Paediatrician in field hospitals: an interview with Dr Maggie Yeung

Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
 
HEALTHCARE FOR SOCIETY
Paediatrician in field hospitals: an interview with Dr Maggie Yeung
Nicole Lau1, Ricky Yau2
1 Year 3, The Chinese University of Hong Kong
2 Year 4, The Chinese University of Hong Kong
 
 Full paper in PDF
 
 
Dr Maggie Man-chow Yeung is a specialist in Paediatrics, the recipient of The Chinese University of Hong Kong Distinguished Medical Alumni Award (Humanitarian Service) 2019, and a long-time volunteer paediatrician at Hong Kong Red Cross (HKRC).
 
When Dr Yeung was just 9 years old, she saw a photo of a bone thin boy from Ethiopia in the newspaper. Moved by the level of starvation and deprivation this boy suffered, the young Dr Yeung started dreaming about treating sick children when she grows up. She reminds us, ‘There are still many young children in impoverished parts of the world struggling to survive.’
 
Dr Yeung heard about the humanitarian services provided by HKRC. However, when she first inquired in 2002, Dr Yeung found out that the training programme was prioritising recruitment of surgeons and midwives at that time. Fortunately, recruitment of a broader spectrum of professions opened in 2007, enabling Dr Yeung to realise her childhood dream of treating sick children as a frontline doctor. Her journey began after taking a basic training course at HKRC and learning the necessary knowledge and skills to work in and operate a Health Emergency Response Unit. Emergency Response Units are made up of a team of trained personnel and sets of standardised equipment that are deployed in emergency situations to provide functions and services such as logistics, IT and telecommunications, water and sanitation, relief, and base camp. Dr Yeung has been volunteering since 2008 in many different environments, including places affected by natural disasters, such as Sichuan and the Philippines, or where people affected have escaped to, such as Jordan and Greece.
 
‘Flexibility is vitally important’ says Dr Yeung. Although this is taught in the training course, it is only understood when practising adaptability in the field. In most missions that Dr Yeung was engaged with, the purpose of the Health Emergency Response Unit was mostly to support clinical services that had been disrupted by disasters. Often, the traditional customs and practices of the local people may lead them to reject antibiotics and other treatments. These logistical issues and cultural beliefs unique to local communities can hinder the delivery of effective healthcare. This is where adaptability comes into play. Dr Yeung believes in respecting local customs while incorporating an appropriate portion of Western medicine into local situations. In Greece, she witnessed a patient with second- to third-degree burns who requested a witch doctor. ‘Miraculously, it worked, and we didn’t know why,’ recalls Dr Yeung. Many cultures and societies are naturally suspicious of “outsiders”. When such people feel that their local customs and practices are respected by the foreign humanitarian workers, they are more likely to trust in these foreigners and become more receptive to the services provided by the Emergency Response Unit in their community. There are bound to be limitations of Western medicine in these locations, especially with the occasional unavailability of equipment. It is therefore essential that humanitarian workers can adjust their mindset before every mission, and can exercise flexibility to meet the needs of their patients in various ethnic communities.
 
Among the many overseas humanitarian missions that Dr Yeung has been on, what has touched her most is the way displaced people value their family. Surviving in a disaster when personal safety is jeopardised and uncertainties prevail, Dr Yeung noticed that many displaced people place family ahead of their own health and wealth. On one occasion, Dr Yeung was taking care of a mother who had just given birth in a field hospital in Jordan a few hours before. This woman requested to return to the camp so that she could be with her family. Recovering from the pain of delivery seemed less imminent than being with her loved ones. These anecdotes were not rare among displaced people. None of them knew what might come next—more damage and destruction, sudden injuries or deaths, but rarely the end of chaos. Staying close to family during times of such uncertainty and upheaval is a lesson Dr Yeung well learned.
 
Family provides a sense of emotional security and comfort that is necessary in building the determination to survive through difficult times and unpredictable missions. Even distance cannot separate family. Dr Yeung feels deeply that nothing is more powerful a driving force than support from her family. Before embarking on a mission, Dr Yeung always seeks support and approval from her family. On one occasion, after returning home from a particularly exhausting mission, she was greeted with a smile and the comment, ‘You smell!’ Dr Yeung read between the lines and knew that her family misses her and supports her no matter what.
 
The picture of the starving boy in Ethiopia has stuck with Dr Yeung in every one of her missions. It has motivated her not only to improve the physical condition of her patients, but also to let them know that someone cares about their existence and well-being. As a volunteer of the HKRC, Dr Yeung has been trained to work closely with members of the local medical communities so that clinic services initiated by humanitarian workers can continue even after they leave.
 
Through sharing her experiences in humanitarian work, Dr Yeung wants to prepare future medical volunteers for potential challenges and frustrations in the field. More importantly, she shows us that it is the heart that values human dignity and human life that enables frontline humanitarian workers to overcome obstacles in the field. Dr Yeung finds true meaning in her work by using the ability to heal to achieve humane outcomes for impoverished communities. As Hippocrates wrote, “Wherever the art of medicine is loved, there is also a love of humanity.”
 
The Hong Kong Red Cross recruits volunteers, including doctors, nurses, and other professionals, to participate in overseas emergency health missions. For more information, visit the website: https://volunteer.redcross.org.hk
 

Figure 1. Dr Yeung on her way to a field hospital in Bangladesh
 

Figure 2. A thin bamboo footbridge in Bangladesh.
‘Beneath that thin bamboo footbridge was muddy water. We had to cross it to build a field clinic up on the hill, with or without muddy water soaking our clothes,’ remarks Dr Yeung, ‘Thinking about my family in such difficult conditions gave me strength to endure such difficult conditions.’
 

Figure 3. Dr Yeung (right) and HKMJ student reporter, Nicole Lau (left) attending the interview at the Hong Kong Red Cross headquarters in West Kowloon, Hong Kong
 

A mind that builds; a heart that serves—An interview with Dr Ben Fong

© Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
 
HEALTHCARE FOR SOCIETY
A mind that builds; a heart that serves—An interview with Dr Ben Fong
Gordon Chin1; Justin Leung2; Oscar Shen2; William Xue3
1 Year 3, The Chinese University of Hong Kong
2 Year 4, The Chinese University of Hong Kong
3 Year 6, The Chinese University of Hong Kong
 
 Full paper in PDF
 
Dr Ben Yuk-fai Fong, Associate Division Head of the Division of Science, Engineering and Health Studies at PolyU SPEED, developed an interest in Community Medicine from the very earliest days of his career. Since graduating from the University of Sydney over 30 years ago, Dr Fong has served in public, private, and university healthcare facilities in both Hong Kong and Sydney. Dr Fong has managed two local hospitals—Ruttonjee Hospital and Union hospital—and he was also the Deputy Medical Superintendent of the Prince Henry Hospital of the University of New South Wales in Australia.
 
Devotion to volunteering
Dr Fong’s volunteer work began while he was still Medical Superintendent at Ruttonjee Hospital. Joining the Auxiliary Medical Service (AMS) in 1995, Dr Fong put his many years of experience in medical administration to good use. The AMS is composed of over 4800 healthcare professionals and lay volunteers, all working together to provide paramedical support in times of emergency and first aid coverage for community events. As Senior Assistant Commissioner, Dr Fong played a crucial role in steering the development of the AMS towards providing more comprehensive and higher quality services. He helped set up the AMS Training Institute in 2000 and the First Aid Bicycle Team in 2002, as well as directing the medical support for large-scale events such as the Standard Chartered Hong Kong Marathon. Constantly striving for improvements, Dr Fong identified and addressed deficiencies in his team’s capabilities, and suggested everything from increasing first aid stations during marathons to providing first aid training for other uniformed services.
 
