Macao News Macao News https://macaonews.org Tue, 12 Dec 2023 00:20:29 +0000 <![CDATA[Joanna Tam: Helping people end life’s journey with dignity]]> Wed, 08 Mar 2023 16:27:35 +0800 Kate Springer 61049 2023-06-14 12:34:30 2023-03-08 16:27:35 A traumatic loss as a teenager motivated Tam to specialise in palliative nursing and improve the quality of end-of-life care in Macao, so that more people can experience death with dignity.]]>Joanna Tam was 14 years old when her grandmother was diagnosed with advanced metastatic stomach cancer.   “It was already far too late for any treatments or advanced interventions,” recalls Tam. “And at that time, the discussion about death or having an illness was very hush-hush.” She says many people in her grandmother’s generation perceived cancer to be a contagious disease, making it hard to discuss. “People were fearful. We felt very helpless when we got the diagnosis, and we didn’t tell her that she was dying.” The next few months were difficult for everyone, especially her grandmother, who was in agony. As Tam recalls her grandmother’s suffering, she describes a death “full of pain” – not just physical, but also spiritual.  “She was a very religious Buddhist – burning incense at the temple every day, observing all the special days – and she questioned her faith, her identity, and everything she had done in life,” says Tam, visibly upset. “It was a horrific experience for all of us.”  When her grandmother died about six months after the diagnosis, Tam felt like her family was collapsing. The mother of five was their matriarch, their pillar. It was a time of deep mourning for Tam, but one that showed her a way forward.  “My career has been grounded in the horrific death that my grandmother experienced. That motivates me to provide better dying experiences for people in Macao.” 

Helping people die better 

[caption id="attachment_61054" align="alignnone" width="2000"]Joanna Tam A young Joanna Tam, left, sits beside her late grandmother, whose painful death inspired Tam to pursue a career in palliative and end-of-life care - Photo courtesy of Joanna Tam[/caption] Born in Macao in 1986, Tam had a happy childhood. Like many other families, her parents worked, and her grandmother looked after Tam and her brother.  Tam learned Cantonese and English from an early age, attended Pui Ching Middle School, and later relocated to the UK to finish secondary school. In 2005, Tam enrolled in nursing school at the University of Edinburgh, where she earned a bachelor’s degree and discovered palliative care while working at St Columba's Hospice Care. “I still remember the first time I worked in a ward. It was an older adult ward, and I had a patient who died about three days into my placement,” recalls Tam. “The process of her death – it was so beautiful. It was without pain and, even though her family wasn’t around her, she was surrounded by nurses and really well cared for.” The team’s sincere fondness for patients and families made a lasting impression on Tam. “In a hospice, you also have the luxury to get to know the person and their family – you learn their story, what brings them joy or what causes their physical, psychological and relational sufferings. That is a big part of palliative care, because pain can be elicited from our psychology.”  [See more: Kiang Wu runs Macao’s 1st Quality End of Life Care for All programme] Moved by the hospice’s holistic approach, Tam questioned why her grandmother couldn’t have died the same way. It planted a seed – and a desire to help more people die gracefully – and led her to pursue palliative care.  As Tam explains, palliative care provides comfort and minimises pain for people with terminal or debilitating illnesses like cancer or dementia. When combined with curative treatment, which strives to remedy the condition but can cause painful side effects, palliative care maximises the benefits of care for patients and families. Palliative care may go hand-in-hand with end-of-life care, which focuses on providing holistic support – medical, physical, emotional and spiritual – at the end of one’s life, as well as support for the family who experiences the loss.  While working at St Columba’s, Tam recalls an older couple who had been married most of their lives. The wife was dying, and since the couple seemed codependent, the nurses expected the husband to struggle. To support him, they conducted risk assessments and arranged for a bereavement team to make calls and home visits. “The continuation of care really matters,” says Tam. “I cannot take away their grief or pain of losing a loved one, but how can we improve this process?” 

A positive path forward

[caption id="attachment_61055" align="alignnone" width="2000"]Joanna Tam Since 2016, Tam has been teaching a course on palliative care for chief physicians and nurses on behalf of the Living Will Promotion Association - Photo courtesy of Joanna Tam[/caption] After completing her degree in 2009, she pursued a master’s in advancing nurse practice at the University of Edinburgh. At the same time, she also researched the bereavement of older people who had recently experienced the death of a partner in a hospital setting.   Increasingly passionate about her field of study, Tam pursued a doctorate in the development of end-of-life care in 2012 while working part-time as a nurse at St Christopher’s Hospice in London. In 2013, she returned to her hometown to study the development of palliative care in Macao for her PhD thesis. As part of her fieldwork, she spoke with 12 stakeholders developing end-of-life-care in the city, including Lo Siu Ha, who founded the city’s first hospice, the Hospice and Palliative Care Centre, in 2000.  After earning her PhD in 2018, Tam accepted a full-time job at North Middlesex University Hospital in North London as an advanced care planning practitioner – a specialist who helps individuals make decisions about the end of their lives with their families. For instance, she might ask the individual where they would like to die, how they would like to be cared for, and any drugs or treatments they do not wish to receive. She went home to Macao at Christmas time with much to celebrate. But during the visit, she started to worry about her father, who was having trouble hearing at dinner. Tam took him to the hospital for some tests.  A few days later, she was on the Hong Kong-Zhuhai-Macao Bridge Shuttle Bus, heading to the Hong Kong International Airport, where her parents would see her off, when her dad received a call from the hospital.  They found something in his nose and needed to conduct a biopsy.  In tears, Tam boarded her flight to the UK, packed her life up in London, and returned to Macao to be with her family. Her father was diagnosed with nasopharyngeal carcinoma, which impacts the nose and back of the throat and can cause hearing loss. 

