今早為Asian Medical Students Association Hong Kong (AMSAHK)的新一屆執行委員會就職典禮作致詞分享嘉賓,題目為「疫情中的健康不公平」。
感謝他們的熱情款待以及為整段致詞拍了影片。以下我附上致詞的英文原稿:
It's been my honor to be invited to give the closing remarks for the Inauguration Ceremony for the incoming executive committee of the Asian Medical Students' Association Hong Kong (AMSAHK) this morning. A video has been taken for the remarks I made regarding health inequalities during the COVID-19 pandemic (big thanks to the student who withstood the soreness of her arm for holding the camera up for 15 minutes straight), and here's the transcript of the main body of the speech that goes with this video:
//The coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus, continues to be rampant around the world since early 2020, resulting in more than 55 million cases and 1.3 million deaths worldwide as of today. (So no! It’s not a hoax for those conspiracy theorists out there!) A higher rate of incidence and deaths, as well as worse health-related quality of life have been widely observed in the socially disadvantaged groups, including people of lower socioeconomic position, older persons, migrants, ethnic minority and communities of color, etc. While epidemiologists and scientists around the world are dedicated in gathering scientific evidence on the specific causes and determinants of the health inequalities observed in different countries and regions, we can apply the Social Determinants of Health Conceptual Framework developed by the World Health Organization team led by the eminent Prof Sir Michael Marmot, world’s leading social epidemiologist, to understand and delineate these social determinants of health inequalities related to the COVID-19 pandemic.
According to this framework, social determinants of health can be largely categorized into two types – 1) the lower stream, intermediary determinants, and 2) the upper stream, structural and macro-environmental determinants. For the COVID-19 pandemic, we realized that the lower stream factors may include material circumstances, such as people’s living and working conditions. For instance, the nature of the occupations of these people of lower socioeconomic position tends to require them to travel outside to work, i.e., they cannot work from home, which is a luxury for people who can afford to do it. This lack of choice in the location of occupation may expose them to greater risk of infection through more transportation and interactions with strangers. We have also seen infection clusters among crowded places like elderly homes, public housing estates, and boarding houses for foreign domestic helpers. Moreover, these socially disadvantaged people tend to have lower financial and social capital – it can be observed that they were more likely to be deprived of personal protective equipment like face masks and hand sanitizers, especially during the earlier days of the pandemic. On the other hand, the upper stream, structural determinants of health may include policies related to public health, education, macroeconomics, social protection and welfare, as well as our governance… and last, but not least, our culture and values. If the socioeconomic and political contexts are not favorable to the socially disadvantaged, their health and well-being will be disproportionately affected by the pandemic. Therefore, if we, as a society, espouse to address and reduce the problem of health inequalities, social determinants of health cannot be overlooked in devising and designing any public health-related strategies, measures and policies.
