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Posts Tagged ‘health’

Fruit and vegetables now defy the seasons … with one exception

Posted in Uncategorized, tagged , , , , on July 31, 2025| Leave a Comment »

When I was a kid my mother was still in the habit of shopping daily. We had a fridge but it hadn’t really changed our eating habits yet. Most shops featured a counter, behind which the “assistant” would stand and fetch what you wanted.

Fruit and vegetables were different. These came from a specialised shop called the greengrocer’s, which was set up rather more like a Hong Kong wet market. The fruit and veg were out on shelves or in baskets so you could inspect and fondle the goods.

There was a big open space in the middle of the shop where the greengrocer performed, juggling fruit, chaffering with the customers (most of whom he knew by name) and weighing purchases on a large weighing machine.

There was, I noticed, a lot of variation in what was available. We were at the mercy of the climate. You ate salad in the summer because that was when lettuce, cucumber and tomatoes were “in season”. You had Brussels sprouts with your Christmas turkey because sprouts were the only green vegetable immune to frost. Strawberries were a treat at Wimbledon because they had been unobtainable for nine months before

Apart from bananas, which came from – I suppose – banana republics by refrigerated boat, and citrus fruits, imported from Spain, to every thing there was a season, as the song had it.

Well we have changed all that. Wandering my local supermarket I find that most of the fruits and vegetables are reassuringly consistent. They may come from different places at different times of the year but they are always there.

This is partly because food now frequently flies. So what is out of season in the northern hemisphere will be just coming into fruition in the southern one. Also a lot of food production is now conducted in entirely artificial environments. Confused plants can be persuaded that it is fruit time regardless of the calendar.

This is all well and good, and no doubt makes it easier to follow a healthy diet. But there is one exception. We have just passed, you may not have noticed, the end of the lychee season.

I was a fan of the lychee long before coming to Hong Kong. This is because Chinese restaurants in the UK, at least outside the big cities, sold a rather specialised foreigner-friendly version of Chinese food, and this did not include desserts.

If you really wanted a dessert there were only two possibilities: ice cream or tinned lychees. This was thoroughly misleading. When I came to Hong Kong I found whole restaurants devoted to Chinese sweet dishes, offering an intriguing range of soups, dumplings, fruits and variations on rice. There were no tinned lychees or, for that matter, ice cream.

In due course I was introduced to the real fresh lychee. In those days the Xinhua news agency office in Hong Kong was routinely described as China’s de facto embassy in the colony, but they did perform some press relations stuff. And so I was invited on a day trip to see the lychee harvest in Shenzhen, which in those days still had trees and farms.

I am not sure how the industrial scale picking is done but we were all issued with bags and urged to help ourselves. The lychee tree is a conveniently low tree.

But it seems somehow to have eluded the trend towards fruit and vegetable globalisation. You can get lychees when they are in season in Guangdong. Outside that time you can’t. This is surprising.

When kiwis were a New Zealand speciality they were seasonal. But the fruit – also known as the Chinese gooseberry – was long ago transplanted and copied. So now they come from a variety of places and you can get them all year round. Why has this not happened to the lychee?

Let me offer a free suggestion to any New Zealand farmer who thinks the kiwi business is getting a bit crowded these days. Buy, borrow or steal a lychee tree. In the summer – that is your summer, not ours – you will have the world to yourself.

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Dear policy secretaries: People with luxurious jobs shouldn’t be complaining about the workload

Posted in Uncategorized, tagged , , on January 9, 2025| Leave a Comment »

A word of advice for policy secretaries: do not, in your laudable efforts to communicate with the general public over social media, tell us all how tough your job is.

This thought was first prompted by an end-of-the-year Facebook contribution from Chris Tang, the Secretary for Security, in which he recalled a year full of challenges, loss of sleep and “inflammation in my eyes and shoulders, and my gout came back.”

Mr Tang is in a sense in a class of his own. As the Secretary for Security he is in charge of the prison-filling machinery. Numerous people who have friends enjoying the unwanted hospitality of the correctional industry will have been tempted to rather uncharitable responses to reports of his medical problems. Like “Gout? Pity it wasn’t ebola.”

Let us, though, avoid personal specifics and concentrate on the situation of policy secretaries generally. There are plenty of things which they all have in common, which make them rather unlikely recipients for public sympathy.

