Hong Kong Needs to Find More Doctors

Hong Kong urgently needs more doctors to alleviate system

 

Hong Kong has a serious shortage of doctors. Currently the ratio is two doctors for every 1,000 residents, compared with Australia at 3.8 and 4.3 in Sweden.

The problem is that the professional medical body makes it near impossible for non-locally-trained doctors to practice in the city with its licensing exams. Dentists also have a similarly difficult exam -- the regulatory body sets the rules and in the case of dentists, the questions aren't necessarily technical questions, so it's impossible to get almost 100 percent on the exam, which is the standard.

The academy says the govt did not consult it

So the Hong Kong government made a bold move by suggesting the city should recruit non-permanent residents to practice as specialists without taking the local licensing exam.

Needless to say the Hong Kong Academy of Medicine was dismayed at hearing the news.

"During the process of drafting the amendments, the government has always maintained good communication with the academy, but it did not consult the academy on the three changes put forward on Tuesday," it said, in response to the announcement from health authorities on proposed changes that included that of allowing non-permanent residents to practice as specialists.

The body claimed just having more non-locally trained doctors alone would not be enough to solve the issue.

"The government should review the system holistically and improve retention measures within the public medical system to ease the loss of talent and ever-growing need for manpower," it said.

Chan suggests ways to recruit more doctors

However, the loss of talent has only been in the recent year or so -- what about for the past years and decades? The body has not helped in suggesting ways to alleviate the pressure on the health system, only to fiercely protect its own.

In May health minister Sophia Chan Siu-chee floated the idea that foreign-trained permanent residents who had graduated from a list of recognized medical schools be allowed to practice without taking the local licensing test.

Another idea is to allow permanent resident medical students trained abroad to do their internships in Hong Kong after passing the licensing test, and giving overseas trained doctors already in the city on short-term "limited registration" contracts a chance at full registration.

Chan says if these suggestions are not implemented by 2030, there will be 1,650 fewer doctors than needed, and the figure will rise to 1,940 by 2040.

Chan wants non-resident doctors to be specialists

It was suggested by Chan's department that some 1,000 Hong Kong medical students educated abroad could do their internships in the city.

While the government insisted the academy would continue as the gatekeeper of specialist qualifications, wouldn't the body still make it difficult for overseas trained permanent resident medical students trying to get jobs in Hong Kong?

Perhaps it's an effort at appeasement, but Hong Kong really needs more doctors to keep the health care system functioning...

Slow Vaccine Uptake in HK

Many have taken selfies of themselves getting the jab

 

Even though a lot of people (mostly expatriates) are posting on social media pictures of themselves getting the injection or of the makeshift medical clinic with the hashtag #HKTwitterGetsVaxxed, only 304,100 people have gotten the jab in total, either Sinovac or BioNTech.

Considering 5.5 million people are eligible for the vaccine, so far only 4 percent of the population has gotten at least the first dose which is still a very low uptake.

As a result the government is considering incentives to encourage people to get vaccinated.

Chan hints at some incentives for vaccinations

Health Secretary Sophia Chan Siu-chee said today on a radio show the authorities would consider measures such as allowing those who have received a vaccine to enter certain premises, to visit care homes and hospitals, or to be exempt from other social distancing measures.

Errr... can you make these incentives more exciting? Sounds quite dull to be honest.

Infectious diseases experts David Hui Shu-cheong who was on the same radio program added that at least 50 percent of the population needs to be vaccinated.

"If the general public actually is actively taking part in the vaccination program, then I think we'll see fewer and fewer outbreaks in the community. By then, a lot of the social distancing measures can be relaxed," Hui said.

Sigh. 

The problem is most people are on the fence or don't care about being vaccinated. My hairdresser said, "I don't want to get the jab. The rest of you can get it so I don't have to."

Those vaccinated get special stickers

My hairdresser is dying to travel -- so getting a vaccine is most probably going to be a prerequisite!  

Even more bizarre is her parents are so pro-China and yet they aren't even touching the vaccine either!

Tonight I had to persuade my relatives to get the jab, that it was better to get it done now than later, but they were not in a rush to book online even though it would take five minutes.

Sigh.

The government better hurry up and come up with some really enticing incentives otherwise we're going to have to wait a really long time for at least half the population to get the jab...