Despite the demands of his other responsibilities, Dr Fong dedicated a great deal of his time to the AMS, including their training, recruitment, field work, and public services. “Volunteering gives me another kind of satisfaction,” said Dr Fong, reflecting on his time in the AMS. When it comes to volunteering, Dr Fong advises that personal ambition and financial considerations should be kept out of the picture. “As a private practitioner, providing free first aid services is bad for business”, he quipped. In his opinion, trying to rise through the ranks of a volunteer organization is simply a distraction from contributing what you can to society, inviting stress instead of fulfilment.
 
When compared to his previous duties as head and Chief Executive of local hospitals, where he had to meet strict performance indicators as expected by the Board, Dr Fong found his volunteer work to be a pleasant change of pace. A community medicine specialist, Dr Fong brought with him a unique perspective. When his colleagues fretted about volunteers leaving the AMS soon after completing training, seeing it as a waste of resources, Dr Fong pointed out that the volunteers would carry the skills and knowledge they learned into the community, and that individuals with paramedical training are useful assets to society regardless of whether they are in the AMS. After all, they might one day save lives, if they happen to be in the right place at the right time. In cases like these, his ability to see the long-term benefit to the population reflects the mindset of an experienced community medicine practitioner.
 
Advocacy of community health
In addition to serving the public through both his work and during his free time, Dr Fong also wants to make a change in society—to promote the concept of community health. With this in mind, he established the Hong Kong College of Community Health Practitioners (HKCCHP) in December 2017. His intention was not only to provide a platform for graduates to utilise their recently gained knowledge, but also to empower citizens with better health knowledge. During the 2019 outbreak of measles, members of the HKCCHP toured around the different districts of Hong Kong to give talks, hoping to raise awareness and educate the public regarding this highly contagious disease which had attracted wide media coverage and caused public fear.
 
Governmental directives and financial incentives are crucial to healthcare policy making, but ultimately healthcare is of the people, by the people, and for the people; thus, every stakeholder has a role to play in upholding community health. “Community health needs a more bottom-up approach, where everyone in society could take the initiative”, said Dr Fong. In 2003, Dr Fong helped to recruit local private general practitioners to visit and consult schools in Shatin, in line with the government’s “one school one doctor” policy. He also responded to the queries of readers of SkyPost and the Oriental Daily regarding the recent coronavirus disease 2019 pandemic, proactively alleviating the concerns of many citizens.
 
Dr Fong believes that community health practitioners play an important role in case management. Such an idea was seeded when he was working at Prince Henry Hospital, where Nursing Consultants were responsible for managing day cases for endoscopic lithotripsy performed by urologists, allowing the doctors more time to concentrate on their own trade. With an ageing population in Hong Kong, the shortage of human resources in healthcare has become an increasingly pressing issue. If community health practitioners were recognised as an independent component of the healthcare workforce as case managers, the expanded healthcare team could provide more effective, individualised, and holistic patient care.
 
Dr Fong revealed his excitement after learning that Kwai Tsing District Health Centre had recently established a post for community health practitioners—the first of its kind in Hong Kong after many years of promotional effort. “Just as we did not have much subspecialty training in Hong Kong back when I first joined in 1985, now we are witnessing a revolution in health team reform,” he commented.
 
Looking forward
Working in public health is very different from treating individual patients. Dr Fong commented that one of the biggest takeaways from being a community medicine specialist is acquiring a wider perspective, “seeing the forest, not single trees”. Because community health and healthcare administration constantly deal with the big picture, Dr Fong advises that those who are interested should enjoy meeting people from different trades, be proactive in managing public provisions before problems occur, and persevere in community health interventions even though results might not be immediately apparent. Above all, he believes that serving the community requires commitment, devotion, and a good heart.
 

Dr Fong at a community lecture on first aid and home safety, co-organised by the Hong Kong College of Community Health Practitioners (photo courtesy of Dr Fong)
 

Dr Fong (third from right) in the Auxiliary Medical Service (photo courtesy of Dr Fong)
 

Dr Fong (second from left) with student journalists (from left: Justin, Gordon and William) at PolyU SPEED
 

Games supporting organ donation: an interview with Dr Ka-foon Chau

Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
 
HEALTHCARE FOR SOCIETY
Games supporting organ donation: an interview with Dr Ka-foon Chau
Chui-ching Chan1; Marco Cheung2; Michelle Tsui3
1 Year 6, The Chinese University of Hong Kong
2 Year 5, The University of Hong Kong
3 Year 4, The Chinese University of Hong Kong
 
 Full paper in PDF
 
 
What would you do if your son only had one more day to live? It was this cliched question that prompted Dr Ka-foon Chau to dedicate her life in advocacy of organ transplantation.
 
Organ transplantation is an age-old topic, with the first renal transplant reported in 1969. However, the rate of organ donation in Hong Kong is low: with only six donors per million population, Hong Kong lags behind many developed countries in this respect. For the past 40 years, Dr Ka-foon Chau, Head of Division of Nephrology at the Department of Medicine, Queen Elizabeth Hospital, Hong Kong, has worked ceaselessly for her lifelong mission of organ transplantation. Dr Chau, also honorary president of Hong Kong Transplant Sports Association and a member of the Committee on Promotion of Organ Donation, gives us a chance to see behind the scenes of organ procurement and the limiting factors in Hong Kong.
 
Forty years ago, organ donation was not a popular concept. Dr Chau recounts a tearful story that sparked her lifelong mission. While she was still a junior doctor, resources were so limited that patients who were unmarried or without children were denied dialysis. Among those denied treatment, some women committed suicide because they could not work or have children, and were incessantly rebuked by their in-laws. There were also young men who were in chronic pain. Dr Chau covertly helped to give peritoneal dialysis to one of these young men who was only in his twenties. After some time, his abdomen was so scarred she could not find a clear space to insert another needle. She spent the last few hours of his life by his side. Dr Chau remembers that he never had a word of complaint, although he was in so much pain. She thought at that time that a kidney would have eased his suffering.
 
“No matter what your calling is, go for it whole-heartedly.”
Dr Chau thus plunged headfirst into organ donation. She joined training workshops and liaised with the Hospital Authority and the Hong Kong Government about the topic. She also led her nephrology team into proactive organ procurement. Nonetheless, while organ donation has evolved to become a more commonly discussed topic, there remains a gap between theoretical understanding and concrete practice. In 2008, Dr Chau inaugurated the Hong Kong Transplant Sports Association, with a vision to improve rehabilitation after transplant surgery, to acknowledge the families of organ donors, and to raise awareness of organ donation in society.
 
She led the first team of transplant patients from Hong Kong to the biennial World Transplant Games in Bangkok, Thailand. Since then, the popularity of the Games has flourished in Hong Kong and internationally. Competitors from Hong Kong have won medals in the Games, and have participated in a wide variety of regional and international championships. For patients, the Games are a strong incentive to exercise, paving the way to better rehabilitation; for donors and their families, the Games provide acknowledgement for their altruistic contributions with vivid, breathing examples. In 2012, Dr Chau coordinated the Hong Kong Transplant and Dialysis Games. This local addition gives more incentive to rehabilitate, and allows for greater connection between transplant recipients and donor families, whose participation is also welcomed. The Games is a powerful testimony to those involved in organ donation, showing the world the life-giving impact that organ donation can make. Perhaps most importantly, the Games reorients any misconceptions and reasserts that transplant patients can achieve many things.
 
“If I don’t give up, why should you give up?” After retirement, Dr Chau is still an unfalteringly passionate advocate of organ donation. Despite years of hard work, the organ donation rate in Hong Kong still remains low. Transplant medicine not only necessitates the transplant itself, but a multidisciplinary approach ranging from psychological support for donor families to hospital management for efficient organ procurement and policy making for better delegation of resources. The limited availability of intensive care unit beds, lack of organisation in organ procurement, unsupportive government bodies, and the conservative local culture are still major barriers to organ donation.
 
