HKU Bulletin May 2008 (Vol. 9 No. 2)

10 11 COVER STORY An Education in Facing Death A new project is helping people face the inevitable. D eath is often a taboo topic of discussion in Chinese society, leaving people unprepared for the inevitable, and their loved ones burdened by guilt. The Centre on Behavioural Health is addressing that situation with a project to educate people about death and dying. The Centre is co-ordinator of the Empowerment Network for Adjustment to Bereavement and Loss in End-of-life (ENABLE), which is seeking to change people's attitudes to death, dying and bereavement through awareness campaigns, training and research. The Hong Kong Jockey Club has donated $20 million to the project. “There is a strong bel ief in Chinese society that any discussion about death will bring bad luck, so people don’t talk about it and they don’t think about it. When it happens, they are always unprepared and there is a lot of regret and blame and guilt in the process,” the Centre’s Director, Professor Cecilia Chan, said. “Our main focus is to raise the general competence of the community to prepare and handle issues related to death and bereavement.” Training programmes have been organised for professionals in social services, health and medical care, and for bereavement counsellors, with the support of 37 community groups. The participants are taught how to encourage people to talk about and prepare for death. They are also shown videos of several local families facing death, such as Assistant Professor in the Department of Professional Legal Education, Eric Cheung Tat Ming, whose wife Portia died of breast cancer in February 2007. Cheung’s video shows a party held days before Portia died. She had wanted to say goodbye to all of her friends and family but did not have the strength to see them individually. Cheung said the party fulfilled her wishes and enabled those close to her, including their children aged 10 and 12, to celebrate her life and face the reality that she would soon depart. “To me, it’s important that rather than try to escape and avoid it, we should embrace and face death and reality. It helps the dying person and those around him or her,” he said. “However, if the dying person is not ready, it can be very difficult. You need to take your cue from the dying person. It’s fortunate that my wife was quite prepared to face death. Indeed she became ready much earlier than I did. Our Christian faith was instrumental in sustaining us as we faced all of this.” Chan said the video was a valuable resource because it showed people there were different, more positive ways of dealing with death and bereavement. ENABLE is also supporting public awareness campaigns that encourage people to see meaning in both death and life, reconcile with loved ones, prepare wills and make other death- related arrangements. Attitudes to death and dying among the elderly are being monitored to see if ENABLE’s efforts have any effect, and research on bereavement in Chinese society is also planned, following a long-term US study that found 10 –15 per cent of bereaved people were still depressed two years after their loved one passed away. “Death is a very important mental health issue. The death of a loved one can lead to a lot of emotional and behavioural problems. We have seen many people who become chronically depressed following a death in the family,” Chan said. “ENABLE is trying to address these complicated cases. At the same time, we want to show that death is not necessarily all negative. It can be converted into a celebration of life because every death means the end of a life well lived.” RESEARCH Centre will host a bio-bank of well-characterized viruses and specimens for the world community with the aim of enhancing pandemic preparedness. Another significant aspect of the project is to nurture the next generation of bio-medical and public health scientists in this area. The AoE builds on a legacy of excellence in influenza research that stretches back more than 30 years. “We have a tradition of work on influenza at HKU that was started by our predecessor Emeritus Professor Ken Shortridge and although his research was focused on animal influenza and its potential risks to human health our knowledge has grown from that foundation, especially in the last ten years or so,” said Professor Peiris. The team has achieved an international reputation for excellence, is the second most widely cited research group on avian flu and is one of nine World Health Organization H5 reference laboratories. The group has contributed an enormous amount to the understanding of how H5N1 emerged, evolved and spread to other parts of the world. “That is an internationally accepted contribution of Hong Kong University,” said Professor Lau Yu Lung, Chair of Paediatrics. “Beyond that we have looked at other aspects of influenza, at pathogenesis – the mechanism of how flu causes disease – and specifically speaking why the H5N1 virus is so lethal to humans, to trying to look at the epidemiology of flu. The ultimate aim is to increase our knowledge, we are thinking broadly in understanding the whole knowledge base of influenza, from seasonal flu to viruses with a potential pandemic threat.” The AoE team comprises over 30 researchers across the four universities in Hong Kong. Led by Project Director Malik Peiris, who is internationally-recognized for his work on influenza, SARS and viral pathogenesis. Likewise, all the group leaders listed below are eminent researchers in their fields: • Guan Yi, Poon Lit Man, Yuen Kwok Yung, N.Y. Ip are ranked in the top one per cent of cited researchers worldwide. • Guan is global ly recognized for his contr ibut ions to understanding the ecology and evolution of the avian flu virus and for defining the animal host of SARS. • Poon is a molecular virologist also highly cited for his work on influenza and SARS. • Yuen has made major contributions to understanding the clinical and virological disease profile of avian flu and SARS, to identify the animal reservoir of SARS and to clinical infectious disease. • Lau Yu Lung is a paediatr ic immunologist who has published extensively on innate immune responses and is on both national and international advisory committees on immunization. • P.K. Chan (CUHK) is a clinical virologist who has contributed enormously to the understanding of respiratory viral pathogens including SARS and avian flu. • Gabriel Leung (with Steven Ri ley) helped elucidate the epidemiology of SARS. • Chen Honglin is a virologist with a strong track record in research on influenza and other viral pathogens. • N.Y. Ip (HKUST) an Academician of the Chinese Academy of Sciences, brings world-class expertise on cell-signalling, bioinformatics, drug-screening and neural cell models. Some members of the team: (pictured from left) Dr Gavin Smith, Dr Poon Lit Man, Professor Gabriel Leung, Professor Lau Yu Lung, Dean Raymond Liang (not a team member), Professor Malik Peiris, Professor Guan Yi and Dr Chen Honglin.