CY Yeung

It is gratifying to be able to publish in this issue a number of good quality original articles on locally conducted research work and observations. It is also encouraging to see several contributions from both University and Hospital Authority's Units, although the tendency has always been for University units to follow the UGC's (University Grant Committee) implicit suggestion to publish in "high impact journals".

Representations had been made to the two Universities to request the authorities to recognise publications by their staff to ensure the maintenance of high local standards as well as to show support of local journals. Regrettably no encouraging responses have been received. It is high time that our own local academic institutions should begin to promote local academic and professional excellence. It is lamentable if our academics and professionals are encouraged to continue their traditional attitude of "foreign worship"( 崇洋 ) regarding that the "moon overseas is always brighter and rounder". These help to invite overseas domination, perpetuate mediocrity in the local scene and continue to encourage "intellectual property drain" from our own institutions.

Authorities should do away with the century-old colonial system which was probably devised to ensure that high-ranking officials would have to depend on and look up towards European especially British standards. Our neighbour in Singapore has already broken all these colonial chains and been able to stand firm on its own system with dignity and pride. Many of their original research are published in their own journals. Higher professional qualifications obtained from U.K., which are in fact entry qualifications for specialist training, are no longer awarded salary increments as inducement to rely on foreign systems for recognition of clinical competence. In these regards, Hong Kong is lagging way behind. Local paediatricians must guard against allowing Hong Kong to lapse into "a new spell" of a self-inflicting form of "intellectual colonialism".

Indeed researchers have a duty to ensure that research data which are locally relevant should be disseminated promptly to local paediatricians, keeping them also updated with recent scientific advances. It is through increasing contributions of quality publications in journals like ours that the standard of these journals can be sustained and international reputation built up. Academic and professional authorities have the responsibilities to encourage and support such direction of development. It seems appropriate that researchers who fail to investigate into locally relevant health issues and those who ignore the importance of keeping their own colleagues abreast of these developments by publishing some of these data in local journals, should be placed in a lower ranking order during Research Assessment Exercises. They may even be placed at a lower ranking order for consideration for promotions. Failure of local academic and professional authorities to recognize the importance to promote local publications may be an important factor in the failure in establishing a "Hong Kong identity" and loyalty to our own community. Hopefully, this unhealthy trend could be put to a halt.

A wide range of uniquely Chinese child health issues are covered in this journal. Growth faltering among Chinese infants has long been suggested to be ethnic or genetic in origin,^1-2 although some observations have indicated traditional under-feeding to be related.³ It is enlightening to note that Tam and her colleagues⁴ have shown in their study that as the socio-economic conditions improved, so has growth faltering in infancy disappeared in Hong Kong. Wong et al⁵ have documented the progressive increasing emergence of lactose-malabsorption in Chinese children beyond infancy when lactose is no longer the natural carbohydrate in the diet. Lee et al's local experience on primary immuno-deficiencies⁶ and Chan et al's review on malignant neoplastic diseases⁷ are valuable information to improve our understanding on these two important childhood conditions.

Various issues related to adolescent health are also reviewed by Cheung & colleagues⁸ in this number. Lun et al's "Treatment of persistent pulmonary hypertension with prostacyclin"⁹ and Lam et al's analysis¹⁰ of risk factors for meconium aspiration syndrome (MAS) are interesting local neonatal problems; although MAS is equally prevalent in Chinese, observation by some¹¹ has indicated that the associated pulmonary hypertension is much less common compared to North American experience.

