China & Hong Kong
China was visited for the first time by the Travelling Surgical Society in May 2007. We went as members of the Royal College of Surgeons, which organised this Voyage of the Eagle through paediatric orthopaedic surgeon David Jones from Great Ormond Street, assisted by Martin Comber and Maria Finnerty of the College, accompanied by Chief Executive Craig Duncan. The President of the College (PRCS) Bernard Ribeiro chose the venue in accordance with the wish expressed by his late predecessor Hugh Phillips.
The programme was busy, meticulously planned and proceeded flawlessly – a remarkable achievement to which members of the TSS contributed with papers and even a clinical poster, “punching above our weight” in the words of TSS President David Ralphs. The 35 members and wives from the TSS constituted a third of the total number on the two-week visit. Scientific meetings were held at our first destination, Hong Kong, and our fourth, Beijing. There was extensive sightseeing with visits to Guilin (the River Li and a tea plantation), Xi’an (the Terracotta Army), the Great Wall outside Beijing and finally bustling Shanghai (with water village then Suzhou) ending with an almost silent 30 km journey at 300 km/hr on the Maglev train to the ultra-modern Pudong International Airport whence most flew home.
In Hong Kong we stayed in the magnificent Hyatt Hotel with its very attentive staff. Our first act was to assemble for an overview of the programme by David Jones, then measurement for a suit (£200) by Sam’s Tailors from Kowloon! From our hotel we sallied forth to the Happy Valley racecourse, an evening boat trip (“Hong Kong” mean fragrant harbour), and of course a drink at the Peak with its extensive views, followed by dinner at the fabulously ornate Aberdeen Marina Club. The second day of the joint meeting with the Hong Kong Surgical Association (held in the Academy of Medicine Jockey Club Building) began with an acrobatic Lion Dance, included tributes to a number of Hong Kong surgeons past and present, conferred diplomas on new graduates, and proceeded with plenary sessions, guest lectures, and paper presentations similar to those at the annual meeting of the Association of Surgeons (an organisation owing its origins, like the TSS, to Lord Moynihan).
From Hong Kong the group flew to Guilin, where its conical limestone karsts were seen from coach and boat as we travelled to and along the River Li savouring the exquisite Chinese scenery, captured forever in the film The Veil (Somerset Maugham’s tale of an English bacteriologist treating dysentery and mending his marriage in the heart of China). Sight-seeing was also the keynote of our next stop, the ancient former capital city Xi’an, thronged with people in its main square on the edge of which we each had a dinner of 16 dumplings. To the northeast of Xi’an has been excavated the magnificent Terracotta Army, twenty of its most precious pieces destined to be displayed at the British Museum until April 2008. Constructed 2,200 years ago and rediscovered in 1974, the Army was intended to protect the first Emperor of China, Qin Shihuang, in the after-life but more prosaically as one of the great marvels of the real world it has brought tourism and prosperity to an area which was once the political and administrative heart of this huge nation.
In Beijing our accommodation – at the Prime Hotel – was again first-class, and within walking distance of the Chinese Medical Association, housed in an unprepossessing building with the obligatory sentry at its entrance. During the one-day meeting honorary fellowships were conferred before a mutual exchange of papers concentrating largely on surgical training and education. There was a stunning demonstration by Terry Irwin on how to produce a memorable PowerPoint presentation which left subsequent speakers somewhat nervous! David Jones gave an illuminating talk on the history, activity and website (www.jbjs.org.uk) of the British Journal of Surgery. David Ward, RCS Council lead for examinations and assessment and soon to be a TSS member, gave an overview of the Intercollegiate Surgical Curriculum Project which has its own website (www.iscp.ac.uk) enabling trainers and trainees to follow structured programmes, mandatory from August 2007. Chinese surgeons are slowly getting to grips with appraisal and mentoring but would like more support from their Ministry of Health to establish their own web-site. Excellent overviews were presented of urology and cardiothoracic surgery in China, contrasting somewhat with a turgid explanation of Traditional Chinese Medicine, widely used throughout the country (often alongside Western-style care) because it is cheap, being based largely on the management of symptoms with herbal mixtures, acupuncture and tuina.
In both Beijing and Hong Kong (which like Macau is a Special Administrative Region with considerable autonomy and no defence budget) we split into groups to visit various hospitals, which were impressive and well-equipped but doubtless the best in the land. In the spotless Beijing Cancer Hospital, for instance, the medical staff seemed well-versed in Western practice and were said to have flourishing multi-disciplinary team meetings. We also visited the very modern Medical Beijing Science Center in which Johnson and Johnson have given laparoscopic and other state-of-the-art surgical instruction to around 20,000 aspiring surgeons, nurses and J&J representatives. The training and techniques in Hong Kong too seemed second to none. One day perhaps the whole of China will benefit from such advances in healthcare.
Throughout the country, there was an impression that its huge population (2.4 billion) had a committed work ethic despite widespread poverty (700 million are said to earn less than $5 a day). Certainly the explosion of exports from the BRICA countries (Brazil, Russia, India, China and Asia generally) is obvious in shops in the West, though issues such as human rights, lead-paint on toys, copyright, corruption, pollution and child-labour constantly rear their heads in the Western press. Every man (and woman) on the streets of China seems to have a bicycle, sometimes motorised and often pulling a trailer containing cardboard or bottles, producing an impression of intense industry in the hope of a better life. Real heavy industry, of course, is highly productive (though often polluting) by virtue of cheap labour harnessed to an entre-preneurial spirit. In Shanghai, Western-style money-making seems to mimic that of Hong Kong. Whether poverty or prosperity represents the true China remains to be seen. Perhaps the Olympics in Beijing in 2008 will offer interesting insights.