Respect for pain

[caption id="attachment_61056" align="alignnone" width="2000"]Joanna Tam Tam and her family celebrating Chinese New Year together in Macao - Photo courtesy of Joanna Tam[/caption] At first, Tam focused on her father’s treatments and care, pouring herself into his well-being to ensure his experience with cancer was nothing like her grandmother’s.  After treatments began, an unrelated liver cancer diagnosis complicated her father’s prognosis. He also needed surgery near the cranial base of his brain to treat the original cancer, so the family went to Hong Kong for the operation then returned to Macao. When the procedure led to a painful infection affecting his brain, Tam witnessed firsthand where palliative care falls short in the city.  “He was in so much pain. I was pushing so hard for the hospital [in Macao] to give him more pain medications because he wanted to kill himself. I felt that his pain wasn't valued or respected, so I got medications from his doctors in Hong Kong. I didn’t want him to suffer.” Pain is a subjective experience, she continues. “As healthcare professionals, we should respect when patients say they are in pain and try to help them.” Tam believes the hesitation in treating pain stems from fear of addiction, wrapped up in layers of history and social stigma. She points to the Opium Wars in China and narratives that label drugs as “very, very bad,” no matter the context.  Since curative treatments can’t help her father recover, Tam and her family are focusing on pain management. At the moment, Tam says he’s physically feeling well and continues to cook family dinners a few times a week.  “He mostly makes noodles, but it’s funny because I’m a vegetarian, my mum and brother love meat, and my dad can only eat soft foods now. So he jokes that every time he cooks one meal, he actually has to prepare three,” she laughs. 

Talking about death 

[caption id="attachment_61057" align="aligncenter" width="640"]Joanna Tam Tam teaching undergraduate nursing students in the ‘Hospice and Palliative Care’ course at Kiang Wu Nursing College of Macau - Photo courtesy of Joanna Tam[/caption] Seeing greater potential for palliative care in Macao, Tam is actively working to improve the experience. That starts with medical education. Traditionally, she says, the discipline is not included in most training curricula in Macao and mainland China. While more programmes have started incorporating palliative care into general medical education and training, many nurses and doctors still need foundational knowledge.    Even before moving back to her hometown, Tam had worked with the Living Will Promotion Association since 2016. Based in Beijing, the charity organisation promotes advanced care planning and palliative care in mainland China. As part of her work with the association, Tam visits Beijing annually to conduct a course on palliative care for senior doctors and nurses.  She has also been teaching the first speciality course in “Hospice and Palliative Care" at the Kiang Wu Nursing College of Macau since 2019. Teaching undergraduate nursing students, who tend to be 19 or 20 years old, can be challenging since few have experienced death.    [See more: Alice Tsang’s nursing career has taken her around the world and to the heights of her profession] Tam tries to help her students connect with their empathic side with creative lessons that evoke feelings about death. “They also learn by doing – we mentor students at the hospital, so they can work on cases, prepare for conversations with families and then do it in a clinical setting.”  In addition to education, Tam believes the city’s hospitals could also incorporate palliative care across different wards, such as A&E or the ICU. “It’s about equality. People need palliative care in many different settings, not just in a hospice, so I hope to see the development of a general palliative care concept in hospitals,” she says. “We also need community palliative care, where a team goes into a person’s home or visits them in a nursing home.”   This year, she hopes to spend more time in local nursing homes and help train staff to introduce palliative care and end-of-life discussions with patients and families. 

