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探访复明25号工作 Visiting METC #25
2015/10/04 22:30:08瀏覽796|回應3|推薦0

Dear Generous Donor,
I am honoured to be appointed as your representative in "observing" the operation of  Mobile Eye Treatment Centre(METC) #25 which you donated last year to Inner Mongolia via The Asian Foundation for the Prevention of Blindness (AFPB). In the subsequent paragraphs, per the requirements of Capt Meng of "when, where, who", I will present the events in chronological sequence followed by feed-backs from the user of METC#25, ie XuYong Hospital personnel, and finally my observations & suggestions.
7 Sep (before arrival)
The observation period of 10 Sep to 12 Sep inclusive was arranged with AFPB in August so as to fit with my schedule as a member of the team of Greenaction inspecting forestation progress in ShanXi山西 in the preceding days. On 7 Sep while I was en-route to ShiLou Xian石樓 from TaiYuan太原, I was surprised to receive a SMS & a phone call from a Mr Zhong of Inner Mongolia's Disabled Persons' Federation(DPF) saying he will receive me at Ordos Airport & then accompany me throughout the subsequent "Observation exercise". I immediately sought clarification with Capt Meng of AFPB, who informed me Zhong is quite senior 副處級。More surprises were to come.
9 Sep -- Day 1
When I arrived at TaiYuan Airport circa 1700 on 9 Sep, I found out the flight was delayed by 1 hour, so I Wechatted Mr Zhong asking him not to wait for me for dinner as the plane would land at 2100 then & I had checked-in baggage. Getting out to the arrival hall at 2120, a party of 4 was waiting for me, the other 3 were Mr Bao of Ordos DPF, Ms Liu a young matron & Mr Yu an officer of XuYong Eye Hospital, They told me Dr Zhang 張院長was waiting for me for dinner in town. Their airport was as far away as ours, we travelled on Dr Zhang's Audi Q7 driven by Mr Yu, I got to see Dr Zhang at the luxurious 4-star Tieniu Phoenix Hotel 东胜区铁牛大酒店 at 2200, also present was Dr Fan副主任醫師. The sumptuous dinner with quite a bit of clear Chinese liquor finished at 2330, Mr Zhong & I stayed at this hotel for this night.
10 Sep -- Day 2
At 0730 on 10 Sep, Mr Zhong asked for my room key during breakfast & he went for checking out the 2 rooms. Over breakfast, Mr Zhong informed me that he was transferred from the Military Police about 4 years ago, where he held the rank of Lieutenant Colonel and was attached to an education unit. This is his first time in Ordos. At 0815, we set out on 2 cars : Mr Yu, Ms Liu, I & Dr Jiang主任醫師 on the Q7, while Mr Bao took Mr Zhong on his Toyota Land Cruiser Prado. I was told we had ample time & I was free to ask to stop & take photos en-route, we stopped briefly twice on our way out of Ordos City.

I was shocked to learn near the end of dinner the previous night of a dramatic change from the itinerary which was discussed back & forth for some 2 weeks before finalising on 18 Aug(see bottom of blog). The agreed plan was to visit & observe the service of METC #25 in remote & relatively poor areas in 鄂托克前旗 in SW Inner Mongolia near YinChuan 寧夏銀川, instead of the originally proposed fringe towns within 东胜区, because of the latters' proximity to the rather prosperous urban centre; and HangJin 杭錦旗 was chosen as the 2nd spot on the way back to Ordos. Without consulting or informing us, suddenly HangJin which is some 2 hours driving to the west of Ordos became the principal destination. The second destination was Dalate达拉特旗 in the north which was the place we went for fish dinner after visiting the desert last year. This didn't seem to be a rational choice of a route as the 2 destinations are not in the same direction of Ordos. The vehicular fleet had to go back to Ordos from the west then turn north. As late as 31 Aug before I fixed my return flight connection back to HK, I did ask & Capt Meng replied that I should not aim at any earlier flight as the schedule was to arrive at Ordos around 2000 on 12 Sep.

