People talk and my ears bleed...and now my hands. I've been typing. I've been coding. There's a new version of TBE in the production facilities--more of an extreme makeover.
Please go to trietstest.blogspot.com and take a look. Remember it's a work in progress. Tell me what you think. I desperately want feedback.
And no, I haven't graduated to the big time of paid servers and snazzy webpages--it's still a blogspot blog (but I like it).
Sunday, April 30, 2006
Sunday, April 23, 2006
Caesarean Sections (HCMC) Part 3
Alright, so I was wrong. I think. In my first post on caesarean sections in Vietnam, I said
"So what is?" you ask. Glad you asked.
After reading my post a couple nights ago, my wife looked at me and said very bluntly:
"It's not the money, it's the government. It's the two-baby rule."
You see, Vietnam cannot openly enforce the "suggestion" that couples should have no more than one or two children. If it did, it would be violating children's rights (according to my wife and Save the Children UK ... my view of rights is different and deserves another post). Such violations would keep Vietnam out of organizations like the World Trade Organization, which it desperately wants to enter, so Vietnam doesn't enforce the rules, per se. What my wife saw at SCUK was a government that enforced the rule on government employees (such as people who worked for the Committee on Population, Family, and children [CPFC]) by writing it in their contract. Otherwise, the government must revert to convincing the population through lots of propaganda.
What is the best form of propaganda for birthing that the government has? It's cult of doctors. The government has successfully turned the profession of physician into a profession tantamount to godhood. There is a doctor's day. Only the smartest test takers can study medicine. At least 40% of all my English students want to be doctors because they are seen as morally above the people, the most intelligent, and very wealthy.
The doctors at hospitals also happen to be under the pay of the government.
So, the government has waged a very successful propaganda campaign against birthing. It has done this in a few ways:
1. It tells women they will get fat. No woman wants to hear this. The doctors tell all newly expecting mothers that they must gain at least 15kg during the course of pregnancy. If you have travelled around Ho Chi Minh City lately, you've seen the prevalence of fat pregnant women. If you do not reach the requisite weight, they will use drugs to keep you from giving birth until you do (I have never heard of this actually happening, but its a threat I have heard uttered)
2. In order to fight the fat, mothers should get a caesarean section. This surgery will make them less fat than giving birth vaginally. Never mind that the fat is already there from the previous 9 months, or the scar across the abdomen.
3. Births, vaginally or via c-section, are painful. Obviously, no woman in her right mind would want to go through surgery more than once or twice.
Now, this information doesn't explain why the doctors FORCE some women, like my friends, to have c-sections, but it does explain more realistically the probable leading driving force in pushing c-sections. Most hospital doctors make pittance from the hospital and get most of their money from private practice--but its the government that holds the key to promotions, prestige, and power. Also, I'm sure many believe what they practice. The doctors hear all through medical school about the wisdom and benefits of having only one or two children--and so they preach this to their patients.
I know this happens with breastmilk vs. formula. Doctors reinforce the incorrect stereotype that formula is better than breastmilk by teaching it to their patients and promoting certain types for fees.
The end result is a country of women who hear bad things about having more than two children (you'll be poor, it'll hurt, you'll be fat, etc.) and revere doctors giving birth in hospitals where doctors willingly push the doctrine either for personal gain or actual belief. The end result is a lot of c-sections and small families.
Now, underneath this discussion on c-sections, has been the discussion about it's legality. Is it legal? Could someone sue? Here's what I found out from my lawyer here in Vietnam. This conversation is paraphrased, but quoted to the best of my knowledge (it only happened yesterday, but it won't be exactly word for word).
[+/-] read/hide the rest of this post
"Doctors force women to wait until late in gestation and to have c-sections so they can schedule in the birth and make more money."I still think this might be true in some cases, since so many people feel that way, but I do not think it is the ultimate reason.
"So what is?" you ask. Glad you asked.
After reading my post a couple nights ago, my wife looked at me and said very bluntly:
"It's not the money, it's the government. It's the two-baby rule."
You see, Vietnam cannot openly enforce the "suggestion" that couples should have no more than one or two children. If it did, it would be violating children's rights (according to my wife and Save the Children UK ... my view of rights is different and deserves another post). Such violations would keep Vietnam out of organizations like the World Trade Organization, which it desperately wants to enter, so Vietnam doesn't enforce the rules, per se. What my wife saw at SCUK was a government that enforced the rule on government employees (such as people who worked for the Committee on Population, Family, and children [CPFC]) by writing it in their contract. Otherwise, the government must revert to convincing the population through lots of propaganda.
What is the best form of propaganda for birthing that the government has? It's cult of doctors. The government has successfully turned the profession of physician into a profession tantamount to godhood. There is a doctor's day. Only the smartest test takers can study medicine. At least 40% of all my English students want to be doctors because they are seen as morally above the people, the most intelligent, and very wealthy.
The doctors at hospitals also happen to be under the pay of the government.
So, the government has waged a very successful propaganda campaign against birthing. It has done this in a few ways:
1. It tells women they will get fat. No woman wants to hear this. The doctors tell all newly expecting mothers that they must gain at least 15kg during the course of pregnancy. If you have travelled around Ho Chi Minh City lately, you've seen the prevalence of fat pregnant women. If you do not reach the requisite weight, they will use drugs to keep you from giving birth until you do (I have never heard of this actually happening, but its a threat I have heard uttered)
2. In order to fight the fat, mothers should get a caesarean section. This surgery will make them less fat than giving birth vaginally. Never mind that the fat is already there from the previous 9 months, or the scar across the abdomen.
3. Births, vaginally or via c-section, are painful. Obviously, no woman in her right mind would want to go through surgery more than once or twice.
Now, this information doesn't explain why the doctors FORCE some women, like my friends, to have c-sections, but it does explain more realistically the probable leading driving force in pushing c-sections. Most hospital doctors make pittance from the hospital and get most of their money from private practice--but its the government that holds the key to promotions, prestige, and power. Also, I'm sure many believe what they practice. The doctors hear all through medical school about the wisdom and benefits of having only one or two children--and so they preach this to their patients.