Hong Kong Hospitals Almost Full Capacity

A makeshift emergency field hospital has been set up in Central Park

In the news there are pictures of large white tents set up in Central Park in New York City, a makeshift emergency field hospital that will hold 68 beds. So far New York has over 33,000 confirmed coronavirus cases, and over 770 people have died.

Dr Lau Ka-hin warns isolation wards are in short supply

Meanwhile in Hong Kong, health officials are warning there soon will not be enough beds, particularly isolation wards. Could there be a field hospital set up in say, Victoria Park? We should not be surprised.

Today in a press conference, Dr Lau Ka-hin, the Hospital Authority's chief manager in quality and standards, warned that isolation beds were increasingly in short supply, revealing that 39 of the infected cases out of 41 cases today were still waiting to be admitted into hospital.

He added the occupancy rate of isolation wards in some hospitals was already at 100 percent as of noon today. Currently there are 489 positive cases being treated in 14 hospitals. While patients are being discharged, Lau added it took time to completely disinfect the bed and area that the patient had occupied so it wasn't as if another patient could take the bed right away.

Some 39 positive cases are waiting to be admitted to hospital

They will determine those without a fever for 48 hours, no breathing problems, infection symptoms or diarrhea could be moved to "second-line" isolation wards, or general wards that had been converted to have isolation functions.

Everyday there are on average over 40 positive cases, the majority of them from overseas, and Hong Kong must accept them if they are residents of the city, so we must care for them too.
This is why people in Hong Kong need to take social distancing very seriously. If there is no particularly reason for you to go out, don't. Best to stay at home and stay clean.

One bar/cafe with this sign on its door

In any event, several restaurants and cafes are shutting down temporarily to protect not only their staff, but also prevent gatherings in their establishments -- they don't want to be in the media to be known for having positive cases.

So there are many signs like this now. And it's true, we're all in this together so we need to work together. Stay home, stay safe.

Everyone Needs to Wear a Mask. Everyone.

Labour and welfare minister Law claims he hasn't work a mask for 22 days

Hong Kong government officials continue to be completely out of touch with the residents they are supposed to serve.

Chief Executive Carrie Lam Cheng Yuet-ngor continues to refuse to wear a mask in public events, and Law Chi-kwong, Secretary for Labour and Welfare has followed his boss, and even bragged about being mask-less.

Lam says her masks are going to healthcare workers -- really?

In his blog, Law wrote he had not worn a mask in the past 22 days. He said he had driven to work, attended meetings everyday at government headquarters in Tamar.

"Most of my colleagues at the Labour and Welfare Bureau have been working from home these days. But they still have to come back for meetings when necessary. For me, apart from attending meetings, most of the time I was in my office alone," he wrote.

"I haven't been to any crowded places over the past 22 days. I have been driving to the government headquarters myself and have not used public transport. I haven't used a single face mask, and thus, I was in a way saving the masks for those who needed them."

We'll get to the question of having enough masks in the city, but what is Law trying to prove?

That he is a privileged person in Hong Kong who has his own car and office that he doesn't need to wear a mask? The vast majority of us need to take public transport and so we are all wearing masks as soon as we step out the door. Needless to say we are all fuming behind our masks.

A guy wears ski googles, mask and gloves

Thankfully infectious diseases expert Dr Joseph Tsang Kay-yan helped us tell off Law and put on a mask regardless.

"Of course he doesn't have to wear a mask when he is driving. I am also sure that he has his own office. But he still needs to take the public lifts. Mainland expert Zhong Nanshan has said that the lifts are high-risk facilities. A lot of people use the lifts," Tsang said.

"I'd suggest that once [Law] is back at the government headquarters, he has to wear a mask."

Tsang explained everyone should wear a mask because some infected people may not have started showing symptoms and so they may not even know they are infected.

Meanwhile, these government officials including Lam keep saying their stash of masks should be given to front line healthcare workers but they don't seem to have received them, as they keep clamouring for more.

Where have the masks gone?

Most people wear masks in Hong Kong in public spaces

Some people on social media have called for an investigation into where the masks have gone... some masks made by prisoners were found to be on sale online! It's absolutely indefensible for front line healthcare workers to not have enough proper equipment to protect themselves on the job when Hong Kong has so much money in reserves.

Perhaps Lam should personally donate her stash of masks to a hospital. Or does she dare not show up in person?