There have been times when Dr Chau has felt helpless, and she cheerfully accounts her unyielding passion to the like-minded friends who gave her a pat on the shoulder and cheered her on. This seems to be her outlook of life: we are all here to help each other out.
 
The recent coronavirus disease 2019 (COVID-19) pandemic casts a lot of uncertainty and challenges on the healthcare system, yet Dr Chau is not staying idle. She is now preparing her first broadcast on RTHK, titled: “The ‘New’ Breakthrough of Transplants”, which will be aired between July and September 2020. Please tune in to her broadcast!
 
What you can do, even from home
Dr Chau’s enthusiasm in her work inspires us to strive for better care for our patients. “No matter what your calling is—it does not have to be in organ transplant—if it is a good and noble cause, go for it wholeheartedly, and you will be working directly or indirectly for organ transplantation too.” We can all play a role in this movement by signing up ourselves, sharing with family members, or even volunteering at the Transplant Games. There is always something we can do to improve our patients’ care.
 
Find out more about organ donation and sign up as an organ donor at: https://www.organdonation.gov.hk/eng/home.html
 
Tune into “The New Breakthrough of Transplants” airing 6 July to September 2020 at RTHK
 
Details of the World Transplant Games Federation can be found at: https://wtgf.org/
 
 

Into the circuit of a pioneering mind: An interview with Professor Vincent Mok

© Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
 
HEALTHCARE FOR SOCIETY
Into the circuit of a pioneering mind: An interview with Professor Vincent Mok
Natalie Cheuk1, Caitlin Yeung1, Cherry Lam2
1 Year 4 (MB BS), University of Hong Kong
2 Year 5 (MB ChB), Chinese University of Hong Kong
 
 Full paper in PDF
 
Professor Vincent Chung-tong Mok leads a research team at the Faculty of Medicine, Chinese University of Hong Kong (CUHK) that conducts cutting-edge studies in Cerebral Small Vessel, Alzheimer’s and Parkinson’s disease. He is a beloved teacher who has been elected Teacher of the Year seven consecutive times and one of the primary architects of the undergraduate medical education reform Global Physician Leadership Stream (GPS) programme in the Faculty. In his roles as a clinician, researcher, and educator, Prof Mok applies a patient-centred perspective, working in different capacities towards the common goal of alleviating and preventing suffering. His humanitarian spirit led to his collaboration with Medical Services International to provide health education to ethnic minorities in some of the most impoverished villages in mainland China, and a recent directorship for a training programme empowering social workers and other healthcare professionals to care for dementia patients and their caregivers in Hong Kong. His desire to serve has consistently guided his career decisions, his approach to patient care, and his research direction.
 
Road to neurolog
Professor Mok first became interested in neurology during his postgraduate training at the Prince of Wales Hospital. He noticed that the chronic nature of many neurological diseases requires the clinician to develop a strong and supportive long- term relationship with patients. He relished the opportunity to connect with patients, especially the older patients, whom he holds close to his heart. The analytical rigor demanded in the specialty also appealed to him. The combination of human connection, intellectual challenges, and the supportive senior specialists he met during his early career drew him towards neurology, which has since become his life’s work.
 
Today, Prof Mok regards research to be an integral part of his duties. However, earlier in his career he was so focused on developing his clinical skills and on clinical service that research did not cross his mind until after specialty training. His perspective on research changed when he witnessed his patients with various neurodegenerative diseases deteriorate before his eyes to the state where they became dependent on others for self-care, despite already receiving the best available treatments. After listening to patients voice their frustration and desperation when treatment options had been exhausted, Prof Mok resolved to help these patients and their families who struggled to maintain around-the-clock care. He understood to find a cure for these devastating neurological diseases, one needs to tease out the mechanisms underlying these diseases. Seven years ago, in partnership with another physician-neuroscientist, the team pioneered laboratory work focusing on untangling the complex mechanisms of Alzheimer’s disease, which is the most common neurodegenerative disease. They later observed a strong link between microvascular dysfunction and Alzheimer’s disease. The team recently discovered that a drug for patients with diabetes could significantly reverse this microvascular dysfunction. This provides hope that disease progression might be slowed by tackling this microvascular dysfunction.
 
On the clinical side, in partnership with a computer engineer, his team has made leaps and bounds towards developing magnetic resonance imaging–based machine learning programmes for detecting early-stage Alzheimer’s disease. In future, this new technology may guide clinicians to select who should receive confirmatory investigation, such as positron emission tomography scan, for diagnosing early Alzheimer’s disease. When identified early, there is hope that prompt appropriate intervention can halt or slow the progress of irreversible dementia. Notably, in partnership with neurosurgeons, the team pioneered the use of deep brain stimulation for advanced Parkinson’s disease in Hong Kong two decades ago. Deep brain stimulation has now become a standard treatment in Hong Kong and has made dramatic improvements for many patients with advanced Parkinson’s disease.
 
Expanding the minds of the next generation
In addition to patient care, Prof Mok has an active role in teaching the next generation of doctors. Under the GPS programme at CUHK, pioneered by Professor Justin Wu, Professor Simon Ng, and himself, students are encouraged to seek out research opportunities, take part in humanitarian service trips, and gain exposure to leadership training or hospital administration, subjects not usually covered in a conventional medical curriculum. Professor Mok encourages all medical students to take advantage of the relative leisure in undergraduate years to explore one’s strengths and develop interests before zooming into professional responsibilities. In other words, it is always best to be exposed early, but as we have learned from Prof Mok’s own journey, it is also never too late to begin. Professor Mok believes that each student is a “gold mine”, filled with different talents. He hopes this GPS platform can help to ‘dig out’ their talents for the benefit of the society in the long run.
 
As an accomplished clinician-researcher, Prof Mok would advise young professionals interested in research to do some soul-searching and discover their true motivation. He hopes that budding researchers realise that medical research should be conducted with the ultimate goal of bringing healing and protection to individuals and to the society, rather than for pursuit of recognition.
 
Spirit of giving
In addition to his career at CUHK and the Prince of Wales Hospital, Prof Mok also enjoys and encourages active participation in voluntary services. In 2003, he went on the first of a series of service trips to Yunnan in mainland China with Medical Services International. This first trip was in the wake of the SARS (severe acute respiratory syndrome) epidemic. Hong Kong doctors who worked through the SARS public health crisis became trained in infection control and were well equipped to fill in the gaps of knowledge in deprived regions. His first service trip was a truly eye-opening experience. He saw the strong need for health education which inspired him to return repeatedly over the next 12 years, leading teams of healthcare workers in training the village doctors and regional hospitals in areas of general medicine and neurology among ethnic minorities. The days were long and gruelling, but the joy of service outlasted any hardship and each trip became a lesson in the gift of giving.
 
Locally, Prof Mok, in partnership with a clinical psychologist and the Hong Kong Council of Social Service, has started a new training programme targeting social workers who serve dementia patients and their caregivers in community settings. Aptly named the GIFT programme (GIFT Care Professional Certificate Programme in Promoting Well-being in Informal Caregivers of Dementia), the programme aims to advise healthcare workers on how to promote psychological and physical well-being in caregivers of dementia patients. The first cohort of students entered the course in January 2019 and the third cohort started this year. With the ‘ageing tsunami’ on the horizon, Prof Mok anticipates that there will be more and more informal caregivers of dementia. These caregivers are commonly the patients’ spouses or children. Many will likely experience significant stress and feelings of helplessness and he hopes that this programme will become a “GIFT” to these informal caregivers who give selflessly to their loved ones suffering from dementia.
 
Finding hope in hopelessness
Reflecting on the past 20 years in medicine, patient stories stood out as the most rewarding moments in his career. He remembers a young man in his mid- twenties who was his youngest case of Parkinson’s disease. Professor Mok experienced a mix of emotions regarding this case: partly disbelief, and partly saddened by the many challenges this patient will be facing, from employment to social relationships, to even self-care in the long term. Professor Mok encouraged this patient to connect with other patients with Parkinson’s disease for mutual support. Over the years, this patient eventually managed to start a support group for other young patients with early-onset Parkinson’s disease who were facing similar crisis and challenges in life. Encouraged by his serving heart, in 2013, Prof Mok nominated this young patient for a Top Ten Regeneration Warriors award and eventually this patient became the first patient with Parkinson’s disease to receive this award.
 