I know this happens with breastmilk vs. formula. Doctors reinforce the incorrect stereotype that formula is better than breastmilk by teaching it to their patients and promoting certain types for fees.
The end result is a country of women who hear bad things about having more than two children (you'll be poor, it'll hurt, you'll be fat, etc.) and revere doctors giving birth in hospitals where doctors willingly push the doctrine either for personal gain or actual belief. The end result is a lot of c-sections and small families.
Now, underneath this discussion on c-sections, has been the discussion about it's legality. Is it legal? Could someone sue? Here's what I found out from my lawyer here in Vietnam. This conversation is paraphrased, but quoted to the best of my knowledge (it only happened yesterday, but it won't be exactly word for word).
The Bleeding Ear (TBE): "Are their lawsuits in Vietnam?"So, ultimately, Vietnam has tort law, but the society doesn't use it to the excess (or probably over-excess in my opinion) that American society does. It also has successfully used propaganda to convince women of the benefits of few children and c-sections, so the quote by Le Anh Tuan, in my first post, seems to be more accurate now. He said:
Lawyer: "Yes, of course! Lawsuits are very much protected underneath Vietnamese law."
TBE: "If a doctor did something wrong, could he or she be sued?"
Lawyer: "Most definitely."
TBE: "...by a regular person? Do they have the money? How much does it cost?"
Lawyer: "Yes, normal people can sue. Typically the lawyer will take 5% of the award. A couple days ago I closed a lawsuit worth over 2 billion VND, which gave me about 100 million VND. Lawyers will definitely take the cases."
TBE: "But I don't see a lot of lawsuits in Vietnam like in America."
Lawyer: "No, that's the difference--the culture. The Vietnamese culture hasn't embraced the concept of the lawsuit yet, so very few people do it or even think about it."
"..many mothers opt for a caesarian as a way of avoiding the average ten hours of labour pain caused by natural child birth.Still sounds like a pretty unethical thing to do, a trend that needs to be reversed for the benefit of Vietnamese family structure and the health of the women, and widespread. I am interested in comparing Vietnamese tort law to China (and it's one child system). Any takers?
...[and] some women prefer this unnatural method as they don’t want to lose their beauty after giving birth, while others want their children to be born on a chosen day.
...[and] it [is] very difficult for the hospital to deny any request for a caesarean. If they were to refuse the request and the mother was to have problems giving birth, the hospital could be sued."
[+/-] read/hide the rest of this post
Caesarean Section Births in HCMC, Part II
I tried to respond to the comments to my last post on caesarean sections, but the blog is acting up. My comment doesn't register on my blog, but if you click on the post comment link, it shows up in the pop-up box....strange. Especially since I haven't changed anything to my code recently.
I wonder if it was the length of my comment.
So, here's my response (comment) to the comments.
****
"Tort Law" exists in Vietnam, but like most law in Vietnam (and I assume China) is severly dictated by the communist party. In English speak, that means they enforce what they want to enforce and make everything else far too hard to do.
Suing someone doesn't involve the government in the USA, but in Vietnam, everything is the government. Even "private" companies are only partially private. The government holds a stake in everything. In my post, I am talking about births in Ho Chi Minh City, which almost exclusively happen at hospitals. Hospitals are government funded and ran, the doctors at hospitals are known to be members of the party--not necessarily the best doctors around.
So, to the best of my knowledge, it is possible to sue in Vietnam (I will find out more). However, in this case, you will be suing, basically, the government. Therefore, the government makes it very expensive, impractical, and scary to try that tactic. Much easier to just get a c-section. You must remember that many Viets (most?) in HCMC make between 600k VND and 1.5 mil VND a month ($37 USD to $93 USD) and suing a doctor/hospital would cost FAR more than that. Normal people just can't do it.
Also, interesting observation about China. I don't know if that's the reason for reticence in the actions of Vietnamese police, but it makes some sense.
About the numbers--I was shocked too. I didn't believe the numbers until I asked other people. I'm not talking about all of Vietnam here. The 40% number is a government figure for all of Vietnam, but the 80% is my straw poll about only HCMC. I expect that most women outside HCMC have vaginal births.
That said, even 40% is sickeningly high.
I have, unfortunately, also heard about giving money to get adequate care. When I heard (and read) about the prevalence of c-sections in Vietnam, I couldn't understand why. I thought that maybe it's part of the Vietnamese obsession to be western, modern, like giving children formula instead of breastmilk. The theory about making money stemmed from the comments I heard people make (it kept popping up) and I included it. It's the only reason I can think of that explains why so many totally healthy women/babies were denied vaginal births/inducement AND adequate hospital time. However, I would like to get my hands on something more and explore this further...maybe someone can help??
Finally, one of the small points I made in my post which I think is worth highlighting is the % of post-partum problems. Reasons why aside, 40% of Viet women are having c-sections and 9% of them are having serious complications afterwards. Two things jump out at me: the government study (not to be publicised) claimed only 0.16% and the independent study found 9%. That's a huge difference. I know people doctor numbers in the government to look better, but you'd think the incentive would be less if the numbers were not to be publicised. It would make the government look bad. It makes me wonder if the 40% number is doctored too.
Second, 9% of 40% is still almost 4%. 4% of all births in Vietnam have serious complications DUE TO c-sections. Vietnam has some brave mothers.[+/-] read/hide the rest of this post
I wonder if it was the length of my comment.
So, here's my response (comment) to the comments.
****
"Tort Law" exists in Vietnam, but like most law in Vietnam (and I assume China) is severly dictated by the communist party. In English speak, that means they enforce what they want to enforce and make everything else far too hard to do.
