Mid September - Early October 2024 - Here is my account

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I spent 3 weeks in a Hong Kong Public Hospital

Mid September - Early October 2024 - This is what happened

Warts and All - These events actually happened with no embellishments and anyone who has spent time in a Hong Kong Public Hospital Ward will absolutely relate to my comments.

The Hospital Authority Hong Kong - a World Class Institution

I am a long term English resident of Hong Kong - my account of my Public Hospital stay for 3 weeks

For the 5th time since 2009 I found myself as a guest of the Hospital Authority in Hong Kong for yet another extended Hospital stay, this time 3 weeks.

I have 8 (manageable) chronic diseases, all long term, I have been a type 2 insulin dependant diabetic for close to 30 years and my hospital stays are generally 2 - 4 weeks and I have no one but myself to blame for this sorry state of medical affairs.

Due to these chronic diseases I have never been able to get Private Medical Insurance.

Thankfully Hong Kong has one of the best Public Healthcare Systems in the world, in 2021 during Covid I was in Hospital for 2 weeks due to a potentially life changing infection, I took a lot of notes but never got round to writing a blog post of my experience and since then, a lot of things have changed.

During my recent hospitalisation I had a lot of time to do research and I do not recall seeing a personal blog post | account of a foreigner spending time in a Hong Kong Public Hospital, so I took a lot of notes.

It also allows me to comment on how the experience has changed since 2021.

I am NOT a naturally gifted writer, my posts are disjointed somewhat and sometimes way too long, but that is my style.

So let the story begin.

It all actually started on September 2nd 2024 when I started to feel really off, at first I thought it was related to the weight loss drug I inject daily but it got worse, I could not eat, I was throwing up but no fever.

I tend to be very Monty Pythonesque when it comes to health matters, “tis but a flesh wound” and all that and the wife and my sons are used to me being under the weather and then I started to get excruciating pain in both of my heels.

I spend many hours on Google everyday and this is where I made a potentially fatal mistake, I researched symptoms of foot pain for Diabetics, I did NOT learn my lesson from 2021 which is that self diagnosis can be helpful (and there are a zillion articles about heel pain on Google) but it also lulls you into a false sense of security and you end up delaying going to the Clinic or Hospital because you have convinced yourself you will be fine…. whoops!

This stupidity on my part goes back to January 2016 when I had 4 heart attacks in one day completing 2 private tours and eventually my guests on my 2nd tour called for help whilst we were in an MTR Station (subway) and that saved my life. I am a Yorkshireman and we can be a tad stubborn.

Anyway, back to the present day, my health deteriorated rapidly and I was a basket case on the couch and developed a nasty fever and my wife (bless her!) had, had enough and called for an Ambulance in the early evening.

I knew there was something quite wrong with my left foot but I convinced myself it was just “a flesh wound”

It took only 15 minutes to get to the Hospital and that is where the fun started.

The Hospital ER Department

Gosh, it was jammed and the wife had to complete the formalities of registration and pay the fee of HK$180 (US$23) - they keep increasing this fee to stop people from flooding the ER because of a few sniffles, it has had no effect., if you arrive by ambulance, you are a priority case.

In the space of an hour I was seen by 3 young Doctors who all told me I had a massive infection in my foot and they seemed to dwell for far too long on the fact that my foot might have to be amputated.!

I know from previous experience that you can ignore the snapshot diagnoses of ER Doctors, they are notorious for talking very bluntly and it is all but impossible to diagnose the issues from a visual inspection (as it happens the infection was causing a lot of internal damage), the did however all agree that I had to be admitted, it just needed a senior Doctor to sign off on that.

So x rays where organised and I was admitted in short order.

My overriding memory of the ER Department was that most of the patients were a lot older than me (I am 63) and there was a lot of people coughing and sneezing and it was very crowded.

Admittance to the Ward

Very straight forward, as usual they did not have my size in Hospital wear so I was allowed to keep wearing my sweat pants and t shirt with an ill fitting “hospital shirt” unbuttoned to identify me as a patient.

The ward holds 10 beds but they always manage to cram in 2 more, so 12 beds with just one vacancy for me

I was then assessed by 2 Doctors in short order and subject to a barrage of blood tests and such and I was on antibiotics within 2 hours, as a start, they do not hang about.

