doctors from multiple specialties provided 1300 jabs to children. In addition, as part of the programme, there will be collaborations with local non-government organisations to arrange vaccination and clinical outreach services to the population of elderly living alone.

Even in her career as a surgeon-researcher, Dr Chan displays her inclination towards helping those less fortunate. With her interest in pseudomyxoma peritonei, a rare entity that is undertreated, she has been performing cytoreductive operations on affected patients. Although these complex surgeries take up extremely long hours, Dr Chan performs them gladly to give her patients a fighting chance.

Dr Chan’s many endeavours demonstrate the variety of ways how doctors can contribute to the community. Perhaps not everyone can meet the stringent recruitment criteria of MSF, but as long as we have the will to help, it is without a doubt that everyone can find a way to bring hope to those who need it.

Professor Ivan Fan-ngai Hung is currently in the public eye with his role in leading Hong Kong’s response to the ongoing coronavirus 2019 (COVID-19) pandemic. As a co-convener of the Expert Committee on Clinical Events Assessment Following COVID-19 Immunisation under the Department of Health of the Hong Kong SAR Government, he is one of the public faces of the vaccination campaign. He is a Clinical Professor and Assistant Dean (Admissions) at the Li Ka Shing Faculty of Medicine of The University of Hong Kong, as well as the Chief of the university’s Infectious Diseases Division since 2018, specialising in infectious diseases as well as gastroenterology and hepatology. Prof Hung is also a Founding Member on the Board of the World Association for Infectious Diseases and Immunological Disorders.

Prof Hung did not envisage himself in such a position two decades ago. Since graduation from Bristol Medical School in 1996, Prof Hung had ambitions of becoming a gastroenterological surgeon. However, after returning to Hong Kong in 1999 and starting work at Queen Mary Hospital, he found that fate had other plans. By chance, he was offered the opportunity to join a new infectious diseases training position under the mentorship of Professor Kwok-yung Yuen, a keenly dedicated and hardworking doctor who still serves as a major influence and role model for Prof Hung. He accepted the offer just in time to be swept up in the severe acute respiratory syndrome (SARS) epidemic of 2003.

Prof Hung’s experiences during the SARS epidemic remain etched into his mind. During the now infamous ‘Amoy Gardens’ outbreak at a residential complex in Kowloon, despite being only a trainee at the time, he joined a team of frontline medical officers. In the span of 3 days, these doctors truly went above and beyond their duties as they examined >100 patients with confirmed SARS at United Christian Hospital, collecting samples to investigate the identity of the pathogen. It was immensely stressful, as they were facing a completely unknown disease with high mortality, and with little available personal protective equipment at the time. Although the team feared for their safety, they maintained their faith and resolve. For Prof Hung, the incident was a turning point in his career, marking the beginning of his rise to prominence.

With the emergence of the new COVID-19 pandemic, it was Prof Hung’s turn to take the lead. In contrast to the situation with SARS, hospitals in Hong Kong are now better equipped to handle such pathogens. Readily available isolation facilities, personal protective equipment, and infection control measures help protect doctors and other healthcare workers, and advancements in investigations and treatment options have improved things for patients. Similarly, the general public has learned

important lessons from SARS, and now frequently follow better hand hygiene and facemask wearing practices to limit the spread of COVID-19. Indeed, everything might have changed after a decade, but Prof Hung’s passion has remained the same. Whereas some people are becoming numb to the continuing COVID-19 facts and figures, Prof Hung still maintains the same degree of dedication and attention for each and every patient, even those very old or frail patients who stand a chance of surviving only with early treatment. “The key is the timing”, he said. “We should never give up on any patients.”

While Prof Hung takes great pride in his translational research—he has made several breakthroughs, such as demonstrating the treatment of severe swine flu with convalescent plasma and hyperimmune intravenous immunoglobulin, as well as the potentiation of an intradermal vaccine for influenza when used with a topical agent—public health education, particularly on COVID-19 early antiviral treatments and vaccinations especially for older adults, remains one of his top priorities. He took the initiative to hold a press conference every week at the beginning of the vaccination campaign, hoping to disseminate accurate information to the public and address any misunderstandings or misinformation. He also observed autopsies of patients who died after receiving a COVID-19 vaccine in order to carefully determine the underlying cause. These acts, he believed, would give the public better confidence in the COVID-19 vaccines and maintain the momentum of the vaccination campaign.

In addition to his efforts to healthcare and education of Hong Kong citizens, Prof Hung contributed to the Hong Kong Anti-Cancer Society as an Infectious Diseases specialist. In this role, he advises immunocompromised patients with cancer to get vaccinations for various infectious diseases, including COVID-19, influenza and pneumococcal infection, and also to prevent herpes zoster reactivation as shingles. The Society, which aims to reduce the cancer burden in Hong Kong, makes various educational resources and videos on updated cancer therapies, cancer prevention, and infectious diseases prevention for patients with cancer (https://www.hkacs.org.hk/en/).

The lessons Prof Hung would share with younger doctors and trainees are drawn from his personal experience. “Stand for your ambitions”, he encourages us, emphasising how he was able to achieve his goal of being a gastroenterological specialist despite facing the major distraction of SARS early in his career. Nevertheless, he reminds us that the future is unpredictable, and that plans should not be set in stone: “Seize opportunities and be open to trying anything”.

