HM Medical Clinic


Powerpoint presentation

Slide 1 – Did you know? HK is drafting its first Biodiversity Strategy and Action Plan.
We don't want to scare you about the environment, because we all know that we can do a lot better.
So we want to share some good news about something amazing that is happening in HK, and how itapplies to you.
HK is putting together its first Biodiversity Strategy and Action Plan (BSAP). This is HK's plan forurgent and effective action to stop biodiversity loss by 2020.
It is led by the Agricultural Fisheries and Conservation Department (AFCD) working with theEnvironment Bureau, and because it is a participatory process, all other government departments,NGOs, universities, business and society are being involved in drafting it too. Even you can getinvolved.
The BSAP will be finished and ready to be rolled out in 2015. We think it is very exciting because it isthe start of our city thinking positively about how we want to connect with nature.
(1) Studies have shown that communicating a positive environmental vision which emphasisessolutions helps to promote sustainable behaviour, and we think HK's BSAP is a great topic to apply this approach. See (2) AFCD's BSAP webpages provide details on how the consultation is being structured, plus upcoming public events about the BSAP eg lectures and roadshows. See . (3) BSAP SC Paper 01/2013 provides a good background to HK's BSAP. See (4) The CBD was extended to HK in 2011. HK has no obligation to do a city-wide BSAP but has committed to this goal, as confirmed in the Chief Executive's Policy Address 2013. See . Slide 2 – It's time to ask a big question. What is nature worth?
Why do a HK biodiversity plan now? After all HK itself is not a signatory of the CBD. And Macau is notdoing a BSAP. Governments, NGOs, the United Nations, businesses, are all realising that protectingbiodiversity is a real economic issue. This new approach tries to place an economic value the benefitsof nature, being the "ecosystem services" provided by biodiversity.
It is not easy to value biodiversity and ecosystem services. But the problem is that if somethingcomes for free, and we do not calculate its true worth, we assume it has zero value and then destroyit.
When we know the value of biodiversity, we can make more informed land-use decisions.
Everyone in HK can understand these trade-offs, and take part in these decisions. That includes youand me! (1) The Economics of Ecosystems and Biodiversity (TEEB) is an international initiative under the United Nations Environment Programme (UNEP) started in 2007 to highlight the economic benefits of biodiversity. See . (2) The Natural Capital Project is another initiative working on valuing biodiversity, formed by WWF, the Nature Conservancy, Stanford University and the University of Minnesota, because: "[p]eople are making conservation and development decisions separately, and therefore are not incorporating environmental benefits into those decisions. Without properly accounting for these benefits, we risk losing them. Accounting for ecosystem services reveals the diverse benefits provided by natural systems, clarifies tradeoffs between alternative development scenarios, and helps people and institutions make more informed decisions about how to use lands and waters." See (3) Timing is also important. According to the UN's Third Global Biodiversity Outlook, 2010: "The action taken over the next two decades will determine whether the relatively stable environmental conditions on which human civilisation has depended for the past 10,000 years will continue beyond this century. If we fail to use this opportunity, many ecosystems on the planet will move into new, unprecedented states in which the capacity to provide for the needs of the present and future generations is highly uncertain." See So it is my career, and your career, that is going to make the difference.

Slide 3 – What provides our clean water?
So how is biodiversity valuable, what are these ecosystem services? Think about where clean watercomes from. How does water become clean and safe to use before it gets treated and comes out ofthe tap? This photo shows the East Kolkata Wetlands. They are responsible for cleaning 1/3 of sewageproduced by the 10m people living in Kolkata, India. Wetlands and all the plants, roots, microbes inthem filter and clean our water, lock up pollutants, and can even break up heavy metals.
(1) "Using the purification capacity of wetlands, the Indian city of Kolkata (Calcutta) has pioneered a system of sewage disposal that is both efficient and environmentally friendly. Built to house one million people, Kolkata is now home to over 10 million, many living in slums. But the 8,000-hectare East Kolkata Wetlands Ramsar Site, a patchwork of tree-fringed canals, vegetable plots, rice paddies and fish ponds – and the 20,000 people that work in them – daily transform one-third of the city's sewage and most of its domestic refuse into a rich harvest of fish and fresh vegetables." See .