From getting on the highway, it took barely one and half hour & we arrived at HangJin Hospital around 1005 on 10 Sep where METC #25 had arrived a day earlier with the majority of the medical team.  Standing next to METC #25 was Ms Yan the Hospital Administrator 行政院長 who we met last year, she was being interviewed by a lone team of TV reporters. A small number of patients had their eyesight tested by nurses inside METC#25. Dr Jiang went up to the ophthalmology section of the hospital. About a dozen patients swamped at its door as if they would have no chance of being examined had they been standing in a queue. Dr Jiang knocked on the door which was then opened with a slit to allow Dr Jiang & me to squeeze through the crowd. A junior doctor Dr Yang 楊大夫 from XuYong was examining a short line of patients inside assisted by a couple of nurses. All nurses plus Ms Yan & even the junior doctor were wearing a bright red sash embroidered with advertisement on both front & back sides.  The deployment from XuYong was enormous, headed by Ms Yan, there were also one Consultant, one MO, 4 nurses, a young girl acted as in-house photographer, the container truck driver, and Mr Yu.


The non-medical personnel then left the hospital for checking into Kingtime Business Hotel 康泰商務酒店 a 4-star level hotel where the medical team also stayed, accompanied by a Ms Liu of HangJin DPF , followed by lunch. Then they proposed to take me to visit the dwelling of a Mongolian shepherd, but instead the 1st stop was a small theme-park on Mongolian culture on the Prairie some 15 min away from HangJin where we spent 1 hour. Ms Yan & 2 other officers of HangJin DPF came there to join us. Almost next door to the theme park is a highly commercialized home of ethnic Mongolian shepherds. Upon notification of our arrival, 2 mid-aged ladies in full gear traditional costumes were waiting at the door with a tray of Mongolian liquor and HaDa 哈達. We were then led into a Mongolian Yurt 蒙古包 built of modern technology & served with traditional food similar to our lunch earlier but with more yogurt & milk products.



We then went back to the hospital, by then Dr Jiang was conducting operation aboard METC #25. Only 4 patients were selected for 4 pterygium operations & 1 cataract. Mr Zhong & Mr Bao soon went back to the hotel. I stayed to watch the operation on the remote screen installed near the middle entrance door of METC#25, and accompanied Dr Jiang to make his round to the ward to check the patients, and left at 17:45 with the medical team to dinner hosted by HangJin's DPF Director, his Deputy & 3 officers. As stated more than once by the Inner Mongolian officials last year & this time, the receptions could not be lavish 沒有山珍海錯, but liquors did flow more than freely this night. Dinner finished around 21:30, back to the hotel I was too dizzy even to take a shower(also no need as the highest temperature was only in the high teens) & fell asleep soon. Around midnight, there was loud knocking on my door, but I was unable to get up & just yelled who's there. At next morning's breakfast I found out it was Mr Yu who invited me to join the medical team for midnight snack.

11 Sep -- Day 3
At 8am on 11 Sep, Messrs Zhong & Bao did not join breakfast, the medical team thought they might also be drunk. I followed the medical team to the hospital, Dr Jiang examined the patients in the hospital, took some photos & the patients were discharged happily. One of them, allegedly a pig farmer Mr Zhang was surprisingly knowledgeable, he talked to me about HK CE CY Leung. He also thanked me profusely. For details, please see this WeiBo page of XuYong Hospital. Back to the hotel ~10am, Mr Zhong checked out his room & mine, Mr Bao checked out separately. We then departed for Dalate on Mr Bao's car with Mr Zhong & Ms Yan, arriving at 12:30. It's good they accepted my suggestion to have a simple noodle lunch costing less than ¥15 per head. Ms Yan took a taxi to join the medical team and the 3 of us checked-in at the 4 star Ausotel Dalat Hotel, and I found out the medical team is staying elsewhere, presumably a less luxurious hotel. In reading a booklet in the room, I learnt that Ausotel & its sister brand Argyle is a high-end Australian hotel management chain newly operated in China with many hotels opening in the past 4 years. Like so many others, only hardware is first class. Dr Jiang, Ms Liu and the photographer had gone back to Ordos. Dr Fan, Associate Consultant & a nurse came to Dalate as replacement. Photo-taking duty was assigned to the truck driver.

