Medical needs are dramatic - starting with clean water

7/9/2001

TRIEU PHONG, Vietnam - Vietnamese doctors are bright, well-educated, and work hard but haven't got much to work with, concluded a medical team from St. Vincent Mercy Medical Center.

“The biggest need is for clean water,” said Dr. Peter Pillitteri, a former medical resident at St. Vincent and now a physician in Boston. “The basic rule of medicine is to wash your hands between patients.”

The people are wonderful, “but the needs are dramatic, starting with basic sanitation, hygiene, nutrition,” agreed Dr. Mike Plewa, an ER physician at St. Vincent.

The seven-member team led by Dr. Paul de Saint Victor, head of emergency medical services at St. Vincent, spent several days working in the new clinic in Trieu Phong built by the Toledo group DOVE - Development of Vietnam Endeavors.

The other members of the team were nurses Marcy Webb and Barb Martin and nutritionist Tina Ferner, all from St. Vincent, and Dr. Jean de Saint Victor, Paul's brother, a gynecologist from Montreal.

Their days were long.

“They had a lot of patients there,” said Ms. Webb. “The word was out that we were there. The people wanted to be seen by an American doctor.”

Ms. Ferner was shocked that a third of the children she saw were suffering from malnutrition.

“We saw this 3-year-old child who looked as if he were only 6 months old,” she said. “They have got a wonderful diet to be well-nourished. But they lack nutritional education.”

The Vietnamese suffer from ailments such as rheumatic fever and infectious diseases rarely seen in the West, but few suffer from heart disease and other illnesses caused by our fatty diets and sedentary lifestyles, medical team members said.

The Toledo medical team marveled at the ability of Vietnamese physicians to make accurate diagnoses on the basis of a physical examination only, without the assistance of tests and diagnostic equipment on which American doctors increasingly rely.

“These guys are rocket scientists when it comes to infectious diseases,” Dr. Pillitteri said.

Vietnamese doctors do amazingly well considering how little they have to work with. The DOVE-built clinic at Trieu Phong is a much more impressive facility than the hospital next door, but there are still two to three patients for each bed, and the clinic has no lights or running water.

A water system was built into the clinic, but the water had to be shut off because patients left the taps running.

“The Vietnamese [patients] didn't know how to turn off the water taps,” said Dr. Pillitteri, shaking his head.

The most appreciated of the supplies the Americans took to the clinic were moist towelettes so that doctors could clean their hands between patients, Dr. de Saint Victor said.

Although Vietnamese doctors do a very good job considering the constraints upon them, they could use their nurses more effectively, said Ms. Martin, head nurse in the emergency department at St. Vincent.

“They don't use their nurses in collaborative fashion,” Ms. Martin said. “They just follow the doctors around.”

Dr. de Saint Victor stayed on for a week after the other members of the team returned to the United States. He visited hospitals in Hue and Da Nang. He hopes to establish a permanent mission to Vietnam for medical residents at St. Vincent.

His plan is to have third-year residents go to Vietnam for a month each year. They would spend 15 to 18 days in Hue, working in the hospital there three to four days a week, and in the Trieu Phong clinic a day or two a week. The remainder of the time would be spent in Hospital C in Da Nang.

Hospital C is about to start an emergency department, which makes it an ideal mission field for emergency room physicians, Dr. de Saint Victor said.

“Da Nang has 700,000 people. There are a lot of accidents,” he said.

Only two or three residents would go to Vietnam the first year, but he hopes to expand the program to include other residencies besides emergency medicine, and other hospitals besides St. Vincent.

“Five years down the line, I'm going to have a guy there every month,” he said.