The little things in life 

[caption id="attachment_61058" align="alignnone" width="2000"]Joanna Tam While living in the UK, Tam enjoyed climbing ‘Munros’ – Scottish mountains over 914 meters tall - Photo courtesy of Joanna Tam[/caption] When it comes to public awareness, Tam visits nursing homes in Macao to talk with older people about end-of-life care. She also believes that introducing sensitive topics like death into childhood education at schools and amongst families will help raise the benchmark for care. Tam encourages families to talk about their end-of-life wishes early (“It doesn't need to be sad – it can be casual.”) and read books about death to overcome our discomfort with the subject.  “Often, when we don’t want to talk about death or are hesitant to comfort someone who has lost a loved one, it’s a reflection on ourselves,” observes Tam. “When faced with death, we have to face our fears, but there’s a cultural hesitancy.”  While she stays busy with her research, teaching, advocacy work and family, Tam enjoys “life's small things” – exercising, hiking (in the UK, she enjoyed summiting Scotland’s highest mountains, known as “Munro-bagging”), socialising and travelling when she can. She visited the UK and Lisbon at the end of 2022 and has her eye on Chile in South America. She’s also one of the only women in Macao’s Ducati Scrambler bike club, a group of local Ducati enthusiasts who gather to exchange insights and ride their racing-inspired motorcycles together. “I have always been fascinated by street bikes and love watching the Grand Prix bike race in Macao,” says Tam, who owns a red Ducati Scrambler 800. “I also want to challenge stereotypes about women.” [caption id="attachment_61089" align="aligncenter" width="648"]Joanna Tam Tam is also part of the Macao Ducati Scrambler bike club - Photo courtesy of Joanna Tam[/caption] Tam also plans to continue advocating for her father’s well-being and, when the time comes, ensure he has the kind of death her grandmother deserved. In the meantime, she helps with his doctor’s visits and end-of-life decisions together with her family. And a few times a week, she savours his dinners.  “Some people don’t understand why we still let him keep cooking. They’ll say, ‘Why are you stressing your dad?’ But even when he was at his sickest, he still wanted to cook for us. That’s how he sees his value in our family, so I will continue to enjoy his cooking.”   ]]> <![CDATA[Alexandra Ascenso]]> Thu, 16 Sep 2021 12:00:43 +0800 Rafelle Allego 43008 2023-06-26 22:39:20 2021-09-16 12:00:43 Ascenso co-founded the TaipaVet Veterinary Clinic in 2014 with Karin Dolp and has been providing quality and trustworthy veterinary care to about 3,000 clients.]]>If you asked a young Alexandra Ascenso what her perfect life would look like, she would have waxed lyrical about safaris, big cats and documentaries. And while the animal lover may not be in the savannas of Africa at the moment, she has come pretty close to her dream job, having co-founded TaipaVet Veterinary Clinic in 2014. Before the Portuguese native arrived in Macao and started her own business, she embarked on countless personal and professional adventures in all corners of the world, from a national park in Mozambique to fieldwork for an NGO in Cabo Verde to the UK to work in a clinical practice.   Her story begins in Coimbra, Portugal, where Ascenso was born in July 1982 to an oenologist father and pharmacist mother. She learned early on that she had a knack for math and science – especially biology.  As a child, Ascenso pictured herself on wild adventures like her environmental heroes. “I think my first memory is watching David Attenborough’s wildlife series on Sunday – I was addicted to that,” Ascenso says. “Of course, I didn't want to be a vet like I am today and instead wanted to be in Africa treating the big animals.”  It was her aptitude for science that led her to veterinary school. Ascenso excelled in school and, in 2001, pursued a Licenciatura (or master’s degree) in Veterinary Medicine for six years at Escola Universitária Vasco da Gama. She then continued her postgraduate studies in Small Animal Surgery, which took another year.  Ever ambitious, Ascenso emailed Gorongosa National Park in Mozambique repeatedly while still in school, hoping for an opening to work at the park. In her final year of study, the park accepted her application. Without a second thought, she hopped on a flight for Africa just a day after presenting her dissertation in 2009. [caption id="attachment_43015" align="alignleft" width="450"]Alexandra Ascenso at the Gorongosa National Park Ascenso worked with the Carr Foundation – which rehabilitated the Gorongosa National Park – for four months in Mozambique - Photo courtesy of Alexandra Ascenso[/caption] “Africa – it’s amazing. It’s a whole other world,” says Ascenso, noting that she loved the wide-open terrain, where animals are free to roam without any human interference. “It was probably the best experience of my life. I loved it, and I’d love to do it again.”  She worked with the Carr Foundation – which rehabilitated the park – for a few months on the population control team. She also worked on disease prevention, ecological monitoring (observing environmental conditions) and buffalo translocation (transferring wildebeest from South Africa to Mozambique).  The team also had to look out for animal poachers since the Mozambican Civil War (which ended in 1992) left the country in poverty.  This led to an uptick in poaching because many people looked to the black market to make a living. But over time, the poachers stopped being a threat as the park started recruiting them, paying them to protect the animals instead. Before this positive change, and so long as she took precautions, Ascenso could explore and fully immerse herself in nature, which she describes as a “perfect scenario”.  She also valued the opportunity to provide veterinary care to injured wild animals, especially from snare traps. She worked with them, learned about their ailments and injuries and helped them heal. In the process, she could still get up close with rare creatures, such as blue wildebeests and buffalos. “I don't have one specific [animal that] fascinated me most,” she says. “It's the combination and the setting that made it all special.” Not every animal encounter was safe, however. Ascenso ran from a herd of buffalos “more than one time”, and, once, she had to jump into a tree to avoid being killed. Another time, she accompanied some rangers and a National Geographic photographer to a lake filled with crocodiles.  “At that time of the day, they were supposed to be in the water, so we walked around slowly taking pictures,” Ascenso says. “Then the grass nearby started moving, and I thought to myself: ‘That’s a crocodile, and I’m going to die.’”  She tried to run but tripped and fell. While looking back, she realised that it was a warthog – and the animal was as scared of her as she was. In the end, the warthog scampered away, and Ascenso lived to tell the tale.

