Cocaine, gambling, and ghosts: a day in the life of Hong Kong’s overloaded social workers

Cocaine, gambling, and ghosts: 

a day in the life of Hong Kong’s overloaded social workers

In Hong Kong's sprawling North District, superstition and social stigma hamper efforts to tackle mental illness, and the lack of space for counselling makes matters worse for staff with heavy caseloads

Monday, 29 August, 2016

Ms Ng was considered lucky in the factory where she worked in Sichuan. The quality assurance manager – a suave man from Hong Kong – fell for her and moved Ng to the city. It was a dream come true, until he became addicted to gambling and cocaine. He was losing HK$200,000 a month and his psychosis was getting out of control. He began hitting Ng, then she began to think about killing him. One day, losing his grip on reality, he took a knife to their three-year-old son’s neck.

In Hong Kong’s North District, the story of Ng (not her real name) isn’t an uncommon one. She’s one of social worker Tammy Tam’s 80 active cases. Tam – with 12 other social workers – works for the district’s only government-funded outpatient centre for mental health. There’s at least one in every district, and sprawling North District – covering Fanling, Sheung Shui and the border villages – is the only district with no space for counselling. Instead, social workers have only an office for doing paperwork.

“We borrow space from other NGOs and the Social Welfare Department, but most of our intervention takes place in clients’ homes,” says Brian Chau, one of the social workers. “In extreme cases, counselling happens in open areas – like in a restaurant or the park – but there, we can’t protect their confidentiality.”

North District is the home of many new migrants from China, like Ng. They can experience serious problems adjusting to the city – the language barrier and small spaces, which often contribute to mood disorders – and social workers’ caseloads have increased to anywhere from 80 to 120. The Social Welfare Department recommends a local social worker’s caseload should be about 40. And because they have to travel to see clients, they can only schedule in two or three clients each day.

Another challenge for social workers in the less developed North District is that Chinese culture can still be very traditional, and stigmatisation runs deep. “Everyone knows each other in the villages and rural areas,” says Christine Cheuk, the office’s head social worker. “If you have a mentally ill patient at home, everyone will know, so they won’t go to see a doctor. Stigmatisation is from the outside and also from the patient.”

Counselling in a fast food restaurant? Fear of the mentally ill makes residents oppose building of permanent counselling centres

Others in the villages blame mental illnesses on apparitions.

“Because of traditional Chinese culture, they think that mental illness is actually the work of ghosts – especially in areas with temples and trees,” says social worker Alex Ho. Cheuk says that in such cases, social workers must persuade younger relatives with better education to intervene, but this doesn’t always work. That’s when a social worker has to turn to Form 123: compulsory hospital admission. Ho says they must involve the police and an ambulance.

“Most of the cases who report they’ve seen ghosts will have additional bizarre behaviour, like hiding specific objects in their home to dispel them, so we try to give them better alternatives, like maybe trying psychiatric drugs to make the ghosts go away,” says Chan.

For 57-year-old Sue (not her real name), her depression and anxiety resulted from the pressure of a traditional Chinese mindset. When she gave birth to her son, who had a severe intellectual disability, her family and community ostracised her. She withdrew from human interaction until she became mentally ill.

“When my relatives visited, I found they didn’t like my son,” Sue says. “My parents advised me not to put too much effort into raising my son. They saw a fortune-teller, who said he’d die before 10 years old.”

Sue’s husband ignored his son’s intellectual disability, but if he became angry, he’d blame trivial problems on her, Sue says. He also pushed her into having another child so that he could have a “perfect” son. When Sue gave birth to a girl, her husband stopped paying attention to her.

“Taking care of my son, I lost myself, and I didn’t know how to find myself until I was diagnosed with depression,” says Sue. “I felt useless. During those years, I hid myself.”

Millions of people with mental illness in China, India go untreated: study

But she’s made progress in the past few years. Sue’s caseworker, June Sze To, says that through medication and therapy, she’s been able to tackle her low self-confidence. “She’s from a Hong Kong rural village, where you’re taught that when you’re young, you obey your father; when you get married, you obey your husband; and when you get old, you obey your son,” she says.

