It’s a dusky afternoon in Kwai Hing when a group of middle-aged women gather in the local government offices for choir practice. The activity releases participants from the domestic pressures they are saddled with on a daily basis.

But put together, the singers make up an altogether different kind of ensemble – housewives, mothers, aunties – aspects of Hong Kong society integral to its function, but whose efforts often go unheeded. 

Founded in 2011, Virtuous Lady Club is a grassroots organisation that advocates on behalf of menopausal women who have felt marginalised by society and for whom the healthcare system has fallen short. Their focus is on providing a safe space for their members who, also faced with the burden of having to provide for their families, often find themselves isolated and powerless.

Virtuous lady club
A photo taken by a member of Virtuous Lady Club shows another member walking up the stairs, clutching the handrail from fear of falling. Photo: Virtuous Lady Club.

“We want to empower women who are going through this difficult time,” club Vice-Chairwoman Winnie Cheung, 48, told HKFP. “They didn’t ask for their bodies to change like this.”

But their work extends beyond community activities, taking aim at the government institutions which uphold what they say are discriminatory policies.

As women reach menopause – the period around 50 years old when the ovaries stop producing eggs – their risk of some medical conditions goes up: osteoporosis, in particular, which arises from a drop in oestrogen levels, leading to loss of calcium that makes bones brittle and more likely to break.

According to a 2015 study by NGO the Family Planning Association of Hong Kong (FPAHK), around one in four postmenopausal women have osteoporosis in the city. Michelle Chak, press officer for the organisation, told HKFP: “After menopause, women’s risk of developing osteoporosis increases with age,” adding that those with significant risk factors, including early or prolonged menopause, should consult a doctor to assess their bone health.

In spite of this, none of the three government-funded women’s health centres offer osteoporosis tests.

‘One of the lucky ones’

After breaking her toe, Virtuous Lady Club member Ms So, 68, was diagnosed with osteoporosis and treated in a public hospital. “She felt that the treatment provided wasn’t working so she asked her relatives in the US to send her medicine and calcium supplements, which helped,” Cheung said. “She’s one of the lucky ones.”

In an effort to drum up awareness of the condition, the club reached out to 194 working class women in Kwai Tsing last year, 90 per cent of whom had never been tested. Those who had been tested had paid for costly private clinics out of their own pockets.

Winnie Cheung
Virtuous Lady Club Vice-Chairwoman Winnie Cheung. Photo: Virtuous Lady Club.

In late 2017, Virtuous Lady Club brought their osteoporosis campaign to the Kwai Tsing District Council, where District Councillor Lam Siu-fai urged the council to invest more resources into the cause.

“The public’s awareness of this health issue [has] been enhanced, but the support provided by the government remain[s] quite insufficient. Additional resources should be allocated to provide women with examinations,” Lam said, adding that the government should work more with private clinics and introduce an examination programme for 50- to 75-year-olds, similar to the Colorectal Cancer Screening Pilot.

A motion moved by District Councillor Wong Yun-tat in the same meeting also urged the Department of Health to carry out bone mineral density (BMD) tests for osteoporosis screenings for women aged 40 or above, either free of charge or at a low cost.

However, a spokesperson for the Department of Health told HKFP that BMD tests for women are not subsidised by the government because there is no evidence that widespread screening helps.

“BMD tests are not provided in view of the absence of adequate scientific evidence to support osteoporosis screening programmes for the whole population or for all women,” they said, adding that men can also be afflicted by the disease.

More than an information service

The implications of the club’s work extend beyond acting as an information service. Their latest drive to encourage women to examine their breasts for cancer symptoms, such as using homemade massage oil to conduct checkups, led a number of them to discover cancerous lumps.

Sixty-eight-year-old Maria, chair of the club, found a lump in her breast after taking part in the campaign last year. Having caught the disease early, she was swiftly diagnosed, treated, and is now in remission.

Virtuous Lady Club
Members of Virtuous Lady Club at choir practice. Photo: Virtuous Lady Club.

But for women faced with the pressure to provide for their families, the onset of a debilitating medical condition can be devastating for them and their loved ones. “If they can’t take care of their children, it affects their family and society as a whole. That’s why early diagnosis is essential,” Cheung explained.

The club, then, urges women aged 40 or above to go for osteoporosis and breast cancer checkups – a message not always well received.

“Many women think, ‘if nothing’s wrong with me, why would I go for a body checkup myself?’ ,” she said, adding that women are often discouraged by the cost of voluntary checkups at private hospitals.

When asked about government support, a spokesperson for the Department of Health again told HKFP that there is insufficient evidence to recommend for or against mammography screenings or clinical breast examinations for women. “It is strongly recommended that women of all ages should be breast aware, meaning that women should be aware of how their breasts normally look and feel,” they said.

Providing a safe space

Above all the club values the emotional wellbeing of their members, many of whom said that they felt neglected by both society and those closest to them: their family.

Virtuous Lady Club
Photo taken by a member of the Virtuous Lady Club depicting a hand plastered with band-aids to depict the harsh chemicals used in cleaning. Photo: Virtuous Lady Club.

“Many people think that women should stay at home and take care of the family,” Cheung said. “If the family could be more understanding it would be better.”

And so in order to deepen public understanding of the difficulties menopausal women face, club members last year decided to take photographs of their various afflictions, printing them on cards that acted as intimate windows into their lives: clumps of matted hair, a sign of hair loss during menopause; a thin sinewy wrist clutching a clay pot, representing a weakening grip; a pale, delicate hand, its fingertips wrapped in multiple band-aids, indicating that it is routinely injured and exposed to harsh chemicals while cleaning.

In neatly packaged bundles, the women sent the cards to local authorities in a bid to raise awareness of their cause.

Virtuous Lady Club
Photos taken by a member of Virtuous Lady Club depicting hair loss in menopausal women. Photo: Virtuous Lady Club.

Virtuous Lady Club, which began with only a handful of volunteers, has since expanded to 124 members as of January, thanks to a grant from capacity building organisation HER Fund in 2017, who also provided them with training in project management and advocacy tactics.

While still relatively small in numbers, the club has high ambitions to expand. Above all else, Cheung said she hopes their actions will reverberate beyond the community in Kwai Tsing. “When we work together we discover that we have a lot in common,” she said. “That way we can help each other.”

jennifer creery

Jennifer Creery

Jennifer Creery is a Hong Kong-born British journalist, interested in minority rights and urban planning. She holds a BA in English at King's College London and has studied Mandarin at National Taiwan University.