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Ophthalmology in Hong Kong
  1. D S C Lam,
  2. C C Y Tham
  1. Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong, People’s Republic of China
  1. Correspondence to: Professor Dennis S C Lam, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, University Eye Center, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong; dennislam{at}cuhk.edu.hk

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A catalyst for ophthalmic developments in China

Hong Kong is unique in China: she is where the virtues of the East meet the values of the West. Her sovereignty returned from the British to the Chinese Government in 1997, but Hong Kong has continued to flourish, under the “one country, two systems” model, and remains international, dynamic, innovative, and prosperous. Western style rule of law and freedom of speech and thought have persisted here. Against this unique historical and political background, ophthalmology has made important strides in Hong Kong over the past decade, both in academic research and in the provision of quality care of international standard to the local population. Hong Kong has also increasingly become a catalyst for ophthalmic developments in China.

One of our earliest projects to bring quality ophthalmic care to remote and poverty stricken regions of China was the “Lifeline Express.”1 (DSCL is a founding executive committee member and an ambassador of sight of the Lifeline Express, and the honorary director of the Shantou University/The Chinese University of Hong Kong Joint Shantou International Eye Center.) The Lifeline Express is a tailor built train to help eliminate cataract blindness in China (Fig 1). It is a charity project with most of its funding raised in Hong Kong. Ophthalmologists on the Lifeline Express are either volunteer doctors from Hong Kong, or doctors from mainland China who have been trained in Hong Kong. Currently there are two trains, but the third will be in operation by the end of 2002, giving a capacity to perform about 10 000 cataract operations per year. The Lifeline Express not only provides totally free cataract surgery for poor and helpless people in remote regions of China, but also helps to train local doctors in modern microsurgical cataract extraction. It is the philosophy of its founders that the best way to help people is to teach them how to help themselves, and this has been the guiding principle for the Lifeline Express from the very beginning.

Many ophthalmic centres in Hong Kong have achieved internationalexcellence in their patient service, training programme, research work, and administrative infrastructure. The PRC (People’s Republic of China) Fellowship Programme of The Chinese University of Hong Kong has made it possible for up to 20 ophthalmologists from the PRC to come to Hong Kong for attachment every year. Through these attachments, it is hoped that PRC ophthalmologists can enhance their clinical knowledge and surgical skills, get exposure and training in quality research, become accustomed to the western style of management that is often taken for granted in Hong Kong, and also become acquainted with the information technologies in the clinic and academic settings in Hong Kong.

Many PRC fellows have also made full use of this very much sought after opportunity to further polish their English. Duration of attachment varies from 3 months to 1 year. The shorter attachments are more geared towards allowing the fellow to learn a specific diagnostic, surgical, or research technique, while the longer attachments are designed for subspecialty or laboratory training. The molecular genetics laboratory of the department has become one of the most popular areas for our PRC fellows. During their stay in Hong Kong, many PRC fellows also have the opportunity to participate in international publication.

The main problems are a shortage of well trained ophthalmologists and modern facilities, especially in poor and more remote regions of China

Though the PRC fellowship programme has offered some excellent training opportunities for the fortunate few, its training capacity is still very limited. In order to help more mainland patients receive high quality ophthalmic care, and to allow more mainland doctors to acquire knowledge and skills of the highest international standard, the Joint Shantou International Eye Center (JSIEC, Fig 2),2 a collaborative effort between Shantou University and The Chinese University of Hong Kong, and fully funded by the Li Ka Shing Foundation,3 was founded in Shantou, PRC, in 2000. The vision of the JSIEC is to achieve international excellence in ophthalmology. It is a very modern and comprehensive ophthalmic centre. Apart from clinical services, a well equipped basic science research facility, with many laboratories and full animal house support, is also established. There are also wet laboratory facilities for training purposes. All medical and nursing staff working over there are given opportunities for training attachment in Hong Kong. Subspecialty experts from Hong Kong also regularly visit the JSIEC to share experience and expertise with the local doctors. The Fourth Hong Kong International Symposium of Ophthalmology was held in Shantou to commemorate the opening of the JSIEC in June 2002. It was well attended by leading national and international renowned experts, as well as PRC doctors from all over China. One very important mission of the JSIEC is to train young ophthalmologists from different regions of China. By setting up a training centre in China, the overall cost of training is much lower. There will be no communication difficulties arising from the speaking of different dialects, as Putonghua is more or less universally spoken within China. In future, it is hoped that many more such joint eye centres could be set up in other cities in China.

In addition to financial affordability of medical care to patients, the other main problems of eye care in China remain the shortage of well trained ophthalmologists and the shortage of modern facilities, especially in poor and more remote regions of China. Hong Kong will continue to have a catalyst role, sharing her expertise in ophthalmology, research, and management, with her mainland counterparts. Through continued training and exposure, PRC ophthalmologists will excel and be more able to provide high quality eye care to their local people. Such a mentoring model may also be applicable to other places when they have a neighbour that can offer such skill and technological sharing and transfer.

Figure 1

The “Lifeline Express.” A modern ophthalmic centre, with diagnostic, therapeutic, and surgical units, all on a train that brings modern ophthalmic care and training to remote, poverty stricken regions of rural China.

Figure 2

The Shantou University/The Chinese University of Hong Kong Joint Shantou International Eye Center: a state of the art ophthalmic service, research, and training centre in mainland China. This may be a role model for future ophthalmic centres in China.

Acknowledgments

We thank Nellie K M Fong, chairman of the Executive Committee and founder of the Lifeline Express, Hong Kong, and Hui-ming Tang, director of the Shantou University/the Chinese University of Hong Kong Joint Shantou International Eye Centre, Shantou, PRC.

Proprietary interest: Nil.

Financial support: Nil.

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A catalyst for ophthalmic developments in China

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