Cheuk says a big trend her social workers see in North District is the number of new women migrants from China facing marital problems and dealing with the fallout. Sadly, their children step in as caretakers when they develop mental illnesses, parenting their own parents. This situation rings true for Ng, who is now beginning to recover from the terrifying ordeal at the hands of her abusive husband.

Hong Kong was never easy for Ng. On arrival she spent six months trying to learn Cantonese by watching television. Working as a part-time waitress, her customers made fun of her accent. She couldn’t get used to the tiny spaces – especially the room in the public flat where she lives. After her husband threatened to kill her son with a knife, she filed for divorce and became not only a single mother but also a hardened alcoholic.

“I sent my son to school and then I started drinking – I would fall asleep a lot and I couldn’t remember anything,” Ng says. “I screamed after I got drunk. I would scream as loud as I could after getting home and closing the door.”

After her divorce, Ng’s father died. She began drinking 10 cans of beer every day while her son was at school. She started receiving Comprehensive Social Security Assistance (CSSA) to support herself.

“When my son entered primary school, I would drink in front of him. I was addicted to alcohol – I wasn’t aware of his presence,” she says.

Ng has now cut down to two or three cans a day, and not always every day. She reached out to a social worker after her sister-in-law suggested her husband find help for his drug problem, and now, years later, Tam counsels her in her flat. Ng works as a part-time cleaner and cares for her son.

“The biggest challenge in raising my son is taking sole responsibility,” Ng says. “I need to accept that I must adjust to Hong Kong – it’s already reality.” Her hope for the future is to support her son through a degree programme, and to travel the world in her retirement – but most importantly, she says, she wants others to know that suicide isn’t the way out.

Hong Kong Ombudsman to investigate community services for mental patients

Cheuk admits that counselling services would be better in the district for patients like Ng if they had a dedicated space. But the stigma around mental illness will stymie the process for at least a decade, she says, because there’s just too much resistance from the community in North District.

“And we’re blessed that we have a psychiatric nurse and an occupational therapist, but we still have two vacancies for social workers,” Cheuk says. “It’s difficult to hire social workers with mental health training.”

In Hong Kong, mental health training for social workers is only offered in graduate school.

“Hong Kong is behind with social service,” Cheuk says. “We don’t have a psychiatrist with us. Medical settings and social welfare settings are two different things – it’s quite weird.”

The number of cases is also rising in the district because of men who’ve lost their jobs. They rarely consult social workers for help for fear of losing face, so a family member normally approaches the social workers after the man has developed an obvious mental illness, which means any intervention comes later than it should. Social worker Karl Sham now has 120 active cases – all men.

For now, Cheuk’s team will concentrate on public education. Community-based activities that raise awareness of mental heath – like a recent run with more than 1,000 participants – may help battle social stigma and pave the way for a dedicated outpatient centre.

Until then, the social workers certainly don’t expect their caseloads to get lighter anytime soon. “There’s no waiting list for us,” Cheuk says. “We take every case promptly. We don’t have a ceiling.”

So where is English and French amongst the immigrants?

Bilingualism growing, but not in French and English 

Oct 24, 2012

Bilingualism is surging in Canada, but not necessarily in the country's two official languages.

Statistics Canada released the last batch of data from the 2011 census on Wednesday, this time focusing on about 200 languages that make up the linguistic portrait of the country.

The data suggest that multiculturalism is not simply an abstract concept to describe a motley collection of diverse communities.

Rather, it is a reality for a growing number of families, even within the confines of their own homes.

The census shows that 17.5 per cent of the population — or 5.8 million individuals — speaks at least two languages at home. That's up from the 14.2 per cent of multilingual households counted in the 2006 census, and an increase of 1.3 million people.

Of those 5.8 million, most of them speak English plus an immigrant language such as Punjabi or Mandarin. Less than a quarter — 1,387,190, to be precise — are using both French and English at home.

Aboriginal languages decline

And aboriginal languages are in outright decline, with usage shrinking 1.7 per cent since 2006 — a loss of 3,620 people despite a concerted effort by many First Nations to revive their culture and language.

"Yes, we see a diversity, but what we see clearly is ... we have all these transition phases where English and French are also spoken at home in addition to non-official languages," said Jean-Pierre Corbeil, the agency's lead analyst on the languages part of the census.

"This doesn't happen only outside Quebec but in Quebec as well."

