Listen to #Hashtag Hong Kong every Sunday morning at 8.15
Focusing on issues affecting civil society, we'll hear from representatives of NGOs, associations, statutory bodies, and non-profit groups.
(Sundays 8.15am - 8.25am)
Hello everyone. Today, I’d like to talk about something that affects far more people than we might imagine, yet often goes unnoticed— and that’s dysphagia, or difficulty swallowing.
I want to begin with a real-life story: A few years ago, I met Mrs Cheung, a devoted daughter taking care of her elderly mother. At first, her mother coughed occasionally during meals. It didn’t seem serious, and her family thought it was partly related to aging. However, everything changed during the COVID-19 pandemic. After being infected, her mother’s ability to swallow deteriorated rapidly. She could no longer handle her usual meals, not even congee.
For Mrs. Cheung, each mealtime turned into a source of anxiety. She watched her mother lose weight, strength, and happiness, while every choking incident filled the family with dread. She expressed feeling helpless, caught between the need to safeguard her mother from the dangers of eating and the pain of watching her struggle with something as basic as eating. For many caregivers, this emotional burden is as heavy as the practical challenges they face.
This is not just a story; it’s real life, and it may resonate with many people because dysphagia happens more often than we realise.
Dysphagia simply means difficulty swallowing, but behind this simple term are complex causes. Swallowing actually involves over 30 muscles and several coordinated steps—from the mouth, to the throat, to the esophagus. When any part of this system is weakened or damaged, swallowing can become unsafe.
There are many possible causes. This includes neurological conditions such as stroke, dementia, or Parkinson’s disease, head-and-neck cancers, age-related weakening of muscles, or structural issues such as narrowing of the esophagus.
Symptoms of dysphagia can vary widely. Some individuals may cough or choke during meals, while others feel as though food is “stuck” in their throats. Many silently lose weight or become dehydrated because eating becomes stressful or exhausting. If untreated, dysphagia can lead to serious complications, including pneumonia, malnutrition, and repeated hospitalizations.
Speech therapists play a vital role in both diagnosing and treating this condition. Depending on the underlying cause, therapy may include strengthening exercises, postural adjustments, or modifications to the texture of food and drinks. For many individuals, safe eating begins with simple yet essential adaptations—like opting for softer, smoother, and easier-to-swallow foods.
In Hong Kong, dysphagia is becoming increasingly prevalent. Our population is aging rapidly, with census projections indicating that one in three residents will be 65 or older by 2036. As we live longer, more people will face swallowing difficulties at some point. This issue extends beyond medical concerns; it impacts families, caregivers, and the social systems that support them.
To ensure that older adults, individuals with disabilities, and patients recovering from illnesses can thrive, we must prioritize their ability to eat well. Eating is not just about nutrition; it embodies dignity, pleasure, and connection.
This is where Care Food comes into play.
Care Food is more than just “soft food” or blended meals; it’s thoughtfully designed to meet various swallowing abilities while remaining nutritious, visually appealing, and culturally familiar. Adhering to the IDDSI international standards, Care Food clarifies how soft or thick a food item should be to ensure safety for those with dysphagia.
However, Care Food goes beyond safety. It aims to restore confidence, dignity, and the joy of sharing meals. Rather than unappealing mush, Care Food dishes can be colorful, well-presented, and resemble the original ingredients—ranging from vegetables to dim sum. For someone with dysphagia, being able to enjoy a meal with family again has a profound emotional impact.
At the Hong Kong Council of Social Service, we recognized early on that dysphagia presents a growing challenge, making community-based solutions essential. Since 2017, we’ve been leading the development of Hong Kong’s Care Food ecosystem.
We collaborate with NGOs that support older adults and individuals with disabilities, speech therapists and healthcare professionals. We also work with restaurants and food suppliers, and government departments.
We develop standards, training programs, and public education campaigns, collaborating across sectors. Over 240 restaurants now offer Care Food menus, enabling worry-free dining for families. Our community program teaches caregivers—family members and domestic helpers alike—how to prepare safe and tasty meals at home, supported by a Care Food website with free learning videos. These efforts are transforming how Hong Kong addresses swallowing difficulties, and we are dedicated to making safe and enjoyable eating accessible to everyone.
Now, returning to the real-life story of Mrs. Cheung’s mother - after transitioning to Care Food under the guidance of her speech therapist, her mother’s appetite gradually returned. Meals became safer, more calming, and enjoyable. She regained strength and, most importantly, could again sit at the table and share meals with her family.
