Missing Links between Primary Healthcare and Rural Elderly

Sai Kung District Community Center, Hong Kong

Missing Links between Primary Healthcare and Rural Elderly

Sai Kung District Community Center, Hong Kong

Health inequity in rural areas is sometimes neglected in our city.  In Sai Kung alone, there are more than 158,800 senior citizens, accounting for 32% of the district population.  It is estimated that at least 10,000 of them are still living dispersedly and remotely among 110 rural villages, very far away from the closest major government-funded healthcare facilities in the urban town of Tseung Kwan O.

In addition, insufficient internet coverage remains as one of the greatest hurdles for implementing telehealth services there, as concluded in our supported pilot project by Sai Kung District Community Centre (SKDCC).    Despite numerous barriers, as a community-based NGO, SKDCC continues its pursuit to address the service gaps at the first contact point of primary healthcare system and to explore more effective solutions for ageing-in-place in rural areas.

Since July 2022, ZeShan Foundation, together with Kerry Group, has therefore been co-funding SKDCC’s another 3-year pilot project “Mobile Primary Healthcare in Rural Sai Kung for Elderly”. The team has been reaching out to elderly villagers to strengthen their self-efficacy, through combining the use of smart devices for monitoring, health coaching, mobilisation of community health ambassadors and case management, with a more holistic lens of maintaining a better quality of life in terms of healthcare and social connections.   These approaches align with ZeShan’s three guiding principles, namely ‘empowerment’ (by increasing the capacity of older persons to take charge of their own health, and of communities to take care of each), “engagement & collaboration” (by facilitating partnerships among social workers, pharmacies, researchers and community members, including the development of protocols and mechanism of collaboration), and “catalyzing innovations and flexibility” (by providing capital to an NGO such as SKDCC to test new collaborations and engage policy-making stakeholders).

Outreach service in the villages
Chinese medicine practitioner checking on villager
Service team visits remote villages
Mobile service can adapt to topography of remote villages
Outreach service in the villages
Chinese medicine practitioner checking on villager
Service team visits remote villages
Mobile service can adapt to topography of remote villages
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Outreach service in the villages
Chinese medicine practitioner checking on villager
Service team visits remote villages
Mobile service can adapt to topography of remote villages
Outreach service in the villages
Chinese medicine practitioner checking on villager
Service team visits remote villages
Mobile service can adapt to topography of remote villages
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Health inequity in rural areas is sometimes neglected in our city.  In Sai Kung alone, there are more than 158,800 senior citizens, accounting for 32% of the district population.  It is estimated that at least 10,000 of them are still living dispersedly and remotely among 110 rural villages, very far away from the closest major government-funded healthcare facilities in the urban town of Tseung Kwan O.

In addition, insufficient internet coverage remains as one of the greatest hurdles for implementing telehealth services there, as concluded in our supported pilot project by Sai Kung District Community Centre (SKDCC).    Despite numerous barriers, as a community-based NGO, SKDCC continues its pursuit to address the service gaps at the first contact point of primary healthcare system and to explore more effective solutions for ageing-in-place in rural areas.

Since July 2022, ZeShan Foundation, together with Kerry Group, has therefore been co-funding SKDCC’s another 3-year pilot project “Mobile Primary Healthcare in Rural Sai Kung for Elderly”. The team has been reaching out to elderly villagers to strengthen their self-efficacy, through combining the use of smart devices for monitoring, health coaching, mobilisation of community health ambassadors and case management, with a more holistic lens of maintaining a better quality of life in terms of healthcare and social connections.   These approaches align with ZeShan’s three guiding principles, namely ‘empowerment’ (by increasing the capacity of older persons to take charge of their own health, and of communities to take care of each), “engagement & collaboration” (by facilitating partnerships among social workers, pharmacies, researchers and community members, including the development of protocols and mechanism of collaboration), and “catalyzing innovations and flexibility” (by providing capital to an NGO such as SKDCC to test new collaborations and engage policy-making stakeholders).

Moreover, this project is also testing a community-based referral system for professional treatment and a co-payment system referencing government subsidy scale like Health Care Voucher and Community Care Service Voucher, etc. Evidence-based evaluation would also be conducted in order to assess the project outcomes, including connectivity between social resources and the actual needs for these underserved communities in remote areas.

