The settlement approved by the Hong Kong high court last Wednesday in the legal action brought by me and my 11-year-old son, Ravi, against the Hospital Authority over the death of Harinder Veriah, my wife and Ravi's mother, represents a major victory. It has taken 10 years and a huge commitment of emotion, time and resources. We have faced monumental obstacles. From the outset the Hospital Authority denied any responsibility and it has used its limitless funds to try to bludgeon us into submission.

Hari died on 2 January 2000 in Ruttonjee hospital. We had been in Hong Kong just 14 months, Hari having been seconded there by her London law firm while I used it as a base from which to write my book on China. Ravi was just nine weeks when we arrived. At 1am on 1 January, Hari had an epileptic fit while we were out celebrating the millennium with our friends, Eric and Marlene Hobsbawm, who had come to stay with us in Hong Kong. Hari was taken by ambulance to the Ruttonjee. When I went to see her for the second time on the evening of New Year's Day, I was anxious about how she was being treated.

As a Malaysian of Indian descent, she had suffered a great deal of racism in Hong Kong, far worse than in London or Kuala Lumpur. People would refuse to serve her in restaurants, keep her waiting in shops, mutter abuse at her in the street, and she suffered at work, too. When we were together she was given my colour; on her own it was an entirely different matter. Barely anyone talked about Hong Kong's endemic racism. Before we went we had no inkling; it was, as one journalist was to write later, "Hong Kong's dirty little secret".

That evening the duty doctor came to see her. I asked him various questions and received only evasive responses. I had been anxious for the medical staff to be aware that I was white; in Hong Kong my colour commanded deference and respect, the opposite to how they saw Hari's beautiful deep brown complexion. When he left, I said to her: "A fat lot of use that was." She replied: "I am bottom of the pile here." Her words travelled through my body like an electric shock.

The hospital staff were no different to the rest of Hong Kong. Prejudice was ingrained and systemic. Hari's words were all the more disturbing because they were so uncharacteristic. She was uncomplaining, patient and extraordinarily compassionate. She would see prejudice as an affliction of the perpetrator that needed her help and kindness to overcome. But lying in hospital, vulnerable and unwell, was a different matter. She uttered these words with a sense of resignation. When I asked her what she meant – expecting her to give examples – she simply said: "I am Indian and everyone else here is Chinese." The staff were no doubt unaware that Hari was fluent in Cantonese and could understand the racial epithets they were using to refer to her. I told Hari I was going to get her discharged. I went to see the nurse, debating in my mind whether to take her home there and then or in the morning. I opted for the morning because she was still unwell. It was the worst decision I have ever made.

At 8.50 the following morning, as I was getting ready to collect Hari, I got a call from the nurse. Hari had had another epileptic fit and I should come to the hospital immediately. I was there in a shade over 10 minutes to be greeted by a scene that will forever haunt me. Hari was deeply unconscious and no doctor was present, just a couple of nurses. Within a minute or so, an alarm went off: Hari had suffered respiratory failure. A doctor belatedly arrived, and then Hari had a cardiac arrest. She died soon afterwards. Two days earlier she had celebrated her 33rd birthday.

Two months later, upon our return to Hong Kong after a family wake in Kuala Lumpur and the funeral in London, I applied for Hari's medical records. When they arrived, I sent them to some consultant friends in London. I had no idea why Hari had died; it seemed like an act of God. But after my friends got back to me, all began to become clear. Abject negligence was responsible for Hari's death. And in my mind I knew that the negligence was a product of racial prejudice. My state of desperate grief was now compounded by the grim realisation of the causes of her death.

I fought for an inquest and eventually it was held in November 2000. It was a travesty of justice. The coroner appeared to have made up his mind more or less from the outset to find for the hospital, ruling that there had been no negligence. In my evidence I quoted Hari's words about being bottom of the pile; assuming a manner of mock outrage, the coroner and the hospital lawyers dismissed her comment out of hand. But Hari's words shook Hong Kong. Finally the veil of denial was pierced and a public debate began. A meeting was organised in Hari's memory to initiate a campaign for anti-racist legislation. The government was forced to abandon its position that racism was only a minor problem, and in July 2008 the first-ever anti-racist legislation was introduced in Hong Kong. It was described in the press as a memorial for Hari.

We returned to England in April 2001. Before leaving, I began to investigate what action I might take against the Hospital Authority. How could I allow Hari to die in the Ruttonjee as a result of negligence and racism without the hospital being called to account? I knew this would be a daunting challenge. The action would have to be brought in a foreign country and in a culture that was very different from what I was familiar with.

