"Cardboard box" men and women

There is an occupation or informal kind of work in Hong Kong that I haven’t seen in other cities of the developed world. Older men and women who do this work are self-employed. They work both outdoors (on the streets) and indoors (in shopping malls). They have flexible working hours but most work at the beginning and end of a business day. They deal with material and not people.

These are the men and women who pick up cardboard boxes. Hong Kong is a highly commercialized city, so the turnover of material goods is huge. We make, import and dispose of staggering quantities of cardboard boxes. Seniors who want to make a few dollars go around collecting cardboard boxes from shops, if the shopkeepers let them. Then, they take the folded boxes to the recycling dealers and sell them for a meager sum of money.

I think of these seniors as highly industrious, but I have seen with my own eyes some sneaky ones who sprayed the boxes with water, making them heavier when placed on the scales. I have also read about heartless dealers who cheat with their scales so they can pay less.

Of course, there is no such thing as a perfectly honest occupation. Nevertheless, I am impressed by the industrious spirit of these seniors. They don’t want to idly waste their time away; they are doing something useful and making a few dollars at the same time. I am particularly impressed by the old lady who, although both of her lower limbs are amputated above the knee, drives her motorized wheelchair around to visit stalls and collect cardboard boxes. I admire her spirit.


For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Life after cancer

Readers of my blog may wonder what I am up to in my life after cancer. Well, life goes on as usual.

When I first went back to work, I felt fine. I was able to keep my cool and maintain a fairly good balance between work and rest. As time goes by, I find myself increasingly drawn to more and more work, and needing to stay up later and later into the night. This is not a good sign. I am still trying to find a new and healthy balance.

One important impact of cancer on my life is that I have started to exercise regularly. No, not exercising three times a week for half an hour each time, but hiking weekly. Above the village behind the housing estate where I live, there is a path that, after a 45-minute walk up and down the hill, converges with the MacLehose Trail, a country-park hiking trail. Every Saturday or Sunday, I make an effort to hike this path. Sometimes, when I don’t feel like going, I tell myself that it is a medicine that I must take, given the Hong Kong-based evidence that shows a positive association between exercise (or lack of it) and occurrence of breast cancer. Sometimes, when I miss my weekend hike, I try to make it up in the middle of the following week.

Those who hike will know that it is not easy to find a hiking partner. Everyone walks at a different tempo, some fast, some slow and some in-between. So I usually hike by myself. Hiking on my home trail—I call it my home trail now—has opened my eyes to the world of nature. I have seen how a snail flips its body trying to shake a bug from its shell. I have seen wild pigs running down the hill, snakes slither across a path and into the grass again, and sometimes, more alarmingly, wild dogs. I always take a hiking stick with me, not for hiking, but to frighten away menacing dogs. I have become much more aware that I am close to nature, observing different flowers that blossom at different times of the year, or fruit trees that I never noticed before. Hong Kong has 7 million people, and it is hard to find a spot where you don’t run into anyone. But, sometimes, I do not run into anyone up on the hill, and it is as if I have all that nature to myself. Such beauty and tranquility!

Occasionally, when I am alone, I ask myself what cancer means to me. There is also a slight fear that I may have forgotten something important about surviving cancer. Sometimes I feel I don’t know what the important lesson was, while, at other times, I believe the key lesson is that I should remember that a good life is about loving and forgiving. Essentially, life goes on as usual after cancer. And that is already very comforting.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

If you were a senior in Hong Kong

If you were a senior in Hong Kong, I would say you could be pretty sure that your later life would be well covered. Well, of course, you would have to make a noise first of all and get into the system, i.e., register with the Social Services Department, and then take it from there.

Hong Kong has universal health coverage. For a nominal fee—really nominal—you will be seen by doctors in public clinics and hospitals. You will also get the drugs you need, without paying anything further. Some really novel and expensive drugs are not covered, but there are always alternative drugs that the doctor can prescribe free of charge. If you consult a specialist within the public system, then you will only pay HK$10 (US$1.28) per drug item. You only pay HK$100 for a day in a public hospital, which is just US$12.80. If you need surgery (even heart bypass or brain surgery), chemo, anything, it is all covered.

Of course, before getting treatment, you will need to wait in line. There can be a long wait for specialist appointments, ranging from a few months—rarely—to a couple of years. People in Hong Kong need to wait for three years for cataract operations within the public system.

There is also low-cost housing. Although Hong Kong does not have an official poverty line, there is a reasonable social security net. You won’t get overly comfortable if you are on social security, but you will be covered one way or another.

There are home-care services, and all kinds of in-home support to enable you to live at home and out of long-term residential care. If you applied for residential care with the Social Services Department, you and/or your family will have to wait for 3-plus years. There are also day hospitals and daycare services. But there are always long queues to get into these.

The worst is probably dental care. But isn’t it the same in other parts of the world?

Many seniors may have their roots in the Chinese mainland. Therefore, they may go back to their hometown to spend the rest of their lives. The cost of living is considerably cheaper and, also, they are with their relatives. You may lose your social security benefits if you leave Hong Kong for more than six months. However, recently there has been litigation against this policy, claiming that it is against Hong Kong’s “Basic Law.” The results are not yet known.

There are, of course, problems in our elderly services. But, in general, I appreciate all these things that society and the government are doing for seniors in Hong Kong. As a nurse, it is especially hard for me, knowing that just across the border in the Chinese mainland, health care is not a right for all.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.