HK Government's Whopping Surplus

All eyes will be on Chan when he delivers his budget at the end of this month

Financial Secretary Paul Chan Mo-po will be giving his budget speech on February 28 and already the projections are that Hong Kong will have a surplus.

How big a surplus?

At least seven times the original estimate of HK$16.3 billion to just under HK$120 billion. But it could go as high as between HK$160 billion and HK$180 billion. If that's the case, then it will beat the record set last year when the surplus was HK$92.8 billion, eight times the estimate of HK$11.4 billion.

Economic experts have criticized the government for not only its conservative math skills, but also its failure in investing in things like public hospitals, and helping the elderly and the young.

Previous administrations didn't do enough for the elderly

They warn that with the growing elderly population, the government's revenue will shrink, while it will cost more in healthcare to look after them.

Two economists said the government failed to take into consideration the "China factor" that fueled rises on the Hong Kong stock market and the record-high land prices in recent years into its surplus projections.

"Hong Kong has been experiencing the biggest structural economic growth and it is because of China," said Franklin Lam Fan-keung, founder of think tank HKGolden50 and a former investment bank analyst who served the government's Central Policy Unit during the Asian financial crisis in 1997.

"But we did not food the growth, we did not pour money into social and economic infrastructure... Offices, hotels, and hospitals ended up being very expensive in Hong Kong.

"Yet with so much money [at hand], the government didn't build a new hospital or build a land bank, and elderly people's savings have been eroded by inflation," Lam continued. He said former financial secretary John Tsang Chun-wah had taken an overly frugal fiscal approach and failed to invest to grow the economy.

The government needs to invest in infrastructure like hospitals

Meanwhile Chinese University associate professor of economics Terence Chong Tai-leung expected the stamp duty to expand, making duty paid on property and stock purchases the biggest source of government income and further driving up total revenues.

It is shocking to find the government has totally missed the mark --again -- and again -- for underestimating its revenues. Do they think the general public will be so thrilled to hear that the surplus is X number of times the original estimate?

Sounds like really bad accounting skills and as Lam said, not taking into account how mainland Chinese buyers have totally jacked up housing prices in Hong Kong. The next question is what will Financial Secretary Chan do with the mind-boggling surplus?

If he can only think of one-off sweeteners and nothing long term then we know what we're in for. If this administration really cares about Hong Kong people then it will have the foresight to think really long term on how it can make lives better for its residents 10, 20 years down the road, not in the coming year.

Silk Road: Learning From Uyghurs

In the doctor's office on the seventh floor where most are Uyghurs

Being in Kashgar for 12 days we got to know Uyghurs better than most tourists, and probably most local Han Chinese. It seemed like the two ethnic groups lived in a parallel universe, where they didn't intersect much, unless they had to work together, like in the case of the hospital.

In the neurology ward, practically all the doctors were Uyghurs, the head nurse too, while only a handful of nurses were Han Chinese. Perhaps it was because the demographic of their patients were Uyghur.

Outside the hospital Uyghurs and Han Chinese didn't have much to do with each other. They didn't eat each other's food -- Uyghurs are Muslim and only eat Halal food, and Uyghurs were forced to speak Mandarin to Han Chinese, who hardly knew any Uyghur.

Our first neighbour waiting to be discharged from the hospital

So you can imagine the taxi drivers' surprise when I would say "hello" (yakshimusiz) and "thank you" (rekhmat) in Uyghur, and to my dad's neighbour's family I would say "good bye" (hosh) and they were happy I was trying to be friendly.

There were benefits to being Han Chinese -- you were less scrutinized when it came to going through security. Uyghurs would be subjected to more thorough searches from their ID to the items they were carrying.

When my dad was in the hospital we had three different neighbours. The first was a young couple, with whom we didn't interact much, but we were cordial.

Next came an elderly man, probably younger than my, with his extended family looking after him -- his wife, sister, and daughter-in-law with her children. We spent the most time with the daughter-in-law and her young daughter Madja.

She had very short hair -- it seems young girls have their heads shaved to ensure their hair grows thicker. At first she and we were shy, but after a day or two she warmed up to us, particularly when I gave her a balloon to play with.

Madja didn't know any Mandarin, though her young mother did. She was busy looking after her father-in-law -- constantly hoisting him up, or turning his body periodically for blood circulation.