Corbeil warned, however, that the data likely underestimate the increase in diversity over the past few years. That's because Statistics Canada had to change the way it collects language data after Prime Minister Stephen Harper scrapped the long-form census in 2010.

Wednesday's information came from the mandatory short form that went to every household in Canada. In the past, language was in the long form that went to 20 per cent of households, and was framed in a different context.

Diversity increasing

The 2011 census numbers suggest that language diversity has been increasing at just half the rate as noted in the 2006 census, but data from Citizenship and Immigration Canada suggests the pace of change is at least the same, Corbeil said.

• Do your grandparents speak a language that you don't? 

The census shows that the most common immigrant language in Canada was Punjabi, reported by 460,000 people. When Punjabi speakers are grouped together with others who speak a closely related language such as Urdu, their numbers total 1,180,000.

Chinese languages are a close second, with a total of 1,113,000 people speaking Cantonese, Mandarin or other Chinese tongues.

Tagalog, the language of Filipinos, saw the biggest surge, growing by 64 per cent since the last census was taken in 2006.

Overall, Canada is home to 6.6 million people — one fifth of the entire population — who speak a language other than French or English. Two thirds of those have adopted French or English as a second language at home.

Official bilingualism, on the other hand, is not growing. About 17.5 per cent of people say they are able to conduct a conversation in both French and English — only a slight change from the 17.4 per cent rate noted in 2006.

Young anglophones are less likely to be bilingual than in the past, but official bilingualism is stable because more francophones are mastering both languages, Corbeil explained.

Still, English and French are by far the most dominant languages. About 22 million people reported speaking English most often at home, and 28.4 million have a working knowledge of the language.

French continues on its long, slow decline, but is still well entrenched, especially in Quebec.

The census shows that nearly 7 million people said they spoke French most often at home. That's up from 6.7 million in 2006, but the French-speaking population is growing more slowly than the population writ large.

Overall, there are 9,960,585 people who report having at least a working knowledge of French.

As has long been the case, immigrant languages are most often heard in Canada's largest cities. About 80 per cent of immigrant-language speakers lived in Toronto, Montreal, Vancouver, Calgary, Edmonton, and Ottawa-Gatineau, Statistics Canada said.

Toronto had the highest proportion of immigrant language usage, with 32.2 per cent of the population speaking a foreign tongue at home. Cantonese was the most popular, followed by Punjabi.

That's a phenomenon that Anne Feather has seen first-hand. She runs Olde Yorke Fish and Chips, a traditional English restaurant in uptown Toronto, where most of her clientele has been people with roots in the old country, and Indians with a penchant for colonial comfort food.

But these days, Feather is seeing an increase in her Chinese customers, especially among the young.

"It always kind of amazes me a little bit, that we get quite a few younger Chinese people," she said in an interview. "I ask myself where did they come from all of a sudden, and how did it happen that they decided to come here?"

While many other countries have struggled to digest multiculturalism, has become generally true of Canada, says Stuart Soroka, an assistant professor of political science at McGill University.

"We celebrate it, seeing it as a challenge rather than a problem," he said in an interview. "Acceptance of diversity is part of the idea of Canadian identity."

However, with French in a long-term decline and aboriginal-language speakers disappearing despite a growing population, there is likely to be some political hand-wringing, he said.

"There is likely to be in some areas of — not angst, but some discussion of the implications of increasing diversity," Soroka said.

Within Quebec, French usage is holding its own. About 94.4 per cent of Quebecers can speak French, almost the same as in 2006.

While the proportion of Quebecers speaking only French at home declined compared to five years ago, immigrants to that province seem to be readily adopting French as their main official language.

Meanwhile, the use of English by immigrants in Quebec is on the decline

Chinese,"an official language of Canada"...and the US be damned

Trudeau touches on trade, human rights in call for ‘new era’ with China

Published Tuesday, Aug. 30, 2016

Justin Trudeau's handlers wants to remake Canada into a bridge between China and the world, a bid to take back the role fashioned by his father more than four decades ago.

Canada is “in a position to help China position itself in a very positive way on the world stage,” Mr. Trudeau said in Beijing, where he arrived on Tuesday afternoon for his fourth visit and first as Prime Minister.