We know from the budget that you all enjoy salaries exceeding those enjoyed in other countries by prime ministers, presidents and even in some modest cases kings. We know from the reported details of the Political Appointments scheme that you have the services of a secretary, a deputy, a personal assistant and a driver.

Where there is a driver we must also suppose there is a free car.

We know from a little glitch in the sewage system of the freshly-opened Central Government complex that your office also has a private toilet, a dream for many Hong Kong people living in subdivided flats or bedspaces.

We know from the difficulties Ms Carrie Lam experienced when thrust out into the real world that these generous provisions lead to helplessness when forced to use public transport, and complete lack of familiarity with the concept of buying your own toilet paper.

Your work may feel challenging and strenuous but it is also clean, safe and prestigeous. Hong Kong’s working population is (latest census figure) 3.83 million. At least 3.8 million of those people would happily swap jobs with you. Many of them are completely unqualified for the work, but would tell themselves that even if they were fired after a month they would still have earned more than they usually get in a year.

But being unable to do anything useful has not historically been a bar to a lengthy period in office as a policy secretary. The rice bowl is not iron but it is not exactly fragile either.

Under the circumstances complaining about your work makes you look like, to coin a phrase, a bit of a wuss. Getting landmark legislation through Legco may be a source of pride. But how hard can it be to get a law passed in a legislature containing 89 government supporters and one independent?

I would also recommend not going on about possibly work-related medical problems. You are all about 60 years old, give or take a few years. You are reaching a stage in life when the biological machinery which you have taken for granted for half a century starts to throw up the odd problem and needs some care and maintenance.

Sooner or later all of you will encounter one or more of arthritis, tinnitis, varicose veins, deteriorating eyesight, cataracts, mysterious muscular twinges, and occasional inability to remember where you put something down five minutes ago. Your doctor will develop a desire to push cameras into places where you do not normally welcome foreign bodies – happily this is done while you are asleep – and subject you to mysterious but expensive scans.

After a few years of this you will find that conversations with other people in your age group often involve comparisons of medical histories. This is all part of life’s rich pageant and nothing to worry about. But people who are already enjoying it will not be impressed by complaints about the first small symptoms.

A final word for fellow gout victims. This problem is not caused by hard work; it is caused by high uric acid levels in your blood. The solution is a cheap pill called allopurinol. I have been taking it for 40 years.

Looking on the bright side, this used to be known as “the disease of kings” because it was erroneously associated with rich food. Famous victims have included Isaac Newton, Christopher Columbus, Benjamin Franklin, Beethoven and George W. Bush’s vice president Dick Cheney. Doesn’t that feel better?

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What have the Consumer Council and Wall Street Journal in common? Timidity

Posted in Uncategorized, tagged , , , , , on July 20, 2024| Leave a Comment »

The Consumer Council is a curious creature. It is, according to its ordinance, not a part of the government. It is, though, according to the same ordinance, required to follow any written instruction from the Chief Executive. And it is, of course, governed, so far as the actual council governs anything, by government appointees.

This is not usually relevant to the council’s work, which is to help consumers with individual complaints and publish reports on topics relevant to consumption. The reports are a reliable source of news, though sometimes seem to be trying rather too hard.

Some of the “safety hazards” of which the council warns us are rather remote. A recent survey of bottled drinking water, for example, worried about bromates, chemicals often found in water which has been chemically purified.

Bromates pose a cancer risk. On the other hand if you drink a daily two quarts (or half a gallon) of bottled water at the upper end of the range allowed by food regulations, your lifetime cancer risk goes up by about two in 10,000 (according to the New York State Health Department).

Other risks which agitate the council are rather obvious. A report on beer, for example, warned that consuming large quantities regularly will make you grow fatter. This will not have come as a great shock to the beer-drinking community.

And so to last week, when the Council departed from its usual confident, if nit-picking, tone to engage in a full-court grovel before a mainland company which had complained about a report on bottled water.

The company, Nongfu Spring, is rumoured to be owned by China’s richest man. In view of the hazards attached to being China’s richest man this is probably a malicious report circulated by his enemies. Still, it is a big company, so we may suppose it to be well-connected.

The council had reported that a sample of Nongfu’s mineral water had a bromate content of 3 micrograms per litre, which coincides with the upper limit in the European Union standard for some water products.