Although a higher rate of incidence and deaths have been widely observed in the socially disadvantaged groups, especially in countries with severe COVID-19 outbreaks, this phenomenon seems to be less discussed and less covered by media in Hong Kong, where the disease incidence is relatively low when compared with other countries around the world. Before the resurgence of local cases in early July, local spread of COVID-19 was sporadic and most cases were imported. In the earlier days of the pandemic, most cases were primarily imported by travelers and return-students studying overseas, leading to a minor surge between mid-March and mid-April of 874 new cases. Most of these cases during Spring were people who could afford to travel and study abroad, and thus tended to be more well-off. Therefore, some would say the expected social gradient in health impact did not seem to exist in Hong Kong, but may I remind you that, it is only the case when we focus on COVID-19-specific incidence and mortality alone. But can we really deduce from this that COVID-19-related health inequality does not exist in Hong Kong? According to the Social Determinants of Health Framework mentioned earlier, the obvious answer is “No, of course not.” And here’s why…
In addition to the direct disease burden, the COVID-19 outbreak and its associated containment measures (such as economic lockdown, mandatory social distancing, and change of work arrangements) could have unequal wider socioeconomic impacts on the general population, especially in regions with pervasive existing social inequalities. Given the limited resources and capacity of the socioeconomically disadvantaged to respond to emergency and adverse events, their general health and well-being are likely to be unduly and inordinately affected by the abrupt changes in their daily economic and social conditions, like job loss and insecurity, brought about by the COVID-19 outbreak and the corresponding containment and mitigation measures of which the main purpose was supposedly disease prevention and health protection at the first place. As such, focusing only on COVID-19 incidence or mortality as the outcomes of concern to address health inequalities may leave out important aspects of life that contributes significantly to people’s health. Recently, my research team and I collaborated with Sir Michael Marmot in a Hong Kong study, and found that the poor people in Hong Kong fared worse in every aspects of life than their richer counterparts in terms of economic activity, personal protective equipment, personal hygiene practice, as well as well-being and health after the COVID-19 outbreak. We also found that part of the observed health inequality can be attributed to the pandemic and its related containment measures via people’s concerns over their own and their families’ livelihood and economic activity. In other words, health inequalities were contributed by the pandemic even in a city where incidence is relatively low through other social determinants of health that directly concerned the livelihood and economic activity of the people. So in this study, we confirmed that focusing only on the incident and death cases as the outcomes of concern to address health inequalities is like a story half-told, and would severely truncate and distort the reality.
Truth be told, health inequality does not only appear after the pandemic outbreak of COVID-19, it is a pre-existing condition in countries and regions around the world, including Hong Kong. My research over the years have consistently shown that people in lower socioeconomic position tend to have worse physical and mental health status. Nevertheless, precisely because health inequality is nothing new, there are always voices in our society trying to dismiss the problem, arguing that it is only natural to have wealth inequality in any capitalistic society. However, in reckoning with health inequalities, we need to go beyond just figuring out the disparities or differences in health status between the poor and the rich, and we need to raise an ethically relevant question: are these inequalities, disparities and differences remediable? Can they be fixed? Can we do something about them? If they are remediable, and we can do something about them but we haven’t, then we’d say these inequalities are ultimately unjust and unfair. In other words, a society that prides itself in pursuing justice must, and I say must, strive to address and reduce these unfair health inequalities. Borrowing the words from famed sociologist Judith Butler, “the virus alone does not discriminate,” but “social and economic inequality will make sure that it does.” With COVID-19, we learn that it is not only the individuals who are sick, but our society. And it’s time we do something about it.
Thank you very much!//
Please join me in congratulating the incoming executive committee of AMSAHK and giving them the best wishes for their future endeavor!
Roger Chung, PhD
Assistant Professor, CUHK JC School of Public Health and Primary Care, @CUHK Medicine, The Chinese University of Hong Kong 香港中文大學 - CUHK
Associate Director, CUHK Institute of Health Equity
同時也有1部Youtube影片,追蹤數超過0的網紅Chandaikim 陳大金,也在其Youtube影片中提到,2015年12月3日,第二條vlog終於剪好!中學果然是回憶中最美好的地方!謝謝大家用耐性睇唒整條片〜 + 按此追蹤我|https://www.youtube.com/channel/UCdPM... + Facebook : https://www.facebook.com/chandaik...
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求職/JUPAS攻略(三)-Interview
1️⃣ Self-introduction
將你自身經歷match去你嗰科需要你有嘅特質,諗佢地expect嘅personalities再配一啲經歷persuade人哋覺得你真係適合呢個program/呢份工。
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2️⃣ 點解入我哋呢科/apply我哋公司?
