In the year IHEEM celebrated its 80th anniversary, the Institute’s Hong Kong Branch marked its own 25th anniversary with a symposium in the city last November. Expert international speakers discussed pressing issues including sustainability and Net Zero, climate change, ‘alternative’ and ‘greener’ energy, the resilience, running costs, and carbon footprint of high-rise hospital buildings, and the fast-developing Chinese healthcare market. Representing IHEEM in the UK were President, Alison Ryan, who gave a keynote speech, and Past-President, Paul Fenton MBE. HEJ editor, Jonathan Baillie, reports.
The one-day symposium, themed ‘Hospital Engineering Design in the New Era of Environmental and Technological Development’, took place on 3 November at the Hotel ICON in Tsim Sha Tsui, Kowloon. Over 200 delegates attended for a mix of interesting conference sessions, to network and learn more about healthcare provision and healthcare engineering in the region, and to mark the Hong Kong Branch’s quarter century – including at a 25th Anniversary Dinner. Alison Ryan, Paul Fenton, and former IHEEM CEO, Julian Amey, were among the UK guests. Alison Ryan presented as part of the symposium, and spoke during the dinner the same day. During her dinner speech, she explained that it had been on 4 March 1998 that a number of IHEEM members living in Hong Kong first met to discuss forming a Hong Kong Branch; they voted unanimously to seek Council’s approval, and that summer, the Branch was formed.
Two and half decades promoting innovation
Alison Ryan told dinner guests: “Over the past two and a half decades, the dedication and expertise of the members have greatly contributed to the advancement of the healthcare industry in the region.” The Branch had, she said, ‘achieved numerous milestones, witnessed remarkable accomplishments, and been a catalyst for knowledge sharing, professional development, and collaboration’. “Through a wide array of educational programmes, conferences, and networking opportunities,” she added, “the Branch has consistently striven to enhance the quality of healthcare facilities and services in Hong Kong.” She particularly thanked the IHEEM Hong Kong Branch Chairman, Dr PL Yuen – who had been instrumental in establishing a Memorandum of Understanding with the Chinese Health Authority, further strengthening IHEEM’s international collaborations. She said: “Tonight’s celebration not only marks a significant milestone, but is also an opportunity to reflect on our achievements, and our aspirations for the future.” She thanked the organising committee for their hard work in organising the symposium and dinner.
In her symposium presentation, the IHEEM President focused initially on Hong Kong’s Climate Action Plan 2050, which sets out the target of reducing the city’s carbon intensity by 65-70% by 2030, with 2005 as the baseline year. Key elements include:
Net Zero electricity generation – currently, about two-thirds of Hong Kong’s carbon emissions come from electricity generation, with combustion of coal, natural gas, and oil the main electricity sources. The Climate Action Plan 2050 proposes ending using coal for daily electricity generation by 2035, and increasing the share of renewable energy for electricity generation to 7.5-10% by the same year (and to 15% subsequently). Hong Kong’s Government says it also wishes to trial new energy sources.
Energy saving and ‘green’ buildings – reducing buildings’ overall electricity consumption via the promotion of ‘greener’ buildings, improving efficiency, and ‘promoting a low-carbon lifestyle’. The goal is to reduce commercial buildings’ electricity consumption by 30- 40% by 2050, and residential buildings by 20-30% (from a 2015 baseline).
‘Green transport’ – with a target of zero vehicular and zero carbon emissions in the transport sector before 2050, through electrification of vehicles and ferries, development of ‘newenergy transport’, and improved traffic management. Hong Kong’s Government will also cease registering fuel-propelled and hybrid private cars in 2035 ‘or earlier’, promote electric buses and commercial vehicles, and work with the city’s franchised bus companies and ‘other stakeholders’ over the next three years to test hydrogen fuel cell electric buses and HGVs.
Waste reduction – Hong Kong’s Government will strive to develop adequate waste-to-energy facilities by 2035, reducing reliance on landfill. It will also further promote waste reduction and recycling, introduce waste charging, and regulate disposable plastic tableware
Within the next two decades it says it will devote ‘about HK$ 240 bn’ to take forward ‘various measures’ on climate change mitigation and adaptation.
