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

甘拎老酥雞掰我的卡在美國被盜刷！盜刷的人一定是個死肥豬，在同一天吃了好幾家餐廳，每筆賬都三百美金，你真好意思用別人的錢吃東西，不會良心不安嘛？不怕澇塞嘛？要不是我今天心血來潮突然登錄網銀查詢，恐怕我下個月去紐西蘭前就全部進到你嘴裡，變成你的一大坨肥肉了😡希望DBS效率很好，快點把1500美金還我！

衰運是一來就趕不走，卡被盜刷已經夠氣，為了明天在臺北辦阿根廷簽證，大老遠舟車勞頓從花蓮上來，好不容易checkin在士林沒招牌的青年旅舍，才出去買個食物回來，就被櫃檯那個一副華人臉卻不會說中文的香蕉妹攔下來說：「我剛剛沒看仔細，我們這裡是規定，如果是台灣人的話只收住一個月的，不行只住一天」
「啊所以勒？」
「我得請你離開，會全額退款」
槓！把我當猴子耍嘛？checkin的時候不是有給護照跟登記資料，怎麼可能不知道我是台灣人？她居然還有臉回我：「我以為你是大陸人」
「.........」
我的怒火瞬間爆發，臉直接垮下來給她臉色看。這次四眼田雞的她總算是有注意到，我不是好欺負的「台灣人」！我問：「難道你們老闆不能通融嘛？畢竟這又不是我的疏失。」她只淡淡的回：「不好意思不行。」好啊，要我走可以，妳出計程車錢，幫我找好另一間青旅，我就站在那裡全程盯著妳看妳怎麼處理。被折騰成這樣，走前我撂狠話說會幫忙他們做負面宣傳，沒想到剛跟漫步的櫃檯說起這件氣人的事，她說我可以去觀光局告發沒執照營業的青旅，好啊我們走著瞧！噢忘記公佈名字「happy Taipei Hostel」please don't ever go there if ur a Taiwanese ,because they discriminate us!

放上一張中午吃的美式超大熱狗堡，因為這是我一整天到現在吃的唯一一餐，氣都氣飽了👿

我們平常接觸的有關朝鮮的訊息是怎麼來的呢？可以看看這紀錄片： https://www.youtube.com/watch?v=eclCfjP7hLM

關於朝鮮戰爭內幕： https://bit.ly/2I9WzU3

臉書專頁： https://www.facebook.com/ComradeXiangyu
專訪： https://blow.streetvoice.com/41873

編曲： Ransom-Notes https://soundcloud.com/ransom-notes
作詞、混音：鍾翔宇
母帶後期製作工程： Glenn Schick


Follow Xiangyu on Twitter https://instagram.com/notXiangyu
Follow Ransom-Notes on Twitter https://twitter.com/ransom1992

有些人會說：「如果朝鮮不是獨裁國家的話，為什麼不給外國旅客自由行呢？為什麼大部分電腦都沒連上境外的互聯網呢？」我希望那些人從不同的角度來思考這些問題。二戰期間的同盟國會開放自己的國家給德國、意大利和日本觀光客自由行嗎？別忘了，朝鮮戰爭只有停火，沒有停戰。

假如互聯網是在 1930 年代的德國發明的，而非 20 世紀下半葉的美國，而德國情報機構能暗中監督和控制一切連上該網路的任何設備（正如斯諾登透露美國國安局所做的那樣），同盟國會讓一般老百姓連上同個互聯網嗎？還是他們會跟朝鮮一樣建設自己的網路？

朝鮮是個小國家。雖然它從 1953 年一直呼籲正式停戰，但它從 1950 年到現在一直與大部分西方國家處於戰爭狀態。只要戰爭狀態不變，這些政策不是「反自由」的，而是任何理性的政府（無論是資本主義國家還是社會主義國家）會施行的防禦性措施。



誰是朋友？誰是敵人？
Who are our friends? Who are our enemies?

我們能否 追究這個問題而不自欺欺人
Can we look into this question without lying to ourselves?

誰的盟友？誰的利潤？
Whose allies? Whose profits?

是誰激於義憤而爭鬥和犧牲
Whose struggle and sacrifice are stirred by righteous indignation?


1.
饒舌的激進份子 被說是憤世
The radical rapper is said to be cynical.

我只想引人深思 和去偽存實
I just want to get people to think, cast aside falsities, and retain the truths,

因為從小到大有太多虛偽人士
because througout our lives, too many hypocrites

灌輸錯誤認識 使人愚昧無知
have instilled false understandings, causing us to ignorantly

地無視 顯而易見 的壓迫和暴行
disregard the clearly visible oppression and atrocities,

使人固執己見 而失去批判思考力
causing us to stubbornly cling to our own opinions and lose our ability to think critically.