“My life difficulties are nothing compared to that faced by my patient, yet even when faced with such health challenges he still has the heart and strength to help others. I am truly inspired by him. Indeed, I consider this young patient and many of my patients, as well as their dedicated caregivers, my ‘teachers of life’. I am really blessed through serving them,” reflected Prof Mok. He also remembers being pulled aside suddenly by a man he did not recognise at the hospital 2 years ago. It emerged that he was the son of a patient under Prof Mok’s care for few years who had recently passed away. He had recognised Prof Mok and expressed his heartfelt gratitude to him for looking after his mother throughout her illness. Although he does not work for recognition, Prof Mok shared that these moments he feels are reward enough.
 
Most valuable lesson
To this day, Prof Mok always ends a consultation with the question: “Is there anything else that I may help you with?” inviting patients to discuss their thoughts and worries with him. Staying true to his course to alleviate and prevent suffering, his passion to serve has formed the foundation for his success and has surely impacted countless patients positively in more ways than he can count. To conclude, Prof Mok reiterated the most valuable lesson that he has learned: it is truly more blessed to give than to receive.
 

Figure 1. Professor Mok examining an elderly lying on a table tennis table in the back yard of a village primary school. Yunnan, China, 2015
 

Figure 2. Professor Mok (fourth from left) with other members of Medical Services International, including neurosurgeons, neurologists, and neuroradiologists from Singapore and Taiwan. Yunnan, China, 2012
 

Figure 3. Professor Mok teaching physical examination in a training session for village doctors. Yunnan, China, 2014
 

Advocacy for resuscitation: any CPR is better than no CPR. An interview with Dr Axel Siu

© Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
 
HEALTHCARE FOR SOCIETY
Advocacy for resuscitation: any CPR is better than no CPR. An interview with Dr Axel Siu
Venice Li, Hilary Kwok, Joey Chan
Year 6 (MB, ChB), The Chinese University of Hong Kong
 
 Full paper in PDF
 
 
The beeps of the machines that monitor patients and the motions of the team of healthcare providers tending to the patients combine to form the intense and action-packed atmosphere of the accident and emergency department that Dr Axel Siu revels in. As an emergency medicine specialist in Ruttonjee Hospital, Hong Kong, this is where his passion lies—a place where every second matters and every decision can mean life or death. But his passion doesn’t stop at the entrance to the accident and emergency ward, it extends through the clinical and administrative work of revising resuscitation guidelines, and beyond, into the public where his involvement in educating the public on out-of-hospital cardiac arrest has had far-reaching effects.
 
Career highlights
After graduating from The Chinese University of Hong Kong in 1992, Dr Siu spent his time as a junior medical officer at Pamela Youde Nethersole Eastern Hospital and this sparked his passion for emergency medicine. He relished the constant challenge of having to make a diagnosis with few investigations and within a limited time frame. His increasing ability to arrive at a timely diagnosis made his newfound passion incredibly rewarding. The fact that his work made a substantial difference to his patients’ condition and recovery made it all the more fulfilling.
 
When asked about his most memorable patient, Dr Siu avidly recounts the time when a young man came into the accident and emergency department with back pain. Initially it had appeared to be a simple musculoskeletal case, but Dr Siu detected a subtle abnormality and ordered a computed tomography scan. As he suspected, the scan revealed an aortic dissection! Dr Siu reflects that it is events like this that make him grateful for the passion he has developed for emergency medicine, and the ability to make a difference to patients’ lives when they first arrive at the hospital.
 
As the years progressed, Dr Siu not only wholeheartedly fulfilled his clinical duties, but also took up administrative positions in various organisations. In 2008, he became a council member of the Hong Kong College of Emergency Medicine and was elected as President in 2017. During his time in the council, Dr Siu has seen numerous advancements in his specialty, including the development of point-of-care ultrasound for identifying small pneumothoraxes and other conditions. Dr Siu has also been involved in establishing the concept of advanced life support in Hong Kong, with its extension to Macau. He has even been supporting the development of emergency medicine in Myanmar.
 
Educating the public
During his precious free time, Dr Siu is an avid sportsman with a love for running and hiking. He integrated this hobby and his profession by developing the field of Wilderness Medicine in Hong Kong. After attending training sessions in the United States, he took it upon himself to establish workshops in Hong Kong. Initially this was to educate fellow colleagues, but in one mid-term break, Dr Siu extended his efforts to teaching secondary school students by accompanying them on an overseas trip to Mount Kinabalu in Malaysia.
 
Dr Siu’s particular passion is for educating the public on the importance and steps of bystander cardiopulmonary resuscitation (CPR). A small incident sparked this enthusiasm when he participated in a 10 km race at Science Park in 2012. While running, he encountered a young runner who collapsed suddenly and went into cardiac arrest. Instinctively, Dr Siu immediately performed CPR on the man, as if on any other day in the accident and emergency ward. He fondly recounts that the man survived and, to this day, they remain very good friends. Undoubtedly, he is very grateful that Dr Siu was around on that fateful day. This even also had a profound effect on Dr Siu, placing in him a strong urge to educate the public on basic CPR skills to save more lives. “As an emergency medicine doctor,” says Dr Siu, “I have seen many cases which patients might have survived if someone could have performed CPR.”
 
Dr Siu points out that a major problem in Hong Kong is that people are afraid to perform CPR and use automatic external defibrillators (AEDs). Bystanders with various degrees of CPR knowledge may choose not to carry out CPR when the time comes, for various reasons. For example, some fear legal consequences if the outcome of the collapsed victim is not favourable. Others assume that formal training is needed in order to operate an AED. Many people are unaware that AEDs are designed to be user-friendly and operated by lay-people, with clear voice prompts and the administration of a shock only if the patient needs one. Dr Siu believes that a ‘Good Samaritan’s Law’ should be implemented in Hong Kong to allay fears of legal action and to encourage people to do CPR when needed by exempting them from litigation. Similar laws have already been implemented in neighbouring regions including mainland China, Taiwan, and Japan. “When saving lives, every second count,” urges Dr Siu, “and although the CPR may be substandard, any CPR is better than no CPR. I hope a ‘Good Samaritan’s Law’ can be implemented in Hong Kong to protect those who choose to save lives out of the goodness of their heart.”
 
Dr Siu also actively promotes the importance of CPR and how to carry it out effectively by teaching students in schools and the public in exhibition events. He finds this experience extremely rewarding as he is able to put into action what he encourages others to do. To advocate resuscitation to the public in an interactive way, Dr Siu sometimes needs to put down his white coat. In a video promoting infant CPR, he dressed up as the Tang Priest and sung an arranged version of the theme song ‘Only You’ from Stephen Chow”s ‘A Chinese Odyssey Part Two: Cinderella’. In another video, he plays Iron Head in ‘Shaolin Soccer’ to teach parents to resuscitate their children. He hopes that these creative ideas could spark interest in the public to pursue life-saving CPR knowledge.
 
Room for improvement
Dr Siu’s passion for promoting CPR to the public follows him wherever he goes. He recounts anecdotes from his travels abroad, such as a trip to Japan when he hiked to the top of Mount Fuji and was pleasantly surprised to discover an AED was placed at the summit. He was equally pleased to find that taxis in Singapore are equipped with AEDs. Such accounts highlight the lengths to which some countries prioritise the importance of bystander CPR and accessibility of AEDs.
 