New horizons

But as with all things, her time at the park came to an end due to visa issues. After four months, she went home to Coimbra for a short break. Soon enough, Ascenso, then 25, packed her bags and was off again.  This time, to Cabo Verde, which was her first contact with small animals. Veterinarians Without Borders approved her application to join a one-month spaying programme on the island, where the stray dog population needed to be controlled and treated for skin mites. The vets operated out of a house in a slum, transforming the living room into a makeshift operating room where residents could bring their animals for treatments. “We worked with the very basics, and although we didn’t have the medication for everything, we still tried our best. We referred people who saw us to whatever [animal] medicines local pharmacies had,” Ascenso says, adding that their budget was minimal.  When the project finished, Ascenso went to England at the referral of a fellow vet. She found a job first at a clinic in Emsworth, between London and Southampton, which was also connected to another in Cosham, on the southern coast of England. There, she mainly treated cats and dogs, with a handful of exotic animals and 2 domesticated chickens. Ascenso earned recognition in her field and a fellowship with the Royal College of Veterinary Surgeons. However, the weather in the UK didn’t suit her. “Clinical-wise, it was good. But everything else was not for me,” Ascenso says. “That's why I went to Portugal – for the sun.”  After a year, she returned to Coimbra and found a clinic where she worked for three years. Back home, she switched to emergency medicine at a newly opened veterinary hospital.  However, it wasn’t as challenging as she hoped, with little work to do.  And when a job offer came from Macao, she “didn’t think twice” and just went because she had always wanted to travel to Asia.