Prof Grace Lai-hung Wong’s tenacity and passionate humanitarian spirit have fuelled her career at the forefront of tackling various gastrohepatic conditions in Hong Kong.

Prof Wong attributes her first forays into the medical system to a series of accidents, including an actual traffic accident during her first year of secondary school that left her with a broken femur. Experiencing the doctor-patient relationship from the patient’s side in her formative years not only bolstered her desire to become a doctor, but also helped Prof Wong understand the importance of viewing the situation from the patient’s perspective. This conviction shaped her career over the years to come.

Nonetheless, Prof Wong’s success is, by no means, an accident. Looking back, Prof Wong attributes her unyielding tenacity and determination to her humble grassroots upbringing. She recalls growing up in a cramped 100-square-foot rental flat that could barely fit a wardrobe and a bunk bed. During that time, she took great inspiration from her father who, in order to support his family, worked as a construction worker and never took a day off. These circumstances in her early development instilled an unshakable work ethic and steeled her to excel in her academic pursuits. An outstanding student at secondary school, Prof Wong became the Tuen Mun district top scorer in the public exams and successfully enrolled to study medicine at The Chinese University of Hong Kong (CUHK).

During her time as a trainee Medical Officer at the CUHK Department of Medicine and Therapeutics, Prof Wong met her mentor Prof Henry Chan, who noticed her blossoming research talent. As a budding researcher, Prof Wong found that the publication process is laden with rejection and disappointment. Despite this, Prof Wong persevered with her research, starting with a small retrospective cohort study, and quickly established a prolific research profile. Her research has been recognised in Hong Kong and internationally through various awards and prestigious lectureships, including the Young Investigator Award of the Asian Pacific Association for the Study of the Liver, the Distinguished Research Paper Award for Young Investigators of the Hong Kong College of Physicians, the Hong Kong College of Physicians Sir David Todd Lectureship, and the JGH Foundation Emerging Leader Lectureship. Today, Prof Wong continues to work as clinical professor at the Department of Medicine and Therapeutics, Institute of Digestive Disease, and State Key Laboratory of Digestive Diseases of CUHK.

Outside of the clinic, Prof Wong is an avid humanitarian. Her long-standing involvement in charity work began when she was a medical student, where she participated in service trips to rural areas in mainland China. In recent years, she has been heavily involved in the New Life, New Liver programme jointly launched by the Center for Liver Health of CUHK and the non-government organisation Caritas Lok Heep Club.

New Life, New Liver is a targeted screening, assessment, and education programme to help efforts towards the elimination of hepatitis C virus (HCV) in high-risk individuals, such as people who inject drugs. The programme aims to raise awareness about HCV in underprivileged and at-risk groups by distributing books and brochures and holding talks on HCV infection, complications, and treatments. At these educational sessions, point-of-care anti-HCV testing is available. Individuals who screen positive can be recommended to attend follow-up examinations at local hospitals or hepatology units, and support can be provided to improve medication adherence.

As a result of the efforts of the New Life, New Liver programme, Prof Wong noted drastic improvements in the targeted individuals, many of whom are homeless or marginalised. Among the patients, only one in five were willing to receive medical treatment, and there initially were many difficulties in engaging these at-risk populations to participate in the programme: “It is incredibly difficult to get a homeless patient to care about their liver when they have more pressing issues on their mind, such as what their next meal is, or where to sleep that night.”

In the 9 years that the programme has been running, there has been a notable increase in treatment uptake. The collaborative efforts of experienced professionals across medical and sociological fields towards the elimination of HCV in Hong Kong lifts the burden of disease from patients, allowing them to move on and pursue their dreams. However, Prof Wong notes that there is still a lot of work to be done. The programme has an important place in her heart as she experienced the camaraderie and wealth of expertise from working with the multidisciplinary team of healthcare professionals and experienced social workers.

In recognition of her contributions to society, Prof Wong was awarded the Ten Outstanding Young Persons Award in Hong Kong in 2014. She credits her mentor, Prof Henry Chan, for providing her with research opportunities early in her career and guiding her through the application. As the Assistant Dean (Learning Experience) at the CUHK Faculty of Medicine, Prof Wong is tasked with mentoring medical students. Just as the liver regenerates, Prof Wong hopes that this new generation will ‘regenerate’ the medical profession.

Currently, Prof Wong is the also Director of the newly established CUHK Medical Data Analytics Centre, and is currently working with a multidisciplinary group of experts in computer science and biostatistics to build models and artificial intelligence systems from large-scale clinical data to aid early detection of gastrohepatic conditions. “Just as hepatitis C viruses mutate very quickly to acquire drug resistance,” says Prof Wong, “we as doctors need to ‘mutate’ too. We need to be flexible and find new ways to improve the efficiency and efficacy of our treatments, to provide the best possible treatment for our patients.” On her online profile, Prof Wong describes herself as “a hepatologist, a researcher and a mother of three kids who loves to sing.” However, this interview showed that she is more than that. Serving as a role model to doctors and medical students, Prof Wong also provides hope to her patients by embracing not only clinical but also technological advances.