Suing someone doesn't involve the government in the USA, but in Vietnam, everything is the government. Even "private" companies are only partially private. The government holds a stake in everything. In my post, I am talking about births in Ho Chi Minh City, which almost exclusively happen at hospitals. Hospitals are government funded and ran, the doctors at hospitals are known to be members of the party--not necessarily the best doctors around.
So, to the best of my knowledge, it is possible to sue in Vietnam (I will find out more). However, in this case, you will be suing, basically, the government. Therefore, the government makes it very expensive, impractical, and scary to try that tactic. Much easier to just get a c-section. You must remember that many Viets (most?) in HCMC make between 600k VND and 1.5 mil VND a month ($37 USD to $93 USD) and suing a doctor/hospital would cost FAR more than that. Normal people just can't do it.
Also, interesting observation about China. I don't know if that's the reason for reticence in the actions of Vietnamese police, but it makes some sense.
About the numbers--I was shocked too. I didn't believe the numbers until I asked other people. I'm not talking about all of Vietnam here. The 40% number is a government figure for all of Vietnam, but the 80% is my straw poll about only HCMC. I expect that most women outside HCMC have vaginal births.
That said, even 40% is sickeningly high.
I have, unfortunately, also heard about giving money to get adequate care. When I heard (and read) about the prevalence of c-sections in Vietnam, I couldn't understand why. I thought that maybe it's part of the Vietnamese obsession to be western, modern, like giving children formula instead of breastmilk. The theory about making money stemmed from the comments I heard people make (it kept popping up) and I included it. It's the only reason I can think of that explains why so many totally healthy women/babies were denied vaginal births/inducement AND adequate hospital time. However, I would like to get my hands on something more and explore this further...maybe someone can help??
Finally, one of the small points I made in my post which I think is worth highlighting is the % of post-partum problems. Reasons why aside, 40% of Viet women are having c-sections and 9% of them are having serious complications afterwards. Two things jump out at me: the government study (not to be publicised) claimed only 0.16% and the independent study found 9%. That's a huge difference. I know people doctor numbers in the government to look better, but you'd think the incentive would be less if the numbers were not to be publicised. It would make the government look bad. It makes me wonder if the 40% number is doctored too.
Second, 9% of 40% is still almost 4%. 4% of all births in Vietnam have serious complications DUE TO c-sections. Vietnam has some brave mothers.[+/-] read/hide the rest of this post
Thursday, April 20, 2006
Caesarean Section Births in Ho Chi Minh City
(Caveat lector: This post is very long.)
Many of you know someone who has given birth via caesarean section--probably all of you. Unlike its portrayal in Robin Hood: Prince of Thieves (where a Moor Morgan Freeman performs the surgery on Little John's wife), it is not just an emergency procedure anymore. For various personal reasons that can be debated another time, some women opt for caesarean section rather than vaginal birth (i.e. drug free) or epidurals.
Why? Some of the leading doctors in America asked this question, along with, "Should we advise or patients to opt for not-medically necessary c-sections?"
Evidence comparing vaginal births to c-sections is scarce, they say. So,
The caveat:
So, experts from the United States of America and Australia have found that caesarean sections produce extra risks on the mother and child in subsequent births, these risks increase more if the subsequent births are vaginal, they increase still if you have more than two children, and the pros are reduced chances of the child suffering already extremely rare complications.
Now, these are results from two industrialized, wealthy countries with good health care programs--one with lots of caesarean sections and one with few. How does Vietnam stack up??
Although Vietnam's economy is growing by around 7.5% a year, it is not industrialized like America or Australia. Doctors are the upper crust in Vietnam--every child wants to be one--but the health system does not have the expertise or equipment that the other two do. The always horribly written and taken-with-a-grain-of-salt newspaper, the Vietnam News, wrote last year that in Vietnam
"40%?" one lady said. "Whatever. The percentage isn't lower than 80%"
That preceeded a flow of caesarean stories that proved the impetus for this research.
Le Anh Tuan, deputy director of the Central OB hospital in Hanoi, openly admitted reasons why women get c-sections in Hanoi saying,
Now, if women just want a baby on a certain day, why would they opt for c-section over inducing labor?
"Because the doctors want money," a Viet kieu friend told me. "When I went to have my last son, about a year ago, they would not let me have him vaginal. I told a doctor, 'This is my fifth child. I know what it's like. My labors are quick (30 minutes) and I want to be induced now.' My bags were packed and I was ready to go. The doctors flat out refused. They made me have it caesarean."
"It's 'cause they want money," chimed in her expat husband. "With c-sections they can charge more, and schedule the deliveries, so they can just have one right after the other, and make more money in a day. Plus they don't keep you in the hospital as long as they should so they can pump you in and out faster."
Then another friend--native Vietnamese with an expat husband--chimed in and said, "me too! I just had my son only two months ago. I wanted to have it vaginal, but they would not let me. I said, 'induce me!' and they said no. Finally, I packed up my bags, and went to the hospital at 39 weeks. I said, 'I'm not leaving until I have my baby.' Their response was, 'go home and come back in two weeks.' I was forced to wait until 41 weeks and then forced to have a c-section."
People ask me why I don't have any children yet. This is my answer. I don't want to deal with this crap. It's insanity. To force a woman into surgery, in a country with health care like this, because you want more money, and then hide behind the assertion that "the hospital could be sued." My father-in-law's a lawyer in Ho Chi Minh City and I'm telling you, the LAST thing a hospital in the city is worried about is some woman suing them. 99% of people don't have the resources to sue, and the current laws aren't strong enough to ever win a lawsuit against a government hospital, especially in Hanoi.
So, 5.5% of America, 25% of Australia, and probably 80% of Vietnam has babies via caesarean section. Caesarean sections provide some benefits to the baby, but are outweighed by increased complications to the mother in the second and subsequent births. These are multiplied if the mother has her other births vaginally or has more than two births total. Post-partum infections in Vietnam are at 9% of c-sections, almost twice as high as the most liberal % of vaginal births. Doctors force women to wait until late in gestation and to have c-sections so they can schedule in the birth and make more money.