I was confronted with extremely powerful and well-funded adversaries. At the inquest the coroner and the Hospital Authority seemed to have been joined at the hip. The lawyers representing the latter were renowned for playing hardball and never conceding. Litigation in Hong Kong is expensive, far more so than in the UK, and my resources were limited. Before leaving I failed to find a single potential lawyer in Hong Kong who, in varying degrees, was not in denial about racism. Although Hari was a lawyer, I knew nothing about the litigation process. And my constant companion in this long struggle for justice was the searing pain of having lost someone I loved beyond all reason or belief.

I made up my mind to organise the action from the UK. I made contact with Frances Swaine, a partner at Leigh Day, a splendid firm in London that specialises in human rights, clinical negligence and much else, the like of which did not exist in Hong Kong. Unlike in Hong Kong, I could talk about the racism Hari suffered, and Frances understood. She was also tenacious and determined. We began the process of gathering expert medical opinion.

One of my biggest concerns was money. I always believed that the other side would try to make the process as costly as possible and thereby force me to quit or even bankrupt me. We tried to obtain insurance for the claim, but not a single insurer would oblige. I left no stone unturned in my efforts to fund the case, but to no avail. Ravi and I looked dangerously exposed.

Before leaving Hong Kong, Frances had urged me to apply for legal aid for Ravi. Alas, we were turned down. So we went to court, the process dragging on until at one point it seemed we were certain to lose. But eventually the court found in our favour and in 2006 Ravi was granted legal aid for his part of the claim. It was our first sniff of justice. Our potential financial loss was still intimidating, but at least it was now possible to pursue the claim.

As we assembled our expert reports, I came to understand in medical terms what had most likely happened to Hari. During her fit, she had been injected with diazepam in order to sedate her. The medical records stated that it was 3mg - a tiny dose appropriate for a baby. None of my experts believed the dosage, although it was impossible to prove otherwise. This is one of the great advantages enjoyed by a hospital and its staff: unless there is some way of proving otherwise, you have to operate according to the records.

The general opinion of our experts was that, in view of what subsequently happened, Hari had probably been given a much bigger dose. After the injection, she never recovered consciousness. Furthermore, a combination of the fit and the diazepam resulted in respiratory depression: while appearing to breathe normally, in fact she was not taking in sufficient oxygen and her oxygen levels began to fall. The doctor said he was present for the injection, but left immediately afterwards while Hari was still unconscious. The nurses failed to monitor her properly or take effective remedial action. After about 20 minutes, respiratory depression resulted in respiratory arrest: Hari stopped breathing. Even though I had come from home, I arrived at her bedside before the doctor. It was not too late to save Hari but, as I was to learn from the reports, they even managed to bungle her resuscitation.

A month-long trial was set to commence on 1 April. My team of lawyers consisted of a QC, Christopher Gibson, and Frances Swaine in the UK, and a barrister and solicitor in Hong Kong. Informed by the Woolf reforms, we made an offer of settlement. The other side did not bother replying. Eventually they came forward with a derisory offer that didn't even cover our costs. Trial awaited.

But then, with a little under a fortnight to go, a pre-trial hearing went against the defendants and suddenly they became desperate to settle. They were now staring at the very real prospect of defeat, despite all the cards having been stacked in their favour. They faced what for them was the nightmare scenario: being found guilty of clinical negligence which, in the light of Hari's now famous words about being "bottom of the pile", would be inextricably linked with racial prejudice by their staff. The Hospital Authority capitulated and offered a substantial sum in settlement. Because Ravi's case was being funded by the legal aid department, we were advised we had no option other than to accept.

In the death throes of negotiations, the Hospital Authority sought to insert a clause that would stop me from publishing, or causing to be published, anything concerned with the circumstances of the case. I said I would not be gagged. The truth was too important, the causes of Hari's death too profound. They climbed down.

Our 10-year struggle for justice is finally at an end. There is no joy, no happiness, no peace. Nothing can bring Hari back, which is all I want. Ravi lost his mother at the age of 16 months as a result of prejudice and negligence. If Hari had been white or Chinese, she would be alive today. If I had taken her home on the evening of 1 January, she would still be with me.

She was the most remarkable person I have ever known and she was cut down, with her life before her, by the most sordid combination of prejudice and incompetence. For us there is nothing to celebrate, but hopefully others will benefit from our struggle against all odds.

Martin Jacques is the author of When China Rules the World, published by Allen Lane