ONE ONLY has to pass a store that sells caskets in Vietnam to see that death takes more than its normal toll in this little country. Unfortunately, children’s caskets outnumber the adult by a considerably large ratio.
As in most of the under-developed nations, the major problem in Vietnam is communicable disease. This is primarily due to the fact that neither adequate preventive nor therapeutic health measures have been fully developed. Illnesses which take an alarming toll are malaria, other insect borne diseases, tuberculosis, intestinal diseases, diphtheria, whooping cough, measles, plague, cholera, typhoid, etc.
Due to the war and its effect on civilians, social welfare also presents a grave problem.
The first doctor in Vietnam was Tue-Thin, a bonze, who lived during the 10th century. Early in his life, he studied to be a teacher.
King Dinh-Tien-Goang wanted to make him a court mandarin, but Tue-Tinh refused because he consulted the Book of Prophecies and learned that the Dinh Dynasty was to be only a transient one.
He told the king that he wanted only to be a good teacher. When the king insisted that he accept, he had to flee to another province from his home. Angered, the king sent an expeditionary force to look for Tue-Tinh, but by this time the bonze has escaped to China. He settled at the Pagoda of Vanphuc which was called the "land of Confucius."
One day the bonzes of this pagoda were visited by Duong-Quang-Thanh, the most celebrated doctor in China at that time. He was very impressed with the bonze Tue-Tinh, and he offered to teach him the art of medicine.
Tue-Tinh gratefully accepted and studied under the master of medicine for ten years. He was said to be an even greater doctor after ten years than his teacher.
The bonze felt the desire to go home again and asked his teacher for permission and it was granted. When he got back to Vietnam, he found that the Dinh Dynasty had, indeed, ended as the prophecy said, and Le was now the king.
Tue-Tinh took up the practice of medicine in the old pagoda in Hong-Van, was so versed that he became famous and was soon overwhelmed by the number of his patients. He took in students, who in turn became well-known.
King Le-Trung-Ton was care for and healed by Tue-Tinh at one time when there was little hope for the king’s recovery. Later, when Tue-Tinh died, the king ordered that an official cult be instituted in his memory and that a temple be erected.
Tue-Tinh was the first man to bring medicine to Vietnamese on a national basis. He did a great deal of research and wrote his observations in a book written entirely by hand, Nam-Duoc (Medicines of the South).
At the present time in South Vietnam, there is only one graduate physician for approximately 28,000 people in the country. This is further complicated by the fact that the majority of the physicians available are in the army.
To alleviate the shortage, other Vietnamese have gone into their own business, labeling themselves as "bac-si" or "doctor." Westerners refer to them as "quacks," but many of these herb doctors are highly respected by the Vietnamese, the literate as well as the illiterate.
Sometimes it is a hard decision for a Vietnamese to make when he must decide whether to use Western methods or Oriental drugs. If it is an emergency, they will usually take Western medicine. If they are not in a hurry, they generally prefer Eastern concoctions which they believe to be slower, but surer.
There are two types of drug stores in Vietnam. The traditional Oriental shop has one or two large chests with hundreds of tiny drawers containing medications. At the cashier’s counter, there is a brass mortar and a pig-iron grinder. This, plus the abacus, is all the equipment needed for preparing remedies.
The Occidental type, or Western pharmacy, on the other hand, has shelves loaded down with numerous little bottles and boxes. Most of the medicines are already prepared.
Though the appearances are different, in some circumstances the medications are very similar. Fort instance, both types of pharmacies stock quinine for malaria, artemisia for backache, etc. Some Eastern medicines have been accepted by Western experts as "law."
While the Western field of medicine is constantly improving, the Occidental one has not changed in thousands of years.
For centuries, Oriental practitioners have been looked upon as altruistic scholars. There are very few textbooks on traditional therapy and most of the physicians have to improve their knowledge by experience and usually earn their reputation after years of practice.
Vietnamese medicine stems from Chinese therapy of centuries ago. The best-known figure in traditional medicine is Hai-Thuong-Lan-Ong (Le Huu Chan) from North Vietnam. He wrote a complete series of medical books in the 16th century which are followed today by Oriental practitioners.
