Winnie Jiang's Trip Report

My Trip Report as a VNHELP Observer on

Project Vietnam Spring Trip

March 22 - April 1, 2001

Winnie Jiang

Earlier this year VNHELP was approached by Dr Quynh Kieu of Project Vietnam with a proposal for financial assistance for many of the charitable medical projects that Project Vietnam does in Vietnam with medical volunteers twice a year. After some consideration of the proposal by the VNHELP Board of Directors and Project Committee, it was decided to provide funding for the spring trip of Project Vietnam.

Project Vietnam is a non-profit humanitarian program founded in 1996 by Chapter 4 of the American Academy of Pediatrics by concerned Vietnamese-American pediatricians. Project Vietnam is supported by medical personnel from several organizations from both the United States and Project Outreach from Canada. The members of spring trip medical team, which I accompanied, came from California, Utah, Montana, New York City, Boston, and Project Outreach members came from Calgary, Canada.

Dr Quynh Kieu, a well-known and respected pediatrician from Fountain Valley, CA, is the energetic coordinator for the Project Vietnam organization. She is a remarkable person in this effort as it is no easy task to continually obtain funding and to continually solicit medical professionals such as surgeons, pediatricians, newborn specialist doctors, emergency care physicians, respiratory therapists, audiology specialists, anesthesiologist, pharmacist, nurses, to name a few, who will travel to Vietnam, paying for their own expenses and providing their professional services for free.

Upon approval of the VNHELP funding for the Project Vietnam spring trip, Thu Anh Do, Chairperson of the VNHELP Board of Directors, asked me if I would spend a few days with the Project Vietnam while they were in Vietnam as an observer in the interest of VNHELP. This turned out to be a compatible request as I had already planned to be in Vietnam about the same time traveling with my aunts from the United States to our hometown of Qui Nhon. I gladly accepted that offer and decided to leave one week early to spend the entire week with the medical team. It certainly will always be one of most memorable weeks in my life.

The medical team traveling on this spring trip had four main activities they were to accomplish. Not all tasks to be done by the Project Vietnam on their trips involve "hands-on" medical help directly to the patients. They realize that not everything can be done in one trip and therefore, they take time out to train the Vietnamese doctors on procedures that will helpful for the Vietnamese doctors to be more effective after the Project Vietnam team leaves. The medical team that travels in the spring is smaller than the November trip, when more surgeries are performed and stay longer than a week. The four activities to be performed on this spring trip by Project Vietnam were:

1. Seminar at the National Institute of Pediatrics (NIP) located in Hanoi (topics were newborn and emergency care, audiology, and infections disease). Also, at the NIP give training course in Resuscitation with final certification by medical team.

2. Training in pediatric surgery for the Vietnam Pediatric Surgery Association with lectures and surgeries by the team from Columbia University led by Dr. Stolar, chairman of the department of pediatric surgery.

3. Presentation to healthcare leadership of Ha Tay province on resuscitation and neonatology topics and launching of the Vitamin K pilot program for newborn babies.

4. Provide for primary care clinics at need communes in Ha Tay province—mainly for small children and for some sick elderly as time and personnel resources allowed for.

A big emphasis on this Project Vietnam trip was to initiate a Vitamin K program for newborn babies. VNHELP has donated funding for this effort to provide for 10,000 doses of Vitamin K and disposable syringes. Every year about 12,500 newborn babies are hospitalized with brain hemorrhage. Of that number 2000 of them die and countless others suffer brain damage because of Vitamin K deficiency. This can be prevented with one injection of Vitamin K after birth at a cost of 50 cents per baby. Project Vietnam intends to set up a pilot project in Ha Tay province near Hanoi, as this province accounts for 34% of the babies with severe bleeding hospitalized at Hanoi hospitals.

Once the Vitamin K program objectives are met in the Ha Tay pilot program, protection will be provided for 52,000 babies born annually from Vitamin K deficiency hemorrhage. Training will be provided for provincial healthcare staff for implementation of the program. There will be public education provided about the risks of Vitamin K deficiency to newborn babies.