Slide 4 – Life on earth purifies our water.
These are some of the plants, animals, microorganisms which provide the "ecosystem service" ofpurifying our water. It is not just chemicals or the treatment plant that cleans our water, it is life.
To give another example, in 1997 New York City needed to increase its drinking water treatmentcapacity. It would cost US$8 billion to build a new water treatment plant. But what they actually didwas spend a fraction of that money, US$1.5 billion, to do the same job. How? By buying andconserving land in the watershed for New York.
(1) Some 90 percent of NYC's water comes from two watersheds in upstate NY and has enjoyed historically very good water quality. (A watershed is an area of land which drains into a body of water, such as a reservoir or the ocean.) In the 1980s due to concern over pollution, the US Environmental Protection Agency initiated a regulation that all surface drinking water supplies must be filtered. NYC obtained a waiver and avoided building filtration plants by buying and conserving land in the watershed, saving billions of dollars. Now the NYC drinking water system is the largest unfiltered drinking water supply in the US, providing fresh water to half the population of NY State daily, see and .
(2) Images (cattail, reed): Fast-growing plants rooted in wetland soils that have been used to treat water polluted with nutrients and heavy metals.
(3) Images (water hyacinth, duckweed, water fern): Floating plants which can absorb and store heavy metals such as iron and copper contained in wastewater. (4) Images (oyster, mussel): Restoration and management of oyster beds is being used to help tackle water pollution, eg in Chesapeake Bay, USA. One average sized oyster filters 200 litres of water a day. (5) See the Ramsar website for more about wetlands, . The RamsarConvention on Wetlands is an international treaty adopted in 1971 by 168 countries, to protect wetlands of international importance ("Ramsar sites"). Mai Po Marshes and Inner Deep Bay in New Territories is a protected Ramsar site.

Slide 5 – What provides our clean air?
Another example is our air. You all know that plants photosynthesise, absorbing carbon dioxide andproviding oxygen.
But trees also absorb particulate matter, PM10 and PM2.5, the particles stick to the leaves of trees,trees also absorb nitrous oxides, sulphur dioxide and ozone. Some plants also filter out pollutantsincluding benzene and formaldehyde.
This is a picture of Beijing. HK is already the greenest city in China, but we can do better, and providean example to China.
(1) A study found that trees in London remove 850-2,000 tonnes of PM10 every year, and as a result the government is planning to plant a large number of trees in London's urban areas to tackle PM10 pollution. A mixture of trees gives the best result. See (3) How can HK be an example of sustainable development to China? We already are! Did you know that in a 2012 ranking, HK won the title of Best City in the world, beating Vancouver, Sydney and all the usual competition? HK won because of access to green space, access to cultural heritage, connectivity and compactness. See Let's continue this trend. What are your ideas?

Slide 6 – Life on earth purifies our air.
All of these plants provide the ecosystem service of purifying our air, and don't forget the animals andmicroorganisms in the soil which contribute.
HK has 70 percent green space and 40 percent protected country park, and yet our air quality is howit is. You can check HK's air quality according to World Health Organisation (WHO) standards from theHedley Environmental Index website, which is a HKU project, and the EPD's new Air Quality HealthIndex. This shows we need to improve HK air quality.
But imagine what our air would be like without all this green space.
(1) In 2012 we only had 69 "clear days" where pollutant levels complied with the WHO's short term Air Quality Guidelines. See the Hedley Environmental Index, which shows HK's air quality as compared with WHO standards and real time economic costs of HK's air pollution, .
(2) The Environmental Protection Department's new Air Quality Health Index (AQHI) launched on 1 January 2014, . (3) Images (banana tree, snake plant, english ivy, gerbera daisy): The US space agency NASA found that these and several other common houseplant species were effective at removing pollutants and improving indoor air quality, see Also see this TED Talk about "How to grow fresh air" using just 3 common household plants, (4) Images (HK orchid tree, Chekiang Machilus, wild coffee): examples of HK native trees and shrubs found on our hillsides and which contributes to improving our air quality. See .