Justin Trudeau says China should strengthen trade with Canada (CP Video)

“How can the relationship between China and Canada set a new tone, and a new era of positive collaboration, that is good for the citizens of both countries?” he asked a group of elite Chinese business leaders in a conversation with Alibaba Group founder Jack Ma.

An Internet livestream of the hour-long conversation attracted more than 9.3 million views.

Related: What Trudeau wants and risks with visit to China

Justin sought to leaven economic ambition with principle, saying Canada is eager for more trade but also hopeful for greater “opportunities for regular frank dialogue on issues like good governance, human rights and the rule of law.”

China would be well served to “ask for advice and take suggestions about how to be better for its citizens,” he said.

It was a sunny view of the role Canada might play in nudging Beijing – one hard to square with a country that under President Xi Jinping has intensified an internal crackdown on dissidents and spurned international opposition with a newly assertive foreign policy. It was only this June that Chinese Foreign Minister Wang Yi told a Canadian reporter that she had “no right” to ask about China’s treatment of its people.

And a day before Trudeau arrived, China broadened its campaign against foreign influence, with a new guideline demanding that entertainment news not “express overt admiration for Western lifestyles.” Meanwhile, state media have recently warned about “foreign and hostile forces,” language used in the aftermath of the Tiananmen Square crackdown, new research from the University of Hong Kong has found.

However, Trudeau has made it his goal to “reset” the relationship with China on his weeklong trip.

It was his father who led Canada into restarting diplomatic relations with Beijing in 1970, a recognition that helped to ease China into a more integrated role in the global system – a role for which Pierre Trudeau remains fondly remembered.

On Tuesday, Mr. Ma, perhaps China’s best-known business figure, offered “special thanks” to the elder Mr. Trudeau. “Our task today is not to establish friendship and trust. Pierre Trudeau and his generation has already established this,” he said.

On Chinese social media, however, it was images of a youthful Mr. Trudeau walking onto a red carpet-draped tarmac in Beijing – dressed in a red tie, next to wife Sophie Grégoire Trudeau in a vermilion dress – that caused a stir. “I thought for a second Tom Cruise became president,” one person wrote.

Celebrity will get Trudeau only so far in a country whose ambitions often clash with Canada’s, such as the desire by China’s business establishment to further integrate Canada into its economic orbit.

That conflict quickly rose to the surface as executives peppered the Prime Minister with questions about whether he would welcome their money in sensitive Canadian industries such as culture and agriculture – the latter from a company with negotiators currently in Canada trying to buy pig farms.

One even suggested making Chinese an official language in Canada. Do that, and “you will certainly be bigger than your father to a lot of Chinese people,” the man said.

Trudeau demurred. Improve the relationship, and there will be more avenues to invest in Canada, he said. But he was more interested in selling Canadian food and agri-food technology to China.

However, he did say Canada is “looking  at joining the Asian Infrastructure Investment Bank", a China-led institution that has challenged the primacy of the World Bank. An announcement could come as soon as Wednesday.

As his father before him, Justin said, he was hoping to pass along a friendship and “openness toward China,” both to a new generation of Canadians and his daughter, Ella-Grace, who is accompanying him on the trip.

The contrast between the two leaders’ first official trips to China underscores the degree to which China has changed. In 1973, Pierre Trudeau walked off the plane and into meetings with Zhou Enlai, the Chinese premier and Mao Zedong’s right-hand man.

Justin Trudeau counterparts were Mr. Ma and the members of the China Entrepreneur Club, which may be the most exclusive of its kind anywhere. It is populated by the top ranks of the country’s billionaires, many of them totems of Chinese private enterprise success. Combined gross revenue at their 49 companies last year exceeded $550-billion, equivalent to nearly one-third the Canadian gross domestic product.

Meeting them gave Mr. Trudeau a chance to promote Canada before a crowd with significant economic power.

Still, it’s unclear how much the Prime Minister can achieve. With an increasingly skeptical population at home, including a business community not certain that free trade with China is in their best interests, expectations are low for a dramatic economic breakthrough during his week in the country.

The visit’s political agenda kicked off on Tuesday evening at a private dinner with Premier Li Keqiang inside Beijing’s Forbidden City, an unusually warm gesture. On Wednesday, Mr. Trudeau also expects to meet Mr. Xi.

He is expected to press China to release missionary Kevin Garratt, who is accused of spying, and allow Canadian canola exports – a victory that, if it comes, would merely mean achieving the status quo.

