Between March 13 – 22, 2015, Jimmy had the privilege of being a part of a medical mission. It is a non profit organization comprised of a wide range of medical professionals and volunteers called Project Vietnam. As many of you discovered, Jimmy was not in the pharmacy but he was still trying to be a pharmacist in his home country. This was his first adventure with this fine group of dedicated volunteers and his first adventure back to Vietnam.
The goal was to provide basic primary care to impoverished areas of Vietnam. When we say impoverished, we do not mean downtown Fresno Fulton mall where we currently reside =). Our location was something you would only see on the Discovery channel. Houses were mud huts with straw and bamboo, the best ones had wooden poles holding them together. The roads are the size of one of our lanes but somehow considered two lanes. The primary mode of transportation are mopeds for the wealthy and foot for the majority. We saw daily activities as rice farming and driving oxen up and down the mountain roads every morning and evening when we left. Fresno cattle have it good compared to these ones out here! But here’s the kicker, all the bamboo hut homes had Dish Satellite!
The day starts at around 5am. Breakfast with the 70 or so team members. Dental, medical, pharmacy, RNs, and volunteers would slowly rise from our 4 star hotel at the sweet serenade of the local rooster. At around 7am, the teams would load onto 3 buses to head towards the site. The site was a school the size of Modern Drug’s parking lot. We had electricity for the most part but no air conditioning.
The conditions by afternoon were about 100 degrees F in a humid heat. Not the dry heat we experience in California but rather similar to Florida. Heat exhaustion by 2pm was a larger problem for staff than the sheer number of patients. Throughout the afternoon, the pharmacy team would have to remind each other to stay hydrated as a couple members looked like they were about to feint. The size of the pharmacy was like the size of a Starbuck’s dining area. We would see between 500-700 patients/day. Hypertension, mild-moderate pain, diabetes, nutritional supplements (vitamins), basic antibiotics like Amoxicillin, Cephalexin, and Bactrim DS were the only meds available. Our ability to treat as a primary care was significantly reduced compared to US. Dental teams would perform close to 200+ dental fillings/extractions under extreme conditions, but nonetheless the ingenuity in setup and sterilization procedures were remarkable to continue their mission.
At around 4-5 pm would be last call for patients. We would close, pack up, and leave around 6pm. It would take us about 2 hours to return to our glamour hotel. Our 4 star hotel had limited electricity, intermittent hot water, giant cockroaches the size of an iPod mini, and sneaky rats in some rooms. We had wooden beds to help straighten out back problems. The bed also had a comfortable setting only in Vietnam– it produced it’s own sweat from the humidity of the room. So when you laid down you couldn’t tell if it was you sweating or it’s just soggy sheets and mattresses! Jimmy and his roommate were fortunate enough to have a room with a lock that broke after a few days and locked us inside our own rooms. This was what they considered the Hilton out there or a high end motel 6 in the states. In the end, this is what we signed up for and we expected much worst to be honest.
The challenges presented to us are much different than what we have to deal with in the states. It reminded me how much I take for granted here in the US. The healthcare here might be a hotly debated issue. Compare it to the rest of the world where there is barely any running water and facilities. We are light years ahead. The staff did not complain about the conditions but rather trudged along aimlessly. Not one patient yelled or screamed or threatened to call corporate at the pharmacy.
The parents were brutal to their kids. At one point while I was hanging around the dental area. A daughter was crying a river because she didn’t want to get her teeth pulled. Don’t forget, our operations were done in the open– 3/4 dental beds in one place. Kids can see their classmates get their teeth pulled out and the agony as they screamed in pain. The dentists told the mother they can’t do the procedure because her daughter was crying and fidgeting too much.
The mother in a literal translation said, “Shut up, stop crying, get your teeth pulled or don’t come home.” The child was maybe 9 years old because the patient age ranged from 7-9 that day! The mother repeated that for 10 minutes, went to her moped, and drove off leaving the daughter there crying. The staff just looked at each other bewildered, “Now what?”
A little more than an hour later, the mother returns to the site. Checks her daughter’s teeth to see if it was extracted and takes her home. Like nothing odd just happened. This is reality they face. They have limited medical care, dental care, and limited money to travel to medical facilities closer to the larger cities. This might’ve been the only opportunity for another year to get rid of the cavity.
There were a few kids with anemia so they couldn’t get an extraction. Instead, they received some cleaning and filling. We were able to talk a little bit with my broken Vietnamese. One was maybe 8 years old and had 2 of his friends there. They all liked to play soccer. But between the 3 kids I asked who was the fastest and who was the best? They just laughed. It turns out one of the kids needed a blood transfusion immediately. We were looking for O- blood types on the spot. The local doctors say he’s needed this for a long time but couldn’t get the approval or the blood donations for it. Within an hour, we had multiple volunteers from within the organization willing to take the risk to do a blood transfusion for this kid. Fortunately, one of our volunteers was able to give it to him. We are hoping he makes a full recovery. Jimmy remembered attending a similar patient while he was on rotations in the ICU and had the doctor advised him, “Don’t get attached to your patients.” I didn’t think this advice would resonate for charity work. As we left, all we can wonder is if it worked or what other complications did he have? What resources do we need to fully treat him?
By the end of the trip, Jimmy was able to pursue one of his legacy goals: to be a part of a charity/foundation. The experience was humbling, challenging, and mind numbing. It was exactly what Jimmy signed up for and exactly why most of us became healthcare professionals. It was a reminder from our grind in the US that we can still make a difference. Throw away the politics, the money, the bad patients taking advantage of the system, and just focus on healthcare. That there are good people out there that need help and would take whatever we can offer and not take it for granted. I would like to thank the PVNF team for giving us this opportunity and the patients that were bused to our sites that made the grueling work worthwhile!