Building a foundation

She started working for the Green Cross Veterinary Hospital in Macao in 2010, where she loved her clients, even though she struggled with language barriers. “When I mentioned infections or inflammations, most of the time, this information got confused,” she says. “I had to learn to navigate this.” Ascenso planned on staying for just a year or two, then travelling around Asia while working.  But life had a different plan for her. She became pregnant with her now 8-year-old daughter and then worked at the Home-Vet Veterinary Clinic, located in the Nam San area of Taipa.  Feeling more settled in Macao, she decided to open her own practice with a business partner in 2014. Ascenso had been happy working for other clinics, but with a baby and difficulties finding her dream job in the city, she thought starting her own business would be more flexible and practical.  [caption id="attachment_43010" align="alignnone" width="2000"]Alexandra Ascenso When making a diagnosis, Ascenso says she communicates clearly about medical procedures and cost breakdowns[/caption] Ascenso met her business partner, Karin Dolp while working at Green Cross. Dolp had called for help after finding a neglected dog, Pipo, who she later adopted, and Ascenso came to the rescue. The two women soon became good friends, and she helped Ascenso get the clinic up and running.  Dolp runs all the management of the clinic, from team building to client outreach. “It was super difficult at first, especially because the location of our clinic is very hidden,” Ascenso says. “I built up my clients through word of mouth – people who referred me. And the clinic has grown since I started.”   Since those early days with just a handful of clients, the clinic has grown to serve about 3,000 clients, and Ascenso is “seeing new clients weekly.”  She performs soft tissue surgeries at the clinic, from routine procedures like spaying to emergencies such as volvulus and gastric dilation (a life-threatening disorder that starts with bloating and can lead to a blocked stomach) and extra delicate matters like liver surgery.  The pandemic has made it harder to run the clinic since Dolp remains stuck in Singapore. That’s been a challenge, says Ascenso, but they maintain close contact. “And she maintains a constant and positive presence,” Ascenso adds.  [caption id="attachment_43013" align="alignright" width="450"]Alexandra Ascenso Small dog breeds are more common than large ones in Macao, says Ascenso[/caption] Both women champion quality, trustworthy veterinary care and clear communication with clients about medical procedures. This is important because many pet owners in Macao are willing to spend whatever is necessary to care for their animals. Some clinics could take advantage of that and inflate prices or recommend unnecessary procedures.  “Instead of going, ‘Okay, you have money so let’s do everything,’ I explain all of the outcomes and cost breakdowns,” she explains.  Over the years, Ascenso says that Macao’s veterinary scene has changed for the better – vets do more for the animals now with better medicines and more advanced procedures. For example, vets can now access upgraded equipment that helps them make diagnoses faster and more accurately. They also have a referral network with other veterinary clinics so their clients can find good care quickly if Ascenso cannot help.  There is also less vet-hopping among clients, which means that the animals’ clinical history can be more easily traced. “Here [in Macao], I usually only see miniature toy Chihuahuas, Schnauzers and Poodles… a lot of poodles,” she says.  Ascenso herself has three pets, with an additional one from her husband. "Cereja was a stray living in a shelter. She got severely sick and could only eat liquid food after developing oesophageal stenosis (narrowing of the throat)," she says. Cereja couldn't return to the shelter and so Ascenso adopted her. "She’s been by my side ever since." The others are two cats brought to her by a client after their owners left Macao. They had been stuck inside a cage for three months and Ascenso gave them a general checkup. "After a while, they were living freely at the clinic, waiting to be adopted," she says. "Then I brought them home… and they stayed." Looking to the future, Ascenso hopes that her clinic continues to grow and helps more animals. “I love working here,” she says. “Macao's changed with this pandemic, and the situation is OK – the pandemic didn't affect us so much. We continue to be cautious before making any big steps. The priority for us is always care and quality.”   ]]> <![CDATA[Alice Tsang Sau Mui]]> Thu, 07 Jan 2021 10:43:03 +0800 Rafelle Allego 33437 2022-02-09 13:55:43 2021-01-07 10:43:03 Alice Tsang’s nursing career has taken her around the world and to the heights of her profession. ]]>“All the opportunities in my life came because I was in the right place at the right time,” says Alice Tsang Sau Mui. As the Vice-President (Academic) and Associate Professor of the Kiang Wu Nursing College of Macau, Tsang has led a wide-ranging nursing career that took her around the world, from Hong Kong to the UK, Australia, mainland China and Macao.  Born on 11 January 1954, Tsang grew up in a middle-class family in Hong Kong with two brothers and a sister. Both of her parents worked full-time: her father as an administrator at a department store; her mother, a shopkeeper.  Beginning in 1968, she attended secondary education at the New Method College on Hong Kong Island (which eventually closed in 2012). When it came to choosing a career, Tsang says she didn't pursue nursing for “any particular reason”.  It was a fundamentally practical choice, she says. In the 1960s and early ‘70s, there weren’t many professional options for women in Hong Kong. The list was short, she recalls, rattling off four choices: office worker, clerk, teacher or nurse.  “In the ‘50s, women worked in factories, and the importance of women’s education only came in the ‘60s,” she explains. “I was fortunate to grow up just as education in Hong Kong started to even out between men and women.” “From the limited choices, I took up nursing because the government had started to increase hospital capacity around the time I finished high school, so they were recruiting more students to train.” 
“I was fortunate to grow up just as education in Hong Kong started to even out between men and women.”