Ottawa has signalled that it will also seek regular high-level meetings between the two countries, as well as an agreement to open new paths for large numbers of additional Chinese students and workers to come to Canada.

On Monday, China’s Foreign Ministry suggested talks were going down to the wire.

“As we speak, the two sides are in close communication on preparatory work of this visit,” spokeswoman Hua Chunying said.

China expects the Trudeau “visit will inject new pressure into building a China-Canada strategic partnership,” Ms. Hua said.   [The US be damned]

BoyTrudeau wants to bolster ties by joining Chinese-led bank-which would hobble the USA

Trudeau shows readiness to bolster ties by joining Chinese-led bank

NATHAN VANDERKLIPPE

BEIJING — The Globe and Mail

Published Tuesday, Aug. 30, 2016 

Hours after landing in Beijing, Justin Trudeau signalled Canada is ready to take the first step in a promised “reset” of its relationship with its second-largest trading partner by applying for membership in the Asian Infrastructure Investment Bank, a China-led institution the United States has refused to join.

Canadian Finance Minister Bill Morneau is expected to meet Wednesday afternoon with Jin Liqun, the bank’s president, in Beijing, at the outset of Trudeau’s inaugural trip to China as Prime Minister.

“We are looking very favourably at the possibility of joining,” Mr. Trudeau said Tuesday after arriving in China.

The AIIB is China’s answer to the U.S.-dominated World Bank and the Japan-dominated Asian Development Bank. The new global financial institution is headquartered in Beijing, with China as its largest shareholder. Though it has been built as an international organization – with Western countries contributing to its governance standards and English as its language of operations – the bank, in selecting which highways, power plants and railways to fund, gives China new power to exert regional influence.

Signing up is a way for Ottawa to curry favour, sending a message that it supports a project central to China’s ambitions in challenging the existing world order. It will not, however, bring new wealth to Canadian corporations, since the AIIB’s universal procurement policy allows any company access to project bidding, regardless of whether its home country has membership in the bank.

And it does little to resolve the tension between Canada’s desire to profit from China and the will among China’s business and political leadership to further entwine Canada into Chinese economic orbit.

Mr. Trudeau, however, has made it his goal to renew friendship and fellowship with China, and his pursuit of the AIIB is one step in that direction – even if Canada’s tardiness in doing so limits the symbolic power of the move.

When Britain joined early last year, it won cheers in Beijing but anger from the Washington establishment, which criticized London for its “accommodation of China,” and for “prostrating” itself before China in the name of winning more business.

Eighteen months later, the United States has made peace with the AIIB – offering an effective truce in the matter with China last fall – while Australia, France and Germany all number among the 57 founding members, giving them additional voting rights and a chance to shape bank governance. China has now opened a second window for applications, saying new members could be added by 2017.

“At this stage, there’s no harm in joining,” said Thomas Wright, director of the Project on International Order and Strategy at the Brookings Institution. “What’s important is that Canada uses its influence to make sure that the AIIB adheres to international standards. The signs so far have been generally positive,” he said.

“It was a major mistake not to have joined in the first place,” said Jeremy Paltiel, a scholar in Asian foreign policy at Carleton University.

“The world needs China to play a responsible role commensurate with its global capacity. The alternative is to exacerbate global economic stagnation or even decline. Is this really what we want?”

For Mr. Trudeau, the bank decision may be the easiest he makes in China, where soon after his arrival he was confronted by the determination of China’s business establishment to focus its immense economic might on Canada.

At a meeting with the China Entrepreneur Club, a collection of billionaires led by Alibaba founder Jack Ma, executives peppered the Prime Minister with questions about whether he would welcome their money in sensitive Canadian industries, such as culture and agriculture. The latter came from a company with negotiators currently in Canada trying to buy pig farms.

One man even suggested making Chinese an official language in Canada. Do that and “you will certainly be bigger than your father to a lot of Chinese people,” the man said, referring to Pierre Trudeau’s renown from more than four decades ago, when Ottawa was among the first Western countries to diplomatically recognize Communist China.

The Prime Minister demurred. Improve the relationship and there will be more avenues to invest, he said. But he was more interested in selling Canadian food and technology to China.