“There is still much room for improvement” was Dr Siu’s reply when asked about the situation of out-of-hospital cardiac arrests in Hong Kong, based on his research in the subject.1 The ageing population in Hong Kong contributes to a low survival rate; however, the lack of bystander CPR knowledge, coupled with the sparse placement of AEDs throughout the city, the lack of confidence in performing CPR, and the fear of legal consequences, has severely hindered the survival rate in Hong Kong.
 
With the collective efforts of healthcare professionals, the Fire Services Department, and various other organisations, improvements are being made and new ideas are being put forward in Hong Kong. To improve knowledge of CPR among students, teachers, and parents, extra-curricular activities in schools have been initiated. It is hoped that by allowing the public to see the value and importance of doing CPR when the time comes, they can help not only their loved ones, but also people they come across in the community. As Dr Siu said, “By planting seeds, we can harvest interest and save more people.” Although Hong Kong has yet to integrate CPR courses as part of the compulsory school curriculum, as is the practice in Japan, we are taking our first step in creating a healthier community.
 
Dr Siu also advocates implementing an AED registry.1 Currently, AEDs can be purchased without official registration. This makes it hard to track the numbers and locations of AEDs in the community. A registry, with formal registration for every AED purchased, including the intended location, would allow all AEDs in Hong Kong can be mapped. Mapping of AEDs is already in place in Singapore and has been further extended through a mobile phone application, myResponder. This application cleverly mobilises volunteers familiar with CPR throughout the community. Whenever a cardiac arrest arises, volunteers within 400 m are notified. Bystanders can locate an AED and receive face-to-face instruction in how to perform CPR and use an AED before arriving at the scene. Using this example, Dr Siu demonstrates the vast opportunities available in expanding public awareness and education on CPR and AEDs.
 
With a positive outlook, Dr Siu hopes that public education in bystander CPR will reach all corners of society. His advice to medical professionals is to equip themselves with skills and knowledge first and to “mobilise people around you”. To the Hong Kong community, he encourages all to try to spare a few hours to learn, and reminds us that “when it comes to saving lives, every second counts, and any CPR is better than no CPR.”
 
Reference
1. Fan KL, Leung LP, Siu YC. Out-of-hospital cardiac arrest in Hong Kong: a territory-wide study. Hong Kong Med J 2017;23:48-53. Crossref
 
 

Dr Siu taking part in promotional videos to promote resuscitation to the public
 

Participation in emergency air medical services
 

Public education on cardiopulmonary resuscitation and the use of automatic external defibrillators
 

Dr Siu with the journal’s student reporters (from left):Venice, Hilary and Joey
 

World volunteer and carer for bones and minds: an interview with Dr Chi-wai Chan

© Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
 
HEALTHCARE FOR SOCIETY
World volunteer and carer for bones and minds: an interview with Dr Chi-wai Chan
Ricky Yau1; Nicole Lau2
1 Year 3, The Chinese University of Hong Kong
2 Year 2, The Chinese University of Hong Kong
 
 Full paper in PDF
 
 
One afternoon in October 2019, Dr Chi-wai Chan returned to the United Christian Hospital, where he was the former Chief of Service in the Department of Orthopaedics and Traumatology, to share his experience of volunteering around the globe. Now working part-time, he looked back on his career as a doctor and carer for all those in pain and agony.
 
In 1996, Dr Chan began his service in mainland China. Although he had acquired a relatively comfortable life in Hong Kong, he wanted to go to the mainland and help fellow Chinese people—the roots are the same despite differences. As a long-time Christian, he was also motivated by the values of love and sharing, which led him to his starting point, Henan, where there had been a flood in 1991. Since then, he has visited more of mainland China, Kenya, Africa, Madagascar, Iraq, and many other places.
 
On some of his travels, Dr Chan was able to treat patients with his professional skills; on others he had more time to connect and communicate with the local people. Natural disasters and wars result in prevalent bone fractures, and Dr Chan’s specialism in orthopaedics and traumatology is invaluable in such situations. He was a volunteer that provided assistance immediately after the 2008 Sichuan earthquake. At a town a couple of hours away from the centre of Sichuan Province, where the hospital had been demolished by the shaking, he encountered a person with a bone fracture. Usually, X-ray examination is needed to precisely locate the site of the injury, but his search for working equipment was in vain. Amidst these difficult circumstances, Dr Chan, relying only on his expertise and keen senses, set the fractured bones. Dr Chan also witnessed first-hand shortages of resources in some less-developed regions or destroyed sites. In one surgical scene, he saw blood-soaked gauze being washed and reapplied to the wound of the patient on the operating table. These nerve-wrecking stories were real challenges for Dr Chan that one can only imagine and hope they turned out well.
 
Among his many trips to Sichuan after the earthquake, the first trip involved a great deal of providing spiritual support, Dr Chan recalls. Six days after the disaster, the most severely injured had already been taken by ambulances to hospitals in other major cities or provinces, so there was not much to do as a doctor. Therefore, Dr Chan took up the role of an educator, teaching children there how to count to one hundred in English. He also communicated with the villagers there—their lifestyle was free and tailor-made for whatever they needed on the field.
 
Despite his utmost efforts, Dr Chan still felt helplessness in some situations, such as dealing with the sorrow of the survivors. He particularly remembers that one 6-year-old wrote ‘I want to see my brother,’ on a wish-making balloon. Sadly, it was already 2 weeks after the earthquake, and impossible for the child to realise that wish.
 
Having been retired for almost 3 years, Dr Chan has witnessed some of his old classmates enjoying fame and fortune. Nonetheless, his belief that money cannot buy true happiness has never been shattered. The Christian proverb ‘it is more blessed to give than to receive’ is imprinted on his heart, and he deeply believes that this is the only way to live a happy and contented life. If he had the chance to choose his path of life again, he says he would live the same life again with no regrets. With thrill and excitement on his face, Dr Chan was eager to share pictures of patients he revisited years after he had performed surgery on in Luoyang. In 1997, Dr Chan was heartbroken when he saw a 9-year-old girl with polio crawling across the floor like an animal owing to her weak lower limbs and back. Despite not being able to completely cure the disease, he greatly improved her ability to stand and walk by operating to straighten the hips and knees and then giving her braces. When Dr Chan revisited her almost 20 years later, she was able to work, get married and take care of herself and her children. She had regained independence and more importantly, she could finally live like a dignified human being with a spouse and family. Dr Chan and his team received a very warm welcome from her family with every moment of their meeting filled with immense gratitude. There is nothing more enjoyable for Dr Chan to see how a surgery completely changes the life of a person and even the fate of a family.
 
Despite having travelled for almost a hundred missions, Dr Chan has no plans to stop. His next destination is Niger in December 2019. He wishes to visit the more difficult and challenging places while he is still physically capable of travelling. Having just visited one of the most infamous war-torn places in the world, Iraq, he also has plans for next year to visit Gabon, which is a severely deprived country in Africa. These are places where few volunteers choose to go, thus are with greater needs that Dr Chan wants to address. ‘If you are willing to go to places where nobody else dares, your presence will make a difference’, he said as he explained the reasons behind choosing the countries or regions to serve.
 
Inside every doctor should bear a compassionate heart. Inside every volunteer is an adventurous soul that wants to understand and experience the adventures of other places and people. The decision comes down the value one holds, treasures and believes in. Dr Chan has both of those, making his determination to change the lives of the underprivileged miles away from Hong Kong unstoppable.
 
 
 

Healing hearts in paediatrics: an interview with Dr Adolphus Chau

© Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
 
HEALTHCARE FOR SOCIETY
Healing hearts in paediatrics: an interview with Dr Adolphus Chau
Cherry Lam1; Natalie Cheuk2; Caitlin Yeung2
1 Year 5 (MB ChB), The Chinese University of Hong Kong
2 Year 4 (MB BS), The University of Hong Kong
 
 Full paper in PDF
 
 
Dr Adolphus Kai-tung Chau’s dedication to advancing paediatric cardiac interventions available in Hong Kong has been evident throughout his career. Dr Chau has served as a consultant at the Department of Paediatric Cardiology at Grantham Hospital and Queen Mary Hospital for 25 years, including 15 years as the Chief of Paediatric Cardiology. He has played a pivotal role in implementing new techniques at these hospitals. Dr Chau currently works closely as an interventional paediatric cardiologist with surgeons, anaesthesiologists, and allied healthcare professionals to ensure the best possible care for his patients. His time is also spent in research on long-term outcomes after interventional and surgical procedures and teaching and training younger generations of doctors, students, and nurses locally and abroad.
 