I'm sick of this. I'm sick of the lack of morals. Forget PMU18, get me an investigation into widespread hospital corruption and hypocracy. Vietnamese ob/gyns at hospitals cause increased health problems in women by doing an unnecessary surgical technique with documented risks on at the least 40% of people in Vietnam (double in HCMC). They are everything I never want to be when I am a doctor.
[+/-] read/hide the rest of this post
Many of you know someone who has given birth via caesarean section--probably all of you. Unlike its portrayal in Robin Hood: Prince of Thieves (where a Moor Morgan Freeman performs the surgery on Little John's wife), it is not just an emergency procedure anymore. For various personal reasons that can be debated another time, some women opt for caesarean section rather than vaginal birth (i.e. drug free) or epidurals.
Why? Some of the leading doctors in America asked this question, along with, "Should we advise or patients to opt for not-medically necessary c-sections?"
Evidence comparing vaginal births to c-sections is scarce, they say. So,
"Based on indirect evidence," the report continued, "there appear to be relatively similar degrees of risk from both pathways in women intending to limit their childbearing to one or two children."The report than summarizes the pros and cons to caesarean sections.
"Potential benefits of a requested Caesarean delivery, compared with vaginal delivery, include decreased risk of hemorrhage for the mother and a reduced risk of certain complications for the baby ... Possible risks of a requested Caesarean include respiratory problems for the baby [and] hospital stays tend to be longer for the mother with Caesarean deliveries." (Emphasis is my own).That is pretty straight forward, and ho hum, but the docs did make a few firm recommendations. One of which is,
"Given that the risks of placenta previa and accreta rise with each Caesarean delivery, Caesarean delivery on maternal request is not recommended for women desiring several children."This alarm over caesarean sections comes because
"One published study found that this type of delivery increased from 3.3% of all live births in 1991 to 5.5% in 2001."Other reports have also found problems with caesarean sections. An Australian study found that
"women faced a higher risk of hemorrhage and hysterectomy in their next pregnancy, and there was a higher risk of stillbirth and maternal death.Anecdotal evidence suggested that women who had caesarean sections were at greater risk of infection and illness which impacted on breastfeeding, bonding between mother and baby, and postnatal depression."
This is important information because Australians have more experience in caesareans than Americans--with almost 25% of births now by c-section.
"[Dr Tracy] said a caesarean section cost on average $1000 more than a natural birth, and women were spending twice as long in hospital - an average of five days compared with two to three days for natural births."Hey, I wouldn't be a microbiologist without at least one scientific study to throw at you. Here's some hard data from the Medical Journal of Australia. (MJA 2005;183(10): 515-519)
The caveat:
"Of the 136 101 women with data on both first and second births, 25 596 (18.8%) had a caesarean section in their first pregnancy. Compared with mothers with primary vaginal birth, mothers who had primary caesarean section tended to be older, more socially advantaged and more likely to have medical and obstetric complications."Now the results:
"We found primary caesarean section (compared with primary vaginal birth) conferred additional risk of complications in the second pregnancy for both mother (primarily if she underwent labour) and baby, and that a substantial proportion of serious complications were attributable to primary caesarean section. However, the complications we examined were uncommon, regardless of whether the mother had a primary caesarean section.
...Among mothers who underwent labour, we found higher rates of PPH, hysterectomy, and manual removal of placenta in those who had had a primary caesarean section than in those who had not.
...Primary caesarean section conferred a higher risk of postpartum infection, which is not surprising given the substantially higher caesarean section rate in the second pregnancy in these mothers (18% v 4%). Primary caesarean section also conferred a higher risk of admission to ICU for women who undergo labour, consistent with higher rates of complications overall.
...Our results lead us to conclude that, if a mother has had a primary caesarean section, she will only reduce her risks of complications in her second pregnancy to the level commensurate with a mother who had a primary vaginal delivery if she also has a caesarean section in her second pregnancy."
So, experts from the United States of America and Australia have found that caesarean sections produce extra risks on the mother and child in subsequent births, these risks increase more if the subsequent births are vaginal, they increase still if you have more than two children, and the pros are reduced chances of the child suffering already extremely rare complications.
Now, these are results from two industrialized, wealthy countries with good health care programs--one with lots of caesarean sections and one with few. How does Vietnam stack up??
Although Vietnam's economy is growing by around 7.5% a year, it is not industrialized like America or Australia. Doctors are the upper crust in Vietnam--every child wants to be one--but the health system does not have the expertise or equipment that the other two do. The always horribly written and taken-with-a-grain-of-salt newspaper, the Vietnam News, wrote last year that in Vietnam
"In 2001, 36.9 per cent of mothers undertook the operation, whereas in the first six months of this year alone the figure is nearer 40 per cent."I dropped this by a few of my friends that have had children recently and was immediately laughed at.
"40%?" one lady said. "Whatever. The percentage isn't lower than 80%"
That preceeded a flow of caesarean stories that proved the impetus for this research.
Le Anh Tuan, deputy director of the Central OB hospital in Hanoi, openly admitted reasons why women get c-sections in Hanoi saying,
"Usually caesarean births are only carried out if there are pregnancy complications, or if the mother is ill, either reason posing serious risks to the health of the mother or child.And the kicker is that he finishes it with this:
...that doctors would also decide to operate if the embryo was over grown, or if the mother was too old or too young. The doctor also said mothers who had received embryo transplants resulting from in vitro fertilisation should also undertake the operation.
...many mothers opt for a caesarian as a way of avoiding the average ten hours of labour pain caused by natural child birth.
...[and] some women prefer this unnatural method as they don’t want to lose their beauty after giving birth, while others want their children to be born on a chosen day."
"it [is] very difficult for the hospital to deny any request for a caesarean. If they were to refuse the request and the mother was to have problems giving birth, the hospital could be sued."What are the statistics from c-sections in Vietnam? A report in the Journal of Health, Population, and Nutrition gives some clues.