As an effort to expand its partnership, SKDCC has also received free health coaching for its nurse staff and free nursing support from the project team of HomeAge of the City University of Hong Kong.

Tsz Kwan Lai
Assistant Operations Manager
ZeShan Foundation

Moreover, this project is also testing a community-based referral system for professional treatment and a co-payment system referencing government subsidy scale like Health Care Voucher and Community Care Service Voucher, etc. Evidence-based evaluation would also be conducted in order to assess the project outcomes, including connectivity between social resources and the actual needs for these underserved communities in remote areas.

As an effort to expand its partnership, SKDCC has also received free health coaching for its nurse staff and free nursing support from the project team of HomeAge of the City University of Hong Kong.

Tsz Kwan Lai
Assistant Operations Manager
ZeShan Foundation

Related Links

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Media (Chinese Only):

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Related Links

Website:

Media (Chinese Only):

外展護士:
不單照顧鄉郊長者的醫療需要 關心她們心靈及社福需要 @ 卓越實踐在社福2021
Link (Youtube 平台)

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Link (Mingpao News)

Law for Change Incubation programmes have blossomed in recent years, supporting myriads of passionate young people to generate social impact innovations. It is encouraging to see growing interests towards certain social topics but some topics seem to remain remote to young change-makers. “Access to legal support” is one of the examples.

Age-related declines in capabilities may compromise older people’s ability to respond to health and safety hazards in home environment, causing increased risk of home injuries and threatening ageing-in-place. Recognising the growing demand for more personalised and preventive home support, ZeShan Foundation rolled out a new partnership with Habitat for Humanity Hong Kong

Clean Air Schools

Clean Air Network, Hong Kong

Environmental protection has been higher on public agenda in Hong Kong. It is exciting to see more information exchanges and community campaigns on pressing issues like greenhouse gases, wastes and habitat degradation. But what about air pollution?

Compared to the extreme hot days, odor nuisances or loss of endangered species, smog might seem to be a less worrying phenomenon. Air pollution, however, can be harming our health at different stages slowly yet severely. Air pollution deserves our attention.

Sharing the same mission that we need more conversations and actions on air pollution, ZeShan Foundation has collaborated with Clean Air Networks (“CAN”) in 2022 to carry out a 2-year school-based project on air monitoring and education. The pilot will support 8 primary and secondary schools in Sham Shui Po and Tuen Mun to gather real-time data on air quality via monitor installation. This is one of our first attempts to develop more community-led initiatives to address our environmental issues. With the available data and technical support from the Hong Kong University of Science and Technology, the participating school management, teaching staff and students will be guided by CAN to develop and test out their adaptation measures to address air pollution in schools.

Sowing the seeds of raising awareness and knowledge, ZeShan hopes to see more behavioral changes around air pollution on a school level, and ultimately a cleaner and healthier learning environment for nurturing young minds.

Alexa Li
Assistant Program Manager
ZeShan Foundation

CAN school project artwork

Chinese medicine practitioner checking on villager
Outreach service in the villages
Service team visits remote villages

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Outreach service in the villages
Chinese medicine practitioner checking on villager
Service team visits remote villages

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More Sustainable Source of Resilience and Recovery

In disaster management, the framework of participatory capacities and vulnerabilities analysis (namely “PCVA”) has been widely adopted for needs assessment over the past three decades in different countries.  This lens was also referenced by ZeShan team to understand not only the impact of the ongoing 5th wave of COVID pandemic on vulnerable people but also the systemic drivers behind such impact.   These often touch upon issues related to social inclusion, public governance, health equity, equal access to public resources and even policy issues.

PCVA is rooted in two proven social development methodologies.  First, of course, it stems from the traditional tool of CVA which enables frontline workers to design and plan relief projects, based on capacities and vulnerabilities of a community.  It recognizes vulnerable people have capacities to cope with adversity and can take actions to improve and rebuild their lives, before, during and/or after a disaster.  Second, PCVA has originated from the belief that empowering communities to participate in program design, planning and/or management would lead to increased ownership, accountability, and impact.  This is therefore the best way to bring about recovery or even changes.

