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Vietnam's Health Crisis and Peace Village Medical Clinic

By Sally Swope

Vietnam's health problems are almost overwhelming. Most health care providers lack even basic running water in treatment rooms. Lab testing is rudimentary at best. Surgical and anesthesia equipment is antiquated and in short supply, and intensive care units as we know them are virtually nonexistent. Dentistry and preventive medicine are rarely practiced.

Dr Peter Singer, an endocrinologist in the Department of Medicine at the University of Southern California in Los Angeles, also serves as President of the Board for East Meets West Foundation based in Oakland. He returned to Vietnam in 1991 and a hiatus of 24 years.

Dr Singer explains, "When I was in Danang between 1966 and 1967, I worked in the same hospital as the one I recently visited, and I saw absolutely no improvement—perhaps even further deteriorations."

"In 1990, the Vietnamese government's health budget was $67 million, approximately $1 per person. Contrast with health expenditures in excess of $2,500 for every man, woman and child in the United States."

Although health officials in Vietnam are aware of the complex problems, the country is so poor that they scarcely have the resources to tackle their health problems. The government no longer pays for primary care, deliveries, operations and aid to thousands of veterans with persistent problems due to injuries from recent wars with Cambodia, China and the U.S.

Many U.S. nonprofit organizations such as East Meet West Foundation (EMWF) in Oakland contribute significantly to improve the health status of the Vietnamese. EMWF makes a critical difference due to physicians and other professionals, who teach and work at Peace Village Medical Clinic in Danang.

Dr. John Murphy, an emergency room physician who practices at Marin General Hospital, worked for three months in Peace Village Medical Clinic last spring. "Physicians in Vietnam don't have high-tech medicine. They lack training, resources to make diagnoses, and technology to provide the best care."

"It's our goal to interrupt this cycle at as many points as possible with increased resources, better training through cultural exchanges and with more volunteer medical personnel in Danang. We hope that Peace Village Medical Clinic will play a major role in this training process for years to come."

Beside training physicians, other critical problems are related to communicable diseases and nutritional deficiencies such as iodine deficiency in mountainous areas that leads to cretinism and mental retardations.

Although the government's efforts to control infectious disease has decreased infant mortality, many infectious diseases that are easily treated in the U.S. often go under-treated or unrecognized. Another medical volunteer in Peace Village Medical Clinic for three months, Linda Meier, is a nurse practitioner at San Francisco State University.

She explained, "Many children were insufficiently immunized or not at all, and they devolved polio. Yet the government exaggerated the statistics about who was immunized, which prevented a more effective public healthy programs from being implemented."

Also there is a mounting incidence of AIDS in Vietnam. CARE recently published a report on sexual attitudes of adult men about transmitting AIDS and the result portends a potential nightmare.

"Vietnam is drowning in children," added Debra Burke, who directs EMWF's overseas programs for its first years and holds a masters in public health.

"Soon 50% of the entire population will be younger than 15. While there is a two-child family policy, only educated urban families find family planning affordable and accessible."

Unfortunately, 80% of the nation lives in rural areas where the primary methods of birth control are abortion and IUDs. To help the situation, EMWF recently added a gynecologist to the staff of peace Village Medical Clinic.

To highlight the shortage of supplies, Dr Singer added, "A Vietnamese colleague pointed out that insulin was in such short supply that diabetic youngsters could die unless their parents could afford to buy insulin. This was hard to fathom—I'd never encountered this here."

Many patients told Ms. Meier about a huge back market where Western medicines, especially American ones, sold at higher prices. "Often appropriate medicines were not available, in part due to cost. For many Vietnamese, the cost of a week's supply of penicillin is comparable to buying a new car."

In Vietnam, the health care issues are every bit as perplexing and complex as those we face at home, but the major difference is the limitation on care due to economic factors. Despite many drawbacks to practicing medicine in Vietnam, the system is not yet bogged down by high-price malpractice suits nor expensive insurance premiums. And in many clinics such as peace Village Medical Clinic, patients can choose both Western and Chinese medical treatments.