Another of the goals of this Project Vietnam spring trip was to have a primary care clinic provided by the Project Vietnam medical team. Subsequently, Project Vietnam will set up an ongoing free health clinic for the village of Kieu Moc in the Ha Tay Province. VNHELP provided funding for these two efforts.

The primary care clinic was held to examine patients and provide free medicines. As previously agreed to, most of the patients that were seen were small children and many elderly. For the elderly high blood pressure and diabetes tests were given. There is a high rate of hypertension (high blood pressure) in Vietnam and especially so in the Ha Tay area. This symptom largely goes untreated due to the unaffordable cost of medicine for high blood pressure.

The ongoing free health clinic for Kieu Moc village will be paid for by Project Vietnam (with funding donated by VNHELP). Volunteer (and paid) physicians from Hanoi University and the National Institute of Pediatrics (NIP) will staff the clinic twice a month. VNHELP provided funding for one year (24 clinic sessions). This will be a tremendous boost to the health of that part of Ha Tay province.

Although I was unable to accompany the pediatric surgery doctors to NIP as I was with the other team members in Ha Tay and Quang Binh provinces, I know they had a very successful week in Hanoi conferring with NIP pediatric surgeons on special patient cases. Additionally, they provided training and lectures to NIP doctors to assist them in doing a better job at NIP, despite limited resources in comparison to American hospitals.

Additionally, an audiologist and an otolaryngology doctor (ear, nose and, throat doctor) provided for lectures and training at the NIP. Also, at the NIP, Jeff Ung (respiratory therapist from the Alberta Children's Hospital in Calgary, Canada) worked with the NIP medical personal on use of respiratory equipment donated by Project Vietnam and Project Outreach. Jeff also was able to fix many of the broken respiratory equipment that had previously been donated and had become unable over the last year.

Part of the Project Vietnam medical group traveled to the Quang Binh province to hold seminars and to confer with medical personnel at province medical center at Dong Hoi and at Quang Trach hospital. I accompanied these team members, led by Dr Quynh Kieu, on this two-day trip.

This side trip to Quang Binh provided a unique "Vietnamese experience" for the American and Canadian team members. After putting in a full day on Wednesday, the team members departed Hanoi at 930p for a 12-hour overnight train ride to Dong Hoi. This was definitely not the express train and beds we slept on in the sleeper cars were "hard beds"—meaning they were wood beds with a thin straw mattress. There were six beds to a cabins and no air conditioning, which required the windows to be open, making it very noisy with all the train and track noise. Although seemingly uncomfortable, all of us were too tired from the day to notice and slept anyway—considering it a night to remember.

On Thursday morning we arrived at Dong Hoi in Quang Binh province. The medical team spent the rest of the day giving a training seminar at the province medical center in Dong Hoi with American and Canadian doctors giving training in resuscitation and pediatric emergency techniques.

After an overnight stay in Dong Hoi, on Friday the medical team traveled to Quang Trach Hospital located northwest of Dong Hoi. There the team gave some of the same training lectures. Subsequently, the team toured the hospital and conferred with the doctors. Before departing, the Project Vietnam team gave much needed medical equipment to the hospital. They were very happy to get this equipment. Otherwise, they are forced to work with very old equipment or do not have enough. At the end of the day, the medical team traveled back to Dong Hoi to leave on the train for the overnight trip back to Hanoi. This time, Dr Quynh Kieu had secured space on the express train from Dong Hoi to Hanoi—which had soft beds (soft mattress with clean sheets and blanket), air conditioning, and was a much shorter train ride.

We arrived back in Hanoi at 500am Saturday where we met the rest of the Project Vietnam medical team at the hotel later. With all planned work done, the entire Project Vietnam team made an excursion to the Tam Dao Mountains on Saturday. That evening the final banquet dinner was held with special guest from the Hanoi medical community. On Saturday all members departed for home except for team member, Dr Chris Stewart, who stayed for an additional two weeks to do more volunteer medical work.

My reflections at the conclusion of the Project Vietnam spring trip were varied. But the biggest thought of all—like everything in life—it all comes down to the individual people. It is the people of Vietnam…it is the people of the dedicated volunteer medical team.