"Results of a longitudinal study showed that the incidence of post-caesarean infection was 9% with 3-4% severe infection ... Yet, these rates are likely underestimates as routine laboratory analysis of post-caesarean patients was not conducted."(This is interesting because the government found only 0.16% post-partum infections in its own unpublished study.) The estimates of post-partum infections after vaginal births range from 1.7% to about 5%. Even the most conservative estimate of vaginal births gives an infection rate 10 times higher than what the government recorded only one year earlier in a private report.
Now, if women just want a baby on a certain day, why would they opt for c-section over inducing labor?
"Because the doctors want money," a Viet kieu friend told me. "When I went to have my last son, about a year ago, they would not let me have him vaginal. I told a doctor, 'This is my fifth child. I know what it's like. My labors are quick (30 minutes) and I want to be induced now.' My bags were packed and I was ready to go. The doctors flat out refused. They made me have it caesarean."
"It's 'cause they want money," chimed in her expat husband. "With c-sections they can charge more, and schedule the deliveries, so they can just have one right after the other, and make more money in a day. Plus they don't keep you in the hospital as long as they should so they can pump you in and out faster."
Then another friend--native Vietnamese with an expat husband--chimed in and said, "me too! I just had my son only two months ago. I wanted to have it vaginal, but they would not let me. I said, 'induce me!' and they said no. Finally, I packed up my bags, and went to the hospital at 39 weeks. I said, 'I'm not leaving until I have my baby.' Their response was, 'go home and come back in two weeks.' I was forced to wait until 41 weeks and then forced to have a c-section."
People ask me why I don't have any children yet. This is my answer. I don't want to deal with this crap. It's insanity. To force a woman into surgery, in a country with health care like this, because you want more money, and then hide behind the assertion that "the hospital could be sued." My father-in-law's a lawyer in Ho Chi Minh City and I'm telling you, the LAST thing a hospital in the city is worried about is some woman suing them. 99% of people don't have the resources to sue, and the current laws aren't strong enough to ever win a lawsuit against a government hospital, especially in Hanoi.
So, 5.5% of America, 25% of Australia, and probably 80% of Vietnam has babies via caesarean section. Caesarean sections provide some benefits to the baby, but are outweighed by increased complications to the mother in the second and subsequent births. These are multiplied if the mother has her other births vaginally or has more than two births total. Post-partum infections in Vietnam are at 9% of c-sections, almost twice as high as the most liberal % of vaginal births. Doctors force women to wait until late in gestation and to have c-sections so they can schedule in the birth and make more money.
I'm sick of this. I'm sick of the lack of morals. Forget PMU18, get me an investigation into widespread hospital corruption and hypocracy. Vietnamese ob/gyns at hospitals cause increased health problems in women by doing an unnecessary surgical technique with documented risks on at the least 40% of people in Vietnam (double in HCMC). They are everything I never want to be when I am a doctor.
[+/-] read/hide the rest of this post
Tuesday, April 18, 2006
The Gospel of Judas
First, a disclaimer: I am Christian. I do not, however, consider myself part of the "religious right" as my libertarian political philosophy often puts me at odds with what they say.
That being said, I watched the Gospel of Judas show the other night on the National Geographic Channel, and wanted to hurl--hurl something at the tv. I think it's the scientist in me. I kept saying (outloud and much to the chagrin of my wife),
"Where's the evidence? ...That doesn't prove that ... how can they make that assertion? Their evidence doesn't back up that."
Et. cetera.
You must understand--I grew up on National Geographic. I remember sitting for hours in the hot garage in Houston, Texas, reading through NG magazines from the '70s and '80s. I remember how much i treasured the issue where the cover was totally holographic with an eagle in the middle--the cover story celebrated the new technology of holograms. In school, as I grew older and fell in love with biology, I always held NG as a pinnacle of science journalism--to bring amazing photographs together with hard science to help explain the mysteries of the world.
There was NO hard science in the Gospel of Judas. It ... how do I say ... betrayed my faith in National Geographic. The first hour was spent trying to debunk the image of Judas that modern Christianity believes in. Carefully spliced interviews of leading Christian theologians I've never heard of and have never influenced my belief painted Judas as a misunderstood character. He was a character painted in an evil light as post-crucifixion Christians tried to distance themselves from Jews. They tried to blame a Roman execution on Jews to assuage their own guilt. They looked down on Jews for stubbornly fighting the Romans in 70 AD.
All of this conjecture might have gone forgiven had it stopped, but no, then they connected the character of Judas to anti-semitism in Europe and as a cause for the holocaust.
Aside: Why does everything bad have to somehow lead back to the holocaust? Can't we just accept that people can be evil, and maybe commit evil acts NOT connected to an obviously horrific act of genocide that has garnered Hitler a special place in Hell??
I don't know about you, but I've never thought of Judas as a Jew, and my acceptance of his betrayal of Jesus hasn't turned me into an anti-semite. Judas was an apostle of Christ, and his betrayal is a tale of tragedy.
The second hour of the show showed how the 85% of the manuscript recovered revealed a document that purports Judas was asked by Christ to betray him. It glossed quickly over the fact that the gospel was written about 100-150 years after the other gospels, was not considered authentic in its own time, nor adequately explains the influence of gnosticism on the manuscript.
That, could have been an interesting show. Two hours of explaining Gnosticism and how the Gospel of Judas helps shed light on this obscure early sect of Christianity. Ah, but history is full of "could have beens."
Dave Kopel, of The Volokh Conspiracy, has a good post on Gnosticism and the Gospel's place in science.
"If modern people believe in the Gospel of Judas, and start a religion around it, would it be called Judaism too?"
