Viva Vietnam!
Alan Huynh gives an account of his recent elective in Ho Chi Minh City, Vietman
Cho Ray Hospital’s main courtyard
Cho Ray Hospital is one of the largest and oldest hospitals in Vietnam. Its 1200 bed facility services Ho Chi Minh City, a bustling metropolis with a transient population of over 9 million people. Given its longevity and recognition within the wider community, the hospital also attracts patients from Vietnam’s rural hinterland, many of whom travel for hours with family to use the reduced costs medical care offered by the public health system. It has a well established student elective program which accepts on average about two international students a week. I spent my time there in the Emergency Department (ED).
Emergency departments tend to the busiest in hospitals. Cho Ray’s ED was busiest than most. The majority of the city folk use older style Honda motorcycles as the primary means of transport. During the time I was there, helmets were not compulsory (which changed from 15 December 2007) and rarely worn. Moreover, road regulations never seemed to be followed nor enforced so head traumas from road accidents comprised a sizeable number of the cases presented. Suturing is one of the most oft performed procedures, one that Vietnamese medical students quickly become competent at. However, it was disheartening to see so many cases which could have so easily been avoided by a simple protective action.
Given that most of the population cannot afford to pay for necessary consultations and medicines, many choose to delay seeking treatment until the condition has become serious. Complications from cardiovascular, numerous musculoskeletal, urological and gastrointestinal conditions were seen, many of which would have been prevented had the patient sought assistance much earlier and diagnosed. Equally as sad was the need for people to queue for long periods of time for medical attention. Waiting relatives would often sleep in the main courtyard if all the covered resting spots were occupied.
However, throughout all of this and as a result of working closely with the same team of doctors and nurses during my stay, I came to realize that like all medical institutions around the world, there was a genuine commitment to improving the lives of other irrespective of the facilities and resources at their disposal. It was a phenomenon which could be sensed quite easily despite the cultural difference and communication difficulties.
To those concerned about language barriers, rest assured that the doctors who directly supervise medical students do have a good grasp of English. Most medical and nursing staff are accommodating and regularly offer elective students opportunities to be apart of a consultation and perform basic procedures such as cannulations, suturing and plastering. They are equally as quick in shuffling along to you to meet any foreign tourists who happen to venture into the ED (and there was at least one case per shift during my time there), mostly unfortunate victims of travellers’ diarrhoea.
Logistically, the ED works on 3 day rotation. Day 1: 7am - 2pm; Day 2: 2pm - 9pm and Day 3 9pm - 7am; repeat, with about 30 mins set aside for meals and a couple of hours for sleep during the late shift. Some of the Vietnamese medical students on the 9pm - 7am shift even had to give presentations a mere 3 hours after finishing their shift! Other departments operate on the ‘normal’7am - 4pm schedule with a break for lunch from 11am - 1 pm, with enough time to catch a quick nap.
With the varied hours and late finishing times, we decided to stay at a hotel close by in the
Chinatown district. We got good facilities and services at a reasonable price and were able to enjoy the local cuisine quite affordably. The locale is peppered with street markets whilst more established shopping precincts could be found in Cho Lon, An Duong and Cho Ben Thanh, all accessible by public transport or a for relatively cheap taxi fare. Walking tours of popular tourist areas were available but nothing compared to the thrill of discovery and sense of adventure in exploring unfamiliar surrounds independently. A day trip out to Cu Chi to view the extensive underground tunnel system built by the Vietcong during the Vietnam War was also worthwhile despite the long bus journey. If so desired, Vietnam is also an excellent launch pad for Southeast Asia but given our extended stay, we still felt that there was a lot more of the country which remained unseen. A return trip is definitely in the works.
In concluding, some words of advice: do your research and apply early, go in pairs or small group to ensure safety and to minimise costs, eat out but choose your dining destinations, don’t forget your insect repellent and travellers’ medications, which if you don’t use, can easily be donated to the hospital for its rural outreach programs. Most of all have, if you are open towards experiencing a different culture and how medicine is practiced in this context, I’m sure you’ll enjoy your time in Vietnam as much as I did.
Alan Huynh
First year medical student
University of Queensland
Queensland
Australia
alhuynh@hotmail.com