Then when we came back one evening, the family was gone and my dad had one evening of quiet. The next day another neighbour came in, another man, probably in his 30s, but by then my dad was well enough to be discharged from the hospital and we left a day or two after.

The head nurse who spoke very good Mandarin

During our time in Kashgar, our tour guide was indispensable -- he came to the hospital a few times to visit dad to see if he was OK, and helped us arrange our hotel accommodation through his tour guide friend, who also helped us exchange money, and arrange a car for us to go to the airport.

These people were so warm and hospitable despite the situation they were living in on a daily basis. They were keen to show us another side of Kashgar and we were so glad and lucky to be at the receiving end of their generosity. I won't forget them.

Rahmat (Thank you).

Silk Road: Keeping Tabs on Hospital Costs

A Uyghur sleeping on a cot in the stairwell in the hospital

From a patient's point of view, Xinjiang Kashgar First People's Hospital is very basic. You have to buy everything -- soap, paper towels, toilet paper, water, even soft pillows, tissues, anything you might need.

At first I was relieved that our shared toilet at least had soap -- but then a few days later our neighbour left and took their soap along with them! That's how we found out the hospital didn't even provide soap so that people would have clean hands to handle the patients...

A quaint-looking restaurant, but food wasn't agreeable...

My aunt told us that even when preparing for surgery, a barber came by and shaved my dad's head -- for 20 yuan (US$3). She saw the tour guide pay him, so she quickly gave money back to the tour guide.

We were also told to have someone look after my dad 24 hours a day in the hospital  -- which explained why people slept in cots like the one we were given our room, or people slept on layers of blankets on the floor anywhere. In the evenings the hospital looked like a refugee camp.

Our tour guide suggested hiring a young man to help look after my dad and it turned out he was very young -- a 17-year-old Uyghur, just graduated from high school. He was the younger brother of another tour guide and was keen to get into this line of work too.

Another relative sleeping by the elevators

In a way this was a good training ground for him, to be able to deal with a variety of situations, translating from Uyghur to English, and also knowing where to go in the hospital to get things, particularly CT scans and such.

This saved my mom and I the headache of having to run around the hospital trying to figure out where everything was, and focus on looking after my dad when we visited him.

There was also no hospital food available, nor a cafeteria. That meant having to buy food everyday. We tried a Chinese restaurant at the back of our hotel and it wasn't that hygienic.

The same could be said for the string of Uyghur restaurants in front of the hospital. My mom and I went to one of them for lunch and ordered a bowl of hand-pulled noodles with ratatouille and bits of lamb.

What arrived on our table were two bowls of lukewarm noodles. I started tucking in but then heard the sound of chopping behind me. It turns out there was a man using an axe to chop the raw meat of a carcass. My mom watched him and immediately lost her appetite and her stomach didn't feel well either.

She made the executive decision that we would only eat food from the hotel. That meant having to wait until noon for the Chinese restaurant to open for lunch to buy take out for my dad, and then going back again around 6pm for his dinner.

We saw meat chopped like this in a restaurant by the hospital

Most of the time we wouldn't eat dinner until 8pm or even 9pm. The Chinese restaurant barely had any business, or if it did, the function that evening was already over so we practically had the restaurant to ourselves.

While the tables looked nicely set from a distance, the tablecloths were never changed, and the same oil stains were there...

The menu was quite limited in terms of what we could easily transport to my dad, and not spicy either, which left the only choice of dumplings, which were made to order -- we could even see the thumb prints on them. But after a while you get tired of eating dumplings with chives and egg, or egg and cucumber.

My mom and I liked a tureen of thick sheets of noodles, practically like squares, with tomatoes and vegetables in a slightly sour broth. Another delicious dish was wai san or a white mountain root stir-fried with black-eared fungus, though a bit on the oily side.

Comforting tart noodle soup dish with tomato and vegetables

While food and transportation were cheap, we worried about the mounting hospital bills. Every day a strip of white recycled paper was our bill for the previous day and it listed various items and deducted from the original 10,000 yuan payment.

Some of the items listed were ridiculous, including Chinese medicine and that they moved my dad's body from side to side so that his back wouldn't get tired. We saw no evidence of that. So that was how the hospital would overcharge patients...