It also made some mildly critical comments on the taste and mineral content, and gave the sample four and a half stars (out of five). Clearly this upset Nongfu, but if you want to dispute and downgrade a report you keep off the subjective stuff and go for the science.

In a strongly worded letter the company complained that the EU standard was inappropriate, and the sample tested was not, as the council had supposed, “natural mineral water” nor “purified drinking water”.

Instead it was in a category recognised by mainland food regulations, “natural drinking water” and met the standards required on the mainland for this category. If not offered a correction and apology the company would take “further action”.

It also complained that it was inappropriate to use food standards from outside Hong Kong, and as the water was produced on the mainland, mainland standards should apply.

Following a meeting the council, usually a robust defender of its conclusions, collapsed in a heap, apologising, reclassifying Nongfu’s masterpiece as five stars, and stressing that all the samples it tested were prefectly safe to drink, as indeed it had stated in its original report.

This is disappointing. Firstly it is important and useful that the Consumer Council should be able to consult and use a wide range of standards from outside Hong Kong. There are many matters for which there is no local standard. Also the phrase “mainland food safety standards” produces a little mental crashing of gears, the kind you get from concepts like “truthful Donald Trump”, “Swiss seamanship” or “Hong Kong’s beloved government”. We can do better.

Secondly, water is water. Nongfu Spring’s business model involves fostering confusion on this point. The company’s website offers Drinking Natural Water, Drinking Purified Water, Natural Jokul Mineral Water, Drinking Natural Water (Suitable for children and nursing mothers), Natural Mineral Water (containing lithium), Drinking Natural Spring Water (suitable for tea making), and Natural Mineral Water in three different kinds of bottle (sports caps, glass and zodiac).

Oddly enough there is no product called “natural drinking water” and people who hawk products called “mineral water” should not be surprised if mineral water standards are applied to them. How can we expect the Consumer Council to stand up for consumers if it is too timid to stand up for itself?

Also an unexpected contender for the traditional white feather this week was the Wall Street Journal, which summarily fired a reporter, Selina Cheng, for accepting the post of chairman of the local Journalists’ Association. Ms Cheng said she had been warned against “advocating for press freedom in a place like Hong Kong.”

Is this the real Wall Street Journal, proprietor R. Murdoch, home in New York, safely headquartered in the home of the brave, land of the free? Alas, so it is. Indeed some people have suggested that the WSJ already has one reporter languishing in a communist jail and is reluctant to risk having another in the same plight. Ms Cheng would not, if such a thing came to pass, be the first JA chairperson to see the inside of a prison.

I know US newspapers have a thing about reporters displaying political preferences. But even the WSJ apparently regards advocating for press freedom as acceptable, in places where there is press freedom – an oddly self-defeating condition. Also Mr Murdoch is famously hostile to unions of any kind.

Still. Ms Cheng’s union activities were not likely to clash with her professional work covering the car and energy industries in China. And the WSJ will soon be free from worries about hostility in Hong Kong because it is moving to Singapore.

In response to inquiries the WSJ borrowed a famous line from embattled government departments and refused to discuss individual cases. It also said it was “a fierce and vocal advocate for press freedom in Hong Kong and around the world.” Bullshit. Had chance. Blew it.

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Diet or die! Do we really need a World Obesity Day?

Posted in Uncategorized, tagged , , , on March 7, 2024| 1 Comment »

It was, as I am sure you noticed, World Obesity Day last Monday. World Days are surprisingly common. The United Nations has about 200 of them, starting with World Braille Day on January 4 and finishing the year with the International Day of Epidemic Preparedness on December 27.

But World Obesity Day is not one of the UN ones, it is an unofficial, or less official, offering from the World Obesity Federation. No, I had never heard of it either.

In fact it is a bit of a mystery why World Obesity Day qualified for a decent third of a page feature in the Standard from the agile pen of Adelyn Lau. There was no recognition in the paper of World Wildlife Day, which was the day before. Well all right they don’t print on a Sunday, but March 1 passed with no mention of the fact that it was in fact two Days: World Seagrass Day and Zero Discrimination Day.

Similarly, Tuesday’s International Day for Disarmament and Non-proliferation Awareness passed unremarked, as far as I could see. Perhaps tomorrow will attract some coverage; it’s International Women’s Day.