I was informed that that an orthopedic specialist would see me the next morning but my health was deteriorating rapidly, something else was going on with me and based on blood results and x rays they decided that the infection in my foot was causing all sorts of other issues (I have 8 chronic diseases and since 2016 I have been taking 16 types of medication daily)

At 3am in the morning I was woken up by a gaggle of Doctors and Nurses who wanted me to provide a pee specimen immediately, I was all drugged up, they wanted to know if I could pee into the bottle so to speak, over 30 minutes they asked me twice and each time I told them that I did not have the urge to pee and could they wait.

They could not.

Oh boy, on the spot I was stripped and then they inserted a catheter and more of that later, it was a simply awful medical procedure to do when I was quite capable of peeing into a bottle! But I was so out of it I could do nothing.

12 hours after admittance

... and the fun begins at 6am when they turn all the ward lights on and the set in stone routines start which for me included daily blood tests and having my blood pressure checked literally up to 20 times a day (seemingly at random) and having insulin jabs 3 or 4 times each day.

I saw the Ward Doctor (who is like a God) at 8am and within 10 minutes he was doing surgical procedures on my foot in a small ante room under a local anesthetic which needed 5 injections, apparently they could not wait to schedule a more structured operation, this took 40 minutes and I had to sign medical waiver forms (I did not read it, I just signed it as it was so out of it) I simply figured that if they had to do quick surgery then it was critical.

Apparently I had 3 types of bacteria slowly eating my foot including e coli!

I saw the wound on my heel, it almost made me throw up, I will not share the images suffice to say it looked as if a shark had bitten out a chunk of my heel.

I was wheeled back to the ward and then the Ward Doctor was back with his boss and his bosses boss an hour later, apparently the infection had caused all sorts of issues with my blood sugar and I was within 24 hours of losing my kidneys, so they injected me with a special drug to try and reverse the process some, long story short the drug came just in time and I actually had the second shot today which had to be administered by a nurse, so fingers crossed

Not only that but I was also experiencing a lot of breathing issues, this coupled with the fact I had a catheter inserted and was wearing a diaper tempered my relief…. I was I admit getting a bit worried.

The Next Day

On day 3, the specialists were confident that the crisis had passed and now it was just a wait and see to see if they had beaten the infection and in theory my health would improve, I was still (and please pardon the expression) feeling like crap and was resigned to the fact I was going to be in the ward for maybe a month.

I was unable to walk because I was so weak, had a bad heel injury and I was not allowed out of bed and I can tell you, that was the moment I decided to write about my experience, ward life is interesting to say the least, excruciatingly boring as well and you cannot help but notice how the system works.

So now the fun part, my observations of ward life in completely random order.

Mask wearing

Covid has changed everything in Hong Kong and in the Public Healthcare System mask wearing is mandatory for everyone, no exceptions, even the bugs wear masks, the problem is that with my lung issues and shortness of breath I refused to wear a mask and the Ward Doctor actually gave me a pass, much to my surprise but that did not stop every Tom, Dick and Harry in the hospital trying to make me wear a mask, for some reason the support staff were very big on the mask issue and I had to get the nurses to intervene - there really is no need and I am a rational person not a hypochondriac , we managed to do just fine without them pre Covid.

I am still incredulous that the Ward Doctor visited every morning with a surgical hat, a mask and a plastic visor, all you could see was a pair of eyes.,

You could line up 12 nurses in masks and I am not kidding, they all looked alike it was like some weird Barbie vision, I am a person who reads peoples faces and I was angry that you could not “read” the medical staff or any staff for that matter, I think this mask wearing nonsense is a terrible policy, but when it comes to mask wearing in Hong Kong logic goes out of the window, it appears the mask wearing mania is because it is the flu season - as I kept telling anyone that would listen, is that we have managed without masks for over 100 years during flu season.

The mask mandate ended in March 2023 and still half the population wear the damn things and the real tragedy, virtually all kids from newborns to 5 years old are being forced to wear masks by the parents even now - it is just wrong but that is my personal opinion.

Medical Waste - Gloves, gowns, hats, diapers, masks and such

Not too many statistics about this, one report suggested the 43 Public Hospitals in Hong Kong produce 45 tonnes a day or more and our one specialised incinerator cannot cope and bear in mind that these items do not weigh much but gowns in particular are very bulky.

