Speaker： Prof. FOK Tai Fai (CUHK)
Paper Title: The evolution of neonatal care in the past 50 years in Hong Kong

Abstract：

The past five decades have seen very rapid advances in neonatal care in the west. In comparison, Hong Kong trailed behind the west by a considerable distance during the first half of the past 50 years, but was able to catch up fairly rapidly in the latter half.

In the 1940s, when rapid technological development was taking place in post-war Western Europe and North America, Hong Kong was still poverty-stricken with hardly any healthcare services available to the general public. Because of the prevalence of Rhesus incompatibility resulting in haemolysis in the newborns, European paediatricians had introduced exchange transfusion as part of the management of severely jaundiced babies. At the other side of the Atlantic, William Silverman in the United States had conducted a randomized controlled trial confirming the causal relationship between the indiscriminate use of oxygen and retinopathy in the preterm newborns. In contrast, newborn care in Hong Kong was limited to the provision of warmth and food (mother’s milk in most cases). Retinopathy of prematurity was unheard of because newborn infants premature enough to be candidates of ROP simply did not survive.

In the 1950s and 60s, neonatal intensive care blossomed in the west but not in Hong Kong. In fact, when I first started my paediatric training in the 1970s, there was not a single physiological monitor or newborn ventilator that functioned effectively in the whole territory. We did have phototherapy units but they were in such short supply that very often two, sometimes even three jaundiced babies had to be put in the same incubator for the light treatment. Neonatal care in Hong Kong came to a turning point in the mid-80s. Now our neonatal intensive care units are as well equipped as most of those in the western world. The infant and neonatal mortality rates are consistently one of the lowest in the world.

In this 15-minute talk, I would like to illustrate the development of neonatal care in Hong Kong in the past half a century using two most common neonatal conditions, namely neonatal jaundice and neonatal respiratory problems.