關於 have no choice but中文 ，我們在網路上蒐集到這些相關的討論、資訊與評價

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

#美國大選
經過將近三天的開票，Joe Biden終於贏得選戰成為美國第46任總統。
聽他選後第一次發表的演說時，我正在曬衣服🤣
帶著耳機邊曬邊聽，很多地方都聽到全身起雞皮疙瘩，所以特別分享影片以及讓我有「觸電」感覺的秒數記下分享給大家🇺🇸必須要說，很多時候聽英文原文真的比看中文翻譯有感覺多了！我盡量在下方解說給大家聽。不過我先說好喔，我不是什麼專業的演講評論家也不是個政治狂熱者，但是這的確是場有歷史意義且優秀的演講，單純分享我自己喜歡的地方囉！也歡迎大家分享你們喜歡的段落給大家一起學習！
(2:52~3:03)
I pledge to be a President who seeks not to divide, but to unify. Who doesn’t see Red and Blue states, but a United States.
我承諾成為一個尋求團結而非分裂的總統。我看到的不是紅州或藍州，而是美利堅合眾國(United States of America)。
👉 USA是United States of America，在這次選舉中清楚地看到不論是種族、黨派或貧富，都深深地撕裂、分化美國，所以希望不再用顏色、黨派分Red states or Blue states，而是回到USA的本意就是United States。矮額～這是我第一個雞皮疙瘩的地方。

(6:20~7:05)
And to all those who supported us: I am proud of the campaign we built and ran. I am proud of the coalition we put together, the broadest and most diverse coalition in history. Democrats, Republicans and Independents. Progressives, moderates and conservatives. Young and old. Urban, suburban and rural. Gay, straight, transgender. White. Latino. Asian. Native American.
I mean it. Especially for those moments when this campaign was at its lowest ebb— the African American community stood up again for me. They always have my back, and I’ll have yours.
還有每個支持我們的人，我以我們建立的競選團隊與選戰操作感到光榮。我以我們組成的聯盟感到驕傲，這是史上最廣泛、最多元的聯盟。有民主黨的、共和黨的，還有無黨籍人士，有進步勢力、中間派還有保守派，有年輕的，有老人，有市區跟郊區民眾，也有人來自鄉村地區，有同志、異性戀者，也有跨性別者，有白人、拉丁美洲裔、亞裔，還有美洲原住民。
特別要紀念我們在選情最低迷的時候，非裔美國民眾再次站起來支持我。他們總是支持我，我也支持你們。
👉 這一整段真的要看現場片段，尤其在列舉各種族性別者時，看到他們如此被包容，有這麼幾秒整個拜倒在Biden演講魅力中了！

(7:34~7:53)
It’s time to put away the harsh rhetoric, lower the temperature, see each other again, listen to each other again. And to make progress, we have to stop treating our opponents as our enemies. They are not our enemies. They are Americans. They are Americans.
這是拋開尖刻言辭的時候，要降溫，再見到彼此，聆聽彼此。如果要進步，我們就必須停止把對手當成敵人。我們不是敵人，我們都是同胞。
👉 這裡Biden即席地重複了兩次They are Americans. 經過四年的人權蹂躪後，現在這句話這麼強而有力地講出來真的很有後坐力！

(9:56~10:17)
That plan (the Biden-Harris COVID plan) will be built on a bedrock of science. It will be constructed out of compassion, empathy, and concern.
I will spare no effort, non, or commitment, to turn this pandemic around.
那項計畫將以科學為基礎，依憐閔、同理心與關懷的原則規畫。我將竭盡全力，全心承諾扭轉疫情。
👉 第兩句話其實真的有當場打臉Trump的意味，”will be built on a bedrock of science”，聽了其實挺過癮的😎

(10:48~11:05)
Refusal of Democrats and Republicans to cooperate with one another is not some mysterious force beyond our control. It’s a decision. It’s a choice we make.
民主黨興共和黨拒絕相互合作的原因，並非某種我們無法控制的神祕力量。它是個決定，是我們所做的選擇。
👉 我人生中的信仰一直就是：也許你天生不善良，但永遠可以「選擇」當一個善良的人。所以聽到這句話也真的很有感。

(13:52~14:17)
We’re always looking ahead.
Ahead to an America that’s freer and more just.
Ahead to an America that creates jobs with dignity and respect.
Ahead to an America that cures disease — like cancer and Alzheimers.
Ahead to an America that never leaves anyone behind.
Ahead to an America that never gives up, never gives in.
我們眼光總是向前看，盼望一個更自由、更公正的美國，一個用品格、尊重來創造工作機會的美國，一個可以治療諸如癌症、阿茲海默症等疾病的美國，一個不放棄任何一人的美國，一個不輕言放棄、屈服的美國。
👉 真的好喜歡最後一句：Ahead to an America that never gives up, never gives in. 我覺得我要把”Never give up, never give in.”當做近期的人生座右銘了！

你們呢？你們哪幾段看到起雞皮疙瘩？也分享讓我知道吧！

影片出處：https://www.youtube.com/watch?v=2Q78XXkhx0o&t=771s

我在2019年的加碼推薦10本書籍，其中一本 “Talking to Strangers" 終於有中文版了！而且中文版很有誠意的設計了一個很特別的機密文件包裝袋，中文版也翻譯得還不錯。

不同於過去Malcolm Gladwell 其他的暢銷書，這一本處理的是一個棘手的議題 -- 人與人之間的信任。

《#解密陌生人》不像過去的著作用故事讓人很容易明白一個新的觀點，而是用故事讓你不得不停下來思考自己平常判斷的模式。它會給你的，不是一個結論，而是一種在必須快速對陌生人下判斷時，稍微能刻意hold住的能力。在實體和虛擬世界中越來越多接觸陌生人的現在，特別可以體會。

“We have no choice but to talk to strangers, especially in our modern boarderless world, ….yet at this most necessary of tasks, we are inept. ….what is required of us is restraint and humility, ….there are clues to making sense of a stranger, but attending to them requires care and attention”

"我們沒有選擇必須要跟陌生人接觸，特別是在這個現代化又沒有邊界的世界，但在這個如此重要的事上我們非常不足，我們需要自制與虛心的態度，要能理解陌生人是有一些線索的，但要能夠掌握這些線索必須格外地留意與用心"

完整的閱讀心得在部落格中👇👇👇
https://dushuyizhi.net/talking-to-strangers-如何理解陌生人/

#TalkingtoStrangers #MalcomGladwell #解密陌生人 #麥爾坎 #葛拉威爾