Personally I found the idea of a World Obesity Day somewhat confusing. Presumably on World Seagrass Day one consumes, or cultivates seagrass. According to the government website there are some seagrass beds in Hong Kong “but they are generally small and sporadic”.

And I suppose on World Press Freedom day one pursues or cultivates press freedom, which is also, in Hong Kong, a bit small and sporadic these days.

In the light of these thoughts it is tempting to suppose that the appropriate way for a conscientious citizen to mark World Obesity Day would be to go out for a double cheeseburger with extra fries. But of course this is wrong. Some World Days are about things you should avoid, like Violent Extremism as and when Conducive to Terrorism (February 12) or Illegal, Unregulated or Unreported Fishing (June 5).

Anyway, to return to obesity, I did notice a certain lack of balance in Ms Lau’s otherwise fluent feature. Those interviewed all turned out to be officials, or the founder, of the Hong Kong branch of the World Obesity Federation. A picture showed all these sources together, looking admirably trim. Unsurprisingly they all had different way of saying the same thing: that obesity should be avoided at all costs.

It is no doubt true that obesity has been “associated” with up to 224 diseases, and the overweight are likely to be over also in measurements of blood pressure, cholesterol and blood sugar. Clearly people who are very overweight have a problem.

And yet… Is it really true, as the Department of Health data says, that 55 per cent of the population of Hong Kong are either overweight or obese? That is more than half. I am sure I am not the only person who does not, in ordinary everyday encounters with Hongkongers, find that more than half of the people I meet are overweight or, as we used to say before euphemisms became compulsory, fat.

One also wonders, with all due respect to the pure motives of the local obesity fan club, whether stirring up anxiety about people’s weight is really such a good idea. It risks tossing many people with a minor, or no, problem into the slavering maw of a large and greedy industry, which makes its money out of people’s desire to lose weight.

As Stuart Richie points out (in “Science Fictions”) it is really hard to draw firm conclusions from research into the effects of diets, and vested interests are happy to push dodgy conclusions out to unsuspecting consumers.

It seems also that medical opinion is increasingly sceptical about the value of badgering people to lose weight. Dr Joshua Wolrich (in “Food isn’t Medicine”) argues that people’s ‘natural weight’ varies enormously and simple formulae used to measure whether you are overweight are not actually very helpful.

People who really eat more than they need, he suggests, are responding to personal or medical problems; the over-eating is a symptom and the cure is to solve the underlying problem.

Meanwhile it is important to foster in everyone a ‘healthy attitude to food’. Otherwise, for every middle-aged man saved from heart disease by dedicated dieting there will be an adolescent, probably but not invariably female, tipped into eating disorders by over-anxiety about the effect of food on her health and appearance.

Well no doubt there are no easy answers to these questions. In my experience losing weight is hard, but not impossible. One does not get much help from the environment, which constantly offers delicious but fattening temptations. It is perhaps time for the United Nations to consider critically the existence of its International Day of Potato (May 30).

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Accident, emergency or error: money is not the issue

Posted in Uncategorized, tagged , , , , on January 24, 2024| Leave a Comment »

Our government is now grappling with a policy dilemma of the kind which is, sadly, particularly difficult for regimes which have dispensed with such luxuries as electoral politics and independent media: what sort of health service do we want?

This is the matter of principle behind the public musings of officials and politicians – including Chief Executive John Lee – about whether there should be an increase in the small fee charged to users of the Accident and Emergency departments of public hospitals.

At the moment this is fixed at $180. This has crept up over the years. The reason given for further tinkering is the number of people turning up in accident and emergency departments with conditions which are neither the result of an accident nor an emergency.

Officials describe this as “abuse” of the service. Let us note first of all that unjustified visits to local hospitals in some number are to be expected. After all potential patients are not doctors. It may be obvious to the medically qualified that the situation is not urgent; the patient may sincerely believe that it is.

Looking back on my personal record I can count six A and E visits: two in which I arrived in an ambulance, two which led to either stitches or immediate admission to a ward, and two cases of “abuse”. One of these was a request for help with a disintegrated and very painful tooth. The doctor could not provide anything stronger than aspirin for out-patients, and suggested washing my mouth with Scotch whisky, which worked. The other was a panic attack over a possible medicine mix-up, which had not in fact taken place: the young man fished out of the psychology department to help me was kind enough to say that I was right to seek help, just in case.