一旦遇到陌生的意見 認知就失調
When we encounter unfamiliar opinions, we experience cognitive dissonance.

變本加厲地延伸原本的錯誤視角
Doubling down on our mistaken views

成為了心理防禦機制 也使我們無意識地
has become a psychological defense mechanism which causes us to unknowingly

成為壓迫自己的體制的棋子
become pawns of the system that oppresses us

即使我們自以為自己是正義的義士
although we think of ourselves as just and morally courageous people,

但其實是我們迷失於斷章取義的歷史
it is actually us who are lost in deliberately misinterpreted history.

而敵視 並歧視 被壓迫的各國人民
We vilify and discriminate against the oppressed peoples of all countries;

自以為仁義 卻把壓迫者 奉若神明
we think we are righteous, yet we deify the oppressors.

不分明侵略和防禦只要求無條件的和平
We don't differentiate between aggression and defense, we simply ask for unprincipled peace,

得到奴隸主的肯定不過不被他們尊敬
gaining the approval of slave masters but not their respect.


2.
監禁率最高的國家被當作自由象徵
The country with the highest incarceration rate is considered to be a symbol of freedom;

最常推翻民選政府的它被當作摯友良朋
we call it our friend as it leads in overthrowing democratically elected governments.

我們只有盲人摸象般稱頌或貶斥
We make praises and criticisms based on conclusions made from bad information,

偏執地不檢視騙子掩飾的現實
stubbornly refusing to investigate the truths hidden by liars.

別人飢餓 我們說是領導人無人性
When others starve, we say their leaders are devoid of humanity

卻不記得制裁的目的 是經過餓死人民
while failing to remember that the goal of sanctions is to sabotage stability

破壞穩定 以迫使 革命群眾 放棄革命
through starvation in order to extort the revolutionary masses into giving up revolution.

如果這不是恐怖主義 那麼你的定義可能有問題
If this isn't terrorism, then your definition might be flawed.

我問你 唯一動用核武器的到底是誰？
I ask you, who is the only one to have used nuclear weapons?

為何朝鮮發展核武就被認為是罪？
Why is it considered a crime when (DPR) Korea develops nukes?

誰的奴性思維被支配得顛倒是非
Whose slave mentality's been been dominated to the point where right and wrong are inverted,

使我們把自衛視為威脅 把威脅視為慈悲？
having us believe defense is threatening and threats are benevolent?

是誰不知不覺地在重複戈培爾所起草
Who unknowingly repeats lies written by Goebbels

的流言蜚語的同時說別人被洗腦
while at the same time calling others brainwashed,

並對用著堅如鐵的毅力英勇地起義
while unreasonably being hostile towards those who use their iron-firm willpower

驅逐侵略者的人民無理地壞有敵意？
to heroically drive out aggressors through rebellion?

#朝鮮 #DPRK #Korea

"I will reply you tomorrow"? "They discriminate me"? 你也這樣講過嗎？其實在這兩個情況裏，reply 和 discriminate 也是不及物動詞，後面不能直接加上受詞 (object)。那應該怎樣說才正確呢？

訂閱與芬尼學英語 Finnie's Language Arts ► http://bit.ly/flayt-sub


▍播放清單：
Word Pairs 怎樣分 ► http://bit.ly/2hS1MCF
品牌名學英語 ► http://bit.ly/2qd3mUq
名人英語 ► https://www.youtube.com/playlist?list=PLs2gyIM_VlT9rX0D4JFat1u0l599g8kbv
朗誦節特訓 ► https://www.youtube.com/playlist?list=PLs2gyIM_VlT82Hlz7ZxH3MqYV1IsoJb0u

▍更多學習資源：
● 訂閱電子報：http://bit.ly/fla-nl
● 下載免費學習資源：http://bit.ly/36VhrYS
● 加入 Finnie's Facebook 群組：bit.ly/flafbgp

▍Follow 芬尼：
● 博客: http://bit.ly/fla-blog
● Facebook: http://bit.ly/fla-facebook
● Instagram: http://bit.ly/fla-instagram
● Pinterest: http://bit.ly/fla-pinterest

?Free stuff!!! :)
Use my iHerb Discount Code: ASC7218
Sign up at AirBnb and get HKD$290 in travel credit: https://www.airbnb.com/c/tiffanys213
Get a FREE first Uber ride (up to HK$50): https://www.uber.com/invite/tiffanys2213ue