An unlucky little girl in Da Nang

Khue is a lovely girl who is 9 years old. Khue has a rare condition which requires special and expensive medications. She is experiencing early puberty which leads her body to develop rapidly. Her body is unable to produce enough calcium to provide healthy bone growth. Her brittle bones affect her ability to enjoy playtime at school and with friends, a broken bone can easily be the result of daily childhood games. Khue has had orthopaedic surgery already approximately 5 years ago to insert a plate and screws in her thigh. We have had a long association with this family and therefore understand their difficulties.

When we met her in 2007 she lived in a happy family with both her parents and her brother. Khue’s father was unable to overcome the pressure of sustaining family life and he disappeared in 2010. As a result the financial burden became the responsibility of Khue’s mother. She has three jobs -fish processing, cleaning houses, assisting her sister in law with cooking for weddings. Even though she works tremendously hard, she struggles to support Khue and her brother who is in grade five and is studying well at school. The school fees for the two children equate to two million VND per month.

Khue also suffers from otitis media resulting in the hearing in both ears to be severely diminished but the family has not money for corrective surgery. The cost of the surgery is around 10,000,000 VND.

Khue’s mother developed goiter (a thyroid condition) for which she has had surgery. Due to her high stress levels, it has recurred and she now needs to take on going medication, which costs 700,000 VND per month. Once again, there are no funds available for this medication.

Now Khue’s family is living with her grandma and uncle’s family. They are hopeful that one day they will be able to have their own home and live independently.

Last week, Khue felt aches and pains in her bones she went to Da Nang hospital to check up. The doctor asked that Khue be seen in Ha Noi to determine whether Khue needs to get the screws in her leg replaced or not.  The screws are supposed to be replaced after two or three years, Khue has had hers for five. The transportation cost alone is too great for Khue’s family to bear. It costs about three millions VND for Khue and her mother to go to Ha Noi by train.

It is an impoverished life without a escaping way. They are grateful to any person who can make a difference for their family.

$35 USD per month will help Khue mother to manage her health condition, $500USD will enable Khue to hear well again. $150 USD will enable Khue to be assessed at the hospital in Ha Noi. Any donation to achieve these funds will make a significant difference in this little girl family life.

A memorable story!

As you know cardiac is one of the main VNHIP projects. I think ít’s also one of our  most  success projects. We have done about 100 surgeries so far and had great results post surgery for our clients. All our patients have memorable stories. This is one of them

Ha is a 42 year old woman, who lives in Hoi An -Quang Nam (near our office) with her family. In July when Dr Josh was here, we had a clinic for some of our patients who we have managed for a long time. She heard about us from some of these patients and came to our clinic with a desire to get "foreign medicine" from us to help her condition. She did not know that we don't provide medications for all patients and that in fact medications cannot fix her condition. Dr Josh saw her and asked her to get some tests done so he can know how to help her. The next day she came back with test results.. After looking at the results, Josh said she needed surgery soon. But suddenly she became very upset, yelled at us and cried and said that we wasted her money for those silly test and why did we not want to give her some medications. We explained to her that meds can't fix her heart condition. But she did not trust us and remained angry with us. Then she went home. 

We felt very upset with her words and worried about her health as we knew she didn’t believe our medical advice. After some team discussion, the next day we decided we have to go to her house and talk to her and her children. We took an hour to explain to them about her condition and that she really need a surgery or it was clear she would have a further stroke and her condition could only worsen without this treatment. Fortunately they were listening to us and understood. It turned out she was diagnosed with valve disease 4 years ago but she never believed she should get  surgery. This family are not so poor as some other cases we have worked with so finances were not so much of a barrier, but she wanted to save money for her children,  and she was very scared of heart surgery so avoided it .She  had heard from some people that after heart surgery, she may get worse and not be able to work. Then she had a stroke 6 months before we met her and after that she had hemiplegia on the right side. We convinced her that surgery was the only option she had for her health, and that without surgery she would have further strokes. Before her stroke she worked as a motorbike driver with an income of about $100/month. But since she had a stroke she has been unable to work. Her husband is a motorbike driver also with income $150/month.  They have 3 children. One of them got married, 2 others still at high school. Finally, she agreed to surgery and got it just 5 days after  we talk to the family. Our biggest success. In this case I have to help patients overcome the fear and have  successful surgery. She looks great now and can ride a bicycle, or even cart to work.

NCD refresher training in Duy Xuyen District

Our NCD Program exists to improve patient and physician knowledge of NCDs. We focus on understanding risk factors and controlling diabetes and hypertension at a low cost. Dr Hoa, a local doctor has partnered with us to develop a model that can change the "culture" of commune level health centers, he does this by sharing his skills and understanding of how to make NCD’s easy to manage. Last week, Dr Hoa helped VNHIP conduct refresher training for medical staff who have participated in the program and staff who are considering using this protocol, the training was held at Duy Xuyen District Health Medical Center. Training is a great opportunity for physicians to network with staff from other communes who have also applied VNHIP’s NCD protocol or who are thinking about it. Doctors and nurses from many clinics were able to share about its effectiveness and the different experiences they have encountered in controlling NCD disease.

One of the barriers that these district hospitals face is that their doctors and nurses are overloaded with work. Doctors who have been trained now understand the complex issues around NCD’s, however; they do not have enough time to educate their patients. Dr Hoa has a sound understanding the problem. At the end of the training about, he emphasized the important role that doctors need to play in helping patients understand how to help themselves in changing their eating habits and doing exercise regularly. He also said that the medical staff needs to take the time to explain to diabetic patients how to understand signs of hypoglycemia. Dr Hoa shared a story of a diabetic patient who was uneducated and took such high doses of medication that he became hypoglycemic and ended up in a serious diabetic coma. If patients know the signs of low blood sugar they can aid themselves and treat themselves quickly by eating  a small candy or drinking some sugar water.

When asked by a nurse at Duy Nghia clinic about why there are sometimes different results between patients who have been diagnosed with diabetes at the commune health centre and the hospital Dr Hoa explained in some detail about four methods of diagnosing diabetes and explained that the different methods used at different health care levels within Vietnam are all relevant. He also emphasized that doctors need to pay attention to the patient’s age in order to give effective drugs.

Dr Dung who is the head of Duy Nghia clinic shared that NCD protocol is very effective in his clinic. Many of his patients now understand the importance of changing their bad habits such as eating salty or sugary foods, drinking too much rice wine and not being active. Although his patients are busy with their farms and businesses they always remember to go to visit the clinic and listen to the doctor’s advice.

It is so encouraging for VNHIP when we hear stories of many patients who have learnt to take better care of their health and who control their NCD. We are excited and overjoyed that physicians in all levels in Vietnam are improving the capacity for health care management of NCDs.