Alison Ryan discussed these proposals, and Hong Kong’s current and future fuel mix and primary energy supplies, before touching on some of the city’s ‘exciting new hospital developments’. She told delegates: “I believe there are currently 43 public hospitals, 13 private hospitals, 49 specialist outpatient clinics, and 74 general outpatient clinics, organised into seven hospital clusters based on location.” She explained that Hong Kong’s 10- year Hospital Development Plan (HDP) includes:
Redeveloping 11 existing hospitals.
The construction of a new major Acute Hospital (Kai Tak), and
The construction of three new Community Health Centres, and Supporting Services Centre(s)
The HDP is anticipated to deliver around 5,000 additional bed spaces, and 90 additional operating theatres. Alison Ryan said she was particularly looking forward to visiting Hong Hong’s new Kwong Wah Hospital the following day. One of the proposals there was to incorporate around 100 single inpatient rooms able to switch to negative pressure isolation rooms for treating those with infectious diseases – something she said the UK had also been looking at, in terms of the ability to ‘flex’ from even an isolation room to an operating theatre – and back, as required.
Children’s Hospital’s H-shaped tower
The IHEEM President also discussed the new Hong Kong Children’s Hospital, with its H-shaped Clinical Tower, designed to allow in increased natural light and improve air circulation. The hospital will link to a district cooling system, has green terraces and roofs, and vertical green walls – to help reduce overheating and mitigate the island effect, plus roof-mounted solar hot water and roof-mounted PV panels. It has achieved a Platinum rating under the BEAM Plus New Buildings Version 1.2 assessment tool.
Alison Ryan explained that some of the other potential renewable energy sources in Hong Kong – which aims to increase the share of renewable energy in its fuel mix from 1-15% by 2050 – include ‘floating’ and ‘thin-film’ solar energy generation systems, food waste and sewage sludge anaerobic co-digestion facilities, solar PV farms, offshore wind, hydroelectric, geothermal, and hydrogen
Later, she focused on some of the NHS in England’s key sustainability initiatives, such as the Delivering a ‘Net Zero’ National Health Service report published in October 2020. IHEEM and HEFMA, in partnership with the Carbon and Energy Fund and others, had – she explained – developed the ‘healthcare engineering roadmap’ titled An Energy Roadmap for Delivering Net Zero Carbon Emissions By 2040, published in March 2021, and since widely adopted.
She also discussed the NHS Net Zero Building Standard, which applies to new hospitals and extensions, and is the first of its kind to set bespoke targets for individual health projects. Its aim is to reduce the embodied carbon and operational energy – and thus the operational carbon, of healthcare buildings. She explained that the Standard differs from LETI or RIBA in setting specific targets depending on building type.
The benefits of standardisation and repeatability in healthcare building design were another focus, with evidence from the ProCure21 framework having shown that standardisation and repetition of selected rooms results in 11% cost savings, and ‘improved patient outcomes’.
In closing, Alison Ryan noted that when London-based ‘think tank’, Well, recently evaluated ‘where to find the best healthcare in the world’, Singapore came top, Hong Kong 14th, and the UK 34th. She said events like the symposium provided the opportunity to learn not just about ‘what is good about healthcare in other countries?’, but also ‘What we can learn?’, ‘How can we deliver better healthcare?’, and ‘What might future healthcare delivery and hospitals look like?’
Branch Chair ‘delighted’ with content
Hong Kong Branch Chair, Dr PL Yuen (winner of the IHEEM Lifetime Achievement Award for 2023), was delighted with the attendance at the symposium and dinner, the high quality of the presentations, and the valuable networking that took place. He said: “The Branch is fortunate to have close connections with a number of other healthcare engineering and construction bodies in the region, plus some organisations with a more clinical focus.” These include CIBSE Hong Kong, the ASHRAE Hong Kong Chapter, the Hong Kong Institution of Engineers, the Hong Kong Society for Microbiology and Infection, the Hong Kong College of Pathologists, and the Medical Laboratory Technologists Board.
“With these links,” Dr Yuen said, “we can help each other stage interesting events such as this biennial IHEEM Hong Kong Branch Symposium, which was supported by all the aforementioned bodies. Symposia and conferences are an excellent knowledge-sharing and contact-making opportunity, and attract many professional engineering and estate management personnel both from Hong Kong and further afield. In recent years we have also built up our network of clinical contacts, and our links with IPC teams and microbiologists.”