Slide 7 – What provides our food?
Another example of an essential ecosystem service that nature provides is our food. This photoshows chickens but they depend in turn on corn and other chicken feed.
To grow that corn we need bees to pollinate the crops. We also need the microorganisms in soil forgrowing the crops.
Then there is biological pest control by birds, reptiles, insects etc to eat caterpillars or other pests keeping the crops healthy.
The more biological pest control we have the less farmers need to rely on pesticides, which can beexpensive and can cause ecological damage.
(1) This infographic published by the UN Food and Agriculture Organisation (FAO) in 2013 shows genetic resources and biodiversity for food and agriculture, see

Slide 8 – Life on earth provides our food.
Here are some numbers about the value of biodiversity to food production.
Soil- More than 90 percent of the world's food depends on soil, excluding wild sea fish andhydroponic plants grown in water in greenhouses. Soil is full of animals, microorganisms and organicmatter and has incredible biodiversity, exactly like above ground ecosystems.
Pollination- How much does it cost to rent a colony of bees for 6 weeks? 30 years ago it was US$10,and in the last few years it has reached US$200 (HK$1,600)! 85% of the world's almonds are grown inCentral Valley, California. Almonds depend on bees for pollination and without pollination there areno almonds. There aren't enough wild bees to pollinate this many trees so farmers have to rentcolonies of bees to do the job, transporting them across the US in trucks.
Biological pest control- In Costa Rica, coffee farmers have been leaving patches of untouchedrainforest around their plantations, so that birds can eat a pest beetle. Stanford scientists calculatedthat this service is valued at US$310 per hectare.
(1) On soil biodiversity, see Did you know that there are totally different ecosystems of animals in soil around the world? Scientists tested soil DNA from the tropics to the poles, 96 percent of animals were only found in one location, see .
(2) On pollination, see Farmers need to rent colonies partly due to lack of wild bees, but also monoculture farming where large numbers of one type of crop plants are grown, without providing the natural habitat to support local bees. The UK government has recognised the value of bees to agriculture and biodiversity in the UK, and is developing a "National Pollinator Strategy" to protect UK bees, see .

Slide 9 – In HK the benefits of biodiversity are everywhere. Raw materials, tourism, recreation,
medicine and more.

In HK the benefits of biodiversity are everywhere. Consider the raw material for bamboo scaffolding.
Ocean Park has around 400 species of animal, plus a fabulous green location. Our country parks had13 million visitors in 2012.
Looking more closely at medicine. A 2013 government Census survey showed that 12.8 percent ofmedical consultations in HK were provided by Chinese Medicine Practioners, that's 1 in 8 people.
But it's not just Chinese medicine, with Western medicines, something like 25 to 50 percent of the USpharmaceutical market is derived from genetic resources. For example one of the world's firstantibiotics, penicillin, was discovered from a microorganism (Penicillium mold).
(1) This is an interesting MSc thesis from University of HK about the HK bamboo scaffolding industry evolution since the 1960s, see (2) On Ocean Park see (3) AFCD statistics on country parks, see .
(4) On use of Chinese medicines in HK, see The pharmaceutical industry also depends on natural resources and biodiversity, see Slide 10 – Life on earth provides valuable ecosystem services. And they all depend on each other.
So biodiversity provides ecosystem services and these are essential for our lives and can beeconomically valued, and valuing nature makes it visible.
We borrowed these icons from the TEEB website. TEEB stands for The Economics of Ecosystems andBiodiversity, they are an international project bringing together scientists and economists, workingwith governments and businesses around the world to value their biodiversity.
You can divide ecosystem services into different roles. What we haven't talked about include: someof the other regulating services (carbon sequestration), supporting services (habitat for species,genetic diversity), and cultural services (inspiration for design, spiritual experience).
Looking deeper you can see that they all depend on each other. For example provision of fooddepends on pollination and climate regulation.
(1) Ecosystem services can be grouped into 4 types: provisioning services (food, raw materials, fresh
water, medicinal resources); regulating services (local climate and air quality, carbon sequestration
and storage, moderation of extreme events, waste-water treatment, erosion prevention and
maintenance of soil fertility, pollination, biological control); habitat or supporting services (habitats
for species, maintenance of genetic diversity); and cultural services (recreation and mental and
physical health, tourism, aesthetic appreciation and inspiration for culture, art and design, spiritual
experience and sense of place). See .
(2) The TEEB's Synthesis Report sets out this new approach analysing the economic value of
biodiversity, For a
shorter overview watch this TED Talk where you can see how complex the task is but also how
powerful this approach can be (you can choose Chinese subtitles). See
Slide 11 – Biodiversity is in genes, species, ecosystems. Biodiversity means the variety of all life on

