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    Wednesday, July 04, 2012

    My First Clinic

    Lang Co is a small hamlet between Da Nang and Hue.
    This month I have two different medical experiences designed to let me see the disparities of care between rural and urban Vietnam. For four days at the beginning of the rotation,i will work in a small rural clinic in Lang Co, Vietnam with an organization called Vets With A Mission. They are a nonprofit organization that provides medical missions to Vietnam with a Christian background.

    Today was my first day in the clinic. VWAM had their in country representative contact local leaders who sent flyers ands invitations out ahead of time to residents advertising them that we would be providing free medical care over four days. Of course the prospect of American physicians and free care is incredibly popular, and we saw 153 patients between four doctors: family practice, orthopedic surgery, chiropractor, and myself ( pediatrics).

    A typical house in rural Vietnam near Lang Co
    A clinic like this provides unique challenges. Many parents being their children just because we are American, even though their children have already seen doctors and received medications. Usually the normal Vietnamese doctor takes the week of because we make crowded and siphon patients. We also see children incredibly sick, who have not received care because their families cannot afford it.

    The rural clinic where we practiced
    Today was a "get the hang of it day," so I only saw 29 patients. Most children came for two reasons: inadequate weight gain and horribly rotten teeth. The chief complaint was " my child is a lazy eater." I am very good now at explaining that milk is not healthy in Vietnam when they mix sugar with it. This causes cavities, which cause pain, which leads to decreased eating and poor weight gain.

    The communist government provides free care "in theory," but in practice those doctors are not respected, wait times are so long, that people don't see them. They go instead to private physicians, but often do not have the money to buy the medicines prescribed. So, in practice the Vietnamese have a very capitalistic health care system with two tiers, similar to the USA system, and very low access for the poor.

    The waiting area on the morning of day 1

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