I infer from this unscientific sample that even a responsible citizen well enough off to use private facilities and happy to do so will in the long run develop some A and E visits, about one third of which will turn out to be unnecessary.

As a parent one also tends to be alarmist. Small children are generally not very good at describing their symptoms, if they can talk at all. I imagine few parents have not on occasion rushed to the nearest hospital, with an ensuing anticlimax. Many of us, including me, have also incurred barely hidden disapproval from a doctor who thought we should have come sooner.

The conclusion from all this is that even in a perfect world there will be quite a lot of arrivals in A and E which turn out to be erroneous. Whether the incidence is unusually high in Hong Kong we have not been told. I note, though, that in England, where emergency service is free, this was not a frequent complaint at all.

What seems to be bothering the Secretary for Health is the thought that people are deliberately choosing their local A and E because it is cheaper than a private GP. One idea he is toying with is to put the A and E fee up to the minimum sum a private doctor might charge for a visit. Another is to have a sort of sliding scale: if you arrive in a pool of blood it’s cheap, if you arrive with sniffles you pay extra.

This suggests some confusion about how our medical system is supposed to work. In the colonial days health was a matter of markets for the rich and charity for the poor. The poor did not do very well out of this.

Then Sir Murray Maclehose was sent to Hong Kong with instructions to turn the city into a colony of which a UK Labour government need not be ashamed. This produced, as well as a lot of public housing, an expectation that there would be enough clinics and hospitals to provide, at least for the grassroots, a service as good as that provided to the prosperous by the private sector.

This did not produce an imitation of the British National Health Service, in which most doctors are paid and hospitals built by the state, and treatment is generally free or nearly free. Nor did it follow the model popular in Europe, with health insurance provided at the public expense for everyone who could not afford their own.

It did embody the progressive consensus that, as the philosopher Michael Sandel puts it, “there are some things that money should not buy”. Patients could choose to “go private”, but inhabitants of both sectors assured them that the medical procedures offered were the same. Private hospitals offered nicer surroundings and, as one doctor told me when considering a range of private venues for an event which I would anyway sleep through, “a Coke costs more in the Mandarin than in 7-11 but it’s the same Coke.”

The consensus that our health system should offer nearly free care to anyone who needed it was somewhat corroded in the 2000s, when some senior officials seem to have come under the influence of Milton Freidman, or indeed of Ayn Rand. Charges were introduced for some expensive medicines. One can only feel grateful that the health machinery was not subjected to the same surreptitious sabotage as the public housing programme.

But where we are is still, in principle, a health service which provides a full range of services to anyone who needs it, at affordable or no cost. I infer that it is quite inappropriate to compare the cost of an A and E visit with the cost of a visit to a private doctor. It is not the job of the government to drum up business for private practitioners.

If excessive reliance on A and E is a problem, the solution should be to divert people with minor complaints to the district clinics set up to deal precisely with out-patient problems. They are generally even cheaper. The money is not the issue here.

There was an interesting piece in one of the public prints last month by two researchers of the Our Hong Kong Foundation, in which they pointed out that old people were particularly likely to turn up in emergency rooms (as indeed they are to turn up in hospitals generally) but experiments by the Housing Association and others had shown that with guidance and help at home seniors could be persuaded to greatly reduce their A and E appearances.

The authors also made some other good suggestions. In the evening the options for people feeling ill are quite limited. Clinics close, private doctors knock off work. The hospital may be the only place open. This is a good point. The only medics working evenings in our neck of the woods are vets.

Another interesting idea is to provide an out-patient clinic next to the emergency facilities to which patients in need of less dramatic help can be politely shunted.

No doubt these and other helpful suggestions would all cost money. They still seem more attractive than extracting what will in effect be fines from elderly hypochondriacs. And the more expensive you make a hospital, the more likely it is that patients who really need treatment will delay it for financial reasons.

If money is a problem, though, the government could reconsider the arrangement under which Accident and Emergency service is provided absolutely free to civil servants, former civil servants and former civil servants’ spouses.

This would have the added advantage that decisions about raising fees would be made by people who would themselves have to pay them, which always helps.

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