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SCMP Reporter

When Sister Helen Kenny talks of the philosophy of death, she seems remarkably cheerful. It's a subject with which she is very familiar.

Since she arrived in Hong Kong as a young nursing sister with the Maryknoll Order in 1958, the Catholic medical worker has counselled hundreds of dying cancer patients and sought to bring solace to their families.

But  she worries about the future of specialised hospice care for terminally ill patients as the government and Hospital Authority downsizes some of what it regards as non-core services.

The authority recently closed the Nam Long Hospice in Wong Chuk  Hang, Aberdeen. That much-praised institution was replaced by beds in surgical wards at Grantham Hospital.

But relatives who took their loved ones to Grantham to die were dismayed at the conditions and the service, which is  not  tailored to cater for the special needs of the terminally ill and their families.

Sister Kenny says home is the best place to die, surrounded by  loved ones. With proper medical care and pain-killing drugs administered by visiting doctors and nurses trained in palliative techniques, people doomed to die can pass most easily out of life in their most familiar surroundings.

But the reality of Hong Kong housing makes this impossible for many people. Homes are simply too small and crowded. Which makes the dwindling hospice options all the more precious and badly needed, she stresses.

Despite what many would consider to be a depressing vocation,  Sister Kenny has a pleasant visage, like everybody's favourite auntie. But behind the soft voice, the white hair and the jovial smile, the bustling American medical missionary is a highly dedicated professional with a vision.

Her ambition is to help people die in peace. She doesn't push her own religious beliefs, but is propelled by a deep compassion for humanity. As a teenager in New York, she felt a call to service. Directly out of high school, she joined the Maryknoll Order and served as a probationer for two years and six months. Before she took her final vows as a nun, she also trained as a nurse in Boston's Carney Hospital for three years from 1954. She became a registered nurse in Kansas City before being assigned to Hong Kong in 1958.

Why did she come to Hong Kong, ask those who do not realise the strict discipline of the medical missionary order to which she has devoted her life.

Sister Kenny smiles. 'God sent me,' she says simply.

The Catholic Relief Service was given land at Wong Tai Sin where it built a hospital which mostly cared for the huge surge of refugees which then crammed squatter villages. Sister Kenny studied Cantonese diligently until the hospital opened, then in 1964 was  sent back to the US to study for a master's degree in nursing administration at  Columbia University.

Back in Hong Kong caring for the dying, Sister Kenny was inspired by the bravery of some patients whose main concern was to help their loved ones cope with  impending  death.

'There was one young woman with five children who had terminal nasal cancer, which was very common, and she was marvellous in consoling her husband,' Sister Kenny remembers.

As professionals like  Sister Kenny and others in Hong Kong cared for the terminally ill, there were huge advances being made in this often overlooked medical speciality.

These dramatic changes were spearheaded by  Dame Cecily Saunders, who founded St Christopher's Hospice in London in  1967.

This was the origin of modern palliative care, the medical discipline of helping to ease the inevitable process of death for the terminally ill and their loved ones. It was the lessons learned from London that led to the foundation of the Society for the Promotion of Hospice Care in Hong Kong in 1986. Within six years, the society had obtained government land in the hills above the Sha Tin Valley, raised money from the Bradbury Fund and built the 27-bed Bradbury Hospice, with money from the Hong Kong Jockey Club to pay for running costs.

With the reorganisation of medical services, the hospice came under the umbrella of the Hospital Authority in 1996. Sister Kenny praises the  authority's doctors and administrators as being 'men and women of vision who helped the society maintain its dream of providing hospice care for as many terminally ill patients as possible'.

But after the bruising experience of Sars, medical services are now concentrated on other essential nursing services. The number of hospices has dwindled from 12 to 10 and further cuts are feared.

The problem is  exacerbated by modern medical advances that have 'turned nurses into engineers' and keep people alive for longer.

'Doctors and nurses are taught to cure, not to let people die,' she adds.

Although she is familiar with the face of death as 'the last experience of life', it is still a hard and frightful experience, she says.

'We try to bring people together at the end of a life,' Sister Kenny explains. 'We can ease the pain with drugs - that's pretty much under control. But it's the mental anguish of the patient and their family and friends that hospice staff are trained to deal with.

'The Bradbury Hospice has become a centre of excellence for dying, a place apart from a busy hospital.

'It's been a Chinese custom for centuries not to tell a person who is dying that there is no more hope, but now people are facing the hard facts.

'Our vision is to be able to provide professional hospice care for everyone who dies in Hong Kong. The Bradbury Hospice is a centre where we can teach nurses and doctors how to care for the dying, and we're getting people from the mainland coming here to learn, too.

'We are trying to be a model, an example of how best to deal with dying.'

Not everyone can handle the job, explains Sister Kenny. It takes a particular kind of devotion to care for people who know there is no hope, and to reconcile their loved ones to the inevitable.

It's a role that Sister Helen Kenny fills with loving care.



Voices for the dying