At 15:40 we arrived at the Dalate hospital where METC#25 had been parked and started examination at 14:30. Like the day before, there was a short queue of about a dozen patients outside METC#25. There was the same publicity stunt with the red sashes. Apparently, those at the queue did not have much a chance of getting operated on during this event. Despite the medical team & METC#25 only started service there at 14:30, operation conducted by Dr Fan started at 16:10. There were just 4 cases of  pterygium. Again, a lone team of TV reporters conducted a short interview with Ms Yan next to METC #25. Messrs Zhong & Bao took me for a short stroll to an underground shopping arcade across the road & returned to the hotel for a short rest.
As Dalate is right by the Ordos Loop 河套邊上, it has abundant fresh water fishery. A fish dinner was hosted by Ms Fan, Deputy Director of Dalate DPF (who also hosted our party at last year's fish dinner) and an officer surnamed Ding 丁主任. You may recall better that she drove a white BMW 535GT, that's what reminded me of her when her car arrived at the same time as Mr Bao's at 18:15. I requested to drink beer instead of liquor, they very kindly acceded. Not as much alcohol since mainland beers contain only 2.5%, but in drinking from the much larger glass than the tiny liquor glass, the sheer volume from numerous rounds of toasting made me get up in the wee hours.

12 Sep -- Day 4
Messrs Zhong & Bao decided we were to leave hotel at 0930 on 12 Sep, surprisingly Mr Bao did not drive to the hospital but a DPF rehab centre for cerebral palsy children some 15 min from town. He wanted Mr Zhong to take a look, but upon arrival found out that the centre did not open in weekends. We arrived at the hospital at 10am, patients operated the day before were already discharged. We went up to the Ophthalmology section of the hospital to chat with the 5 patients selected for operations in the afternoon. Dr Yang was examining some other patients there. Dr Fan had already left for Ordos. The majority of the rest of the XuYong team were idling, as nothing was going on between discharging the patients of the day before and the commencement of operations scheduled at 14:30. The Dalate Hospital was newly built, it was spacious, brightly lit and tidy; quite a strong contrast with the HangJin Hospital. We went back to the hotel where Officer Ding had come with the Director of Dalate DPF Mr Zhang, to have buffet lunch with us. Mr Zhang mostly chatted with Messrs Zhong & Bao.

Ms Yan had told me that the patients chosen for operation that afternoon were mostly relatives of the doctors or related parties of Dalate Hospital who had long ago requested that these patients be operated by Dr Zhang XuYong at the next visit by the XuYong team to Dalate. We checked out of the hotel after lunch and went back to the hospital at ~14:10. Dr Zhang was already inside the operating theatre of METC#25 and about to commence the 1st of the 5 cases of Cataract. I waved to him through the glass partitions & watched him perform his first one and half operations on the remote monitor, by then Mr Bao said it's time for us to leave for Ordos. By 16:30, we were back at DongSheng东胜 District, the 1st stop was TieNiu Hotel where Mr Zhong went inside to get a "bill or receipt". The 2nd stop was to the Ordos Train Station which is outside KangBaShi District 康巴什 & literally in the middle of nowhere. Mr Bao said the old train station near town centre had stopped service some 2 years ago & moved to this inconvenient location. Mr Zhong came to buy his return ticket to Holhot the next morning.  It was 17:30 when we got into KangBaShi, with half an hour before dinner, Mr Bao took us to a theme-park on Mongolian Marriage Tradition. He bought 2 tickets at ¥30 each for Mr Zhong & me. Once inside, Mr Zhong told me it's now not allowed to get reimbursement for entry tickets as official expenses. So. when Mr Bao came to pick us up at 18:00, I tried hard to re-pay him the ¥60, but in vain.
We arrived ~18:20 at the restaurant just outside KangBaShi very close to the office of Mr Bao, which is a fabulous complex of 6 office buildings of the Ordos Government. Mr Dai, Deputy Director of Ordos DPF, the ethnic Mongolian who sang like a Pro in last year's reception, was waiting for us there. Dr Zhang came with Mr Yu ~19:00, and we had a very pleasant dinner.