All I know is what I observed in my ward for 3 weeks.

It is staggering, basically all the above items are single use, with I reckon thousands of each item thrown away every day in just one ward, gloves - well the rubber gloves, they seem to put on a new pair every couple of minutes.

The cleaning lady of the support staff was a fixture in the wards even after midnight.

Given the risk of infection and such I do not think they have any choice, patient health is paramount but even so, it is quite shocking and I guess great news for the suppliers of these products.

Ward Heirarchy

A fascinating subject

To keep a ward functioning and sterile requires a lot of people, this is not like private hospital care, there is really no down time and quiet periods. There is always someone or something that stops you from sleeping and invariably between 2am - 3am there is always something happening in the ward, with all the lights on and shouting staff.

so you have : -

• The Ward Doctor, who visits every morning to update you, you basically have 3 or 4 minutes tops to discuss your health

• Twice a week the Ward Doctor is accompanied by his boss and a bunch of Doctors in training, they are very thorough

• The Head Nurse who supervises all the nurses - a team of between 10 - 12 nurses both male and female and there are always a lot of trainee nurses floating around learning on the job.

• Then there is the support staff, they seem to change every 3 days (shift work I guess), they are responsible for keeping you clean, serving meals, keeping the ward spotless, cleaning you up after a diaper moment (they change diapers at least 6 times over a 24 hour period (they often do it a 3am in the morning!) And you can ring an “alarm bell” for assistance at anytime, these people have a thankless task oh and a separate team of “porters” who transfer you when need scans and x rays

• during the day and night you get a constant stream of Doctors, Specialists and other staff visiting patients.

A joyless experience for the most part

For the most part ward life is not a happy place and I can understand that but I always make a concerted effort to engage everyone from the cleaners to the top brass and at the very least to interact with the patients - because of the masks you cannot tell if people are happy or sad and to me seeing a happy smiling face is crucial in the recovery process and I was untouchable when it came to mask wearing my emotions were written all over my face.

At least half the wards occupants never had family or friends visit.

I remember fondly my 2016 Hospital Stay where no one wore masks and ward life was a lot more interesting.

Shout and Shout Louder

The doctors, nurses and support staff have zero concept of talking quietly, no matter what time it is they always seem to be shouting at each other, telling stories and such from opposite sides of the ward, it takes a lot of getting used to particularly when they are shouting at 2am, there is really no need for it and I cannot figure our why they need to do this, it is just plain annoying, it does not seem to occur to them that “peace and quiet” are important, it is as if they assume that all patients are hard of hearing.

... and please note there is NO privacy, when the Doctors and Nurses talk to you all your medical secrets are out in the open, everyone in the ward can hear, it takes a lot of getting used to and everyone is aware of your wounds so to speak, my heel attracted quite a few patients who wanted a look.

The most bizarre one is the diaper changing team of 2 people which is one support staff member and a trainee nurse, they will shout across the ward “have you poo - pooed” to all of those wearing diapers.

They do provide the diapers but please note that they expect you to provide your own (I refused) and I have no idea why, they can be expensive (we have 3 boys, I remember) - one of life’s mysteries.

You cannot close the privacy curtains

Each bed has a wrap around curtain and they do not like you to close them as apparently it is so they can keep an eye on people, which is a bit odd because many times during the day, support staff and nurses walk up and down the ward, it takes about 10 seconds.

Personally I prefer to pee in a bottle behind a closed curtain and why should everyone be subjected to looking at the diaper changing exercise?

Rules are rules and this is one rule you have no say on

Yes, there is one large TV in the ward

They turn it on at precisely 10.30am and turn it off at precisely 10.30pm and it has one local channel only and the volume is set so low you cannot hear it

You cannot charge your smart phone

I do not know who thought up this rule, out of the 12 beds in the ward only my bed had no spare socket to plug in a charger and for some reasons they would not allow people to use empty sockets to charge their phones, so a lot of the guys did so at 3am when no one was around, I witnessed a couple of heated arguments between patients and nurses on this issue.

This maybe a rule just for the Hospital I was in?