It is very refreshing to note an attempt was made by Goh and her group¹² to improve the quality of life of the underprivileged such as children with Duchenne muscular dystrophy; their implementation of ventilation support for those children is apparently one of the many programs their group has been pioneering for Hong Kong children with various handicaps.¹³ But et al's case report¹⁴ on acute poisoning by a Chinese herb is a timely reminder of the need to place emphasis on research into "Traditional Chinese Medicine" rather than encouraging the adoption of herbal medicine through traditional beliefs without scientific studies.^3,15

Davies et al's observations¹⁶ on sudden infant death syndrome(SIDS) place "low socio-economic conditions" as potential etiologic association to a long list of child health problems besides SIDS, although it may not explain its rarity in our community in the past, for which many other indirect factors have been indentified.¹⁷

We are also grateful to contributions by members of the Hong Kong Paediatric Society for their papers on "State of Hong Kong Children" to be published by the Association of Paediatric Societies of Southeast Asian Region(APSSEAR).¹⁸ This series is first of two parts, aiming to document the current status of child health in Hong Kong, in ten important areas. The first part is on Health Indicators, Growth, Nutrition, Breastfeeding and Immunisation, all of which are barometers of how successful or otherwise we are as child health care provides.

We sincerely hope that more contributions will be forthcoming, especially from our own local research workers to make our journal a more meaningful vehicle of-academic and professional exchanges especially among child health workers in our community.

References

1. Field CE, Baber F. Growing in Hong Kong. Hong Kong University Press 1977.

2. Leung SF, Davies DP. Infant feeding and growth of Chinese infants: birth to 2 years. Paediatr Perinat Epidemiol 1994;8(3):301-13.

3. Yeung CY. Influence of some Chinese traditional practices on child health. Acta Pediatr Sin 1988;29:33-9.

4. Tam SYM, Karlberg JPE, Kwan EYW, Tsang AMC, Baber FM, Low LCK. The improvement in growth, socioeconomic and health status in Hong Kong Chinese infants in the first two years of life - 1967 to 1994. HK J Paediatr (New Series) 1999;4:3-9.

5. Wong FHW, Yeung CY, Tam AYC, Fung KW. Lactose malabsorption by breath H₂ test in chinese children. HK J Paediatr (New Series) 1999;4:10-5.

6. Lee TL, Chan GCF, Ha SY, Lau YL. A single center experience of primary immunodeficiencies in Hong Kong. HK J Paediatr (New Series) 1999;4:16-20.

7. Chan GCF, Ha SY, Chan KL, Lee TL, Cheng W, Hung KN, Fan YW, Tans PKH, Lau YL. Malignant neoplastic diseases diagnosed in the infancy period. HK J Paediatr (New Series) 1999;4:25-31.

8. Cheung PCH, Ip PLS. Vital information on adolescent health from a hospital perspective. HK J Paediatr (New Series) 1999;4:38-42.

9. Lun KS, Poon LKH, Lee WH. Continuous infusion of prostacyclin into pulmonary artery in the treatment of severe persistent pulmonary hypertension of the newborn. HK J Paediatr (New Series) 1999;4:45-7.

10. Lam BCC, To WK, Yeung CY. Meconium aspiration syndrome - incidence and perinatal risk factors. HK J Paediatr (New Series) 1999;4:21-4.

11. Yeung CY. Chinese neonates are different. In Yu V, Feng ZK, Tsang R, Yeung CY (eds): Textbook of neonatal medicine: a Chinese perspective 1996;p877-884. Hong Kong University Press.

12. Goh W, Lee SL. Pulmonary rehabilitation in children with Duchenne muscular dystrophy. HK J Paediatr (New Series) 1999;4:38-42.

13. Wong VCN, Yeung CY. Services for children with neurodevelopmental disorders: the Hong Kong experience. J Paediatr Obstet Gynaecol 1996;22(4):5-10.

14. But BWM, Chan WH, Yau YS, Chan GLH. Acute poisoning with chinese medicinal herb-fibs daturae (Nanyanghua). HK J Paediatr (New Series) 1999;4:48-9.

15. Yeung CY. Traditional Asian practices and their influences on child health. J Paediatr Obstet Gynaecol 1991;17:5-12.

16. Davis DP and Sudden unexplained infant deaths in South Glamorgan, Wales, 1993-97: a worrying social residuum. HK J Paediatr (New Series) 1999;4:43-4.

17. Yeung CY. Sudden infant death syndrome - a Hong Kong Perspective. JAMA Aug 1995; 13-14.

18. "State of Hong Kong Children (Part 1)". HK J Paediatr (New Series) 1999;4:52-62.