In recent years, he explained, IHEEM Hong Kong Branch members have visited a number of Chinese hospitals to see how they are being designed and built, and how fast-changing clinical trends are impacting on this. Dr Yuen said: “Alongside my other roles, I am a Council Member of the China Hospital Association. The Chinese healthcare market is huge; I believe China has at least 30,000 hospitals, and more operating theatres than the rest of the world put together. When you visit Chinese hospitals, it’s not unusual to see 4,000-10,000 bedded facilities.”
The value of networking
IHEEM Past-President, Paul Fenton, said: “Following Dr Yuen’s welcome address at the start of the symposium, Dr Tony KO Pat-Sing, CEO of the HSKAR Hospital Authority, had also highlighted the value of networking and knowledge-sharing within the healthcare engineering and wider healthcare communities – referring cleverly to the value of ‘napkin innovations’ – i.e. the fact that some of the most useful conversations take place during coffee breaks, or at the dinner table. He also spoke enthusiastically about Hong Kong’s 10-year Hospital Development Plan, which Alison Ryan had referred to, explaining that a key element would be increasing use of ‘smart’ technology and AI.
“Dr Pat-Sing also discussed some of the learnings for engineers post-COVID, such as ensuring sufficient hospital supplies of high-flow oxygen; shortages had impacted many countries, including the UK. Hong Kong had learned some valuable lessons on hospital ventilation during the 2003 SARS outbreak, while COVID-19 had created some significant further technical challenges and lessons for healthcare engineers, and indeed clinicians, particularly around containing airborne virus transmission, and – in the latter case – the most effective treatment methods. The pandemic had, he emphasised, particularly highlighted the need for both a resilient oxygen supply, and robust, wellmaintained hospital infrastructure.”
One of Dr Yuen’s close business associates in Chinese healthcare is Wang Gang, Director of the Shandong Provincial Architectural Design Institute, who spoke on trends in hospital development, design, and construction in China. In his presentation, ‘Architectural and Environmental Artistic Design and Integration’, he focused particularly on the new RMB 2.83 bn (£255 m), 1,200-bedded, 23,000 m2 Urumchi Children’s Hospital in Xinjiang, and some of the key design aspects – both from an architectural and construction perspective. The latter included a tight construction timescale, high construction costs, limited material availability, and transporting goods to the remote location. Wang Gang also discussed more detailed elements such as the façade design, and some of the key considerations in designing specifically for children.
Dr Yuen added: “We find considerable reciprocal benefits in our relationships and dealings with those working in Chinese healthcare. Not only can we learn from them, and hear about some of the fast-moving development in healthcare building design in China, but our Chinese counterparts can hopefully also gain from our experience and expertise.”
Imparting some of that expertise was Professor Thomas KC Chan, Executive director, Building, MEP, at WSP (Asia), who trained both in Hong Kong and the UK, and has over 38 years’ power and building services engineering experience. A PastPresident of the Hong Kong Institution of Engineers, Chairman of the IET Hong Kong, and Chair of the CIBSE Hong Kong region, he is also a Fellow of IHEEM, CIBSE, HKIE, and the IET, a Chartered Engineer, and the current Chairman of the Electrical Safety Advisory Committee, Electrical and Mechanical Services Department, at the Government of HKSAR. In his presentation, ‘Climate change and safety impact on high-rise hospital design’, Prof. Chan explained that until 2000, most public hospitals built in Hong Kong were between 10 and 15 storeys high, and many private hospitals ‘low-rise’. However, there had been a growing trend for those being built since 2021 to be over 20 storeys high – creating new challenges for designers and constructors – both as regards their ability to withstand extreme climactic events, and their increased carbon footprint.
Looking first at high-rise buildings’ resilience to extreme climate ‘events’, Prof. Chan said that when designing healthcare buildings in Hong Kong with the ability to withstand a typhoon, for example, one had both to conduct a Wind Analysis on Building Height Impact study, and to consider the impact of wind pressure on the facade, and the rigidity of the MEP plant support. Black ‘rainstorms’ can see rainfall of over 100 mm/hour, while the highest rainfall recorded by the Hong Kong Observatory (since 1884) was 145 mm/ hour. Such ‘black rainstorms’ currently have a 100-year return risk, with a ‘worst case’ scenario of 250 mm of rain over a 10-minute period. The Professor discussed some of the key mitigation measures against such weather extremes, particularly in protecting buildings from flooding.
