Everybody was up early as this was the first day of real medical work.

Part of team including Dr. Charlie Stolar, chairman of the department of pediatric surgery at Columbia University, were involved for the day with training in pediatric surgery for the Vietnam Pediatric Surgery Association with lectures and surgeries. During the day they worked with Vietnamese pediatric surgeons in the medical center's monthly review of special cases and were amazed at some of the severe cases where they might see something like once in three years, but here in Hanoi there were two cases already in that month's case review. For Dr Stolar and associate Dr Jeff Zitsman from Columbia University this was their first time to Vietnam and was astonished at the things they saw in the hospital there.

Another part of the medical team included Dr Stan Lowenberg, an otolaryngology doctor, and David McPherson, an audiology specialist from Brigham Young University, spent the day at the National Institute of Pediatrics (NIP) in Hanoi giving training lectures to Vietnamese doctors and looking at cases.

The remaining medical team members traveled to Kieu Moc village in the Ha Tay province to provide primary care for young children and some elderly as time permitted. As part of our group for the day there came along some Vietnamese doctors from Hanoi hired by Project Vietnam to help with the primary clinic. In addition, English-speaking students from the language university in Hanoi came along to assist with patients in interpreting for the Canadian and American doctors.

Kieu Moc village is a tiny village about 50 miles northwest of Hanoi and is beside the banks of the Red River. This village held a special importance for team member, Dr Ann Nguyen, as this was the village where she was born. As there were many of us on this trip out to the village a big bus transported us out to the rural village--probably too big of a bus for these small dirt roads. Nearing the village we came upon a small bridge which was had unfinished concrete work. I could not see how the bus driver was going to get the bus across but he did—after having all of us depart the bus and walk to the other side to lighten the load. Safely across we all jumped back in. For many of the team members this was the first time in the countryside, which was mostly a rice-growing region.

We soon arrived at Kieu Moc village where the driver drove the bus right upon the river levee--another daring driving endeavor by the bus driver. Already most of the village was there at the entrance to the town to greet us. Quickly villagers determined who their American relative (medical team member Dr Ann Nguyen) was and quickly swarmed her with hugs and tears. We then were escorted through the village to a community building where we invited to have bottled water and tea—and the village and province leaders welcomed the medical team.

After the welcoming ceremonies the team was led the village school, which was be our medical clinic for the day. Already there was a huge crowd from the village surrounding the school waiting for the free medical care. Quickly the medical team broke up into medical stations while the rest of the team tried to organize the check-in process that included a blood pressure reading for elderly people and weight/height measurements for all the children (which could be used later for growth information). Although no children were starving, many were undernourished and this accounted for them being under weight and height standards for their ages.

Jim Brennan, the medical team pharmacist from Missoula, quickly set up a mini-pharmacy in one of the school's rooms. Jim Brennan is a regular member on these teams and comes with Project Vietnam twice a year. Like many team members, he comes on these trips at great sacrifice in time and money. However, a huge bureaucratic roadblock soon prevented him from dispensing most of the medical supplies at this day's primary care clinic. The local province health authorities would not allow him to fill the doctor's prescriptions as the medicine had to still be approved by health authorities in the country's capitol of Hanoi. Obviously, this was a big disappointment to all the team members. For every medical diagnosis that needed medicines, it could not be given to the Vietnamese patients. Despite the bad situation it was hoped that a pharmacist could go back later and dispense the free medicine.

This humanitarian trip, like many others before, is still plagued by the bureaucracy process of the Vietnamese government. It is something the medical team has come to expect and has to endure. Everyone does their best but these setbacks while the doctors are trying to do their work can be frustrating. Giving free medical help and free medicine to the poorest people, within such a government, is not easy. Even though things can be better, much is done anyway.

The crowd at the free primary clinic was overwhelming at times for the doctors, as people shoved and pushed to get their children in to see the team of American and Canadian doctors. Often it seemed like a riot because of the size of the crowd and with them being overly anxious to see the doctors for the free medical care. I asked Jim Brennan, a regular on these trips, if it was always this bad. He replied, "Yes, most of the time it is worse". It was easy to ponder and get emotional at the scene of all these people badly needing medical care, but soon we all realized we had to "buckle down" and get to work.

I spent most the day assisting the American doctors with interpreting duties, listening to the parents and trying to convey their symptoms to the doctors. I do not know how many sick children I saw that day but I am sure the doctors saw 30 times more patients than doctors normally see in their average day. And, with being around so many sick children you would think surely I would have caught something but I was lucky to have not.

No doubt when the word spreads that American doctors are coming with free medical care, everybody will show up. By the end of the day the team had seen 1500 people. Many of the parents did not want to pass up the opportunity to see an American doctor for free and even brought their well children to see if there was anything wrong with them. These people are very poor and work hard in this farming area and except for severe medical problems, cannot afford to see a doctor.

Many of the children came dressed in their best clothes to see the doctors, as this was a special day for them. Some of the children had severe conditions that could not be handled by just this clinic and needed special treatment requiring a hospital and many weeks of care with need for an operation or many. All that could be done is to refer them to a province hospital or if lucky, go to Hanoi for more special treatment. Or, possibly receive treatment on a subsequent trip by Project Vietnam when they will be performing operations. Probably for most, they will not receive any treatment and perhaps have to live with the condition permanently. Although the team members feel they have accomplished much, it is those situations that leave them disappointed they cannot do more.

Finally the day came to end and everyone had to catch the bus back to Hanoi. But that left many still seeking treatment at the front of the schoolhouse. Probably the team could have worked till midnight and many would still be waiting for treatment. But the people kindly understood and the villagers—especially the children—gave us all a very abundant good-bye

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