Still, it’s unclear how much Mr. Trudeau can achieve. With an increasingly skeptical population at home, including a business community not certain free trade with China is in their best interests, expectations are low for a dramatic economic breakthrough during Mr. Trudeau’s week in the country.

On Wednesday, Mr. Trudeau expects to meet Chinese President Xi Jinping.

The Prime Minister is expected to press China to release missionary Kevin Garratt and to allow Canadian canola exports – a victory that, if it comes, would merely mean achieving the status quo.

On Tuesday, Mr. Trudeau pitched Canada as a bridge between China and the world, a bid to take back the role fashioned by his father.

Canada is “in a position to help China position itself in a very positive way on the world stage,” Mr. Trudeau said Tuesday.

“Around the world, there is anxiety around trade; there is anxiety around China,” he said, adding: “How can the relationship between China and Canada set a new tone, and a new era of positive collaboration, that is good for the citizens of both countries?”

He called for “regular frank dialogue” on issues such as human rights. China, he said, would be well served to “ask for advice and take suggestions about how to be better for its citizens.”

What Trudeau should do in China

MONDAY, AUGUST 29, 2016 

Canadian Prime Minister Justin Trudeau, his wife Sophie Gregoire, and daughter Ella-Grace wave as they board a government plane in Ottawa, Monday August 29, 2016. THE CANADIAN PRESS/Adrian Wyld

As Prime Minister Justin Trudeau makes his first official visit to China, reality squares off against his previous notorious comments.

At a Liberal fundraiser before the election, Trudeau stated:

“There’s a level of admiration I actually have for China. Their basic totalitarian dictatorship is actually allowing them to turn their economy around on a dime.”

His choice of words.

“Admiration" for a dictatorship is inappropriate when the Chinese regime is known to have harvested organs from its citizens (see reports by former Liberal secretary of state David Kilgour and lawyer David Matas), culturally suppressed minorities, including Tibetans, Mongolians and others, tossed human rights and democracy activists into jail, continued intellectual theft & cyber attacks on the west, bullying its neighbours and disregarding international rulings from UN- sanctioned tribunals.

Of course as a threat, China has an economic and military presence which requires our engagement on a series of issues.

It is a current trading partner and Canadians of Chinese origin make a some contribution to our country.

China has also taken advantage of Canada's naive openness, most significantly when it acquired Candu nuclear technology in the early 1990s.

It has used it to build a new industrial/military power, domestically, and now for the export market.

China remains a core market for our raw materials and resources such as Saskatchewan potash, Canadian lumber and other products.

We make allowances for Chinese goods and investment in oil and gas, mining, telecommunications, infrastructure, banking and other sectors.

Consequently, any new engagement with China under Trudeau will challenge even deeper our Canadian values, national interests, sovereignty  and rule of law.

Canada should advise Beijing we will not be bullied into conditions which permit temporary foreign workers from China to fill jobs in businesses which should be available to Canadians.

National security assessments must be taken into consideration when investments impact critical infrastructure such as ports in the Arctic, telecommunications, defence or the power sector.

As chair of the cabinet’s intelligence committee, the prime minister should strongly condemn Chinese espionage and cyber attacks on Canada.

Remaining silent in front of President Xi Jinping on this will send Canadians the wrong message.

We should speak out in support of our friend, Taiwan, which is finding its new, democratically-elected government subject to renewed harassment and bullying by China.

The prime minister should support conflict prevention measures by demanding President Xi to respect the Hague ruling on the South China Sea and honour resolutions in line with the UN Convention on the Law of the Sea.

On agriculture and trade, we must respond strongly and swiftly to the recent regulatory prohibitions on Canadian canola, which place a $2 billion market at risk.

This attempt to drive prices down and hurt Canadian farmers should be met with equal penalties on Chinese imports.

Relations with China, including any potential free trade agreement, must be based on respect, not Trudeau's blind admiration.

Canada should be a partner, not a colony.

Indeed it is hard to see how a free trade deal is possible given the tenuous state of the rule of law in China.

I do wish the prime minister well on his visit, and remind him that Canadians will be watching closely to see how he champions these issues, including the rights of 300,000 dual nationals who reside in Hong Kong, and are seeking greater consular support from their government in Ottawa.

If this is a time for engagement with China, it is most definitely not a time to abandon our Canadian principles and national interests.