Carbon impact in focus
He also discussed the carbon impact of higher-rise hospital facilities, embodied and operational carbon optimisation measures when designing them, floor efficiency improvement and planning vertical transportation, and the benefits of Modular Integrated Construction (MiC). Professor Chan’s presentation also covered thermal performance improvement, hospital orientation and façade design, opportunities to use renewable energy, natural daylighting and ventilation, co- and tri-generation, and the need to carefully consider aspects such as MEP plant location and space planning. With a growing number of ‘high-rise’ hospitals in the region, he also stressed the need to embed sufficient electrical and other building services resilience.
The next speaker, Professor Hiroshi Yasuhara, has been President of the Hospital Engineering Association of Japan (HEAJ) since 2017. Before moving into healthcare engineering, he spent over 25 years as surgeon and a professor at Teikyo University and the University of Tokyo. He served as the OR Medical Director at the University Hospital of Tokyo, and from 2019-2022 as director at the Tokyo Teishin Hospital. His presentation focused on planning healthcare facilities, and HVAC design guidelines, in the wake of COVID-19, and some of the associated learnings.
COVID-19 case numbers
Beginning with some statistical data on COVID-19 case numbers at various stages of the pandemic, he highlighted the importance of infrastructure adaptation in the early phases, before discussing research evidence around coronavirus transmission, explaining that the virus can be transmitted both via droplets – in common with some other infections – but also aerosolised during dental and medical procedures. He emphasised how the definitions used by clinicians and healthcare engineers for both aerosols and droplets – for instance as regards their size, behaviour in air, and exposure pathways – have changed with experience and emerging information. For instance, while an aerosol particle was ‘traditionally’ typically considered to be under 5 µm in size, ‘updated’ thinking indicates that aerosols can be particles less than 100 µm in size, and comprise a stable suspension of solid and / or liquid particles in air. Research has also demonstrated that they can remain airborne for extended periods, travel over 2 m, and build up in a room, where they can then be inhaled.
Prof. Yasuhara also considered aerosol and droplet transmission of coronavirus, and the extent of protection from surgical masks, highlighted some of the key differences between aerosol and droplet transmission, and scenarios when infection will pass from an infected to a previously uninfected person. He also discussed some of the key factors – such as particle size and numbers, humidity levels, and exposure duration, that determine symptomatic infection. He subsequently focused on the HEAJ Guidelines for Hospital Facilities for minimising airborne infection rates, recommended air change rates in private rooms to prevent infection, considered the impact of confined spaces with poor ventilation, plus the ‘pros and cons’ of CO2 levels as a marker.
The Professor touched on the ASHE Current / Updated Healthcare Facilities Ventilation Controls and Guidelines for the Management of Patients with Suspected or Confirmed SARS-CoV-2 (COVID-19), and some of the potential ‘interventions to mitigate aerosols infection in a clinical setting’, comparing current guidelines from Japan, the World Health Organization, and the CDC in the US. Another focus was the WHO’s global guidelines for the prevention of surgical site infection. Prof. Yasuhara also considered evidence of the degree of effectiveness of laminar airflow ventilation in preventing infection during orthopaedic surgery, US-derived recommendations on appropriate ventilation in theatres, and some of the ‘important issues’ still to be solved. Among such COVID-19-related issues were the ‘simplified relationship between coronavirus and ventilation in complicated indoor structures’, that there seems ‘little differentiation between ventilation and airflow’, ‘no assumption that patients wear face masks’, and the need for cost/performance analysis when renovating existing HVAC systems
Prof. Yasuhara was followed by Dr Bjorn Werner of the Association of German Engineers (VDI) and German Industrial Engineers, who is MD of Health Tec, part of the HT Group. In his presentation, ‘Prefabricated and sustainable room solutions from a single source’, he discussed how Modular Integrated Construction ‘can reduce contamination and infection in healthcare facilities’. He began by looking at some of the key elements of MiC, and its practical and economic benefits, comparing its use to more ‘traditional’ construction. He showed slides of MiC in practice in a variety of healthcare settings, before discussing modular-built intensive care units, and what Health Tec dubs its ‘flexible isolation rooms’. His presentation included reference to several case study hospitals – including in Germany, Switzerland, and Malta – where the company has provided ICU isolation rooms for patients with a range of infectious diseases. He explained how the flexibility of the design Health Tec offers enables such facilities to be tailored to the particular hospital’s needs, while reducing the risk of infection spread.
