今早為Asian Medical Students Association Hong Kong (AMSAHK)的新一屆執行委員會就職典禮作致詞分享嘉賓，題目為「疫情中的健康不公平」。
感謝他們的熱情款待以及為整段致詞拍了影片。以下我附上致詞的英文原稿：

It's been my honor to be invited to give the closing remarks for the Inauguration Ceremony for the incoming executive committee of the Asian Medical Students' Association Hong Kong (AMSAHK) this morning. A video has been taken for the remarks I made regarding health inequalities during the COVID-19 pandemic (big thanks to the student who withstood the soreness of her arm for holding the camera up for 15 minutes straight), and here's the transcript of the main body of the speech that goes with this video:

//The coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus, continues to be rampant around the world since early 2020, resulting in more than 55 million cases and 1.3 million deaths worldwide as of today. (So no! It’s not a hoax for those conspiracy theorists out there!) A higher rate of incidence and deaths, as well as worse health-related quality of life have been widely observed in the socially disadvantaged groups, including people of lower socioeconomic position, older persons, migrants, ethnic minority and communities of color, etc. While epidemiologists and scientists around the world are dedicated in gathering scientific evidence on the specific causes and determinants of the health inequalities observed in different countries and regions, we can apply the Social Determinants of Health Conceptual Framework developed by the World Health Organization team led by the eminent Prof Sir Michael Marmot, world’s leading social epidemiologist, to understand and delineate these social determinants of health inequalities related to the COVID-19 pandemic.

According to this framework, social determinants of health can be largely categorized into two types – 1) the lower stream, intermediary determinants, and 2) the upper stream, structural and macro-environmental determinants. For the COVID-19 pandemic, we realized that the lower stream factors may include material circumstances, such as people’s living and working conditions. For instance, the nature of the occupations of these people of lower socioeconomic position tends to require them to travel outside to work, i.e., they cannot work from home, which is a luxury for people who can afford to do it. This lack of choice in the location of occupation may expose them to greater risk of infection through more transportation and interactions with strangers. We have also seen infection clusters among crowded places like elderly homes, public housing estates, and boarding houses for foreign domestic helpers. Moreover, these socially disadvantaged people tend to have lower financial and social capital – it can be observed that they were more likely to be deprived of personal protective equipment like face masks and hand sanitizers, especially during the earlier days of the pandemic. On the other hand, the upper stream, structural determinants of health may include policies related to public health, education, macroeconomics, social protection and welfare, as well as our governance… and last, but not least, our culture and values. If the socioeconomic and political contexts are not favorable to the socially disadvantaged, their health and well-being will be disproportionately affected by the pandemic. Therefore, if we, as a society, espouse to address and reduce the problem of health inequalities, social determinants of health cannot be overlooked in devising and designing any public health-related strategies, measures and policies.

Although a higher rate of incidence and deaths have been widely observed in the socially disadvantaged groups, especially in countries with severe COVID-19 outbreaks, this phenomenon seems to be less discussed and less covered by media in Hong Kong, where the disease incidence is relatively low when compared with other countries around the world. Before the resurgence of local cases in early July, local spread of COVID-19 was sporadic and most cases were imported. In the earlier days of the pandemic, most cases were primarily imported by travelers and return-students studying overseas, leading to a minor surge between mid-March and mid-April of 874 new cases. Most of these cases during Spring were people who could afford to travel and study abroad, and thus tended to be more well-off. Therefore, some would say the expected social gradient in health impact did not seem to exist in Hong Kong, but may I remind you that, it is only the case when we focus on COVID-19-specific incidence and mortality alone. But can we really deduce from this that COVID-19-related health inequality does not exist in Hong Kong? According to the Social Determinants of Health Framework mentioned earlier, the obvious answer is “No, of course not.” And here’s why…

In addition to the direct disease burden, the COVID-19 outbreak and its associated containment measures (such as economic lockdown, mandatory social distancing, and change of work arrangements) could have unequal wider socioeconomic impacts on the general population, especially in regions with pervasive existing social inequalities. Given the limited resources and capacity of the socioeconomically disadvantaged to respond to emergency and adverse events, their general health and well-being are likely to be unduly and inordinately affected by the abrupt changes in their daily economic and social conditions, like job loss and insecurity, brought about by the COVID-19 outbreak and the corresponding containment and mitigation measures of which the main purpose was supposedly disease prevention and health protection at the first place. As such, focusing only on COVID-19 incidence or mortality as the outcomes of concern to address health inequalities may leave out important aspects of life that contributes significantly to people’s health. Recently, my research team and I collaborated with Sir Michael Marmot in a Hong Kong study, and found that the poor people in Hong Kong fared worse in every aspects of life than their richer counterparts in terms of economic activity, personal protective equipment, personal hygiene practice, as well as well-being and health after the COVID-19 outbreak. We also found that part of the observed health inequality can be attributed to the pandemic and its related containment measures via people’s concerns over their own and their families’ livelihood and economic activity. In other words, health inequalities were contributed by the pandemic even in a city where incidence is relatively low through other social determinants of health that directly concerned the livelihood and economic activity of the people. So in this study, we confirmed that focusing only on the incident and death cases as the outcomes of concern to address health inequalities is like a story half-told, and would severely truncate and distort the reality.