So what is Biodiversity? It is simply the variety of all life on earth. It can be described as the diversityof genes, populations, species, communities and ecosystems.
Here we have diversity of genes, our DNA variation is what makes human different. In species youhave for example apples and bees. In ecosystems you have for example wetlands and rainforests.
(1) Biodiversity is defined by the CBD as "the variability among living organisms from all sources including terrestrial, marine and other aquatic ecosystems and the ecological complexes of which they are part; this includes diversity within species, between species and of ecosystems." (Article 2). See Slide 12 – Diversity matters as it makes living systems less vulnerable to disasters. Consider our
long term food supply.

Why does biodiversity matter? So it provides beneficial ecosystem services. But these are not "niceto have", more like "must have". The key is diversity, because it makes these living systems lessvulnerable to disasters, eg disease, temperature, rainfall, climate change.
Think about our food supply, what would happen if disease hit our food sources? In India in the 1970s scientists tested over 6,000 varieties of Indian rice for sensitivity to rice grassystunt virus, and only found one variety had resistance. Scientists used this variety to breed newvarieties still eaten today.
So the message is don't put all your eggs in one basket. Otherwise the staple food of almost half ofthe world's population is at risk, including you and me in HK.
(1) On Indian rice biodiversity see (2) Lack of genetic variation in Irish potatoes was a major cause of the Irish potato famine in 1845. The country relied on one variety of potato, the Lumper, which was propagated by cloning. Harvests were wiped out by potato blight disease brought to Europe from Mexico. Out of a total population of 8 million, 1 million died of starvation and at least another 1 million emigrated. See , and (3) According to the UN Food and Agricultural Organisation, 75% of the world's food supply is provided by only 12 plant species and 5 animal species. See .
(4) One way to protect crop biodiversity is through seed banking, see and Slide 13 – 193 countries have signed the Convention on Biological Diversity. But in 2010
biodiversity was being lost faster than ever.

What global action is being taken to protect biodiversity? 193 countries got together to sign the CBD.
This confirms the value of biodiversity and the actions all countries should take to reduce biodiversityloss.
In 2002 the parties agreed on a target to "significantly halt the loss of biodiversity by 2010". But thiswas a very broad target and failed, in 2010 the UN reported that that biodiversity loss actuallyaccelerated.
It is impossible to count exactly the change in numbers of species (and genes and ecosystems) but thestudy showed more natural habitat was being lost (eg forests and coral reefs), more species werebeing threatened with extinction, and factors which are known to reduce biodiversity are increasing,such as pollution, invasive species and climate change.
(1) The CBD was one of the results of the UN Conference on Environment and Development (known as the Earth Summit or Rio Summit) in 1992 in Rio de Janeiro, Brazil. This was the first time so many countries and NGOs got together to talk about sustainable development, and the conference produced 5 major documents: the Rio Declaration on Environment and Development; Agenda 21; the UN Framework Convention on Climate Change; an agreement on forests, which led to the Forest Stewardship Council for sustainable forestry; and the CBD. See (2) The principles for sustainable development are set out in the 1987 report of the World Commission on Environment and Development, "Our Common Future" (known as the BrundtlandReport) and provided the "classic" definition of sustainable development as development which "meets the needs of the present without compromising the ability of future generations to meet their own needs", see . We think it means, simply, making the world better for everyone's children, for evermore.
(3) UN Global Biodiversity Outlook 3, see Slide 14 – Realising we needed urgent and effective action, the Aichi Biodiversity Targets set
measurable goals for 2011-2020.