One of the examples he referred to, as he switched to the impact of ‘healing architecture’, was a study of a ‘pilot ICU’ at Berlin’s Charité Hospital, where modification of the ICU environment (involving elements including lighting, colours, noise reduction, workflow optimisation, and infection control), had shown a ‘significantly reduced incidence of delirium’, with shorter stay lengths, reduced drug dosages, and lower mortality.
Opportunities for hydrogen
With an increasing focus on renewable energy sources in the face of climate change, opportunities for use of alternative fuels are now, literally, a ‘hot topic’, and Cynthia Zhu, CEO of Sinosynergy International, a founder and Council member of International New Energy Industry Alliance, and a Committee Member of the Chinese Financial Association of Hong Kong, discussed ‘Potential applications for hydrogen and fuel cells in hospitals’. Dubbing hydrogen ‘a clean and renewable energy source’, she explained that it can be produced ‘without carbon footprint’, transported long distances, has high energy density when compressed, produces ‘clean’ power and fuel, is a clean industrial feedstock, ‘versatile as an energy vector’, and has similar safety considerations to natural gas and petroleum. With Governments globally targeting phasing out sales of new ICE vehicles, Cynthia Zhu said this ‘paved the way’ for the roll-out of HFC vehicles as ‘an attractive alternative’. Globally, she explained, based on data from the Hydrogen Council, there were already over 1000 hydrogen-orientated projects in hand, including in the UK, while estimates from the McKinsey Center for Future Mobility indicate that the global commercial fuel cell vehicle market is projected to grow by 34% CAGR to US $20 bn in 2030, ‘driven by policy tailwinds, rapidly falling costs, and governments’ strategic planning worldwide’. Among the key drivers, she explained, are the falling cost of hydrogen technologies and products due to economies of scale, and more than 60 countries – including China – committing to zero net emissions by 2050.
China’s own plans
Cynthia Zhu also discussed China’s medium and long-term plans for hydrogen industry development, which include encouraging low carbon and renewables-based hydrogen production, and ‘steadily constructing hydrogen storage and transport systems’, as well as promoting R&D in the core technologies, participating in international cooperation and standardisation, and ‘educating a hydrogen workforce’. China is also keen to advance demonstration projects in transport, storage, urban districts, and the metallurgy and chemical industries.
She later considered how the hydrogen industry has ‘evolved’ since 2015, before discussing Sinosynergy’s background, heritage, and capabilities in hydrogen production and storage as ‘the number 1 HFC manufacturer in China by market share’. The company has one of the world’s largest fuel cell production lines, and continues to expand its production capacity. In China, the annual carbon dioxide emissions of ‘heavy duty’ trucks account for 54% of all vehicle emissions, despite these ‘trucks’ making up only about 4% of all road vehicles – a factor she said made them the key vehicle type to focus on to reduce all vehicle-related carbon emissions.
Meanwhile, as major consumers of electricity and other energy to provide a continuous clinical service, there was, Cynthia Zhu stressed, considerable opportunity for hospitals to use hydrogen fuel cells – both as a power generator, and for daily operation and back-up, in the process reducing their carbon emissions.
‘State-of-the-art and efficient hospital vertical transportation’ was the subject of the symposium’s penultimate presentation – from Edmundo Klophaus, Vice-President of TK Elevator, a specialist in the supply, installation, and maintenance of lifts and elevators. Born in Chile, Edmundo Klophaus is a graduate of Fontys University of Eindhoven, and lives in Hong Kong. His career has seen him employed in businessto-business, business-to-consumer, and business-to-government roles at both a regional and national level. In 2013 he joined Thyssenkrupp Elevators – now TK Elevator – as Head of Marketing & Communications in Asia Pacific, and he is currently VicePresident NI Sales & Marketing, Asia Pacific Region. His focus was TK Elevator’s TWIN elevator system – reportedly the industry’s first lift system with two independent cars, ‘one on top of the other,’ in one shaft – giving users ‘the same conveyance capacity in 25% less space’.
TK Elevator explains: “With TWIN, both cabins use the same guide rails and landing doors. Each car has its own traction drive, controller, ropes, counterweight, and governor. An intelligent Destination Selection Control system gets people to their destination faster by grouping together individuals travelling to the same floor.” TWIN also boasts a TÜV-tested safety design ‘to satisfy even the most stringent requirements’. TWIN is targeted at ‘high-rise’ hospitals, offices, and hotels, and is also equipped with AGILE Destination Control, which ‘minimises average travel time to the destination, and increases handling capacity’.