Truth be told, health inequality does not only appear after the pandemic outbreak of COVID-19, it is a pre-existing condition in countries and regions around the world, including Hong Kong. My research over the years have consistently shown that people in lower socioeconomic position tend to have worse physical and mental health status. Nevertheless, precisely because health inequality is nothing new, there are always voices in our society trying to dismiss the problem, arguing that it is only natural to have wealth inequality in any capitalistic society. However, in reckoning with health inequalities, we need to go beyond just figuring out the disparities or differences in health status between the poor and the rich, and we need to raise an ethically relevant question: are these inequalities, disparities and differences remediable? Can they be fixed? Can we do something about them? If they are remediable, and we can do something about them but we haven’t, then we’d say these inequalities are ultimately unjust and unfair. In other words, a society that prides itself in pursuing justice must, and I say must, strive to address and reduce these unfair health inequalities. Borrowing the words from famed sociologist Judith Butler, “the virus alone does not discriminate,” but “social and economic inequality will make sure that it does.” With COVID-19, we learn that it is not only the individuals who are sick, but our society. And it’s time we do something about it.

Thank you very much!//

Please join me in congratulating the incoming executive committee of AMSAHK and giving them the best wishes for their future endeavor!

Roger Chung, PhD
Assistant Professor, CUHK JC School of Public Health and Primary Care, @CUHK Medicine, The Chinese University of Hong Kong 香港中文大學 - CUHK
Associate Director, CUHK Institute of Health Equity

蔡英文 Tsai Ing-wen 總統2019年5月9日於《外交政策》(Foreign Policy)期刊投書之中文翻譯。

譯者：
劉仕傑 （青年外交官 劉仕傑 ）
楊晴翔律師（哥倫比亞大學法學碩士）

Taiwan's Self-made democracy still needs U.S. partnership
台灣自為的民主仍需美國作夥同行

On April 10, 1979, the Taiwan Relations Act was signed into law after being passed by the U.S. Congress the month before, in response to President Jimmy Carter’s decision in January 1979 to establish official relations with the People’s Republic of China and sever diplomatic ties with the Republic of China (Taiwan). At the time, Taiwan was not yet a democracy, with a population of 17 million and a GDP per capita of $1,958―a flickering candle in the storm of the Cold War.

1979年4月10日，就在美國國會通過後一個月，台灣關係法經簽署成為（美國國內法）法律。台灣關係法係回應卡特總統在1979年1月決定與中華人民共和國建交而與中華民國斷交。當時台灣尚不是個民主國家，人口僅1,700萬，GDP僅1,958美元，可以形容為冷戰風暴中的殘燭。

The Taiwan Relations Act mandates the U.S. commitment to peace, security, and stability in the Western Pacific. More important, it defines how the United States engages with Taiwan and ensures that our country has adequate defense capabilities to be free from coercion.

台灣關係法制定了美國對西太平洋地區民主、安全及穩定的承諾。更重要者，它定義了美國如何與台灣交往，並確保了本國能有適當的防禦能力，並從強脅中得到自由。

Against the backdrop of the Cold War, no one could have imagined that Taiwan would emerge as a beacon of democracy in Asia.

對抗冷戰黑幕，當時沒有人能想像台灣可以成為亞洲民主的燈塔。

By embracing democratic values, the people of Taiwan took their fate into their own hands. The resilient Taiwanese defied all odds and kept making progress.

擁抱民主價值，台灣人民自己掌握自身命運。充滿韌性的台灣人跌破大家眼鏡，持續獲得進展。

With steadfast support from our partner in democracy, the United States, the people of Taiwan transformed an authoritarian regime into a vibrant democracy and held their first direct presidential election by popular vote in 1996. Democratization was further consolidated four years later with a peaceful transfer of power from one political party to another. Then, in 2016, Taiwan broke through the glass ceiling by electing its first female president and a record number of women into the legislature.

藉由我們的民主夥伴美國所提供的穩健支持，台灣人民將一個威權政體轉型為充滿活力的民主政體，並且在1996年舉行首次總統直接民選。四年後，台灣的民主進一步鞏固，政權和平移轉。接著，2016年台灣打破看不見的性別限制，選出首位女性總統，女性國會議員數目也創新高。

Taiwan has also transformed itself from an aid recipient into a high-tech powerhouse featuring outstanding human capital, a rules-based market, and a sound legal framework that upholds property rights. Taiwan now ranks as one of the top 10 freest economies in the world and has become an important partner for many U.S. companies in the region and around the world.

台灣本身也從受援國轉型成為高科技重鎮，擁有著名的人力資源、法治市場及完善的法治架構並尊重智慧財產權。台灣目前為全球十大最自由的經濟體之一，且成為此區域及全世界許多美國公司最重要的夥伴。

Since I took office three years ago, Taiwan and the United States have stepped up our joint efforts to promote our mutual interests, such as religious freedom, media literacy, and fighting corruption, safeguarding our shared values in the Indo-Pacific region.