Which brings me to my concluding thoughts. I don't read conservative christian blogs much, but I ran across this post to American Digest from Instapundit. Read it. Superbly written, even if you don't agree with what he says. Here's one of my favorite quotes (On professional intellectuals including the editors of NG):
That being said, I watched the Gospel of Judas show the other night on the National Geographic Channel, and wanted to hurl--hurl something at the tv. I think it's the scientist in me. I kept saying (outloud and much to the chagrin of my wife),
"Where's the evidence? ...That doesn't prove that ... how can they make that assertion? Their evidence doesn't back up that."
Et. cetera.
You must understand--I grew up on National Geographic. I remember sitting for hours in the hot garage in Houston, Texas, reading through NG magazines from the '70s and '80s. I remember how much i treasured the issue where the cover was totally holographic with an eagle in the middle--the cover story celebrated the new technology of holograms. In school, as I grew older and fell in love with biology, I always held NG as a pinnacle of science journalism--to bring amazing photographs together with hard science to help explain the mysteries of the world.
There was NO hard science in the Gospel of Judas. It ... how do I say ... betrayed my faith in National Geographic. The first hour was spent trying to debunk the image of Judas that modern Christianity believes in. Carefully spliced interviews of leading Christian theologians I've never heard of and have never influenced my belief painted Judas as a misunderstood character. He was a character painted in an evil light as post-crucifixion Christians tried to distance themselves from Jews. They tried to blame a Roman execution on Jews to assuage their own guilt. They looked down on Jews for stubbornly fighting the Romans in 70 AD.
All of this conjecture might have gone forgiven had it stopped, but no, then they connected the character of Judas to anti-semitism in Europe and as a cause for the holocaust.
Aside: Why does everything bad have to somehow lead back to the holocaust? Can't we just accept that people can be evil, and maybe commit evil acts NOT connected to an obviously horrific act of genocide that has garnered Hitler a special place in Hell??
I don't know about you, but I've never thought of Judas as a Jew, and my acceptance of his betrayal of Jesus hasn't turned me into an anti-semite. Judas was an apostle of Christ, and his betrayal is a tale of tragedy.
The second hour of the show showed how the 85% of the manuscript recovered revealed a document that purports Judas was asked by Christ to betray him. It glossed quickly over the fact that the gospel was written about 100-150 years after the other gospels, was not considered authentic in its own time, nor adequately explains the influence of gnosticism on the manuscript.
That, could have been an interesting show. Two hours of explaining Gnosticism and how the Gospel of Judas helps shed light on this obscure early sect of Christianity. Ah, but history is full of "could have beens."
Dave Kopel, of The Volokh Conspiracy, has a good post on Gnosticism and the Gospel's place in science.
The roots of the Gospel of Judas and of gnosticism go back to Marcion (approx. 100-160 a.d.). After he was excommunicated for heresy, he founded his own sect, the Marcionites.It's a good post, which led a coworker to speculate,
...The Marcionites believed that the physical world was created by the angry god of the Old Testament, and that Jesus had been sent by a different god, who had nothing to do with the created world. Marcionites strove to avoid all contact with the created world. They were celibate, and ultra-ascetic.
"If modern people believe in the Gospel of Judas, and start a religion around it, would it be called Judaism too?"
Which brings me to my concluding thoughts. I don't read conservative christian blogs much, but I ran across this post to American Digest from Instapundit. Read it. Superbly written, even if you don't agree with what he says. Here's one of my favorite quotes (On professional intellectuals including the editors of NG):
"Addicts of auto-erotic spiritual asphyxiation, their onanistic pleasure in these deeds is only enhanced if they [critizing and denegrating Christianity] can be performed during the most holy days of the Christian calendar. Only then can maximum profit and pleasure be assured.In the words of the modern American teenage Generation Why-er: "Ohhh! Snap!"
This dark thrill of denigration has the immediate benefit of pleasingly confirming them in their own Church of Zero ..."
Thursday, April 13, 2006
The Girl in the Library
[Like The Face at the Restaurant, "the purpose of relating the story is to highlight life's many fork-in-the-road situations." It is a moment in time, a person, a "what if" situation, and an indelible part of me.]
Slowly the bead of sweat dripped down my forehead. Winding it's way amid the unseen nooks and ravines of my skin, it brushed my right eyebrow, dipped down toward my eye, and caused an insatiable itch rewarded by a quick flick of the wrist and a wipe.
"Man, this wasn't what I had in mind," I thought.
Sick. Fever. And I was stuck wiping my sweat with my starched white cuff. Clearing my throat I adjusted my tuxedo once again.
"I don't know how much longer I can do this, feeling light-headed and all," I mused. My eyes drifted down to the new ring on my finger and locked onto a reflection of black hair.
All at once I found myself at a desk on the bottom floor of the library, trying to separate my life from the muck. So many distractions.
Like an underwater dance, moving oh so slowly, words sounding hollow, deep, and distorted, my life of the last two years swirled around me. Heck, the last fifteen minute walk to the library swirled around me. Swirling, swirling ... and BAM!. Snapped back to reality, seeing clearly, maybe too much so, I saw her.
Why hadn't I noticed her earlier? I had sat right next to her. Black hair, the soft kind with a sheen that speaks to you. Eyes, wide, in that European way, contrasting the delicate asian features of her face like a heroine's eyes in Japanese anime. Simple shirt, simple clothes, but that smile ... that smile ... almost tangible like the sweet taste of strawberry in the summer.
Her lips moved, and then I saw her eyes. They darted at me, then away into space, then back again.
"Are you speaking to me?" I thought, as her eyes moved again.
"What? Don't you think I'm pretty?" She asked.
Did the words come from her moving lips or riveting eyes?
"Of course. You're amazing." I replied, entranced with the woman before me. How could someone like this be found on the bottom floor of a library. Truly the best things in life are unheralded.
"Then kiss me, you fool," said those beautiful black eyes. "What are you waiting for?"
"You're kidding me," I thought. "I don't know you. We've only just met."
"Kiss her, you moron," said a voice. "Obviously she wants it--just look at her eyes."
"Don't be stupid. You don't even know her," came my mind's reply.