This framework indeed aligns very much with ZeShan’s core approach of community empowerment in all program planning.   We believe, in every community, people have resources and capacities, but often unnoticed and then under-utilized.  In the process of disaster relief and recovery, it is therefore very important to identify these resources and capacities, and then empower people at all levels, including the so-called victims.  This process is always a more sustainable way to help people help themselves and others, and rebuild their own life and community.

In the past three months, through this lens, we discussed with peer foundations, project partners and people in Hong Kong.  We have identified the pressing needs of the most vulnerable ones as well as some of their precious but unnoticed resources and capacities.   With more than 10 new relief grants, ZeShan has focused on those marginalized or excluded under the existing policy frameworks and mainstream service provision or subsidy schemes.  These include grassroots families, ethnic minorities, refugees and asylum seekers, small businesses and social enterprises struggling with unsold food stock and poor cashflows.   Designing each of our relief programs, we have tried hard to mobilize their own untapped labour and unused materials inside our hard-hit communities, with a view to preparing themselves better and stronger in the forthcoming process of economic recovery.

For a charitable foundation, we consider it not difficult to hand out materials to the needy.  We are therefore trying hard to be more forward looking.  At this current relief stage, whenever possible, a more empowering process was consciously designed and executed in our relief projects.  For we believe, this will be a more effective and sustainable way to help them rebuild their own communities at the next rehabilitation phase.

Our recent relief grants:

Initiated by Project
Chow Tai Fook Charity Foundation Wu Wu Cheng” Community Mutual Support Initiative”
Fullness Social Enterprises Society Limited Love Our Neighbour
Dialogue in the Dark (HK) Foundation
WeCare (Emergent Emotional Support for Vulnerable Elderly)
Health In Action Emergency Relief to Cleaners and Deprived Families Working and/or Living in Kwai Chung
Run Hong Kong Covid Relief – Health and Essential Services
Covid Relief – Psychological Support
Christian Action – Centre for Refugees COVID-19 Fifth Wave Emergency Distribution
United Christian Nethersole Community Health Service COVID-19 Care for Ethnic Minorities
The Neighbourhood Advice-Action Council Friendly Food Support Scheme
Hong Kong Unison 5th Wave (COVID-19) Ethnic Minority Emergency Relief Project

Irene SO
Executive Director
ZeShan Foundation

Staff and volunteers distributing relief packs to elderly (Dialogue in the Dark (HK) Foundation)

Staff and volunteers distributing relief packs to elderly (Dialogue in the Dark (HK) Foundation)

https://zeshanfoundation.org/wp-content/uploads/2022/04/wuwucheng-800600-640x480.jpeg

Volunteers distributing vouchers to beneficiaries
(“Wu Wu Cheng 2.0” Community Mutual Support Initiative/ Chow Tai Fook Charity Foundation)

https://zeshanfoundation.org/wp-content/uploads/2022/05/FSES-LON-packing-640x480.jpeg

Social Enterprise (Angelchild) staff packing food packs
(Fullness Social Enterprises Society)

https://zeshanfoundation.org/wp-content/uploads/2022/04/CRF-COVID-800600-640x480.jpeg

Staff distributing daily necessities to refugees and asylum seekers (Christian Action- Centre For Refugees)

https://zeshanfoundation.org/wp-content/uploads/2022/04/RUNHKCOVID-800600-2-640x480.jpeg

Fresh shop at RUN! Refugees and asylum seekers collecting fresh food, milk, cleaning supplies and toiletries every fortnight.
(RUN Hong Kong)

https://zeshanfoundation.org/wp-content/uploads/2022/04/Volunteers-packing-Covid-Relief-Packs-640x480.jpg

Volunteers packing COVID relief packs
(Hong Kong Unison)

Staff and volunteers distributing relief packs to elderly (Dialogue in the Dark (HK) Foundation)

With help of volunteers, the COVID-19 Care Package were delivered to different districts
(United Christian Nethersole Community Health Service)

Staff visited cleaners’ workplaces to talk about the proper usage of PPE correctly and the use of Rapid Antigen Test (RAT) kits, etc. (Health In Action)

Staff visited cleaners’ workplaces to talk about the proper usage of PPE correctly and the use of Rapid Antigen Test (RAT) kits, etc.
(Health In Action)

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Related Links

Green Collar Incubation Hub

A Plastic Ocean Foundation, Hong Kong

In recent years, a growing number of recycling stations has been noticed in many urban communities, housing unwanted household items. Recyclables in the rural side, however, do not share the same story – valuable recyclables are often turned into mismanaged waste or even pollution menace, where recycling facilities or services are lacked or limited.