Hospital Food and slurping congee

I have to say, you will never starve in a hospital and feeding time (!) Is strictly by the book at very set times

Basically the default choice is Chinese Food, typical of food you get in cheap fast food restaurants in Hong Kong - a rice + 2 dish, portions a large, no dessert unless you like an orange or a sesame cracker, the food is just fine and most patients are brought food at visiting hours by friends and relatives.

I was off solid food for 2 weeks before admittance and refused all solid food in hospital (I have lost a lot of weight in the past 6 weeks) now I know from my previous experience in 2021 that the Hospital can offer alternatives but this has to be approved by a nutritionist, I am not kidding it took 5 days for this person to visit me and approve my liquid meal supplement, (our chat lasted less than a minute) 5 days, luckily I had a picture of the liquid meal from 2021 and the support staff and nurses found a way of delivering it to me 3 times a day for those 5 days which was very kind of them.

The Hospital is obliged to feed you and it should not take 5 days to get a visit from a nutritionist, the nurses advice was to get your family to bring food but this liquid supplement is not available in shops as it is made for Diabetics and people with Renal issues, the other issue is that there are 2 sizes one of the bottles is 125ml and one 230ml and for some reason they think 3 bottles a day of a 125 ml liquid supplement is enough, it is not.

Once I was approved then they delivered it with everyone else’s meals and quite often the kind support staff would slip me an extra bottle.

,.. And for 5 days they would deliver me Chinese food from the cart 3 times a day even though I refused to eat it, quite a waste of a perfectly good meal.

One of my pet hates is people who slurp congee which is served every morning and for some reason they serve 2 bowls and everyone attacks it with gusto, I hate the dish, always have, they do not serve breakfast cereal, toast and coffee, all my life lip smacking congee slurpers have annoyed the hell out of me!

Visiting Hours

Pretty rigid rules

12pm - 1pm and 5pm to 8pm and yes, 7 days a week

There is only one chair for visitors and there is only 18 inches of space between the beds so having more than one visitor is a big problem and naturally there is NO privacy, I had made it clear to my family that I preferred not to have visitors but they came anyway, bless them.

I was constantly amazed at how much food people brought for the patients and I was always gifted oranges (which I cannot stand!) friends and family of patients where always nice to me., you do not often see white foreigners in a public hospital.

Nurses, mobile blood pressure machines and dispensing Medicine

I like nurses even though you cannot see their faces and they are always shouting, I am always amazed that when it comes to medical issues they know perfect English as the medical language in Public Hospitals is English, they always sound as if they are quoting from a medical textbook.

They work incredibly hard and you can actually talk to them, what I find interesting is these days the nurses are split 50 | 50 male and female and despite being so busy they are always happy to chat for a minute or two.

One of their prime tasks is to do all manner of tests and dispense medicine and they are very well trained, that much is certain

on average

• I had my blood drawn and tested daily (and sometimes twice a day), these are very specific nurses who wear a light green top (rather than blue) and who push a pink cart with all their equipment, I took to calling them the Vampire nurses and they think nothing of drawing your blood at 2am

• I had blood sugar tests on average 10 - 15 times over a 24 hour period, every day

• I had a blood pressure test up to 20 times a day, I thought this was just for me, it isn’t they test everyone

• and every day they gave me 16 types of medicine including 4 injections a day

• and every day I was on IV drips which means you cannot move around much

They are very rigid, professional and courteous

Both Doctors and Nurses always seem to have mobile devices and work stations on wheels it is all very high tech and they can pull your records in front of you and show you on computers the results of scans and such.

Oh and everytime they visit you with meds or to do a test they scan you QR code which is on your wrist, this did not happen in 2021 and I also had a yellow bracelet on my other wrist which identified me as someone who is prone to falling! so I was basically confined to bed for 3 weeks.

Hospital Beds and Bathrooms

Gosh, so hi tech and clearly very expensive but the mattress is totally useless, it is hard to sleep and get comforable.

You can adjust the beds, up, down and sideways it reminded me of those car crushing machines in junk yards but I would settle for a bed with a decent mattress, the bed comes with a panic button that looks like a hand held microphone and when you press it, a nurse turns up within 20 - 30 seconds on average, you do learn NOT to abuse it.

When they take you for scans, they just transport you in the bed!