Near the end of dinner the night before, Ms Yan said Mrs Zhang 闫董事长 would present gifts to you – the generous donor, Mrs Chan – CEO of AFPB, and me(as their messenger) when Dr Zhang was to dine with me before my departure from Ordos. Knowing that you would not prefer to take gift, I made a long distance call to Capt Meng & requested him to ask XuYong to present their gifts to you & CEO when you visit Ordos the next time. Despite my request, in addition to handing me 2 DVDs & a report from XuYong on their use of METC #25 since Jul last year, Dr Zhang forced me to take 3 rather bulky paper cartons when they dropped me at the airport at 2145 on 12 Sep. Inside the terminal, I found out each carton contains one big & one small scarfs made of Mongolian wool/cashmere. I could have put all 6 scarfs inside my small suitcase of “cabin hand-carry” size if I discarded the cartons, but it wouldn't look good for gifts without packaging, so I had to carry an extra big bag almost two-third the size of my suitcase.  The flight took off on time at 23:45.
13 Sep –- Day 5
I arrived at Beijing Airport JinJiangInn 锦江之星 at 0140 13 Sep, and departed at 0700 13 Sep for my return flight to ShenZhen深圳 scheduled at 0925. I took the 1330 airport bus #9 to HuangGang皇岗 and arrived home 1540.
Everyone I encountered in this trip has accorded me with very high degree of courtesy and generosity. I am much grateful to all of them.

Feedbacks from XuYong Eye Hospital as users of METC #25
The following comments and questions were raised to me by Ms Yan, Matron Liu & Dr Zhang over the visit period.
The Sterilizer has not been working since day 1, temperature does not reach set level.  They said they had to put another one on board. I said if they had let AFPB know at once, perhaps a replacement would have been obtained from the manufacturer.
It was also suggested that METC should be equipped with sterilizing air filter in addition to air-conditioning.
They recalled there was a short meeting after the donation ceremony at Holhot on the possibility of exchange programs between Inner Mongolian & HK Ophthalmologists. They were wondering about the apparent lack of progress.
You may no doubt have noticed that I mentioned above many times on the models of car. One reason is I am a car lover, but the main reason was I had been expecting to ride on the SUV which you also donated. Without seeing it , I eventually asked Ms Yan who replied that the SUV was NOT delivered to Ordos & was never used together with METC #25. She thought the SUV might be being used by the Inner Mongolia Regional DPF.
They repeatedly stressed METC #25 was being meticulously cared for, I did see that the body was very clean and looked virtually the same as last year except an apparent minor damage to the rear bumper as shown in the pic at the bottom. METC has travelled ~38500km up to 12 Sep 2015, and it's used only between Apr and Oct.

A noteworthy point : in the morning of 10 Sep at HangJin, I saw the nurses handed an instrument as a free gift to an elderly patient who came for examination but was not selected for operation. I went over & asked, they showed me the item was a “Sight Enhancing Device” 增視儀, something I have never heard of. The nurses said the device would help the old man.