As Chief of Service, Dr Chau oversaw many regional firsts in paediatric cardiology in Hong Kong, including the establishment of the first extracorporeal membrane oxygenation (ECMO) programme. Among his many experiences, the introduction of mechanical circulatory support by ventricular assist device (VAD) for children is a bittersweet story that Dr Chau holds close to his heart. In 2001, an 11-year-old girl with dilated cardiomyopathy complicated by end-stage heart failure was placed under Dr Chau’s care. Without a heart transplant, the girl would rapidly succumb to her illness. Up to that point, paediatric heart transplantation had never been successfully attempted before in Hong Kong. Moreover, the number of suitable donor hearts for children was very limited. In his determined search for a way to save the patient, Dr Chau became aware of the VAD which could prolong the patient’s survival and act as a bridge to transplantation. The medical team identified a suitable device which had been developed at the German Heart Centre in Berlin, Germany. Unfortunately, the VAD was prohibitively expensive. Ultimately, in collaboration with the cardiothoracic surgeons, Hong Kong Heart Transplant team and with funding from the Children’s Heart Foundation (CHF), the VAD machine was made available for temporary use to save the dying child. Dr Chau quietly recalls the tragic fatal stroke that the young patient subsequently suffered 2 weeks later, as a complication of VAD treatment. Despite his relentless perseverance, the child he had so desperately tried to save passed away.
 
However, his efforts were not futile, and Dr Chau saw the opportunity for advancement. This young patient had exposed the severe lack of life-saving technology in Hong Kong needed by such children waiting for a heart transplant. A team of doctors, including Dr Chau, travelled to the German Heart Centre to learn more about VAD and afterwards established its use in Hong Kong. Dr Chau reflects that even though this was not a success story, this first experience was very useful in saving other children afterwards. In 2004, a paediatric patient who suffered from fulminant myocarditis survived through the use of the VAD. In 2009, Dr Chau collaborated with the Hong Kong Heart Transplant team and the Cardiothoracic Surgery Department at Queen Mary Hospital for the first paediatric heart transplant operation in Hong Kong.
 
Dr Chau is well-known for his successful career in Paediatric Cardiology, but he is particularly proud and enthusiastic for his work with the CHF, of which he is the current chairman. In 1994, Dr Chau co-founded the CHF with a group of concerned parents and colleagues, in order to support families with children suffering from congenital heart disease. Over the years, CHF has expanded to provide families with subsidies and psychosocial support to fill the gap between hospital clinical services and the personal needs of patients and their families. Now in its 25th year, the CHF has over 5000 members in Hong Kong and is an integral step in the care plan for patients with cardiac disease. As a registered charity, the CHF offers counselling services, peer support groups for parents, medical advice, and school talks on heart health. It also provides developmental rehabilitation for children with congenital heart diseases, whose medical condition often impacts negatively on their self-esteem.
 
The CHF is also concerned with heart health of the population at large. Recognising that heart diseases is a local top killer, the CHF has been actively disseminating information about heart health through public exhibitions, such as at shopping malls, and on its website. In addition, the CHF has conducted health talks in primary and secondary schools in the past decade to educate and advise children and teenagers on cardiovascular health. As Dr Chau remarked, “Heart health must start at early childhood.”
 
Although the CHF was established as a patient support group, it has also proved to be an invaluable partner to Dr Chau and his colleagues in bringing cutting-edge technology to Hong Kong, such as the VAD. The organisation’s all-encompassing approach and foresight is particularly evident in their current projects. A good example is the House of the Heart. Dr Chau understood that parents are an essential part of in-patient care for very young patients, and their reassuring presence is vital for a child’s recovery. However, the frequent commute to and from the hospital can be taxing for parents who live far away, and cramped wards do not have the luxury of space for an extra bed for parents to sleep next to their sick child. Dr Chau brought his observations to the CHF and together a plan to provide convenient accommodation for the parents of in-patients at Grantham Hospital was shaped. Grantham Hospital offered a unit of senior staff quarters free of charge, which was then converted into the House of the Heart, a dormitory for parents during their child’s in-patient care.
 
Always going the extra mile, Dr Chau also saw the House of the Heart as a space for parents to reach out to each other during difficult times. In-patients are invariably the most acute cases, which also brings the greatest anxiety for parents. The House of the Heart was designed with a common area to encourage parents to socialise and support each other, and CHF also brought in counsellors to facilitate group meetings. When the department moved to Queen Mary Hospital in 2008, the CHF rented a government property next to the hospital as the new House of the Heart and expanded its services to include parents of paediatric oncology in-patients. Unfortunately, in 2016, the site was re-purposed to become the current University Pathology Building. The CHF had to overcome significant obstacles to ultimately secure a new House of the Heart dormitory at Wah Fu Estate. Although the new location is further away from the hospital than the previous House of the Heart at Grantham, it remains very popular with consistently full occupancy rates.
 
Since the establishment of the Hong Kong Children’s Hospital in Kowloon Bay in 2017, Dr Chau has been at the helm of transferring the Department of Paediatric Cardiology there, from Queen Mary Hospital. Setting up a new CHF service centre near the new Children’s Hospital is another project that Dr Chau is spearheading, working tirelessly to overcome numerous hurdles along the way. The CHF has successfully negotiated an affordable deal for new premises in Kowloon Bay and is now working towards fundraising to continue its services for children and families.
 
In Dr Chau’s many years of caring for some of the most vulnerable children in Hong Kong, his insight into his patient’s needs beyond medical services alone has proven invaluable to families. Children with congenital heart disease encounter social and psychological challenges as a result of their physical problems that must be addressed. His experiences have impressed on him the importance of holistic medicine—not only to repair anatomical defects, but to truly heal hearts—which is a core value for the CHF. Thus, Dr Chau considers his clinical work and community services to be inseparable from each other.
 
For the next generation of doctors, Dr Chau advises perseverance through the inevitable career ups and downs and adherence to the belief that knowledge can help patients. He also stresses that effective communication and collaboration with other doctors, nurses, and allied health professionals is essential for delivering the best care that patients deserve. He ends the interview with a quote from Pat Patrick: “In life, we leave a legacy to our children, we leave our footprints wherever we travel, and we leave our fingerprints on every heart we touch.”
 

Figure 1. Dr Chau at the Children’s Heart Foundation’s annual Heart-to-Heart Charity Walk
 

Figure 2. Dr Chau (right) during an interventional procedure
 

Figure 3. Dr Chau (third from left) was interviewed by the journal’s student reporters (from left): Cherry, Caitlin and Natalie
 

Pioneer of nursing reforms: an interview with Professor Frances Wong

© Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
 
HEALTHCARE FOR SOCIETY
Pioneer of nursing reforms: an interview with Professor Frances Wong
Venice Li, Hilary Kwok, Joey Chan
Year 6 (MB ChB), The Chinese University of Hong Kong
 
 Full paper in PDF
 
 
Professor Frances Kam-yuet Wong’s warm smile and friendliness were what first caught our attention. Bringing along some cinnamon tea she bought from the United States, she openly offered to make us tea, as she guided us through her life story of working beyond the call of her duty as a nursing profession. Charged with a passion to serve the community Prof Wong, President of the Hong Kong Academy of Nursing (HKAN), described her determination to embark on a journey to lobby for better patient care through advocating for policy changes and leading spear-headed changes to introduce multidisciplinary care into the Hong Kong community. Hers is a story that echoes her belief that the whole is greater than the sum of its parts.
 