你要對院校/公司有一定認識,如果in大學就要知curriculum、排名、獨特嘅地方,我當時什至用CUHK EngEdu同HKU嘅curriculum同學科做比較,講出HKU點解好啲,所以記住真係要睇清楚人哋網頁揾啲relevant information, 揾唔到嘅就揾你啲上咗大學讀嗰科嘅師兄師姐幫手啦。至於見工嘅就要諗公司做嘅嘢<—>個人ability/interest同埋公司理念<—>個人理念。
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3️⃣ 對industry嘅認識
講完personal嘅,就會講同學科相關嘅industries,例如Business可能會問你點睇未來中國同香港嘅商貿發展,Education會問你如何改善現時嘅教育制度。你interview前可以估吓題目,search吓啲新聞、articles嚟睇吓,可能會揾到啲examples套到用,對俾人搏學嘅印象有幫助㗎。至於見工都係差唔多概念。
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4️⃣ 預備一至兩個問題問返interviewer
去任何interview, 正常嘅interviewer都會喺臨完問你"Do you have any questions?" 呢個係最後機會表現自己,千祈唔好答"no"或者任何人哋webpage都答到你嘅低質問題。宜向兩個方向建立問題,一係能夠表達個人優勝特質,二係展示你對佢哋學科、學院有充分了解,例如我當年問過:"As I know, one of the areas you will focus on is education psychology. I am particularly interested in this topic. Could you tell me more about what you are going to teach and suggest one book that a beginner can read during summer?" (表示了解課程同埋好學一面😎)。如果見工的話就可以問吓公司未來發展,近來我常問嘅一題係”What challenges do English teachers face in this school?”(理解嗰度嘅學生狀況同老師需要)。
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5️⃣ Thank you letter
如果in大學,都可以send返封thank you letter多謝interviewers嘅。唔好諗住interview係入去見人嗰十五分鐘,由你踩入人哋學校(如果見工都一樣,我由入校門開始對住所有人都係friendly樣😂)到你send thank you letter都係interview。人哋見你、同你傾計都喺好嘅(人哋professor/老細都係job duty先要in你,而世界上冇乜邊個鍾意翻工)。所以點都好,interview時留意interviewers面前個名牌,冇就出去問receptionist,in完後上faculty webpage揾返佢email send封信,多謝人地抽時間見你,最好寫返佢講過乜嘢係inspiring嘅,署返個全名,俾人覺得你有禮貌、醒醒目目,起碼佢要翻工都翻得條氣順啲吖😂同埋一個program in咁多人,有封thank you email留個全名都係有著數嘅。至於見工就睇返個field嘅習慣啦,之前in PR我有send, 不過呢排in學校又冇,不過講至尾,呢樣都係bonus嚟嘅。
//
覺得有用嘅擺低個like, 咁我哋出文又動力大啲、快啲啦!
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希望大家可以幫吓可仁啦😢 我希望個個小朋友都可以健康快樂咁成長,可以一齊去公園玩
【最新消息:募捐行動已於2018年12月3日結束】中大校友慈善基金感謝各界慷慨支持,募捐行動已結束。所得善款將支持張可仁及患上相類疾病需免疫治療的其他6位病童。
詳情請參閱中大校友慈善基金網頁:https://www.facebook.com/cuhkacf.org/posts/589827338133781
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(2018/11/22)
中大醫學院向大家作出緊急呼籲,支持我們2000年的醫科畢業生張俊傑醫生,拯救他只有17個月大的兒子張可仁的性命。
可仁早於出生第4天時已被診斷罹患一種罕有心臟病「主動脈狹窄」(Coarctation of Aorta),需要接受緊急手術。極之不幸的是,可仁最近再被確診患上「第四期神經母腫瘤」(Stage IV Neuroblastoma),目前可仁的頭骨至腰椎和盆骨均受到癌細胞擴散,脊髓神經線受到癌細胞壓住,痛楚非常,並有癱瘓的危機,癌細胞更正轉移至骨髓。
可仁現時正住在威爾斯親王醫院兒童癌症中心隔離病房,極容易受到感染。他已開始接受化療,而治療方案將包括化療、手術、放射治療、骨髓移植、免疫治療,治療時間約一年至一年半。他完成化療、手術和放射治療後,會進行骨髓移植,之後需要免疫療法,這可大大提高存活率,由20%升至50%。
然而,免疫治療需要病人自費,所需費用高達港幣200萬元。張醫生另一兒子患有自閉症,太太辭掉小學主任一職,全職照顧兩位小朋友,並要照顧父母親,經濟上未能承擔高昂的醫療費用。
中大醫學院2000年畢業同學會發起是次籌款,目的包括:
1. 為可仁進行骨髓移植後的免疫治療;
2. 引發社會人士及政府對兒童罕有癌症治療的關注。
查詢:
香港中文大學校友慈善基金
電郵:info@cuhkacf.org
電話:2180 4316
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【Fundraising Campaign Completed on 3 December 2018】According to CUHK Alumni Charity Foundation, the fundraising campaign for Mark CHEUNG Ho Yan has completed. The fund raised will be used to support the immunotherapy of Mark and 6 other patients who are suffered from the same disease. Thank you for all your kind-hearted support and generosity.