A few days into our extended stay in Kashgar we started worrying about having enough cash and I would periodically count the red 100 yuan bills to make sure we were covered. Being away from home and no friends or family to rely on, we had to estimate how much more money we needed. We had American cash, but the bills were considered too old to exchange. Even in Kashgar the banks are picky.

Silk Road: Late Night at Kashgar Hospital

The view outside my dad's hospital window of a colourful tower

It was around midnight when we arrived at Xinjiang Kashgar First People's Hospital. We had to have our passports checked at the gate and then our bags screened by X-ray machines.

Turns out we would have to do this every time we went to the hospital, which was twice a day.

Then we went to the emergency room where my dad was lying on a stretcher and he wasn't very comfortable. We took his jacket and tried to make a pillow out of it. Inside the bare room were other patients. To the left was a young man in black curled up in the fetal position with lots of bandages covering his head.

Outside the room a young mother was wheeling her young daughter on a stretcher. The girl, about six or seven years old, was naked from the waist down and her right leg was severely bruised. It didn't look too good.

An ATM machine with cameras above

We were trying to keep my dad entertained while my mom, our doctor friend and the tour guide went to the doctor's office. The doctor was Uyghur and so the guide acted as a translator, explaining each step of the surgery, the surgeon even drew a diagram showing how he would drill holes in my dad's head to drain the blood from the clot.

Then we had to get dad's paperwork done to have him admitted but more importantly to pay the hospital 10,000 yuan (US$1,506) in cash right away. My mom went to the Bank of China ATM and thank goodness was able to withdraw cash. She could only do it in increments of 3,000 yuan which mean withdrawing at least four times.

We wheeled my dad across the hospital compound into another building -- again we went through security checks before he was put into the elevator to the seventh floor -- the neurology ward.

The nurse asked us if we had paid yet and we replied we were in the process of doing that, but she still wouldn't wheel him into the room until she'd seen the receipt. It was that bureaucratic.

Finally the payment was sorted and dad was wheeled down the hall then to the left.

The Han Chinese nurse flicked on the flourescent lights of a semi-private room (no private rooms exist in the hospital unless you're a VIP on the top floor of the hospital). In the bed closest to the door was a young Uyghur man with bandages around his head, while in the other bed was a woman, his wife.

The nurse shooed the woman out of the bed and forced the bleary-eyed Uyghur woman to help put fresh bedding on the bed my dad would be lying on. Then he was transferred from the stretcher to the bed.

At the foot of the bed was a bare bones metal frame cot with bamboo slats with a thin mattress and lump pillow. We were told that since we were foreigners they would let us use the cot free of charge -- usually others would have to pay to rent it on a daily basis.

My dad was given pyjamas but they didn't fit -- we would later find out we had paid a 100 yuan deposit on them.

Another Uyghur doctor who spoke some Mandarin asked us more questions, the answers he entered in the computer, like how many children does my dad have, what medications is he taking, when was his last surgery.

We were told by hospital staff that one family member would have to be there for the night, and my aunt, my mom's younger sister, immediately volunteered. She insisted, saying surgery would be the next day and that we needed to rest. We also gave her the authority to sign all the papers the next morning for the surgery to go ahead.

But it would be a sleepless night for her having to tend to my dad's needs, while we went back to the hotel before 4am. Our tour guide was amazing, there the whole time, translating and advising us on how hospitals work here.

I didn't get much sleep -- at one point I woke up crying and scared, trying to process what was happening and wondering if things would be OK.

Silk Road: Our First Kashgar Hospital Experience

A standoff simmered between hospital staff and us over my dad's well being

The next morning my dad's situation didn't improve -- in fact at one point he fell in the bathroom and my mom had to get my uncle who was traveling with us, to come and help pick him up from the floor.

After a mini conference that included three doctors, it was decided that my dad should go to the hospital for a CT scan.

The ambulance leaving our hotel the first time

Our tour guide arranged for a non-emergency ambulance to come and take him to Xinjiang Kashgar First People's Hospital -- the best hospital in the city -- but a traffic jam resulted in the ambulance instead driving to Xinjiang Kashgar Second People's Hospital which was closer to the hotel.

The hospital looked drab and since my mother, her good friend and I followed in a taxi, we weren't quite sure where to go look for my dad. We soon realized we were in new territory, as most of the patients were Uyghurs and some of the staff were Han Chinese.

After asking reception a few times in Mandarin, we finally got some directions and managed to find him in a nearby building with two of his doctor friends.

