By Grace Li
Bass Connections in Global Health
I have spent summers in China and summers in the US, and yet my summer in Hong Kong was wholly different from either of those experiences. I spent the month of May conducting a Duke Bass Connections in Global Health research project on the ethical and practical issues associated with non-invasive prenatal testing (NIPT) in, yes, Hong Kong. Hong Kong is a city of many things but perhaps the best way to describe it is a place of contrasts. It is the only place I know that has juxtaposed the East and the West so neatly. After all, it is a part of China, but it’s also not subject to many of the restrictions that China has (for example, I could access Facebook in Hong Kong but not while I was staying with my grandparents in mainland China), and they speak both Cantonese and English there. China, on the other hand, speaks primarily Mandarin. As do I.
I was there for a month working with my research professor. We were interviewing key stakeholders in the world of NIPT, and so every day we would meet with different people to gain information on the landscape of NIPT in Hong Kong. For some background, NIPT is a new technology that was invented a couple years ago, and makes testing for chromosomal abnormalities (as well as gender) far easier and safer. Coincidentally, it was also invented in Hong Kong.
Ethical concerns, then, ranged from the question of whether the price tag of NIPT was increasing the gap between the rich and the poor to the dilemma of sex-selection and, of course, the infamous abortion debate, and all of those and more were addressed during our time in Hong Kong. By interviewing doctors, pregnant women, and scientists, all of whom had different perspectives on NIPT, we were able to see all the factors involved in NIPT implementation – and also see the city. In a day, we could go from the glittering financial district of Hong Kong to the outskirts of the city, a forty minute train ride away, and these locations depended on where our interviewees worked.
Like I said, Hong Kong is a city of contrasts, and we interviewed doctors that worked mainly with expats and had offices in downtown Soho and we also interviewed those who treated primarily locals and people from mainland China. If there’s any better way to get a feel for a city than by talking to those who live and work there, I don’t know it. And if there’s any better way to learn about NIPT in Hong Kong than to conduct fieldwork firsthand, well, I’d be amazed.
By now, I’m far enough removed from my experience that I can say, objectively, that it was a summer that has forced me to learn and to grow in ways that were wholly unexpected but absolutely necessary. I’ve learned how to navigate a foreign city and I’ve learned how to conduct semi-structured interviews. I’ve learned a lot about NIPT, way more than I knew coming in, and I’ve learned a lot about Hong Kong and the people there. I’ve learned how to work the subway system in Hong Kong and I’ve learned enough Cantonese to shake my head when the cashier asks me, “Would you like a bag for your groceries?” I’ve learned to live on my own, and I’ve learned what research means in the real world, not just through literature reviews or in a lab.
I’ve learned that someday, I would like to go back to Hong Kong.