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(2018/11/22)
This is an urgent appeal for your generosity to save the life of the 17-month-old son of Dr. CHEUNG Chun Kit, our medical alumnus of Class 2000.
Dr. Cheung Chun Kit is a CUHK medical graduate of Year 2000. His younger son, Cheung Ho Yan Mark, has recently been diagnosed to have Stage IV Neuroblastoma in November 2018, and is in an emergency need of donation to provide the necessary funding to support the life-saving yet expensive immunotherapy.
Mark was presented to his paediatrician for fever and cough in late October 2018. His cough resolved with treatment but his fever never completely went away. Two days prior to his diagnosis, Mark was more clingy than usual and did not like to walk. On a video clip, Mark was noted to have foot drop, a very significant red flag which may indicate a compression on the spinal cord. Emergency scans were immediately performed that night, and Mark was found to have a large tumour on the left side of his abdomen. The aggressive tumour had already spread silently to the back of his skull, his spine, his hips and had compressed his nerves which control his lower limbs, resulting in pain on standing and difficulty in walking. Mark is facing an imminent risk of paralysis.
Mark is diagnosed to have a rare childhood cancer which is called Stage IV neuroblastoma, a cancer which typically presents at late stage because it arises deep in the abdomen. To cure his aggressive cancer, Mark needs to survive through rounds of intensive chemotherapy, radiotherapy, surgery, bone marrow transplant, and finally, immunotherapy. The whole treatment duration lasts 1.5 to 2 years. To completely eradicate all cancer cells, immunotherapy will be needed to boost Mark’s survival from 20% to 50%. However, immunotherapy is a self-financed treatment in the public hospital and the treatment costs could be up to 2 million.
Such close encounter with death is not the first time for Mark. At the first week of life, Mark was diagnosed to have a rare heart problem called “Coarctation of Aorta”. Mark had received life-saving surgery to reestablish the blood flow across his aorta, the major blood vessel that allows blood to go from the heart to the brain and the rest of the body. In a report published in 2002, only 67 cases with dual heart condition and neuroblastoma were reported, giving an odd of 1 in 100 million for a child to be hit by these two rare diseases. Scientists have not yet completely understood the mechanisms that may cause the two conditions to appear in a single child.
It never rains but pours that Mark’s elder brother, now 5 years old, was diagnosed to have autism at around age 2. To enable the elder brother to have intensive training to improve his outcome and development, Mark’s mommy quit her job as a primary school teacher since the diagnosis of autism was made for his elder brother. Dr. Cheung, who is a medical doctor for the elderly, became the sole bread-winner of his family.
CUHK Medical Graduates of Year 2000 have initiated a fund-raising campaign for Mark and his family with the following two objectives:
1. To appeal for donation to support the costs of immunotherapy for Mark
2. To increase the public awareness on the grave needs of children with cancers
Enquiries:
CUHK Alumni Charity Foundation Limited
Email: info@cuhkacf.org
Telephone: 2180 4316
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2015年12月3日,第二條vlog終於剪好!中學果然是回憶中最美好的地方!謝謝大家用耐性睇唒整條片〜
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