Never Give Up

From Taiwan Review 2021-05-10

BY MEG CHANG
PHOTOS COURTESY OF TAICHUNG VETERANS GENERAL HOSPITAL

Dr. Huang Fang-liang, right, gives a high-five to Ng Zi-heng as his father looks on Feb. 8 at Taichung Veterans General Hospital.

Taiwan Can Help realize Health For All by combating COVID-19 while providing top-notch health care to those in need around the globe.

As the world keeps grappling with the impact of coronavirus, Taiwan is maintaining a relative sense of calm and normality while continuing to offer critical medical care to those with special needs from around the globe.

An inspiring example demonstrating how Taiwan Can Help realize the World Health Organization’s goal of Health for All amid COVID-19 is the story of Ng Zi-heng—a 22-month-old toddler from New Southbound Policy (NSP) target country Malaysia who received life-saving treatment a year ago at Taichung Veterans General Hospital (TVGH) in central Taiwan.

The NSP is a key plank in the government’s national development strategy. It aims to enhance Taiwan’s agricultural, business, cultural, education, tourism and trade ties with the 10 Association of Southeast Asian Nations member states, six South Asian countries, Australia and New Zealand.

At six weeks, Zi-heng’s parents noticed a loss of appetite and lump near his stomach. Diagnosed with acute lymphoblastic leukemia by a hospital in Kuala Lumpur, the baby received several rounds of chemotherapy to no avail, with repeated infections further compromising his condition.

To complicate matters , Zi-heng’s elder brother was unsuitable as a bone marrow donor. Mother Jessica Lim said the hospital told the couple to prepare for the worst as the infant’s chances of survival were only 10 to 20 percent. “It was devastating, but we had to do everything we could to give our baby a chance.”

In addition to seeking help in Singapore and the U.S., Lim asked her sister—who lives in Taichung— if there was the possibility of redress under Taiwan’s world class health care system. Zi-heng’s case was ultimately referred to Dr. Huang Fang-liang (黃芳亮), director of the Department of Pediatric Hematology and Oncology at TVGH.

“Zi-heng was a severe case, and while he was only 4 months old at the time, there was still hope that we could save him,” Huang said.

As Huang was the only pediatrician who responded to the family’s request for assistance, Zi-heng’s parents believed TVGH was his one chance of salvation. But the medical expenses and logistics proved a nearinsurmountable challenge.

Quick to step into the breach was One Hope Charity, a nonprofit based in the Malaysian city of Bukit Mertajam. More than NT$5 million (US$175,439) was raised for Zi-heng within days, which helped the Ng family relocate to Taiwan in November 2019.

Zi-heng receives medical attention from staffers at TVGH.

When the family first met Huang, he told them he would not give up until all options were exhausted, Lim said. “I knew at that moment that coming to Taiwan was the right decision,” she said, adding that this made it easier to commit to renting an apartment close to the hospital and spending the next year caring for the infant.

According to Huang, blood tests showed Zi-heng’s leukocyte count was 85 times higher than average. But the baby also had a mutation in the KMT2A gene, implying a rather pessimistic prognosis for the disease. “We explained to the parents that there were great challenges ahead, and matters needed to be taken one step at a time,” he said.

Three chemotherapy sessions later under the expert and watchful eye of Huang and his team, the cancer cells in Zi-heng were eliminated. Therapy-induced infections were also properly managed courtesy of TVGH personnel. More good news came when the hospital identified an exact match for umbilical hematopoietic stem cells, and proceeded with a much-needed transplant March 31, 2020.

But it was not all smooth sailing. Zi-heng developed postoperative hepatic vein obstruction, a rare but potentially fatal complication causing him to experience bouts of abdominal distention, hydroperitoneum and jaundice.

“We had to give Zi-heng injections of a special medication and performed daily ascites puncture for his condition,” Huang said. “He was so brave, and the whole team could not have been prouder of him.”

Zi-heng, hospitalized for 80-plus days after the transplant, was discharged from hospital in June 2020. “We continued to follow up on him through hospital visits for six months and performed three additional tests to confirm there were no cancer cells in his body,” Huang said, adding that today, the toddler is no longer on medication.

Although Zi-heng’s treatment at TVGH ended, the family opted to stay in Taiwan for several more months given the country’s success in combating coronavirus.

Lim said it had been an incredible year for all of them. “There were so many times when I felt Zi-heng might not make it; words cannot describe my gratitude to Taiwan.” The Ngs have since moved back to Malaysia, where Zi-heng has his condition monitored at a local hospital.

According to Huang, it was destiny that brought Zi-heng to TVGH. “His parents never gave up on him,” he said, adding that playing a part in his recovery was a deeply personal and satisfying experience. “Nothing is more rewarding than putting the smile back on your patient’s face.”

2021 WHA