The system has already been installed at healthcare facilities including the Royal London Hospital in London – which has the first bed TWINs worldwide, South Korea’s Ajou University Medical Center, and the Nanchang University Hospital in China.
Air distribution for infection control
The day’s final presentation was by Marco Sauder, a certified HVAC engineer in Germany, on air distribution systems for infection control and exhaust air treatment, particularly in the wake of COVID-19. He based his presentation about suitable air distribution systems for hospital environments on generally small patient rooms, a high number of occupants per m2 , high levels of staff activity and short staff-to-patient distances, and it frequently being difficult to refurbish existing HVAC systems.
Among the areas discussed were air change rates in different spaces – and the correlation with infection risk, plus the ‘conflicting goals’ of saving energy and reducing a building’s operating costs while reducing pathogen concentration – for example using water-air systems and displacement ventilation in cooling mode. Also examined were tracer gas measurement, and the need for exhaust air treatment in hospitals – to prevent the growth and spread of bacteria, viruses, and spores, in the environment, and their accumulation in recirculation mode. He also highlighted some specific hospital areas – such as isolation wards, laboratory areas, and patient rooms, that merited special attention.
Critical component characteristics
Marco Sauder explained that for effective exhaust air treatment, critical components needed both to be easy to disinfect, and resistant to disinfectant. Equally important was the ability to fumigate with formalin or hydrogen peroxide, and carry out leakage testing and inspection of HEPA filters and shut-off dampers. HEPA filters should not only be able to be inspected ‘as installed’, but also exchangeable with ‘low contamination’. Similarly, room pressures, air flow, and direction, needed to be controlled, while any measurement and test equipment must be suitable for the application. He also discussed the critical components of air duct, pressure / volume control systems and gastight dampers, and some of the key criteria when specifying HEPA filters for healthcare use
Paul Fenton said of he and Alison Ryan’s visit to Hong Kong as UK representatives of IHEEM: “The entire programme was really well organised, and the standard of presentations high. Alison and I were also extremely well looked after.”
The day before the symposium, the current and Past-President had attended a meeting at the offices of the Hong Kong Institution of Engineers. Paul Fenton said: “This was primarily to strengthen the relationship between the HKIE and IHEEM, and for contact-making. It was useful to meet with some of the senior HKIE personnel – including Vice-President, Alice Chow, a director at Arup in Hong Kong. At the end of the visit she kindly presented Alison with a plaque. We were also joined at the HKIE by Thomas Chan, Dr William Fung, and Ricson Tsang of the IHEEM Hong Kong Branch. Interestingly, alongside hearing about some of the ventilation challenges hospital engineers in Hong Kong have faced, and associated research, and the HKIE’s input into local healthcare engineering guidance, we learned that Modular Integrated Construction has already been used in the city on hospitals up to 20 storeys high, and in residential buildings of up to 40 storeys. It was also interesting to hear that the HKIE has Chapters in Canada, Australia, and the UK.”
Kwong Wah Hospital visit
On the day after the conference Alison Ryan and Paul Fenton visited the new, ‘redeveloped’, Kwong Wah Hospital, currently being constructed in two phases on the site of the former hospital there. Phase 1 has already been completed. The 1790-bedded hospital will be 19 storeys high, preparatory works having cost HK$ 552.7 m, the demolition and structural works for Phase 1, HK$ 654.8 m, and the superstructure and associated work for Phase 1, HK$ 10,083.3 m. Paul Fenton said: “During a really interesting visit, we were able to see some of the clinical facilities completed under Phase 1 – such as the Emergency Department, diagnostic imaging suites, and isolation wards. We were also amazed to see bamboo scaffolding used on a number of building projects in Hong Kong, showing how some age-old traditions also encompass true sustainability aspects in using this very strong, natural material.
“All in all, the visit to Hong Kong to mark the Branch’s 25th anniversary – including at a dinner where we enjoyed a 10-course dinner – proved productive and extremely valuable in strengthening IHEEM’s links in the region, and educational and highly enjoyable, for us both. Our appreciation, thanks, and congratulations, to all involved for a great event, and for making us feel so welcome.”