Hoping to change the narrative in the rural setting, ZeShan Foundation has partnered with A Plastic Ocean Foundation (“APO”) to develop a community-led waste management model in rural villages. In this one-year pilot project, two cohorts of passionate young adults will be equipped with professional training on recycling operation. Guided by APO’s recycling partners, the trained green collars will then take the lead on running a series of community recycling drives for people residing in villages located in the New Territories West. These range from collecting household plastic waste to processing them into quality recycling materials that can be repurposed for a second life.

Through mainstreaming the green practices in rural neighbourhood and cultivating a pool of green talents, ZeShan hopes to test and demonstrate this alternative model in strategically addressing the growing waste problem and rivitalising the recycling industry in Hong Kong.

Alexa Li
Assistant Program Manager
ZeShan Foundation

A Plastic Ocean Foundation's Education Team is introducing rural green facility and the natural habitats of Ha Tsuen to university students

APO’s Education Team is introducing rural green facility and the natural habitats of Ha Tsuen to university students

A Plastic Ocean Foundation's Education Team has been invited to offer a career talk on Green Opportunity and Employment for IVE (Shatin)

APO’s Education Team has been invited to offer a career talk on Green Opportunity and Employment for IVE (Shatin)

A Plastic Ocean Foundation's Education Team's mobile clean recycling station where our officer is introducing the concept of clean recycling to rural residents

APO’s Education Team’s mobile clean recycling station where our officer is introducing the concept of clean recycling to rural residents

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HandsOn YOUTH EMPOWERED

HandsOn, Hong Kong

Volunteer Training during COVID-19 Pandemic.
A yoga session led by those supporting migrant workers helps this vibrant community to increase their confidence and build social connections.
Youth Leaders organised an outreach event to inform and educate Hong Kong's migrant worker community with useful information.
Youth Empowered's environmental team got "hands-on" to organise a coastal clean-up.

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Over the years, we have seen a rise of change-makers in different communities of Hong Kong. Yet, it is not easy to find the footsteps of secondary school students. Compared to their elder counterparts, teenagers are often considered lacking passion, awareness and know-hows around social issues. Such perception might also hamper the opportunities for the ones with the right hearts and minds to contribute.

Determined to dispel the myth, ZeShan Foundation is keen to cultivate an enabling environment for young people channeling their passion to positive impact, together with like-minded allies. Since 2021, ZeShan has supported HandsOn Hong Kong’s YOUTH EMPOWERED, a 10-month project focused on empowering Hong Kong youth to be active change-makers in serving the community. About 30 youth volunteering leaders representing a cross-section of Hong Kong secondary schools will be gifted opportunities to explore community needs and develop leadership skills. The volunteer leaders will also be missioned to develop and lead six new community service programmes, under the collaboration with HandsOn team and NGO partners.

By putting youth in the driver’s seat, ZeShan hopes to instil a sense of ownership and agency of young people, while at the same time, to initiate a shift in mindset in embracing youth capability, an indispensable element in building our community.

Alexa Li
Assistant Program Manager
ZeShan Foundation

Youth Empowered's environmental team got "hands-on" to organise a coastal clean-up.
A yoga session led by those supporting migrant workers helps this vibrant community to increase their confidence and build social connections.
Youth Leaders organised an outreach event to inform and educate Hong Kong's migrant worker community with useful information.
Volunteer Training during COVID-19 Pandemic.

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Haiti Earthquake Relief

World Vision

Early in the morning of 14 August 2021, a 7.2-magnitude earthquake rocked Haiti, causing hospitals, schools and homes to collapse, claiming over 2,200 lives and leaving communities in crisis. According to UNICEF, it has been estimated that about 1.2 million people, including 540,000 children, have been affected by the powerful earthquake.