The answer was 20 targets for 2020. In 2010 the 193 countries got together and looked at the targetof how can we stop biodiversity loss by 2020, and divided that goal into 5 strategic goals, and then 20narrow measurable targets.
For example Strategy Goal A is to mainstream biodiversity, and Target 1 is to get everyone tounderstand the values of biodiversity and how to conserve it and use it sustainably. Guess what we'redoing in this talk! Other ways to do get the message out could be: education, TV adverts, and you canmeasure this easily for example using a survey and show using a graph.
(1) 20 Aichi Biodiversity Targets are set out at divided into 5 broadstrategic goals: Strategic Goal A: Address the underlying causes of biodiversity loss by mainstreaming biodiversity
across government and society, eg the first 3 are:
Target 1: Biodiversity awarenessTarget 2: Biodiversity values integrated into local development strategies and planning processesTarget 3: Eliminate incentives harmful to biodiversity Strategic Goal B: Reduce the direct pressures on biodiversity and promote sustainable use
Strategic Goal C: To improve the status of biodiversity by safeguarding ecosystems, species and
genetic diversity
Strategic Goal D: Enhance the benefits to all from biodiversity and ecosystem services
Strategic Goal E: Enhance implementation through participatory planning, knowledge management
and capacity building.
(2) Article 6 of the CBD provides for national biodiversity planning. A national strategy will reflect how the country intends to fulfill the objectives of the Convention in light of specific national circumstances, and the related action plans will constitute the sequence of steps to be taken to meet these goals.
Slide 15 – Why make a BSAP for our city? HK has world class biodiversity.
Have you seen Pirates of the Caribbean? HK has more species of coral than the Caribbean Sea.
HK is famous for birdwatchers, we have about 500 species of bird, which is far more than London,more than Singapore, and 1/3 of the total number in China.
HK has about 250 species of butterfly, which is far more than New York, and 1/6 of the total numberin China.
Don't forget how big Mainland China is. It is the 3rd largest country in the world by area. HK is tinyby comparison, and enjoys a disproportionate share of Chinese biodiversity.
(1) HK has 84 species of hard or reef building coral, see In 2001 scientists estimated 174 species of reef building corals in China, however studies in 2004 showed that over 90% of coral reefs in the South China Sea have been destroyed, see.
(2) Country bird counts, see(3) HK and China butterfly counts, (4) HK has a land area of 1,104km2 as compared with 9 million km2 for China. Even if you compare HK with Hainan Island which is tropical, with an area of 35,400 km2, it has only 420 recorded species of birds. See Slide 16 – HK's biodiversity relates to geography and climate.
HK is a transition area between tropical and temperate zones providing diverse habitats.
In terms of climate we have humid maritime airstreams from the south and cool dry continentalairstreams from the north.
In terms of the marine environment we have the Pearl River Delta emptying fresh water to the West,and oceanic salty waters in the East. As well as this, HK is essentially a collection of rugged coastlines,mountains, bays and 200+ islands carving out niches for different species to thrive.
If you fly 1 hour north, it snows, and 1 hour south, it is tropical. Macau is only slightly West to us buttheir waters are totally different, more freshwater and more silt, because they are just a little closerto the Pearl River Delta.
(1) "Hong Kong has thousands of square kilometres of rugged coastline, mountain ranges and country parks. So not surprisingly it is home to an impressive range of wildlife. Straddling the transition zone between the tropics and the temperate region, its biodiversity is greater than usually found in such a small area. Almost 3,000 varieties of flowering plants including 120 orchid and over 300 native tree species, more than 2,000 moth, 110 dragonfly and 230 butterfly species make their homes here. Hong Kong also boasts one third of the total bird species in China, and an array of freshwater fish, amphibians, reptiles and mammals." See (2) HK's coastal marine biodiversity is explained in The Sea Shore Ecology of Hong Kong by Brian Morton and John Morton, 1983.
Slide 17 – The HK Government is leading the way drafting and implementing the Biodiversity
Strategy and Action Plan but needs our support.

In the last few years the HK government has implemented some radical, and highly effective policiesfor environmental protection. The question is can BSAP be the next success? In 2009 HK introduced the use of a 50 cent levy on plastic bags, one year later this was reported tohave reduced the number of plastic bags distributed by 90%. The government is now consideringextending that scheme to cover all retailers.
Last year all trawling was banned in HK waters, this is something that only a handful of othercountries have done. Scuba divers have already reported more fish and cleaner water! The government is now seeking feedback on how to implement a policy of waste charging forreduction of waste. We need to respond by January 2014! (1) The trawl ban (including pair, stern, shrimp and hang trawling ) came into effect on 31 December 2012, see . (2) Plastic bag levy, see .
(3) The deadline is 24 January 2014 to respond to the public consultation on municipal solid waste charging, see . This policy falls under the HK Blueprint for Sustainable Use of Resources 2013-2022, see Have you read these documents? What is your view? Slide: 18 – 60+ HK conservation groups are participating in the BSAP consultation. A city wide BSAP
will be developed by 2015.