In 1974, when Tsang began her nursing studies at Queen Mary Hospital. “I was not particularly keen at the start,” she admits, “but the training changed me quite a bit – I learned to be more active and independent.”  When Tsang became a registered nurse in 1977 and completed her nursing training in 1978, “the road was set”, she says. And just like that, she became the first and only person in her family to pursue healthcare.   Tsang immediately started working as a staff nurse at Queen Mary Hospital while continuing her studies -- the young nurse was keen to learn as much as possible within the medical field. She hoped to become a midwife. Due to the limited slots available in the government’s training programme, however, she had to look outside of Hong Kong for the experience.  As a state-registered nurse trained in English, Tsang could work in the UK as well. So she quit her job at Queen Mary in 1978 and moved to the UK to work and train as a midwife at Marston Green Maternity Hospital in Birmingham.  Always open to new experiences, she joined a friend – a nurse stationed at a Vietnamese refugee camp in Staffordshire – to volunteer in late 1979. She ended up staying on for three months to work as the camp’s nurse.  “The camp was quite big, with around 150 or more people,” Tsang says. “My role was to attend to any emergencies, conduct medical follow-ups, and help with translation since most of the refugees were Chinese-Vietnamese, and I could speak Cantonese.” After taking a specialty course in cardiothoracic nursing at the East Birmingham Hospital  in 1980, Tsang returned to Hong Kong and focused on cardiothoracic intensive care at Grantham Hospital in Aberdeen, Hong Kong. She worked there for eight years, from 1980 to 1988, then moved to Australia. She worked as a nurse specialist in the coronary care unit and pursued her academic studies, graduating with a Bachelor in Applied Sciences (Nursing) in 1990. While working at the Royal North Shore Hospital in Sydney, Tsang simultaneously completed the bachelor programme at the Sydney University in 1990. She then pursued a part-time master’s degree in Health Administration at the New South Wales University, while still working at the hospital.  Having studied in western countries, Tsang observed how nursing differs from one culture to another, especially when it comes to bedside manner and nurses’ relationships with patients. “It depends on the situation. There are definitely differences in practices, cultures, expectations and nurse-patient relationships,” she says. “For instance, nurses in Hong Kong are comparatively more respected than in Macao and mainland China. As for the UK and Australia, they are similar [to Hong Kong] and more respected.”  She moved back to Hong Kong in 1992 to be with her sister, who had been diagnosed with cancer. Around this same time, The Hong Kong Polytechnic University (PolyU) offered her an Assistant Professor position, where she instructed various courses in the school’s nursing programmes for both undergraduate and master’s students.  Tsang’s sister died of cancer four years later, in 1996. Tsang remained at her full-time teaching position at PolyU and also served as President of the College of Nursing Hong Kong. At the same time, she pursued a PhD in Nursing online from the Queensland University of Technology, which she completed in 2002. Tsang continued at PolyU but shifted her focus toward training nurses for leadership and management positions. With the college being a member of the International Council of Nurses, she also got involved with the international nursing community, which opened more doors for her.    She remained in her position at PolyU until 2010 when she moved to mainland China for a job at the Beijing New Century International Children’s Hospital. As the nursing director for the private pediatric centre, Tsang was responsible for training nursing staff. When it comes to nursing education, she believes nursing students best learn through experience in the field. By shadowing doctors and working directly with patients, they absorb practical skills and cultivate a profound sense of responsibility – something books and university laboratories alone cannot provide.  “It was a very different environment, and there were expectations that I could not comply with, so I left in 2012,” she says. [caption id="attachment_34507" align="alignnone" width="1333"]Alice Tsang Sau Mui Alice Tsang at the KWNC campus on Avenida de Venceslau de Morais in 2020 - Photo by António Sanmarful[/caption] Tsang returned to Hong Kong at the age of 58, intending to retire. But after just a few months, she grew restless and bored. Tsang reached out to the Kiang Wu Nursing College of Macau about a part-time role as a nursing teacher, splitting her time between Macao and Hong Kong. She joined the college in 2012, then moved to Macao and started working full-time in 2016 as the Vice-President of Academics and an associate professor.  These days, Tsang no longer works directly with students but instead focuses on course planning, curriculum design and research. In her research, Tsang tackles all aspects of healthcare, from government policies to medical leadership, job satisfaction among nurses, and career development pathways.  With a front-row seat to an ever-changing industry, Tsang says she’s watching the nursing industry evolve, not just in Macao but all over the world. Today, nurses are needed in hospitals, she says, as well as casinos, hotels, schools, airports and various other industries.  “Nursing manpower is in shortage globally, no matter where you are,” says Tsang, noting the global pandemic has only exacerbated the issue. In Macao, like other countries, she says the next big challenge after Covid-19 will be caring for the city’s rapidly ageing population. Currently, there is roughly one nurse to every 250 patients in Macao, which is significantly lower than Hong Kong’s average of one nurse to every 10 patients. “We need more hands-on deck to care for our ageing population, so we’re hoping to start more programmes for nurses and other healthcare professionals,” she says. “Not only more students, but also experienced nursing professionals who can help train and educate the next generation. Overall, there is a nursing shortage worldwide.”  ]]> <![CDATA[Jorge Sales Marques]]> Wed, 08 Jul 2020 15:00:55 +0800 Catarina Brites Soares 27145 2022-11-07 17:02:12 2020-07-08 15:00:55 Sales Marques is the director of paediatrics and neonatology at Conde de São Januário Hospital Centre.]]