Back and forth they went, the voices in my head, arguing "to do or not to do" and the world started spinning again. Those eyes, all I knew were those eyes were speaking to me. I had sat next to an amazingly beautiful girl, her eyes were speaking to me, and both sides of my conscionce were duking it out on my shoulder.
And then ... kiss. The world focused instantly on our lips, lightly locked in the library. A second, a blink, and it was over.
What had I done? What had I done? Why did I do it? It was her eyes! They made me do it! They called to me, asked me, pleaded, even.
My hand quivered and the reflection in my ring was gone.
"How long was I gone?" I asked. "A minute? No, only seconds."
Slowly, I exhaled.
Looking to my right, I saw her again, that same girl from the library, even more beautiful than in my memory. Succulent red lips, braided black hair, a stunning white wedding dress...
Boy am I glad I kissed her.
[+/-] read/hide the rest of this post
Slowly the bead of sweat dripped down my forehead. Winding it's way amid the unseen nooks and ravines of my skin, it brushed my right eyebrow, dipped down toward my eye, and caused an insatiable itch rewarded by a quick flick of the wrist and a wipe.
"Man, this wasn't what I had in mind," I thought.
Sick. Fever. And I was stuck wiping my sweat with my starched white cuff. Clearing my throat I adjusted my tuxedo once again.
"I don't know how much longer I can do this, feeling light-headed and all," I mused. My eyes drifted down to the new ring on my finger and locked onto a reflection of black hair.
All at once I found myself at a desk on the bottom floor of the library, trying to separate my life from the muck. So many distractions.
Like an underwater dance, moving oh so slowly, words sounding hollow, deep, and distorted, my life of the last two years swirled around me. Heck, the last fifteen minute walk to the library swirled around me. Swirling, swirling ... and BAM!. Snapped back to reality, seeing clearly, maybe too much so, I saw her.
Why hadn't I noticed her earlier? I had sat right next to her. Black hair, the soft kind with a sheen that speaks to you. Eyes, wide, in that European way, contrasting the delicate asian features of her face like a heroine's eyes in Japanese anime. Simple shirt, simple clothes, but that smile ... that smile ... almost tangible like the sweet taste of strawberry in the summer.
Her lips moved, and then I saw her eyes. They darted at me, then away into space, then back again.
"Are you speaking to me?" I thought, as her eyes moved again.
"What? Don't you think I'm pretty?" She asked.
Did the words come from her moving lips or riveting eyes?
"Of course. You're amazing." I replied, entranced with the woman before me. How could someone like this be found on the bottom floor of a library. Truly the best things in life are unheralded.
"Then kiss me, you fool," said those beautiful black eyes. "What are you waiting for?"
"You're kidding me," I thought. "I don't know you. We've only just met."
"Kiss her, you moron," said a voice. "Obviously she wants it--just look at her eyes."
"Don't be stupid. You don't even know her," came my mind's reply.
Back and forth they went, the voices in my head, arguing "to do or not to do" and the world started spinning again. Those eyes, all I knew were those eyes were speaking to me. I had sat next to an amazingly beautiful girl, her eyes were speaking to me, and both sides of my conscionce were duking it out on my shoulder.
And then ... kiss. The world focused instantly on our lips, lightly locked in the library. A second, a blink, and it was over.
What had I done? What had I done? Why did I do it? It was her eyes! They made me do it! They called to me, asked me, pleaded, even.
My hand quivered and the reflection in my ring was gone.
"How long was I gone?" I asked. "A minute? No, only seconds."
Slowly, I exhaled.
Looking to my right, I saw her again, that same girl from the library, even more beautiful than in my memory. Succulent red lips, braided black hair, a stunning white wedding dress...
Boy am I glad I kissed her.
[+/-] read/hide the rest of this post
Tuesday, April 11, 2006
Wanna head a Vietnamese Government Agency? Only $1 Mil. USD
Today the Người Lao Động printed an interview with Đỗ Quang Trung, head of the Interior Ministry. Interesting article. The best part is this question (all translation is my own):
"Có dư luận nói rằng chức thứ trưởng “chạy” hết 8 tỉ đồng, chức bộ trưởng hết 15 tỉ đồng, Bộ trưởng có nghe thông tin này?"Answer:
(Minister, have you heard the public assertions that to be a deputy minister requires over 8 billion VND, and becoming a minister needs over 15 billion VND?)
"Việc chạy chức chạy quyền có dư luận lâu rồi chứ không riêng ở Bộ GTVT. Công tác cán bộ không một cá nhân nào quyết định mà phải là tập thể. Ngay việc Thủ tướng quyết định không phải qua Ban Bí thư thì cũng phải lấy ý kiến các ban Đảng, các cơ quan tham gia. Đây cũng là một cách khắc phục việc chạy chức chạy quyền. Nếu giao cho một cá nhân nào quyết định thì cực kỳ nguy hiểm."Way to beat around the bush, Mr. Đỗ. So I'm supposed to understand that the $500k USD or $1 mil. USD needed to be a deputy minister or minister must be shared with many people instead of given to just one person, right? Ah, I see...
(This opinion has been around for anyone in office for awhile, not just for the Ministry of Transportation & Traffic. An officer's work is not the decision of one person but a group of people. The choice of a deputy minister is not just the committee of the Secretary's decision, but they also get the opinions of other party committees, and other organizations participate too. This is only one way to check abuses of position and power. It is extremely dangerous to entrust one person with all decision-making power.)
Sunday, April 09, 2006
Comments Bug
This is a note to readers:
Recently I instituted a new tagging system using del.icio.us tags to make pseudo-categories. (I love it by the way). However, since then, the comments I've made (only on this blog) have not been preview-able. Is this only me, or do you other readers have problems previewing comments also?
The del.icio.us system required FreshTags and Greasemonkey for Firefox. So, if it's only me, maybe it has something to do with my Greasemonkey addition. If it's everyone, maybe it's the FreshTags.
