A is for Assessment

Have you noticed some changes in what we have been posting lately? With your help VNHIP recently provided a little girl and her grandmother who had no mode of transport with new bikes! We are also in the process of raising money for a family to build a life changing toilet in their home! Our aim at VNHIP is to improve the health of individuals and communities in Vietnam and our organization is growing and understanding that the concept of ‘health’ is multifaceted and that health needs are not limited to medical care and treatment. 
 

Earlier this year the team developed a tool to assess the holistic health of children living with HIV currently in our program. Each child and their family are now being assessed annually on not only their physical health but also their emotional, social and environmental health. Evidence is stacking up internationally that all of these dimensions of health are intrinsically linked http://www.who.int/social_determinants/en/ . This assessment helps us identify needs (like those mentioned above) and you, our wonderful supporters, generously help us meet them!

The information gained in this process has invigorated not only those in the program but also the team at VNHIP. It has definitely challenged us to put our thinking caps on as we partner with these children and families while they hurdle obstacles every day. The assessment is breaking down barriers and helping us gain a deeper understanding into the lives of these children and their families, their joys, their challenges and their sorrows. One thing which we have learnt is that many of these families have multiple health needs which they can not possibly meet on their own and that there is a constant battle in choosing which of these needs is the bigger priority.

While this assessment can be somewhat confronting and emotionally challenging for everyone involved there are some truly beautiful moments. My favourite part of this assessment is when we ask the child and their carer what their personal strengths are. Even though I don’t speak Vietnamese I know when this question is asked – the general response is a startled look and either a laugh or a shake of the head. Sometimes there is no answer, sometimes there is a blush in response, and sometimes the child says 'I am strong' or 'I am caring' or 'I am honest' and every time it totally blows me away.

Free dental care for those in dire need

The problem of dental decay in Viet Nam is escalating rapidly. According to a National Oral Health Survey (2001), more than 85% of 6-8 year olds are affected by tooth decay. It’s a particularly significant issue for the children with HIV that we work for whom oral hygiene is even more important for a range of reasons. For example, such decay and possible systemic infection if untreated are much more serious.

East Meets West http://eastmeetswestdental.org/   is an international NGO who sees private clients which in turn helps fund the charity work they do in schools and with other identified groups in need such as VNHIP.  Recently we partnered with East Meets West in Da Nang city to have the children we work with assessed, something we now hope to do annually.

We had noticed that many of the children we work with had frank and visible decay. While there are local dentists this is not without its problems. On one such visit recently at a large public hospital, the dental staff were clearly discomforted that they were treating a child with HIV. They also suggested there was no issue with the several rear molars that were brown and broken off half way down the shaft and that we should just wait for them to come loose. This is in stark contrast to western thinking  re oral care, and likely represents a lack of up to date training for the staff.

The staff at East Meets West were extraordinary in their warmth and commitment to making the kids comfortable and giving them the time they needed to adjust to the unfamiliar environment and the work that needed to be done. The director showed them how to brush their teeth on a model jaw, they watched DVDs to reinforce the message, and took home new toothbrushes.

To give you some idea just how necessary our dental visit was, one young person alone had 7 fillings and one extraction in just one side of his mouth and will need to return for further work. Another young girl had frank and visible decay not only on her rear molars but on almost every visible tooth. For all the children that were seen we know that this work has prevented much more serious dental, and broader resultant health, issues down the track.

VNHIP is very grateful to East Meets West for their support and expertise.

A REWARD

During Non- Communicable Diseases (NCDs) project implementation, it’s always satisfying for the VNHIP team when we get to witness the patient’s disease become better controlled and the capacity for health care management of NCDs at the local level improved. One of the districts we are currently working in is Duy Nghia - a beautiful island where the living standard is still relatively poor.

One client presented with both Hypertension and Diabetes. Five months ago, doctors at Danang hospital where he initially sought treatment suggested he needed insulin injections, which he commenced. This proved very difficult. Too frightened to inject himself, he attended the clinic in his local town daily for them to inject him. He then decided to seek treatment at nearby Duy Xuyen district hospital instead. Although he took the medicine as it was prescribed to him, his blood pressure and blood sugar level were not controlled to acceptable levels.

He was recommended for the VNHIP NCD trial where he has attended for around one month now. Within one month’s treatment following our NCD Management protocol and guidelines, his blood sugar decreased to 7.1 mmol/l and his blood pressure was down to 130/80 from 160/100.

While the medication used in the VNHIP protocol is the same used in Duy Xuyen hospital or Da Nang hospital, one of the major differences of the VNHIP protocol for commune health center is its focus on patient counselling and education, which happens on a fortnightly basis to begin with. Throughout this process, local medical staff come to more easily understand the personality, circumstance and condition of the clients. They also get to know whether the medication is working, side effects and any other barriers to compliance with treatment. Just as importantly where NCDs are concerned, conversations happen about lifestyle factors contributing to disease and to self-management. While such information counselling has become pretty standard fare in the West, it is still a rare phenomenon here in Viet Nam.

During a follow up meeting with Quang Nam Department of Health, Dr. Dung who is the director of Duy Nghia clinic, has reported positive results and clear behavioural differences in patients who have applied VNHIP’s protocol.

This is one of the greatest rewards for team VNHIP.

Water Babes

VNHIP staff are very aware of the need to incorporate exercise into our daily lives. Not only do they educate the community regarding health and nutrition , they “walk the talk “ in their own lives. Two of our staff members have been attending swimming lessons twice weekly at the local pool under the guidance of Swim Vietnam. 

Many Vietnamese are afraid of the water and unable to swim or even float. Only recently the staff were witness to one of our own team members ,who is unable to swim , in a swimming pool with no idea that the depth of the pool changes from shallow to deep. Whilst all those present were happily splashing and chatting she had moved away to the deep end of the pool and went quickly and quietly under water, unable to get herself to the surface. Thankfully she was rescued and survived to tell the tale. 

We are very proud of our young ladies who are facing their fears in the water whilst enjoying  a solid hour of exercise as well.