The CT scan did reveal a blood clot and the medical staff there -- in particular the administrator -- insisted that we had to stay and do the operation in the hospital.

One of the doctor friends -- the one who first assessed my dad -- was insistent that it not be done in this hospital which didn't seem to have the highest hygienic standards. He called long distance to a neurosurgeon he knew in Vancouver and briefed him on the situation.

At this point there was a bit of a standoff between the Han Chinese and Uyghur medical staff and us as to what would be best for my dad. Seeing him lying in a bare bones room didn't seem to be the best option for him, and yet the Chinese administrator claimed my dad was in no condition to leave the hospital.

Dad's medical booklet at the first hospital

Finally our insistence was respected -- but not without signing several forms saying the hospital was not responsible for what happened to my dad. My mom had to sign the forms and put a red thumb print on top of her name. That's what you call double-step verification Chinese style.

Eventually he was released and we all returned to the hotel in time for a late lunch.

During lunch we made calls to my dad's medical insurance company in Quebec, Canada, and after listening to the situation and seeing pictures of the CT scan, they insisted my dad could not fly in his condition and that he had to be "treated locally".

Our doctor friend tried very hard to explain where we were (we're in a remote area in China!) and the conditions of the hospitals here, but the insurance company didn't seem to care. I would later find out that flying in dad's condition would have been impossible.

in the evening we gathered again for another conference, and there were suggestions of getting into Xinjiang Kashgar First People's Hospital tomorrow morning. And then someone threw out the idea of going now to avoid traffic jams.

By now it was 11pm and I contacted our tour guide again -- can you help us arrange for an ambulance to take my dad to the hospital? The guide rushed over and accompanied my dad, the doctor friend and my mom in the ambulance.

I was not far behind with my aunt and uncle. It was going to be a long night ahead.

Too Many Births, Too Little Money

About 400 pregnant mainland mothers show up at Hong Kong emergency wards

There were news reports today saying three years after Hong Kong Chief Executive Leung Chun-ying announced a "zero-quota" policy banning mainland women from having babies in the city, there were still about 800 cross-border births each year.

Almost have of the babies were born in already overcrowded public hospitals so that they could get right of abode in the city.

Before Leung's announcement, there were some 200,000 babies born to mainland parents here. This followed the 2001 ruling that newborns should be given right of abode status.

Babies in the nursery of a public hospital

However 800 babies born of mainland parents seems like a lot, and the policy needs to change.

Last year there were 755 babies born to non-local parents last year among a total of 60,083 births. Half of the 755 births took place in public hospitals, the rest in private ones.

Doctors say with mainlanders gatecrashing Hong Kong hospitals, these mothers are putting not only themselves and their babies at risk, but also compromises local mothers who are waiting to use such urgent hospital services.

What's probably even more interesting is that while mainlanders may gate crash public hospitals to give birth, they even avoid paying hospital fees.

A record HK$52 million in debts were racked up last year by public hospitals -- mostly due to mainland couples who refused to pay for treatment. In 2014, the amount was HK$45 million.

Public hospital debts rose to HK$52 million this year

Around HK$7.6 million of the HK$52 million in debt were mainlanders who went to Hong Kong accident and emergency units. For non-local mothers to give birth it costs them HK$100,000 for the delivery and three days' hospital stay.

"Even though there is no way to turn away mainland parents with urgent medical needs due to humanity reasons, there should be more administrative measures to make them pay," said lawmaker and doctor Kwok Ka-ki.

Public hospitals depend on subventions to provide an almost free service to Hong Kong people.

It is believed mainlanders use public hospitals by registering with fake addresses, and then skip town.

Critics say the government is being too passive -- that it sends medical bills to these defunct addresses, and when nothing happens, legal action is taken, but they're not going to catch anyone who gave a fake address.

Kwok says the authorities should be more stringent by forcing mainland parents to pay up before issuing birth certificates.

One would have thought these mainlanders would not mind paying up for good medical service, especially for their children, but it seems like they know they can evade the hospital bill and do so.

How embarrassing is that, that the Hong Kong government does nothing about this serious loophole?

It just gives the impression the city is too rich to even acknowledge this serious oversight and so yet another mainland baby is born in Hong Kong with right of abode, and for free! Talk about a double bonus!

It's too embarrassing and guess who has to foot the bill?