Recently I instituted a new tagging system using del.icio.us tags to make pseudo-categories. (I love it by the way). However, since then, the comments I've made (only on this blog) have not been preview-able. Is this only me, or do you other readers have problems previewing comments also?
The del.icio.us system required FreshTags and Greasemonkey for Firefox. So, if it's only me, maybe it has something to do with my Greasemonkey addition. If it's everyone, maybe it's the FreshTags.
Friday, April 07, 2006
Nosy Viets
Yesterday was one of those days...sometimes I love the people here in Vietnam and sometimes I hate them. Right now, I feel much more of the latter than the former.
Yesterday I left the house about three o'clock to pick up the wife from work (Save the Children UK) and biked to the corner of Đỗ Ngọc Thạch and 3 Tháng 2. At the intersection I must turn left onto "3/2" and take that a long ways to District 1. However, the intersection was packed. Gridlock. Absolutely packed. Not uncommon in Vietnam, but never exciting either.
In great Vietnamese fashion, the light turned green and I took off, jutting into the middle of the intersection, weaving in between bikes, and making it almost to the end when I became lodged in the mass of flesh and steel, shouts and horns. To my right was a group of people standing outside a house and two green-clad policemen with their traffic batons out.
"Ah hah!" I thought. "The typical police coming to a house and everyone wants to see it mess. Why are people here so nosy?"
Then I looked closer and saw a man kneeling on the ground, his arm covered in blood as he desperately tried to stop the red geyeser erupting from another man's neck. At that moment I realized the situation was bad. A traffic accident. Dunno why. Dunno how. But I know the results.
Everything suddenly came into focus: two policemen, trying their hardest to get people to move, but nobody was moving; one man lying on the ground, dying; another man desperately trying to save his life, irregardless of AIDS or other possibilities; and maybe a hundred people on motorbikes disobeying the police, blocking any hope of an ambulance, and gawking.
At that moment I lost it...I blew up. I compared the scene to America, where people are required by law (and follow it) to help or get out of the way. This just seemed so wrong, so evil. Worse than tò mò (nosy), worse than mất lịch sự (rude), worse than ... worse.
So I did what I could do--scream. I started yelling at the top of my lungs at everyone around me. The only way for the situation to get better is for people to leave. So I started pushing people to leave.
"Đi nhé!" I yelled. "Đi mày đi! Mày ngư quá à!"
("Go!" I yelled. "Go you moron! You're freaking retarded!")
My invectives were at anyone I could point a finger at and get eye contact. Slowly, people woke up and some took off, even if only for 20 meters before stopping and watching from afar. The lane opened up for me, and I took it too, doing my part to let a dying man have his peace, his chance for life, and his dignity.
Later that night, driving home from dinner, I saw six teenagers in a fist fight, two with boards, and some men stopping to try and break it up. I thought to call the cops, but my wife stopped me. "That's not how it's done in Vietnam," she said.
Well, if this is how it's done, then I'm glad to be headed back to the states in two months.
Yesterday I left the house about three o'clock to pick up the wife from work (Save the Children UK) and biked to the corner of Đỗ Ngọc Thạch and 3 Tháng 2. At the intersection I must turn left onto "3/2" and take that a long ways to District 1. However, the intersection was packed. Gridlock. Absolutely packed. Not uncommon in Vietnam, but never exciting either.
In great Vietnamese fashion, the light turned green and I took off, jutting into the middle of the intersection, weaving in between bikes, and making it almost to the end when I became lodged in the mass of flesh and steel, shouts and horns. To my right was a group of people standing outside a house and two green-clad policemen with their traffic batons out.
"Ah hah!" I thought. "The typical police coming to a house and everyone wants to see it mess. Why are people here so nosy?"
Then I looked closer and saw a man kneeling on the ground, his arm covered in blood as he desperately tried to stop the red geyeser erupting from another man's neck. At that moment I realized the situation was bad. A traffic accident. Dunno why. Dunno how. But I know the results.
Everything suddenly came into focus: two policemen, trying their hardest to get people to move, but nobody was moving; one man lying on the ground, dying; another man desperately trying to save his life, irregardless of AIDS or other possibilities; and maybe a hundred people on motorbikes disobeying the police, blocking any hope of an ambulance, and gawking.
At that moment I lost it...I blew up. I compared the scene to America, where people are required by law (and follow it) to help or get out of the way. This just seemed so wrong, so evil. Worse than tò mò (nosy), worse than mất lịch sự (rude), worse than ... worse.
So I did what I could do--scream. I started yelling at the top of my lungs at everyone around me. The only way for the situation to get better is for people to leave. So I started pushing people to leave.
"Đi nhé!" I yelled. "Đi mày đi! Mày ngư quá à!"
("Go!" I yelled. "Go you moron! You're freaking retarded!")
My invectives were at anyone I could point a finger at and get eye contact. Slowly, people woke up and some took off, even if only for 20 meters before stopping and watching from afar. The lane opened up for me, and I took it too, doing my part to let a dying man have his peace, his chance for life, and his dignity.
Later that night, driving home from dinner, I saw six teenagers in a fist fight, two with boards, and some men stopping to try and break it up. I thought to call the cops, but my wife stopped me. "That's not how it's done in Vietnam," she said.
Well, if this is how it's done, then I'm glad to be headed back to the states in two months.
Tuesday, April 04, 2006
Tags and Categories
Well, I've added some new blogs to the blogroll. Look to the side and you'll see blogger hacks, ecmanaut, freshblog, and the last word. All are blogs dealing with blogger hacks, coding, and making life easier for a starving blogger using blogspot.
Hopefully, this post will be the first of many to be tagged with del.icio.us tags and eventually that will be used to form categories...that's the hope at least. Until then, enjoy my new drop down menus for archives and recent posts.
Hopefully, this post will be the first of many to be tagged with del.icio.us tags and eventually that will be used to form categories...that's the hope at least. Until then, enjoy my new drop down menus for archives and recent posts.
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