My Observations & Comments

Let me begin with minor points.
1. Usually, once operation has started inside the METC, despite there were remaining team members from XuYong that did not get on board, no one manned the outside of METC, relatives of the patients sometimes climbed up the ladder & knocked on the door, thereby causing minor vibrations unnecessarily.
2. The patients were required to put on outside their clothings operating gown, cap & socks. But then they put back their feet with the operation socks into their shoes. I thought in so doing the interior of their shoes might contaminate the socks, defeating the original intention. Perhaps, patients should be asked to wear slippers provided instead of their own shoes after putting on socks.
3. About the patients swamping to be examined at the ophthalmology unit of HangJin Hospital on 10 Sep, order can be improved simply by registering and giving them numbering chips 派籌。
4. As described above, XuYong deployed 3 different doctors to perform operations on the 3 days. It's highly inefficient, time & resources were substantially wasted in transporting the doctors between Ordos & the towns. I shudder to think how this inefficiency would have been magnified if the location of operation location had been much further away. Perhaps, if we had gone to 鄂托克前旗, XuYong might have made the daily deployment change from their hospital in 榆林YuLin.
5. About the pre-destined patients on the final day 12 Sep, it's not unusual that strings are being pulled in China so that some got benefits not because of their conditions but of connections instead. Yet, even Dr Zhang himself mentioned over dinner & Mr Dai concurred that it's outrageous not such patients jumped the queue but they even had the totally undeserved privilege of demanding a specific doctor to perform the operation. Condoning by XuYong no doubt contributed to the inefficiency & wastage of resources.
6. The phenomenon of the medical team wearing the red sash outside the METC & even during eye-examination gave me the impression that the activity is not routine but rather rare & precious. Otherwise, it would not justify or merit to be a publicity stunt, even the local TV stations would care to cover.
7. Ms Yan & Mr Bao stressed to me ALL operations performed during this trip were totally free of charge to the patients. Obviously, this was the very reason why the event should be documented(by XuYong's in-house photographer using a SLR camera) and publicized.
8. A total of 14 operations, 6 cataracts + 8  pterygiums, were performed on 13 patients, over a 4 day period(METC arrived at HangJin on 9 Sep for selection of patients 筛查) seemed to me an appallingly low figure, especially relative to the team size deployed. Compared with the observation from multiple times of my participation in similar Catract & Pterygium operations hosted by Greenaction 力行植林慈善基金, an minimum of 15 operations is performed in each half day and over 30 operations each day. Greenaction's events in YangShan阳山 & MeiXian梅县 are also typically of 4 days of operations(usually preceded by 6 days of in situ selection 下乡筛查 a few weeks in advance), at least 120 cases of Cataract are conducted plus up to a dozen cases of  Pterygium. Incidentally, Greenaction's activity in GuangDong also collaborate with the local DPF. Only very occasionally would a local TV station come to cover the charity event. Even then none of the Greenaction volunteers or the medical team would wear publicity sash.
9. The deployment of Messrs Zhong & Bao by Inner Mongolia DPF & Ordos DPF to accompany me throughout, was unnecessary and served no useful purpose. Again, compared with Greenaction in GuangDong, only working level personnel from the local DPF would suffice.
10. Without saying to them what was on my mind, I asked Mr Zhong the operation capacity of METC #24 which covered the eastern half of Inner Mongolia. I was told both METC #24 & #25 carried out 2,000 operations per annum, and both vehicles were required to conduct 15% of operations totally free of charge, ie 300 free operations per vehicle per annum. There are also many cases where the local DPF would sponsor some 70% of the cost, and the patients each need only some ¥400 out of own pocket. 300 cases of free operations a year, and a useful life expectancy of 10 years of the METC, this works out to a total of 3,000 beneficiaries for an almost HK$3M donation. This figure should be interpreted from 2 perspectives. First, a breakdown between cataracts & pterygiums is useful, as the latter is cheaper than the former because only man-cost of doctors & nurses are incurred. Second, time frame is of essence. The value of $3M upfront donation is much higher than $3M to be paid by installment, when interest is taken into account, ie the concept of Present Value. Upfront donation money is meant to be put to work to provide benefits as early as possible. I believe donors to Greenaction get a higher number of beneficiaries per dollar of donation.
11. Looking at the pic taken at Hohhot last year(above), the SUV you also donated was clearly marked 復明25號篩查車, I think Inner Mongolia DPF needs to clarify & rectify why the SUV has not been working with METC #25.

All the above are by no means criticism. Perhaps, the discrepancies I described reflect the difference in culture & level of development between GuangDong & Inner Mongolia. It is my fervent wish that AFPB can work out with its counterparts to see whether any of my suggestions can be adopted to improve efficiency & better value for donors' money.

上面内容全乃余之个人意见, 并没有与任何人商讨, 更不代表文内任何机构。

( 在地生活大陸港澳 )
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Wilson Chan
探访复明25号工作
2015/10/09 16:59

到遙遙萬里外的內蒙古做義工及探訪,真令人敬佩!


Michael Wong
复明25号
2015/10/06 11:34
十分難得的機會, 工作有意義, 令人欽佩!

林坚
reply
2015/10/05 23:09

哈达只献给尊贵的客人!你是他们尊贵的上宾!

Jian