自從我三年前就任台灣總統職位以來，台灣與美國共同升高努力推動我們共同的利益，例如：宗教自由、媒體素養，並且對抗腐敗體制，保衛我們在印太地區之共同價值。

One lesson of the 20th century is that the forward march of democracy is not a given.

二十世紀告訴我們重要的一課是，民主的推進，不會從天而降。

For the past 40 years, many members of Congress and successive U.S. administrations have honored the Taiwan Relations Act, making our partnership irreplaceable and shielding our region from increasingly aggressive anti-democratic forces. We stand together because we believe that the darkness and fear imposed by authoritarian regimes cannot withstand the light of democracy.

過去四十年來，許多美國國會的成員以及繼任的美國行政體系都對台灣關係法給予肯定，這部法案鞏固了台美之間無可取代的的合作夥伴關係，也讓我們在逐漸深化的反民主的侵略力量面前，得以捍衛區域安全。台美堅定站在一起是因為我們相信極權政權帶來的黑暗與恐懼將無法遮蔽民主照耀出的光亮。

The U.S. government has stood firm and responded to challenges to our partnership with determination and perseverance.

美國政府一直立場堅定並且以決心與毅力回應任何可能傷害台美關係之挑戰。

The U.S. Congress has consistently demonstrated bipartisan support for stronger ties with Taiwan through legislation like the Taiwan Travel Act, proof that the creativity and commitment that created the Taiwan Relations Act are still alive in Congress today.

美國國會持續不分黨派，以推動台灣旅行法等立法作為，展現他們對於加強台美之間緊密合作關係的支持。這是制定台灣關係法當年之創造力與承諾，仍然在美國國會活躍的證明。

Our shared commitment to democracy and freedom is something that people living under authoritarian regimes can never understand. Faced with the growing challenges to the rules-based order established after World War II, our partnership is more important than ever.

我們共同對民主與自由的承諾是生活在極權政權底下的人民所無法理解的。在二次世界大戰以來民主秩序所面臨的挑戰更加艱困之際，台美之間的夥伴關係無比重要。

Taiwan has survived and thrived under the most challenging circumstances of the 20th century. The people of Taiwan have not given in to the fearmongering of authoritarian regimes and never will. At this critical juncture, we celebrate and reaffirm our partnership with the United States and look forward to the next chapter in our success story.

二十世紀以來，台灣從最艱困的環境下生存下來並且蓬勃發展至今。台灣人民從不也永不向極權的政權屈服。值此重要的關頭，我們與美國共同慶賀並且更加確定彼此的關係，並且展望在未來的歷史中，成功寫出一頁新的篇章。

As president of this beacon of democracy, I am committed to fighting the good fight. I will continue to work with our friends in the years ahead to create a better world for future generations and a more open and free Indo-Pacific and beyond.

身為民主燈塔的一國總統，我非常堅定的信守我的承諾，克盡當為之事。我會持續與我們的友人在未來共同努力，為往後的世世代代，打造一個更加美好的未來，以及更加開放自由的印太地區。

Tsai Ing-wen is the President of Taiwan.
台灣總統，蔡英文

（以上歡迎分享）

NBA 11次領導冠軍隊的禪師教練Phil Jackson，他的自傳和貫穿其中的領導哲學 （有中文版！）。雖然結尾略弱，但本書很精彩也很有啟發性

”In my view, the key to becoming a successful NBA player is not learning the coolest highlight-reel moves. It's learning how to control your emotions and keep your mind focused on the game, how to play through pain, how to carve out your role in the team and perform it consistently. How to stay cool under pressure and maintain your equanimity after crushing losses or ecstatic wins"

身為牧師的孩子，除了學會牧師們建立緊密社群的方式外，他融入了一些禪學和許多的老子道德經思想。很不同於當時一般歐美管理方式，反而像是在調配精油一樣，根據球員們的特質，調配比例和添加順序，再加以引導，讓化學作用自然爆發。可以說是運動界的無為而治

主要的篇幅是那11個球季的戲劇化過程。

他的11要訣如下：
1. Lead from the inside out 發自內心的領導
2. Bench the ego 教練也是人，管好你的自我
3. Let each player discover his own destiny
幫助球員自然找到他們的路
4. The road to freedom is a beautiful system
設計良好的系統讓大家可以盡情自由發揮
5. Turn the mundane into the sacred
將一些瑣碎的例行變成有意義的儀式
6. One breath = one mind
同一氣息，同一身體 （團隊合一的重要）
7. The key to success is compassion
邁向成功領導的關鍵是同理
8. Keep your eye on the spirit not on the score board
聚焦在士氣而非計分板
9. Sometimes you have to pull out the big stick
領導少不了界線和指正
10. When in doubt, do nothing
有時一動不如一靜
11. Forget the ring
忘卻得失，在盡力之後讓比賽的樂趣主導一切

更多內容，照片，和中文版鏈接在部落格中:
https://dushuyizhi.net/eleven-rings-the-soul-of-success-禪師的領導哲學/