Everywhere we went the Vietnamese people who were treated by the doctors were always appreciative. Everybody on the medical team could not help noticing that no matter how poor they were they always had smiles and seemed happy. And, certainly the Americans and Canadians on the medical team always noticed how well behaved the children were and constantly remarking how "cute" all the children in Vietnam were. Everybody enjoyed the children throughout the medical mission and there were always a motivation and satisfaction factor for the doctors.

It is an inspiring thing to see these doctors from the U.S. and Canada come to Vietnam with much sacrifice in money and time. Most have families who support their husbands and wives to take a week out of their family life, to donate a week or two during the year, to treat strangers in a foreign land, without absolutely any compensation except for the personal satisfaction of helping people. For that, members of the team have earned my admiration and the medical team members I worked with on this trip will be good friends for life.

Practically everybody on the team makes sacrifices to go on these charity medical missions. Take for example, Jeff Ung, a respiratory therapist with the Alberta Children's Hospital in Calgary, Canada. Because he is a hospital staff member, he has to juggle his work schedule around for 1-3 months working 7 days/week in order to get enough time off from work. And, then have others cover for him in his hospital position in his absence while away in Vietnam. And, then he leaves his wife and two children, who support him in doing this medical work, to go half way around the world and work for a week free.

And, there is Dr Chris Stewart on the team, who lately finished his residency out of UCSF Medical Center. He worked with the Project Vietnam team for a week and then stayed another two weeks to help treat the Vietnamese sick. So, he gave up three weeks of salary and paying for his own living expenses for the sake of treating the sick of Vietnam.

But I always noticed, not only did these doctors cared about professionally doing a good job and willing to work long hours while in Vietnam, they also took time out to enjoy and know the country—and appreciate the people. All recognized that they would go home with a different perspective of their own life and country. And, more importantly they go home with a different perspective of their own professional occupation.

Everybody worked hard during the week and the doctors accomplished as much they could within the limits of inadequate facilities and far too many patients to adequately devote the proper time to each. But it is far better than what the Vietnamese patients would have otherwise received.

But despite much that was accomplished and many things planned well, it is easy to notice that some things could go better. Most noticeable at the very beginning, the inability to get Government approval to use and distribute the free medicine brought from the United States. By the end of week—and the medical team had already left—the medicine still had not been released by the Government and distributed to the people. Such was the case at the Kieu Moc village where doctors saw patients, wrote prescriptions for their illness, and then could not give them the free medicines for the prescriptions for which they had written. And even now, it is unclear if the free Vitamin K medicine is being utilized yet in the treatment of newborn babies in the Ha Tay providence.

Getting Government health officials to approve the free medicine brought into Vietnam from the United States has always been a problem on past Project Vietnam missions and it was no different on this trip. Invariably it will mean a delay in getting the medicine to the Vietnamese patients seen by the Project Vietnam medical team. Or, if distributed later after the medical team has left, the medicine might not get to the Vietnamese people at all. Or, the Vietnamese officials might charge the Vietnamese people, for what is to be free medicine for the people.

In some way this problem needs to be worked out in the future as it may result in donated medicines being misused or wasted. And, certainly the credibility of the medical team is jeopardized. It does not look good when doctors diagnose an illness, prescribe a medicine, promise free medicine for them, and then they never get the medicine one or two weeks later—or perhaps not all!

But despite these setbacks, the medical team does accomplish a great deal. Without these doctors coming to the rural areas, most of these people probably would never see a doctor for their illness. Hopefully, the problem of medicine distribution will be solved soon.

Overall, it was a very stimulating week for me. I saw many people in medical need and I saw a devoted bunch of doctors trying their best to meet their needs. All the doctors came away--myself included--with a good feeling of helping others. And, with that feeling of satisfaction the Vietnamese people gave us all something in return. And, if nothing else, the side benefit of it all is to bring the countries together down at the people-to-people level. And, yes, I would love to do it again helping the medical team in any way I can contribute. That is my answer to a wonderful week

	Winnie Jiang
		jiangpooh@yahoo.com winnie.jiang@deca.mil