The CBD states that preparing a national or regional BSAP should be a participatory process, since theissue affects society broadly.
The government has assembled a broad advisory team including from NGOs and academia to work onthe process.
The Civic Exchange, a leading HK public policy think tank, has also convened groups to gatherfeedback. Over 60 groups are involved in the process.
(1) AFCD's BSAP webpages are at .
(3) The government has set up a three-tier structure to develop HK's BSAP, there is a Steering Committee, three Working Groups on Terrestrial Biodiversity, Marine Biodiversity and Mainstreaming and Sustainability, plus various Focus Groups under each Working Group. You can participate in the consultation through the Focus Groups, and through the activities organised by the government about the BSAP. Slide 19 – What are the priorities for the first BSAP? HK's conservation community agrees on the
most important tasks.

For the NGOs involved through the Civic Exchange, the first task was to decide on the most importanttasks needed in order to formulate the BSAP. These include: • Review of conservation policies and legislation. Did you know that HK's laws were enacted primarily to protect species from hunting, and not according to their conservation status? So it isillegal to hunt a sparrow, but there is no protection for whale sharks which occasionally come intoHK waters, even though they are endangered and protected under international law.
• Create a Red List of HK species. The IUCN Red List of Threatened Species is the internationally accepted way to assess species for conservation status.
• Establish strategy and actions to reduce HK's ecological footprint to more sustainable levels.
• Establish and maintain conservation and sustainable use of biodiversity as part of the core curriculum in all primary and secondary school systems in HK.
The tasks seem complicated and they are, and experts from all fields are contributing. But think back the 20 global targets for 2020. Target 1 is about biodiversity awareness. If we are able to realise and convince others, that HK and global biodiversity makes a huge difference to our lives, this is the difference between the BSAP making a real difference in how HK develops, and it being just another policy document on the shelf. (1) HKU wildlife protection laws review, (2) Freshwater fish have no protection under HK's existing laws because they are specifically excluded from the definition of "animal" under the Wild Animals Protection Ordinance.
(3) According to the WWF, if everyone in the world lived in the lifestyle we have in HK, we would need 2.6 earths to fulfill our need for resources. See Slide 20 – Support HK's Biodiversity Strategy and Action Plan.
HK needs your support to make the BSAP something that will have real impact on our futuredevelopment. This is what you can do.
We talked about water, air, food and other ecosystem services that biodiversity provides, and howmuch worse our lives would be without them. Try to notice and record the biodiversity in oureveryday lives. Join courses to learn about local wildlife and plants, visit a wildlife reserve, organise orjoin a BioBlitz… Then figure out what the world has agreed to achieve by 2020, in order to protect biodiversity.
Learn about the value of biodiversity to us in HK. How would you try to value a local ecosystemservice, like a garden in your school, or a local park? Can you do your own BSAP for that? Figure out what you think HK should prioritise and get involved in the consultation by sending yourviews to Focus Groups, direct to the AFCD, and joining the public activities.
And finally explore what we have, and tell others about our amazing biodiversity! Version 4: 11/02/2014 (jhm)


Microsoft word - little peoples place early learning centre diversity calendar 2016.docx

Little Peoples Place Early Learning Centre Diversity Calendar 2016 Celebrations can be as diverse as each of the children in a child care service. When incorporated into children's services appropriately, celebrations can be used to bring people together, to create a feeling of belonging and to develop a sense of community amongst families, educators and children.

The Oncologist CME Program is located online at Symptom Management and Supportive Care The Assessment and Management of Delirium in Cancer Patients HIRLEY H. BUSH,a,b,c,d EDUARDO BRUERA aDepartment of Palliative Care & Rehabilitation Medicine, University of Texas M.D. Anderson Cancer