Humble beginnings
The humanitarian aspect of medical care touched her heart. After graduation and assuming the role of a registered nurse, Prof Wong had a renewed sense to directly touch the lives of others. This motivated her to spend her weekends visiting refugee camps in Kowloon City. By helping in the clinics, she was able to provide valuable help that these clinics depended on by assisting in essential procedures that were in heavy demand. With a motivation to lend a helping hand wherever it was welcomed, she also regularly visited children with intellectual disabilities. Prof Wong recounts a particularly memorable time during her time as a young nurse when she was able to share a unique and deep bond with her long-term patients in the intensive care and renal wards. With in-depth conversations made with every decision, a naturally close rapport was built between them. She was deeply touched when she was invited to the funerals of her dear patients.
 
Positive impact on Hong Kong’s nursing profession
Unlike their medical counterparts, nursing specialists in Hong Kong previously did not have any registries or accreditation systems. That began to change in October 2011, when HKAN was established, with the aim to strive for regulation of advanced nursing practice and to accredit nurse specialists on par with international standards. Prof Wong played a pivotal role in the establishment of the HKAN, and her mission now is to achieve statutory status and gain legal protection for nurse specialists in Hong Kong so that the public is protected by safe professional practice. Prof Wong’s diverse background and extensive clinical experience guide her to lead the fight for the rights of nurses. Prof Wong is a key player in HKAN’s efforts to regulate advanced nursing practice. In large part as a result of her efforts, numerous nurses in mainland China have received an internationally recognised accreditation status, and it is hoped that this system can achieve statutory status in Hong Kong. This system would provide legal protection for specialist nurses and enhance healthcare services provided to the community by ensuring that safe, professional nursing care is provided to all patients. Not only does Prof Wong approach her daily work with an incredible amount of passion, she has also always taken the initiative to go the extra mile for example by working with the underprivileged on her days off during her time as a practising nurse, and more recently through lobbying and advocacy for policy changes that will improve patient care. Prof Wong serves as an exemplary model of how healthcare professionals should approach their work.
 
Community-based interdisciplinary healthcare support
“Hong Kong has medical services but not healthcare services.” These words from an American professor gave Prof Wong pause for thought. During her research in transitional care from hospital to community, Prof Wong realised that the inadequacy of post-discharge community healthcare leads to high readmission rates and increases the burden of Hong Kong’s healthcare system. This led her to the idea of community-based health centres, which consist of interdisciplinary healthcare professionals such as nurses, physiotherapists, occupational therapists, and counsellors. Together, the team help to solve underlying social problems that contribute to health problems, so that the public can receive community-based support. The government-funded pioneer district health centre will be established in Kwai Tsing district, with hopes to enhance the public’s awareness of disease prevention and to provide support for the chronically ill. As a member of the Steering Committees on Primary Healthcare Development and Prevention and Control of Non-communicable Diseases, Prof Wong envisions the progressive participation of other districts and the involvement of the whole Hong Kong population. She hopes that ultimately, more and more citizens will take an active role to manage their own health instead of solely relying on healthcare professionals.
 
Inspiration and drive
Prof Wong describes nursing as a calling, saying, “I did not choose nursing, but nursing chose me”. Since the early days of her career, when she decided to pursue nursing instead of a Sociology degree, Prof Wong has always found the job to be incredibly rewarding. She feels privileged to be trusted by patients and is grateful for the opportunity to accompany them on their journeys. This immense job satisfaction drives Prof Wong to further her career as a nurse, and also to advance the profession as a whole. Along the way, she has met many inspirational figures, whose passion for the profession and for the care of patients she greatly admires. They include professors who taught her in nursing school and numerous members of the HKAN.
 
Parting words
To draw our interview to a conclusion, Prof Wong offered a few words of advice for both healthcare providers and the public. To healthcare professionals, she says, “Follow your passions, as this will be better for both yourself and your patients.” In general terms, she also advises everyone to, “Take more responsibility for your own health, and remember to practice self-care.”
 

Figure 1. Professor Frances Wong conducting a nursing round in a hospital in Guangzhou
 

Figure 2. Professor Frances Wong (second from left) was interviewed by the journal’s student reporters (from left): Joey, Venice and Hilary
 

Clinician and teacher, sportsman and coach: an interview with Dr Henry Lam

© Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
 
HEALTHCARE FOR SOCIETY
Clinician and teacher, sportsman and coach: an interview with Dr Henry Lam
Bianca Chan1; Henry Evan Cheng2; Man-tsin Lo2; Nathan So2
1 Year 3 (MB ChB), The Chinese University of Hong Kong
2 Year 1 (MB ChB), The Chinese University of Hong Kong
 
 Full paper in PDF
 
 
 
When we interviewed Dr Henry Lam, he had just returned from Thailand where he had competed in a bridge tournament. Dr Lam is known among medical professionals for pioneering the breast screening service at the Well Women Clinic in 1990 and serving as College Warden from 2008 to 2016. But, as if his stellar medical credentials were not impressive enough, Dr Lam was also the team official for the Hong Kong bridge team at the Asian Games in 2018 which brought back two silver and two bronze medals. “My annual leave is mainly spent on sports training, academic conferences, and clinical teaching,” he explained, as we wondered how he manages to juggle his roles as a radiology consultant at Kwong Wah Hospital, Hong Kong, a trainer in radiology, and an avid athlete.
 
Dr Lam’s love for bridge began long before his love for medicine when, at age 10, his elder brother taught him how to play. He went on to join the bridge team at his high school, where he learned to perfect the game and won Inter Secondary School Championship at age of 19. Despite his hectic work schedule as a medical student at the University of Hong Kong, Dr Lam became a dedicated member of the Hong Kong Contract Bridge Association. After graduating, Dr Lam did not give up his passion for bridge, despite the frenetic pace of life as a doctor, and travelled the world representing Hong Kong in multiple regional and international competitions. He attained the grandmaster grade in Bridge after becoming Hong Kong Open Champion in 2010 and 2011. His World Ranking is currently 181 in the senior series.
 
Although Dr Lam has won a plethora of tournaments and competitions throughout his bridge career, he spoke fondly about winning the 18th Asian Games in 2018. “It was definitely the most memorable moment in my journey,” he said as he proudly showed off his collection of trophies. As the Hong Kong team official, Dr Lam was responsible for training and improving the team, helping them to identify their strengths and weaknesses, and boosting team morale. He explained to us that bridge is like a “mind marathon”, requiring immense focus and attentiveness for many hours. As a result, he had to ensure that the team were in a level-headed mental state throughout the marathon. His dedication to the team and their hard work ultimately led to the success of the Hong Kong team in the event.
 
Dr Lam is most proud of his personal achievement in winning the Hong Kong Medical Association’s Sportsman of the Year award 3 years in a row. Throughout his life and medical career, Dr Lam understood the importance of a healthy work-life balance: “Time is not a problem; the problem is how to allocate your time,” he opines. Growing up, Dr Lam enjoyed playing various sports, from badminton and table tennis to sailing and windsurfing. Even as a practising physician, Dr Lam continues to dedicate time to exercising every day, reserving his Mondays and Sundays especially for his childhood favourites, table-tennis and badminton.
 
Physical fitness was not the only reward that Dr Lam earned from sports. Dr Lam appreciates the importance of transferable skills, and he has learned techniques from sports and other professions or specialties that have helped him in his medical career; such as adopting a surgeon’s practice of chatting to a patient while allowing local anaesthesia to take effect, which could also help to calm a patient undergoing radiological procedures.
 