Theory
of Oriental
Medicine
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According to traditional medical theory, the human body includes five main of Oriental internal organs: heart, liver, spleen, lungs, and kidneys, plus six secondary viscera. Besides having a close connection with each other, these organs are also considered closely related with the five senses represented by the tongue, nose, ears, eyes, and mouth. Five juices: sweat, urine, sputum, saliva, and tears; the five tastes: salty, bitter, hot, sour, and sweet; the five colors: red, blue, black, white, and yellow; and five types of weather: hot, cold, windy, dry, and humid, all play an important role in the theory. In addition, the body is considered to undergo the influence of five natural elements that surround it, metal, wood, water, fire, and earth, plus the five directions of north, south, east, west, and center.
The Oriental doctor practicing traditional medicine also believes in the concept of a close connection between the universe and the human body. Therefore, he must be versed in many sciences, such as physics, mathematics, astronomy, and astrology.
By tradition, the physician should be altruistic and not out to earn a lot of money. Though many have become wealthy, many are content to live modestly, and often treat the sick free of charge.
Doctors practicing traditional medicine should not be confused with the real "quacks" giving medical advice on street corners and selling their wares. Unfortunately, many Vietnamese put their trust in these "overnight" doctors and pay out large sums of money to them. Though Westerners may frown on the doctor practicing traditional medicine, there is a vast different in their methods of practice and these street corner merchants.
A FEW IMPORTANT STATISTICS
In all of South Vietnam, there are approximately:
- 800 physicians, 500 of whom are in the Armed Forces
- 75 dentists
- 380 pharmacists (Western oriented)
- 1,200 midwives
- 3,100 nurses at various levels, including non-graduates
- 4 sanitary engineers
- 140 sanitary agents
- 3,500 village health workers
The Vietnamese government’s Department of Health conducts the medical program in South Vietnam. It is responsible for technical direction to almost all of the hospitals in the country. A few private institutions, mostly in Saigon, are excepted.
The Department of Health maintains training schools for nurses, midwives, and auxiliary health personnel. A typical provincial health department will have a hospital with 100-300 beds and supervises a varying number of district infirmary-maternities and health stations. All of them are under-staffed, and many of the smaller units are run by midwives and nurses. An American joke that is only too true is that "semi-private" in a Vietnamese hospital means two in a single bed.
What is
Being Done
to Help
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The major help for South Vietnam’s medical problems is now coming from the United States. Of the various United States sources, the main help comes from the American government aid program.
The Agency for International Development (AID) programs has worked toward expansion and improvement of the medical college in Saigon. Plans are in effect which will bring 150 new graduate physicians into practice each year beginning with 1966. U.S. aid has also assisted in the building a new medical school at the University of Saigon, including a school of dentistry, a biochemical laboratory, a library, and an auditorium.
An extensive effort to cope with the predominant disease conditions by developing and enlarging upon the basic health facilities in Vietnam by the government, is being supplemented with help from the AID program. American teachers have been supplied to the Vietnamese government until more Vietnamese can be trained both at home and abroad.
A Department of Preventive Medicine has been established with malaria eradication as one of its principal goals.
The Rural Health Program trains auxiliary health personnel to perform as health workers in the countryside. Though their work is simple, it is much needed and can often save hundreds of villagers’ lives. For instance, a child in Vietnam may lose his sight because of the lack of simple antibiotic treatment. There are thousands of blind people in the country whose sight could have been saved with this simple treatment. The Rural Health workers are trained to recognize such diseases and treat them. The U.S. Army Special Forces also work as medical cadre in remote outposts. In recent months other military personnel have joined in this work, holding sick call along with their military operations.
Health films are now presented and lectures are given throughout the country in an attempt to educate the people in the ways of sanitation and good health.
Surgical teams provided by the United States, Korea, the Philippines, Australia, New Zealand, Italy and Taiwan, are now performing surgery in the provinces.
"Project Vietnam," the result of President Johnson’s call for medical help in June of 1965 is also in effect. The program calls for $500,000 grant aid from the agency for International Development to be administered by the People to People Health Foundation.
It is a 3 year plan to help with increased civilian casualties on account of the war. Twenty American doctors will serve for 90 or more days in hospitals in Vietnam on a rotating basis under the program. Response from medical personnel in the United States has been quite good.
There are two nursing education centers in South Vietnam. One is in Saigon and the other 600 miles north in Hue. More dormitories and class rooms have been constructed. Other assistant nurse programs have been improved.
Many private agencies have lent aid in the medical field in Vietnam. There are far too many to enumerate here, but a few of the best-known include the following:
The Care-Medico program has sponsored one-month tours by American plastic surgeons, orthopedic surgeons, obstetricians, gynecologists, and general surgeons in the medical facilities for several years. The physicians pay their own expenses to Vietnam and donate their time. In addition, Project HOPE maintains a full-time Orthopedic Clinic in Saigon with an American Surgeon in residence.