For Mrs. Cheung, this was a turning point. “Care Food gave us our mealtime back,” she said. “It restored my mother’s dignity, and it gives us hope.”
If you or a loved one is facing chewing or swallowing difficulties, know that you are not alone and support is available. Speak to a speech therapist or visit the HKCSS Care Food website to learn more about dysphagia and how Care Food can assist you.
We are pleased to share in Hashtag Hong Kong on an important topic of child protection. This year is our 45th Anniversary. Our mission is to promote a caring and non-violent environment for the optimal growth and development of our children through quality services in prevention, crisis intervention, treatment, training and advocacy.
On gravity of the problem, from year 2011 to 2019, there were around 800 to 900 cases of child abuse every year. This number has been increased by 45% last year to over 1,400 cases. Then you may ask why?
One of the reasons is increased public awareness, from high profile cases in 2018 and 2019. There was an increase in identification and reporting of abuse. In 2019, the Law Reform Commission issued a consultation paper ‘’Failure to Protect Offence.’’ This new offence tackles the question of ‘’which of you did it’’ in serious abuse or child deaths investigations. And a reference chapter on Mandatory Reporting of Child Abuse was included as additional information.
In 2020, professional awareness was heightened when the ‘’Procedural Guide for Multi-disciplinary Co-operation’’ was published by the Social Welfare Department, and delineation of roles and responsibilities of professionals was clearly made.
Then in 2020 the pandemic COVID-19 led to family conflicts, job insecurity, children at risk of sexual abuse online etc, adding to the toll of child abuse. Then in 2021, the community was shocked to know that 40 children were abused in a residential child home. So you can see how vulnerable children are in the society.
Even worse, it was estimated that only 1% of abuse cases come to the attention of professionals. Therefore, to save lives, early identification, reporting and intervention are vital. ACA has advocated Mandatory Reporting of Child Abuse for some 20 years. In 2013, the United Nations Committee on the Rights of the Child recommended Hong Kong to establish a mandatory reporting mechanism. In 2019, our Ombudsman suggested the same. Soon followed were Government consultations, debates, dialogues and forums among legislators, professional bodies and the community. Now the Mandatory Reporting of Child Abuse Ordinance was finally passed and will be in full effect in January 2026. A simple message – ‘’if you see a problem, you must step forward and ask for help.’’
The main causes of child abuse is a complex issue, multifactorial in origin. Poverty, domestic violence, lack of social support, financial difficulties, parents with mental health problems, drug taking, teenage pregnancies, parents abused as a child, unplanned pregnancy or early separation from parents are risk factors of child abuse. Online child sexual abuse and exploitation is another pressing concern. Such risks easily escalate if proper assistance is not rendered.
The word to remember about the long-term effects of child abuse is ACE - Adverse Childhood Experiences. In 1998, Dr Vincent Felitti and colleagues reported the relationships between the ACEs and leading causes of child deaths. There are seven ACEs: 1)psychological abuse, 2)physical abuse, or 3)sexual abuse; 4)violence against mother and household members who were 5)substance abusers, 6)mentally ill or suicidal, and 7)ever has been imprisoned. The more ACEs you have as a child, the more problems you have in adulthood, like diseases of the heart, lung and liver, cancer and bone fractures. People with 4 or more ACEs, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt in adulthood when compared to people with none.
In a study by the Centre of Disease Control and Prevention in the United States, the estimated average lifetime cost per victim of non-fatal child abuse, including childhood health care costs, adult medical costs, productivity losses, child welfare, criminal justice and special education costs was USD830,000 in 2015. The estimated average lifetime cost per abuse death was USD 16.6 million.
We advocate a number of issues. The institutional child abuse in 2021 was a serious wake up call. ACA has a strong view that each child-related organisation should establish its own ‘’organizational child protection policy’’. Our Child Protection Institute was established in 2013 works with organizations on this, such policy will greatly safeguard our children.
The Report by Law Reform Commission in 2021, ‘’Failure to Protect Offence’’ needs to be enacted soon to provide deterrence to those who knowingly fail to protect a child from serious harm or death. Further, the maximum penalty under section 27 of the Offences against the Person Ordinance should be reviewed. This has been recommended by the court in recent years.
There are many more to do in child protection. Our other advocacies include total banning of corporal punishment, child central databank to inform policies and practices, online safety for children, home visitation service for at-risk children which is well proven in its effectiveness in child abuse prevention, a comprehensive Child Ordinance and Child Policy.
To end with an important note, when we work with children, their best interest must take priority.
Lastly this morning, I would like to dedicate a song 小時候 by 路家敏 to remind us all our precious childhood moments.
