Famous for her campaigns to enlighten people and governments about the dangers of nicotine, Mackay has for just as long been vigorously telling people about sex and sexual health - broadcasting on sex on RTHK and writing an advice column in the South China Morning Post in the 1970s and 1980s. Her broadcasts on the issue were frank, sensible and eliminated medical jargon. This book does the same. 'I took on the sexuality book thinking that gathering data to collate the atlas would be simple,' says Mackay. That was the start of five frustrating years as she tried to trace facts and figures that few societies seemed to record.
'I wanted to put together data from across the spectrum,' she explains. 'I wanted to write and explain the intensely personal aspects of sex and its enormous economic and political impact. It isn't meant for just clinicians and anthropologists, but also for young people wanting to learn more about their bodies.' Mackay laughs. 'It was enormously complicated to collect the data,' she adds. Work on her latest book began in 1985 when she was talking to executives at Penguin about her earlier State Of Health Atlas. 'I told them I didn't know much about sex, but knew a lot about compiling an atlas,' she explains.
Mackay, who has been happily married since 1967, now knows an awful lot about sex, as will anyone who studies the fact-packed, attractively designed pages. 'One problem I had was how to make the subject cheerful, which sounds bizarre,' she says. 'Much of the data was negative.' A Hong Kong resident for 33 years, she knows her stuff, having been a senior health adviser to the World Health Organisation and to many governments, including China. She says she would like to see the sexology atlas, which goes on sale at Dymocks bookshops ($175) this week, in every school library.
Packed with information covering sex from pre-mammal times, the pages are arranged in sensible sequence. Bright graphics and maps display overall trends on pages studded with facts, such as Africans have the most babies (5.9 per woman) and Europeans the fewest (1.7). And there are oddities too - such as the fact the sperm count of outdoor workers in Texas drops 32 per cent in hot summer months, while if a Danish woman has 10 alcoholic drinks a week after giving up the pill, she's nine per cent less likely to get pregnant than if she has fewer than five drinks a week. But not all the information is fun. In fact much can be jaw-droppingly shocking: every day a million people catch a sexually transmitted disease. More than 10 per cent of the population of southern Africa are HIV-positive or have Aids. Every 24 hours, genital excision is performed on 6,000 girls aged between four and 10, while in eight countries, homosexuality is punished by the death penalty.
Mackay is careful to maintain a non-judgmental attitude, but the reader is still likely to be stunned by some of the revelations. Much of the sexual hardship experienced across the globe is endured by women - such as the 60 per cent of divorced women in the Malaysian state of Selangor who turn to prostitution because they are destitute, or the 20 per cent of American women who are victims of date rape. It leaves the reader full of questions. How come a third of women in Gambia don't know they are married until the ceremony is over because nobody bothered to ask their consent? Why hasn't anything been done to stop the sexual harassment of 95 per cent of Mexico's female workers? Although intensely thought-provoking, such grim facts make up just a small part of this fascinating work. The book starts with the most basic question: why did sex begin when life used to be efficiently reproduced asexually? Mackay then moves on to examine the human body and its evolution - and turned up some incredible findings. For example, she discovered Asian women's breasts are getting bigger: in the 1980s, bra sizes were commonly 34A but have increased to 34C.
And what is surprising is that in much of the world there is no official data about when people start having sex. But research does show that it's 16 in the United States, 18 in Brazil, and 20 in Kazakhstan.
And for the all-important comparative question that people from all nations ask: how often do people have sex? Well, more than half the world's men (54 per cent) think of sex at least once a day, but only 19 per cent of women do the same, Mackay discovered. Russians do it more than 130 times a year but Latin lovers - the Spanish and Italians - can manage only between 50 and 99 times annually, while 20 per cent of the population of France say they have no interest in sex. Indeed, Mackay says, a third of adults virtually live without sex and the incidence of sexual activity falls sharply in long relationships where the partners get older.
Then there is the question of 'what is normal sex'? In the doctor's view, it comes down to two principles: sex that does no harm and is done with informed consent. But that is not the way society sees it, she admits, and the atlas often reflects these social beliefs between the lines of scientific fact. It also details how the largest religions view sexual activities and some of the inventive constraints placed upon the faithful. One example given is that Hindus think men should stop having intercourse after the age of 50 for health reasons.
There is also the question of what makes people attractive and the results, though mostly predictable, have turned up some startling discoveries. In Britain, 22 per cent of women consider shoulder blades the most attractive part of the male anatomy, while 32 per cent of the men like large breasts. Thrown into the sexual melting pot are facts like this: in Japan, 40 per cent of men pluck their eyebrows and 19 per cent of young women are anorexic - all in the name of sex appeal.
Sex is also big business, according to Mackay's research. In Thailand, prostitution generates US$25 billion (HK$195 billion) a year and people spend US$51 million a year on more than 600 commercial Internet porn sites. Even though prostitution is illegal in India, there are 450,000 child prostitutes and in the US there are 300,000 prostitutes under the age of 18.
Maps featured in the atlas graphically trace the routes of sex tourism, with the busiest traffic of heterosexuals flowing from Japan and Europe to Thailand and the Philippines, and homosexuals heading eagerly for Indonesia, Gambia and Sri Lanka.
People, it appears, want more sex: this year alone Viagra sales will top US$1 billion. But not us, it seems. In a 1997 survey by the condom manufacturer Durex, sexually active Hong Kongers, aged between 16 and 45, had sex 57 times a year - the lowest among 15 countries surveyed and less than half the amount of Americans, who were highest with 138 times a year.
We are a chaste lot, too. While 24 per cent of Hong Kong respondents admit to being sexually unfaithful, that compares with 50 per cent of Americans who admit to philandering and 42 per cent of Britons. But our divorce rate is low - 1.1 per cent for men - and contraception is high, at 86 per cent for married women.
As for the question of sex education, Mackay has her fears. Everywhere, she sees constraints and restrictions against 'lewdness and nudity'. 'Is there any sex education that teaches sex can be a nice thing?' she asks. Research showed Latin America was one region that had refreshingly removed the negatives from teaching young people about the facts of life. Elsewhere, the picture is bleak with laws, regulations, policies and public opposition restricting balanced teaching about the essential subject.
Then there is the future of sex on the Internet. 'Do you want your child to learn about sex from a qualified sex educator or a pornographer?' Mackay asks. Of course, they could always read her book.
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