>José Luís de Sales Marques] was studying economics there. It wasn’t easy back then as I came from a small city. Macao wasn’t what it is today,” he recalls. After finishing his studies in 1982, Sales Marques began his career at Gaia Hospital where he specialised in paediatrics. He then passed his final exams after the residency stage with high grades (19.3 out of 20) and was admitted to the Portuguese Medical Order in 1991. From 1992 to 1995, he practiced at the Institute of Medical Genetics Jacinto de Magalhães in Porto, Portugal. During that time, he also trained for three months at Necker-Enfants Malades Hospital in Paris, overseen by one of the leading figures in the area of metabolic disorders, Jean-Marie Saudubray. Sales Marques had previously trained in the endocrinology and growth unit at the University Hospital of Santiago de Compostela in Spain with Professor Manuel Pombo, a world expert doctor in growth disorders. In 1995, his work brought him back to Macao, where his brother was the president of the Leal Senado from 1993 to 2001. “But in 1999,” he explains, “despite having been asked to stay on as director, our family decided that it was better to go to Portugal.” Sales Marques once again settled in Gaia, across the river from Porto. By 2007, he was head of service of the Hospital Centre of Vila Nova de Gaia and, a year later, was asked to head the paediatrics department. Sales Marques – who speaks Portuguese, English, French, Spanish and Cantonese – continually sought to expand his knowledge, specialising in various additional areas, such as in paediatric endocrinology in 2012 and hereditary metabolic disorders in 2014. A year later, he and his wife returned to Macao, where he would work as the Chief of Service at Conde de São Januário Hospital Centre. After three short months, the hospital invited him to take on the post of the Head of Paediatrics. “Lately, I have been intrigued by the fact that there were so few cases of COVID-19 in children and was able to find the reason,” he proudly states. The paediatrician, who is on the Macao medical team at the forefront of combating the COVID-19 outbreak and is the Health Bureau’s spokesperson, explains his theory that children are less affected by the new coronavirus because their immune systems are more agile in responding to the virus. Younger people have stronger immune systems due to consistently being stimulated by both frequent infections and vaccines administered throughout childhood, up to 13 years old. In adults, although both viral infections and vaccinations are frequent, immune memory is just not the same. He shared this theory in a short review published in an American academic journal in early April, just the latest example in his long career: of 151 academic papers published, 107 have been in international publications. He’s also authored five books, including one – “O Que os Pais Devem Saber de Pediatria” – featuring illustrations by his then 10-year-old daughter, and another – “O Bebé no 1° ano de Vida: Perguntas e Respostas” – co-authored with his son, Rui Sales Marques. Both are parenting guides, appropriately enough. Rui also joined him on stage at the 10th International Congress of the Angolan Medical Association in 2015, a “unique moment” for Sales Marques, who has spoken at more than 230 conferences around the world. Sales Marques has won 33 prizes, including the “Nutrição Infantil Manuel Suarez Perdigueiro” award in Spain in 1990, best monthly publication in paediatrics magazines in 2017 and 2018, and the third prize in the Asian Congress of Metabolic Diseases in New Delhi in 2018 – an award he is particularly proud of, as he was the first doctor from Macao to win this prize. His dedication to medicine has not gone unnoticed in Macao: In 1999, Sales Marques drew praise from the Macao government for his work in paediatrics, and again in 2018, for his contributions to the area of health in general. He has also served as president of the Macao Association of Portuguese-speaking Physicians (AMLPM), as well as president of the paediatric endocrinology section of the Portuguese Paediatric Association (APP) and president and founder of the Paediatric Association of Gaia. Even though medicine takes up most of his time, he is still able to devote time to his family and his hobbies. Paddling, table tennis, photography and walking are the main ones. “I try to do 10,000 steps a day, though sometimes I’m not able to. I always take a late afternoon walk at Praia Grande or Guia. When I arrived in Macao, my weight went up slightly, which is natural due to the great food here, so I decided I’d have to set an example by exercising. After all, I’m a paediatrician.” In 2020, he returned to Porto, Portugal. In October 2022, he was appointed Clinical Director of the CUF Trindade Hospital in Porto.  ]]> <![CDATA[Dr Manson Fok]]> Mon, 25 Feb 2019 12:54:36 +0800 Mark O'Neill 17695 2021-02-03 10:22:48 2019-02-25 12:54:36 Dr Manson Fok is Dean of Health Sciences at Macau University of Science and Technology (MUST) and Director of the MUST hospital. He has launched the city’s first degree course to train doctors, which will begin in September 2019.]]> <![CDATA[Maggie Hoi]]> Tue, 25 Sep 2018 11:58:12 +0800 Macao News 16688 2021-02-03 10:30:51 2018-09-25 11:58:12 After graduating Cambridge university, Maggie Hoi moved back home to Macao to start her career at the the Institute of Chinese Medical Sciences. She continues her quest to apply the Dan-Shen and Chuanxiong herbs towards a treatment for Alzheimer’s disease.]]>Finding her passion Maggie Hoi was born in Macao in 1981. She and her younger brother grew up in a warm family environment, supported by her loving mother and hardworking father. He was one of the first people from Macao to travel to Thailand and work with the rice merchants. This led to a successful rice exporting business first to Macao, and then later China, with his income helping to provide his children with the best possible education. Hoi’s early education could be considered quite unique, as she was one of the few female students given the opportunity to study at all-boys school Yuet Wah College. Unfortunately, girls were only allowed to attend until primary 2, and so she was forced to move to a new school. This wasn’t an easy task, but in time Hoi joined São Paulo primary school where she excelled in her English language studies. This led to her teachers and mother later enrolling her into Sacred Heart Canossian College (SHCC). It was here that Hoi first discovered her passion for science and medicine. She credits this to her inspirational biology teacher Ms Yee. Out of 50 students in Ms Yee’s class, roughly half of them have gone into careers within the medical sector – including Hoi herself. After completing Form 5 in Macao, Hoi continued her education at Wymondham College, a public boarding school in Norfolk, England. Here she learned more about medical science and her interest expanded into pharmaceuticals. Two years later she was accepted to University College London (UCL), where she spent three years pursuing an education in pharmacology with a focus on immune cells and immunology.