The disaster caused damages in mainly the departments (or provinces) of Sud, Nippes and Grand’ Anse which were 125km away from the capital city of Haiti. There were severe damages to infrastructure, including shelters built from previous storms, buildings like hospitals, schools and churches, roads which were necessary for the community to carry out relief services and to recover. Several hospitals have been damaged or destroyed, while those still operating are overloaded, with a serious shortage of personnel and medical supplies to address growing health needs.

Social challenges emerged as gangs’ violent activities spread over the country urged the need to support on protection or security alongside the intervention like health, WASH (Water, Sanitation and Hygiene), shelter, food security, children protection and education to the damaged area.

Before this earthquake, Haiti was already the poorest country in the Western hemisphere; about 65% of its population live under the national poverty line. Political instability has hindered the economic and social development.

According to the latest Integrated Food Security Phase Classification (IPC) analysis, about 4.3 million people (44 percent of the population analyzed) were expected to be starving severely from September 2021 to February 2022. The worst situations were reported in Nord-Ouest, Centre (the Haut Plateau), Sud and Nippes, which are classified to be in IPC Phase 4 (Emergency). (Source: Food and Agriculture Organization of the United Nations. Dated 12 Nov 2021)

ZeShan therefore made a relief grant to support World Vision’s relief work to address the pressing needs of health and nutrition, child protection, water, sanitation and hygiene, as well as shelter.

Deworming activities are on-going in schools

Deworming activities are on-going in schools  ©World Vision

children friendly space

Children friendly space.   ©World Vision

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Forget Famine Not

Oxfam, World Vision and Medecins Sans Frontieres

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A deadly mix of conflict, COVID‐19, insect attack and persistent droughts have pushed more than 7 million people across six countries in East Africa to the very edge of starvation. According to UN reports, approximately 108,000 people there were under catastrophic famine‐conditions, a phase marked by critical acute malnutrition, starvation, destitution and death. This phase is understood in the humanitarian sector as the highest and most urgent Integrated Food Insecurity Phase Classification (IPC) of level 5. Additionally, almost 7.8 million people are exposed to emergency phase (IPC4), and if things worsen are one step away from famine. As many as 26 million are classified at “crisis level” (IPC3), where action is needed now to stop them sliding into emergency.

The region has endured substantial and widespread breeding of desert locusts since late 2019, resulting in loss of pasture and crops. Added to this, from June to December 2020, rising conflicts has exacerbated the food insecurity situation in the region. The Climate Prediction and Application Centre and the UN’s Food and Agriculture Organization have both made predictions of dry conditions and worsening food insecurity situation in 2021. Coupled with economic impact of COVID‐19, lockdowns continue to destroy livelihoods and push millions into desperation.

This challenging period could erode human and economic development gains that have been made towards the global Sustainable Development Goals across the region. The rising food insecurity also increases the risks faced by women and girls, including gender‐based violence and sexual exploitation and abuse.

In view of these pressing emergency needs, ZeShan Foundation made in the summer of 2021 three major emergency grants to support the ongoing famine-related relief operations in South Sudan and Ethiopia by three INGOs, namely Oxfam, World Vision and Medecins Sans Frontieres.  The relief efforts include provision of food relief, clean water and sanitation, emergency healthcare and protection of vulnerable groups, especially children and women.

Hundreds of people in Shire’s University IDP site live in an unfinished building, where they sleep, cook and eat. Many don’t have mattresses or blankets. ©Claudia Blume/MSF

Hundreds of people in Shire’s University IDP site live in an unfinished building, where they sleep, cook and eat. Many don’t have mattresses or blankets. ©Claudia Blume/MSF

It is one of the camp sites in Tigray region. Oxfam is providing life-saving aids, including food, water and hygiene kits to displaced people in Tigray since Jan 2021. ©Oxfam

It is one of the camp sites in Tigray region. Oxfam is providing life-saving aids, including food, water and hygiene kits to displaced people in Tigray since Jan 2021. ©Oxfam

Caregivers preparing nutritious food. ©World Vision

Caregivers preparing nutritious food. ©World Vision

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