Oh and I did not know that each bed has an alarm under it, if you leave the bed a silent alarm sounds and someone will come and check, the turned mine off as it was more comfortable for me during the day to sit in a chair

As far as I could tell I could not see any CCTV camera‛s in operation

I only got to use the proper bathrooms twice near the end of my stay, they are spotless and are scrubbed down, 5 or 6 times a day

Scans

I had 2 CT Scans, an ultrasound scan and 3 X Ray sessions., in non urgent cases you can wait for 5 years to get a CT scan, I had 2 in 3 days, amazing machine, it is like being inside a jet engine.

To be honest it can be nerve wracking waiting for the results but they also picked up a real issue with my lungs on one of the CT scans which was not readily apparent.

Good News and Bad News

Doctors do not spend much time with you, a couple of minutes a day if you are lucky as they might be seeing 100 patients every morning, you immediately realise that NO news is good news and basically they only go into detail if it is bad news, so you don‛t ask, be assured they WILL give you bad news and the nurses will not tell you either, everything has to go through the Ward Doctor.

They are very strict about this.

Patients in the ward

• mine was an all male ward (they do have wards which have both male and female patients) as such no one had any compunction about farting, have they no shame? It is such a personal thing and I prefer not to share with the rest of the ward and no one cared if ladies were present!

• and yes, clearing your throat is a sport in Hong Kong, I find it to be awful and one gentleman had a thing for farting and clearing his nose at the same time

• the “nutter in the ward” I am a big fan of Jasper Carrott the English comedian from years back, he did a popular skit about the “nutter on the bus”, there is always one. At the end of our ward was an old geezer at least 90 years old whose skill was shouting out gibberish for 3 hours in the early morning (2am) when I mean shouting I mean shouting, it was a recurring nightmare for me and everyone else - it always happens and I had no choice but to tolerate it for 3 weeks, the Hospital cannot or will not do anything.... even worse was a chap in the ward opposite ours who screamed obscenities for hours every day. I half expected to see him doing a Linda Blair Exorcist trick of crawling along the ceiling. Both families knew it was an issue and apologised

The Pee Ladies

This is not a job for the nurses but the support staff who collect your urine 24 hours a day.

Hospitals are obsessed with your pee, every patient must use a special bottle once or twice a day (even if they can visit the toilet) and apparently measuring urine output is crucial and they can test it for so many things.

It can be quite unnerving to get a thumbs up from support staff when they collect the bottle from your bed, I convinced myself that they took bets on patients urine output.

The Spiritual Advisor

I was also visited by a Spiritual Advisor, once, she was dressed like a nurse and I politely listened to her for 30 minutes, she talked with every patient

It just seemed a bit odd to me and clearly she was deaf as I kept reminding her that medicine was curing me and not my spiritual beliefs which are just about non existent.

She was however a very pleasant and patient lady.

Wearing Diapers

Not my favourite subject at all but for 5 days when I first entered hospital and because I had a catheter inserted, going to the bathroom to poop was not allowed or feasible, so they made me wear a diaper (they had trouble finding one my size) I resisted using it for 5 days, I simply felt so embarrassed and ashamed, for Brits, it is always a very private thing.

When I could not hold out any more (they were feeding me laxatives as poop gets rid of the toxins in your body) I let rip (sorry) and it was like an out of body experience, my diaper expanded like a balloon, I am sure there was a pool running to see how long I could hold out.

I rang my alarm bell and 3 female support staff dealt with me much as you would deal with a baby except this was a white male 63 year old, 200lbs with tattoo‛s.

In a nutshell it is simply an awful experience but there were no other options for me heaven knows how the female support staff can stomach this task, I guess you get used to it.

The awful Catheter experience

This is going to be detailed as it was by far a preventable experience and I should never have forced to use one.

Use Google and see what is is entailed about being fitted with a male catheter, it is enough to make you wince

For some reason when I was admitted and using the results of my first blood test, they were convinced my issue with my kidneys was causing me not to pee which was far from the truth, inserting a catheter is one of the most painful and uncomfortable procedures I have ever undergone, it is hard to describe and I would not wish it on my worse enemy

What happened over the next 4 days should not have happened, they kept telling me it was a painless experience and I would get used to it, I did not and the pain started and just got worse and worse. On day 4 I could not stand it any longer, the Ward Doctor was having a day off and I spoke to 4 Doctors over a 12 hour period and demanded that they remove the catheter, but they refused as apparently only the Ward Doctor can make that call.

