Most doctors talk about life, but one doctor stresses the importance of discussing death. Dr. Fan Ning (MBA in Health Care 2009) acts as Associate Consultant of the Surgical Department at Yan Chai Hospital. He has served the Hospital Authority for 20 years, and frequently takes part in humanitarian work overseas. Besides practising medicine, Dr. Fan has set up two non-government organisations, Health in Action and Forget Thee Not to promote health equality, life education and eco-friendly funeral services. He aspires to change the existing healthcare system and social norms one step at a time so that everyone can have both a good life and death as well.
Dr. Fan performs medical exams on tuberculosis patients at a Manila slum (cemetery) in 2010
Frontline Experience Reignites Passion
The year 2000 was a turning point for Dr. Fan. As a favour for a friend, he served as the team doctor to a mountaineering group of more than 30 university students. The team was set to climb the Qilian Mountains in China, with an altitude of over 6,000 metres above sea level, but the plan was interrupted when many of the team developed altitude sickness around half way up. They took refuge at a village school-turned-hospital, where Dr. Fan alone took care of all the patients. A few days later, everyone recuperated and reached the destination together.
Dr. Fan Ning (in black) receives out-reach training during his MBA in Health Care study in 2005
That experience gave Dr. Fan a chance to break out from the norm of everyday life and reflect on his original aspirations as a doctor. “In the business world, the relationship between healthcare providers and patients is often distorted. That experience reminded me that I became a doctor to help people. Hong Kong doctors usually only encounter diseases of affluence. Much of our medical knowledge is never used. It inspired me to practise more comprehensive medicine. Besides, medical advances make doctors forget the fundamentals. That trip made me realise that as long as I have the skills and knowledge and basic supplies, I can treat patients even in the most underdeveloped place.”
Dr. Fan later acquired overseas medical service training at Red Cross and joined Médecins Sans Frontières. He has since participated in many international humanitarian relief projects, offering pro bono consultations in areas struck by the Sichuan earthquake and war zones wrecked by the Libyan Civil War. In 2005, he enrolled in the CUHK MBA in Health Care Program, but his commitment to aid work delayed his length of study from three years to five.
Dr. Fan (2nd from right) attends the premiere of The Tail Before at the Jockey Club Centre for Positive Ageing, a film that explores elderly palliative care and dying
Turn Shellshock into Motivation to Promote Health Equality
In 2012, his organisation Health in Action led a team of volunteers to the Philippines to offer free consultations in a slum. The poor living conditions shook him to the core. “Kids lived up in dumpsters and played in a sewage-filled river. Their faeces were covered in parasites. The locals were used to this kind of life. I felt sorry for those stuck in this cycle of misfortune.” Dr. Fan concluded that the health problems faced by both the poor in the Philippines and those with low-income in Hong Kong were the result of social issues. After returning to Hong Kong, he repositioned Health in Action into an organisation that champions health equality.
Health inequality is due to factors such as race, language and poverty. It concerns issues including housing, water and education. For instance, a recent study by Health in Action reveals that low-income families in Kwai Tsing District and ethnic minorities have higher than average readings in blood glucose, lipids, and pressure. The team aims to develop Hong Kong into a healthy city by adopting a service-research-advocacy cycle. It urges the government to set goals and guidelines in order to improve the overall community health.
Dr. Fan also campaigns for a reform of the current “treatment-based” specialised healthcare system. He calls for a reallocation of resources to a “prevention-based” social healthcare system. “The idea is like vaccinating the entire society. With fewer patients, problems such as the overloading of A&E departments and hospital staff shortage will be resolved.”
Dr. Fan introduces green coffins to members of the public at a “silent teacher” event held on CUHK campus
End-of-life Management: Take Charge of the Next Step in Life
Many healthcare professionals view death as a failure, but Dr. Fan believes that doctors are not Gods. Although resurrection is beyond their power, doctors can help people understand death to minimise their pain instead. He notices many peculiar phenomena surrounding death in Hong Kong. For example, despite the fact that home death is legal, there is no related support in the community. Many dying people are sent back to the hospital. Another example is that many Hongkongers have life insurance or health insurance, but somehow very few put their end-of-life plans, advance directives, or funeral arrangements in writing. The final wishes of the few who do may not even be honoured due to a lack of communication with their family members.
Dr. Fan (right) and DJ Big Soil host a show on Metro Radio to discuss and explore life
In view of this, Dr. Fan set up Forget Thee Not in 2013 to advocate advance directives and home death through end-of-life management and empowerment. It also appeals to the government to make palliative treatment and hospice policies to address the needs of the ageing population. “To anyone who is dying, no professional service compares to the care of their own family. Instead of keeping them in the hospital, just let them go home and reunite with their loved ones. Let them pass on with dignity.”
In addition, Dr. Fan is a proponent of sustainable funeral services through Forget Thee Not. The organisations have introduced coffins made of recycled papers and other environmentally-friendly offerings as an alternative to traditional funeral arrangements. He hopes to inspire people to consider an eco-friendly and respectful way of honouring the dead.
Doctors are like gardeners in the garden of life. Although they cannot alter the seasons or reverse the cycle of living, they can help flowers reach full bloom when the right season comes.