Dr Lam says that the mental discipline needed for sports and professions stems from a conscious-subconscious distinction. His experience with sports showed him that a good foundation of basic skills is earned through good practice, so that these become subconscious and habitual, leaving more conscious brainpower to devote to the game at hand. Dr Lam finds this process of learning and developing subconscious skills to be directly applicable to the workplace. Once basic skills have become routine and part of the subconscious, one can use logical deduction for more complicated investigations and analysis of the clinical information available. The parallels between training for bridge and practising medicine allowed Dr Lam to hone his skills in both at the same time.
 
Dr Lam has also had a remarkable medical career. When decided to specialise in radiology, it was still a rather undeveloped specialty in Hong Kong. Doctors had only plain film imaging and fluoroscopy. Surgeons had little information prior to operating, unlike today, where various imaging modalities and other information allow for much more precise planning of operations. Dr Lam identified a need for development in the Radiology Department at Kwong Wah Hospital, as well as in neuroradiology and breast-focused medicine subspecialties. He saw Kwong Wah Hospital as the perfect opportunity to develop his pilot project, the Well Women Clinic, which provides breast and cervical cancer screening services for women. Despite the number of cancers detected by screening, Dr Lam remarked that the high opportunity cost associated with population breast screening hinders it being adopted as a Government Policy.
 
Owing to his expertise in radiology, Dr Lam was the Examiner for the Joint Fellowship Examination of the Hong Kong College of Radiologists (HKCR) and Royal College of Radiologists and represented the HKCR in the Macao Consultant Examinations. He was also the External Examiner of the Final Master of Medicine (Diagnostic Radiology) Examination in Singapore. Dr Lam was also instrumental in establishing a structured radiology training rotation in the early 1990s, and he continues to teach trainees annually to prepare for fellowship exams. As Dr Lam prepares for retirement, he has meticulously annotated and organised his previous work to pass down a treasure trove of knowledge to future radiologists.
 
Although Dr Lam will be taking off his white coat soon, he has no plans to put down his badminton and table-tennis racquet: “it’s less about longevity than active life expectancy, for which I have plans to extend as long as possible.” Before we bid our farewells, Dr Lam showed us one of his latest hobbies—Chinese calligraphy. He wrote the Chinese character for “to be still like water”, perhaps alluding to the fluidity of his life as both a clinician and teacher, and as a sportsman and coach.
 
 

Dr Henry Lam (centre) with student reporters (from right) Nathan, Man-tsin, Bianca, and Henry
 

A pioneer in comprehensive rehabilitation: an interview with Professor Chetwyn Chan

© Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
 
HEALTHCARE FOR SOCIETY
A pioneer in comprehensive rehabilitation: an interview with Professor Chetwyn Chan
Michelle Tsui1; Marco Cheung2; Chrystal Chan3
1 Year 3 (MB ChB), The Chinese University of Hong Kong
2 Year 4 (MB BS), The University of Hong Kong
3 Year 5 (MB ChB), The Chinese University of Hong Kong
 
 Full paper in PDF
 
 

©The Hong Kong Polytechnic University
 
Professor Chetwyn Chan is a pioneer in his field—one of the first to integrate academia with the community. Driven by his strong belief that academia should pivot on the wider community, his research efforts revamp the traditional concept of rehabilitation, firmly establishing rehabilitative community services as an integral component of modern healthcare.
 
Background and mission
A distinguished figure in the community, Prof Chan serves diversified leadership roles in both administration and academia. He is presently the Associate Vice President (Learning and Teaching), Chair Professor of Rehabilitation Sciences, and Director of the University Research Facility in Behavioral and Systems Neuroscience at The Hong Kong Polytechnic University (PolyU). Outside of his official duties, he is perhaps more well-recognised within the community as the Vice-Chairman of the Executive Committee of The Hong Kong Society for Rehabilitation (HKSR).
 
“I don’t believe academia is limited to only research,” Professor Chan asserts. “Academia must not neglect social needs.” It appears that few university graduates actively participate in Hong Kong society, and he considers this a pitfall of the tertiary education system. Unwilling to fall into this trap, he takes a further step, using PolyU as a cradle for knowledge transfer.
 
After 3 years of clinical practice as an occupational therapist, Professor Chan pursued a PhD in Educational Psychology. He then became a scholar and researcher at PolyU and invested his efforts in psychology and rehabilitation sciences. One of his main research areas is post-stroke rehabilitation; an interest driven by a vision of creating a paradigm shift in the community of stroke patients: from engaging in activities of daily living to autonomous and independent living.
 
“Things don’t happen easily with a mere desire to take an extra step”, Professor Chan concedes, “it is important to choose to do something that society truly needs and is willing to receive.” His interest in helping disabled individuals coincided with an unmet gap between post-stroke patients being discharged from hospital and their leading a meaningful and productive life. Rehabilitation services were often delayed, offered long after discharge from hospital, and the services themselves were limited to the bare essentials. Aside from the institutional shortcoming, there was a lack of patient awareness. Post-stroke patients seemed to be led to believe that the basic services provided by the Hospital Authority were adequate, and they were unaware of needs- and community-based rehabilitation services that are crucial to attain the goal of independent living. For instance, vocational rehabilitation is pivotal in enabling young post-stroke patients to regain a worker role in the family. Activity and participation have become the cornerstones of the contemporary rehabilitation recommended by the International Classification of Functioning, Disability and Health (ICF); however, the Hospital Authority and post-stroke patients appeared unmotivated to fund or purchase such services. There was a profound need to develop rehabilitation services in conjunction with official healthcare services.
 
Community-based post-stroke rehabilitation project
The field of rehabilitation has evolved greatly over the past 30 years. In the past, it was little more than an afterthought. In an ageing population and with younger onset of some chronic illnesses, rehabilitation has developed into an integral part of the patient healthcare journey.
 
Current stroke rehabilitation services provided at the Hospital Authority focus on conventional skills training, helping patients regain their ability to perform activities of daily living through repeated practice. However, when patients are exposed to a different scenario in the community, it is difficult for them to turn their training into actual coping skills. To tackle this challenge, Professor Chan, with his doctoral students, constructed the first self-regulated learning protocol. The value of this protocol in helping post-stroke patients to regain lost daily activity skills has been validated in a series of randomised controlled trials. This day-to-day intervention protocol consists of a three-stage training programme based on cognitive neuroscience knowledge-task chunking, self-referenced appraisal, and mental rehearsal. Self-regulated learning allows patients to be more aware of their strengths (abilities) and weaknesses (disabilities), so they can address new scenarios through integration and synergy of skills they have learned or regained. This, as noted by Professor Chan, is a good demonstration of pushing the limit of the patients’ frontal cortex to produce the executive functions necessary for achieving independent living in the community.
 
Using his knowledge of self-regulated learning and the ICF model, Professor Chan established comprehensive rehabilitation services for post-stroke patients in the HKSR. Professor Chan found that this was as a great platform to bridge the divisions between academia and community, as well as his interests to find solutions for addressing patients’ needs in the community. The HKSR wholeheartedly embraces the mission of providing community-based rehabilitative services for patients with chronic diseases. Patients who have suffered from stroke are one of the core groups benefitting from its services. The new service focuses on the activity and participation needs of post-stroke patients and, in particular, their return to work and community living. With this service and the self-regulated learning strategy, post-stroke patients benefit from a greater capability to work and live independently, as well as contribute (rather than be a burden) to the well-being of their families and communities.
 
By taking many carefully considered extra steps, Professor Chan is transforming the post-stroke rehabilitation services that were once an afterthought into a full-fledged framework with holistic care. However, patient awareness of the new services is still lacking, and rehabilitation services remain disconnected from hospitals. Professor Chan continues to work hard, hoping to generate sufficient evidence and impact with the new services, so that the government will adopt the new service model into the health system. Professor Chan hopes, one day, to see hospital- and community-based rehabilitation services in parallel, as a cohesive whole.
 

Figure 2. Prof Chetwyn Chan (third from left) met student reporters (from left: Michelle, Marco and Chrystal) at The Hong Kong Polytechnic University
 

Pages