So I went up the food chain, the 2nd Doctor I saw said if I signed a waiver form they could remove it, 3 hours later they informed me that they could not find the form, so I insisted on seeing a more senior Doctor, he basically told me to hang on for another 24 hours but I refused.

So a 4th Doctor came to see me 8 hours later with the waiver form, I signed it and one of the nurses told me the catheter would be removed shortly and then she literally without warning pulled the damn thing out, 18 inches of a plastic tube being pulled out from your bladder through your penis. The pain was indescribable and guess what, they found out that I had a severe infection in a very sensitive part of my anatomy and there was a lot of pus leaking out of my penis which explained the pain.

Just for a moment reflect on a nurse pulling an 18 inch plastic tube out of your most intimate parts., it was like something out of a SAW horror movie.

I had no desire to make a complaint, they were following standard procedure and something got lost in translation but ignored the fact that I could pee into the bottle which is the standard way to collect urine, I let it slide and the subject was not brought up again, other than I spent the next 16 days peeing with gusto and satisfaction into the bottle at will 3 times a day, just to prove my point.

Bath time with Fred and Wendy

That’s right, Fred and Wendy (not their real names!)

Due to my medical conditions, foot infection and such a shower was not allowed and after 14 days they relented when a nurse informed me that 2 staff were in a position to offer me a bath at a pre determined time.

So they rolled me onto a special “plastic waterproof bed” rather like a coffin on wheels and took me to a special room where they undressed me and used a hose to basically hose me down and washed my hair etc.

So ? you may ask ? Well it it was a male and female which came as a surprise to me but I decided it was not as embarrassing as pooping into a diaper so I just let them do their thing.

If you are a long term patient I guess you get used to this.

Strange moments

Strange things happen

• the 90 year old elderly geezer in our ward with a talent for yelling in the middle of the night, it was all very odd, every day without fail, twice a day his sister and her Indonesian helper would visit for precisely the allotted visiting time - you could set a clock by them, I remarked to a few people about the Indonesian helper who was mid 20's and rather like an Amazon Goddess - she spent 4 hours a day cleaning him. feeding him and massaging him.......!!

• After 2 weeks one morning I woke up to find another hospital bed had been parked at the end of my bed and there was chap snoring away. When he woke up I looked at him, I actually knew him by sight, he lives in the same town as me and I had seen him a few times - Half Australian and Half Chinese, we talked for about 10 hours straight, he had caught an infection from a dead fish in his wife‛s restaurant close to the Hospital, this fish infection was big news here as people had died, luckily he was fine and was discharged later in the day

Other than that you get used to the boredom and tedium.

Conclusion

If you are not well off and have no medical insurance then a Public Hospital is your only real option

I cannot stress enough the professionalism shown over the whole 3 week hospital experience (catheter experience apart) the quality of care is amazing, they are totally dedicated to making you better and this is the 5th major incident I have gone through, they have gone high tech in many areas.

They leave nothing to chance.

I am now at the stage of follow up visits and have a period of at least 6 months visiting a Government Clinic as well as the Hospital to dress the wound to my foot every 2 days and follow up consultations regarding my lungs | kidneys and such.

• The best part, my 20 and a half days in hospital came to a total of HK$2,160 or US$277

• If I was a non Hong Kong resident the bill would have been HK$91,782 or US$11,872

Everything including the medicine was included and you simply cannot argue with the subsidised cost and the bill if I was in a Private Hospital could have easily been 3 to 4 times higher, the cost of HK$91,872 is what you would pay in a Government Hospital if you were not eligible for the subsidy.

The Hong Kong Public Health Care system is fantastic in an emergency (a quote from a great friend) but falls short in non emergency cases (I am blind in one eye and just to get an appointment at a Government eye hospital is a 4 year wait, my appointment made in 2022 is not until 2026! And I am supposedly a priority case)

I guess no system is perfect

The one thing that stands out is it is hard to reconcile private healthcare costs in Hong Kong relative to staying in a Public Hospital and really the only difference is that you have your own room and TV or share with one other person, I guess if privacy is thing then you would go private.

The Hong Kong Government deserves a lot of credit for the Public Healthcare System.

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