When culture meets medicine

Coming from a Chinese background, where traditional Chinese medicine (TCM) is fairly prominent, herbal medicine intrigued her from the start. Hoi received a full scholarship at Cambridge University and completed her PhD in 3.5 years. She was the only Macao person in her department studying the influence of cannabis on the cardiovascular system. As fate would have it, during her final year of study at Cambridge, delegates from the University of Macau and local politicians visited Hoi’s laboratory while she was hard at work. A conversation with Professor Vai Pan Iu, the rector of the University of Macau at that time made her think of returning to Macao to further her scientific career. After graduating, Hoi seriously considered her options. She could pursue a career in the UK or go back to Macao and be close to her family. In the end, she felt a need to give back to her home city. “I feel that in the UK and USA, there are many people like me. But in Macao, we need more people like me to inspire the younger generation to engage in science,” Hoi explained. And so, after graduating from Cambridge University in 2007, Hoi applied for a position in the Institute of Chinese Medical Science at the University of Macau’s Institute of Chinese Medical Sciences. She has now been working here for almost a decade.

Working towards the future

Alongside this work, Hoi tries her best to keep life balanced with business and pleasure. One of her favourite pastime activities is exploring Macao with friends; especially taking her foreign friends around to see the world heritage sites, admire the architecture, and share the Macanese culture. For quiet time, she delves into her recent favourite book, ‘Thinking, Fast and Slow’ by Daniel Kahneman. Hoi has also been giving back to the local community by becoming a science, technology, engineering, and mathematics (STEM) volunteer. She currently judges high school science competitions in the hope that her experience will motivate more children from Macao to consider STEM education and careers. At the moment, Hoi’s focus has shifted from the cardiovascular system to the brain – specifically Alzheimer’s disease. For the past few years, drugs developed to treat Alzheimer’s have not proven to offer any beneficial effects. This has led researchers, including Hoi, to broaden their perspective. A new approach is to address the disease holistically, by assuming there are several directions leading towards a cure. Since TCM has always been seen as a way to make the body well through multi-target and multi-pathway effects, Hoi has been researching how to apply this herbal medicine to Alzheimer’s disease. She has been successfully working with two specific blood-promoting Chinese herbs, Dan-Shen and Chuanxiong. Having studied their compounds for over five years, she has already been able to help patients suffering from ischemic heart disease and strokes. Hoi has documented her findings by publishing papers that show the underlying mechanisms of how Chinese herbs’ chemical compounds work to strengthen and, overall, improve the organs and cellular system. However, many foreign Western researchers do not trust TCM due to the lack of scientific backing. Even though TCM practices date back centuries and have solid evidence-based support through the generations, evidence-based support is still different from scientific-based support. Another difficulty with TCM is that it is mainly a preventative medicine and unfortunately works slower than most western medication. Therefore, when facing a viral infection that needs immediate care, most doctors opt for western medicine that provides quicker results. Regardless of these differences, Hoi is continuing her quest to apply the Dan-Shen and Chuanxiong herbs towards a treatment for Alzheimer’s disease. One piece of advice that has resonated with Hoi to keep motivated is that success comes with hard work and circumstance. In other words, working hard is of utmost importance; however, sometimes even if you work hard, you may face failures along the way, so don’t be upset because these are just the circumstances- always keep trying. “I might not be able to discover a cure but I believe every little step will help the medical community understand the disease better and to build a better future for the growing ageing community,” she said.  ]]> <![CDATA[Mário Évora]]> Sat, 24 Mar 2018 11:21:13 +0800 António Bilrero 15303 2022-11-07 17:00:24 2018-03-24 11:21:13 Mário became interested in medicine when he was 15 or 16 years old. “I chose the only thing in sciences for which mathematics was not a compulsory discipline."]]> <![CDATA[Wendy Chan]]> Tue, 10 Jan 2017 21:12:33 +0800 Macao News 11111 2021-02-03 10:10:45 2017-01-10 21:12:33 Wendy Chan is founder and clinic director of PhysioOne Centre. Born in Macao in 1975, she moved with her family to Toronto, Canada at the age of 13. In high school, she volunteered in hospitals and nursing homes which paved the path to her future career.]]>Room by Irish-Canadian author Emma Donoghue and The Life-Changing Magic of Tidying Up: The Japanese Art of Decluttering and Organizing by revolutionary Japanese organising consultant Marie Kondo. Since moving back to Macao, Chan and her family have found it a great hub for travelling around Asia. With a myriad of diverse Asian metropolises within a 5-hour flight radius, her favourite cities include Tokyo, Osaka, Kyoto, Bangkok, Hua Hin, Taichung, Taipei, Seoul, Shanghai and Beijing. She often combines passions together by enrolling in international professional development courses while visiting her favourite cities. With its diverse and colourful history as well as its proximity to numerous food meccas of Asia, Macao is a heaven for food lovers, offering endless food adventures for Chan to enjoy.  ]]> <![CDATA[Ruan Bester]]> Tue, 11 Oct 2016 17:55:18 +0800 Leonor Sá Machado 10528 2021-02-03 10:00:39 2016-10-11 17:55:18 Ruan Bester is the founder and practicing veterinarian at the Royal Veterinary Center Macao opened in 2013. He has been in Macao since 2004.]]>Royal Veterinary Center opened in 2013. He is fluent in English and Afrikaans and has been in Macao since 2004. Born 19 December 1974, in Pretoria, South Africa, Bester grew up on a big farm near Cape Town surrounded by a menagerie of exotic and wild animals, including spiders, snakes and birds. His passion for animals came at a young age, and he would often take spiders, scorpions and snakes to primary school, which delighted his classmates. Upon completing secondary school, Bester decided to travel the world for one year, which ended up being four. His travels took him to Turkey, Greece, Switzerland, Sweden, Canada, the United Kingdom, Japan, Korea, Hong Kong, just to name a few. He worked part-time and freelance jobs to support his travels, moonlighting in the U.K. as a chef (his favourite job of the four years) and picking fruit in Israel. Other jobs included carpentry, working in a dairy farm, landscaping, picking strawberries and working with hot air balloons. After his epic four-year adventure, Bester began his degree at the University of Guelph in Canada. A year later, he moved back to South Africa to finish his studies at the University of Pretoria’s Faculty of Veterinary Science at Onderstepoort. He graduated November 2003 with a Bachelors of Veterinary Science and worked at the Australia Zoo for three months alongside Steve Irwin treating koalas and turtles, among other animals. Studying to become a vet, according to Bester, is not like studying to become a specialist doctor, as one must know how to treat any animal, from a cat to a giraffe. “We are radiologists, we are dentists, we are ophthalmologists, we are surgeons.” Between 2004 and 2006, Bester lived between Macao and Hong Kong. Originally looking to get a job as a vet in an animal clinic in Hong Kong he was transferred to Macao to manage a clinic while waiting for his Hong Kong registration to take effect. Although managing a small clinic was supposed to last only one month, Bester extended it to six. Finally, he opened his own clinic in Macao in 2006. Throughout the course of his life, Bester has kept some interesting animals. In college, his dorm room was home to snakes, spiders and even a baby crocodile. Bester would sometimes find the snakes breaking out of their cages in the middle of the night and climbing into his bed. “I had the crocodile because my friends had a crocodile farm in South Africa, but I would never do it again because it’s completely wrong. They should be in the wild. Bester later released the crocodile in Kruger Park. Since arriving, in Macao, he has gathered 40 tarantulas, one scorpion, a few snakes, four cats and two dogs as house pets. It should come as no surprise that what Bester likes most about the animal kingdom is the range of exotic animals. Treating exotic and dangerous animals, however, has its disadvantages. Being stung by a scorpion, for example, feels similar to being burned by a lighter. Racing cars and flying aircraft are Bester’s other passions. He divides his time between Hong Kong, Macao and South Africa pursuing these hobbies and belongs to a supercar club that organises races across Asia. In addition to flying planes, Bester is also learning to navigate helicopters. Bester’s long-term goal is to open a massive animal hospital in Macao staffed with a team of veterinary specialists. Dealing with unqualified vets has become a frequent and major problem for Bester, resulting in numerous cases requiring second-round surgery to fixed botched jobs. “It’s just not right; it is extremely frustrating to know that the public does not know the difference between good and bad vets.”  ]]>