American heart specialists have made periodic visits performing operations and demonstrating to medical personnel the latest techniques to treat heart diseases.
The United Nations Children’s Fund has worked closely with South Vietnamese government in implementing laboratory services, nutrition courses, and leprosy control. They have also provided equipment for the creation of three mobile teams, including laboratory equipment, drugs, and vehicles. Funds have been contributed for a maternal and child health center, tuberculosis control and community education programs.
Often the things that people remember most, no matter where they live, are the events that are quick and dramatic. In Vietnam, one group of Americans came in the height of a cholera epidemic and quickly earned the reputation among those witnessing their work as being the American Magic Men.
During this major epidemic, the U.S. Navy applied its latest cholera techniques, helping to save thousands of lives. Captain Robert A. Phillips was the Commanding Officer of the first team to arrive. He is credited as being one of the major "inventors" of the successful cholera treatment which is now being accepted around the world.
Basically, the treatment is an effort to replace fluids which have been lost as a result of diarrhea. The antidote consists of infusions of saline solutions and sodium bicarbonate. Rapid infusions and constant nursing care are vital to the treatment.
As a witness to this terrifying disease and having seen the patients brought into hospitals in comatose states with little hope of survival, I, along with the Vietnamese attest to the magic qualities of Captain Phillips and his men during their stay in Vietnam.
There have been hundreds of people, including Vietnamese, Americans, and French, who have worked quietly for their fellow man in Vietnam, without any thought of recognition or payment. Now, there are more coming from other friendly countries. Though they may despair at times because of the size of their chosen tasks their efforts are greatly appreciated by the individual Vietnamese they have helped. Their work is generally done in off-duty hours and there are no headlines proclaiming their good work. People like these are making a contribution that cannot be measured in dollar marks or words and certainly deserve the admiration of their fellow man.
SOCIAL WELFARE
Because of the war in South Vietnam, social welfare, for the most part is in a state of chaos. Here again, many voluntary agencies are assisting. Some of them include: CARE, Foster Parents Plan, Catholic Relief, Oxford Committee for Famine Relief, International Voluntary Service, Belgian Caritas Organization, The Red Cross, and The Asia Foundation. The Vietnamese government organizations and those from official American agencies continue their work under the worst possible conditions.
There are a few traditional social organizations which play an important role in Vietnamese rural village where most of the people live. Some of these organizations have remained unchanged for several hundred years. They still function where any degree of peaceful living can be maintained. They include:
Religious Womens'
Association
"Hoi Chu Ba"
Little Helpers
| |
If a village has a Buddhist pagoda, it will more than likely have a Buddhist Old Women’s Association. It is an organization for women at least fifty years of age or older. A few women who are widows in their late forties are also accepted.
These women are usually free of household cares because they are older and their children are grown. Normally, they are being supported by their children financially, so they are free to join the association. The old women try to go to the Pagoda each evening and study Buddhism and pray for the salvation of their souls.
They engage in welfare activities and also go to homes where a death occurs to pray for the deceased and help the family.
Professional
Guilds
"Hoi Bach Nghe"
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In the past, most villages have been relatively economically independent. Foods, building materials, etc. are local products and every village usually has its own carpenters, blacksmiths, painters, masons, etc. Each trade has its own guild.
The guilds work at improving skills and also promote mutual friendship and help when in need. Gifts and cash are given to members on such occasions as marriage, child birth, and death. Needy or extremely large families are sometimes helped on a regular basis.
The group often has an investment club financed by the dues collected. These profits are distributed yearly among the members. A few of these guilds do not have dues. Instead, wealthy members contribute funds when the organization is set up.
If a member of a Mutual Aid Society is in need of funds for a funeral, wedding, special building project, etc. he applies to the chairman of the society. The chairman goes to other members and collects a sum of money as specified in the regulations and gives it to the person in need. In the case of death, members of the society help the bereaved family and dress in mourning attire and accompany the burial party to the cemetery.
The Emperor Tu-Duc (1847-83) declared that a relief fund would be set up in every village in the land. Farmers would contribute rice based on the acreage they cultivated. The relief fund is supposed to be closely regulated, with officers making spot checks and accounting for funds and rice. In the event of a flood or other disaster, the rice is distributed to needy people.
There are many other such organizations in the villages. But those described above seem to be the most popular, with each succeeding foreign influence; i.e., the French and the Americans, new institutions
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