A recent survey, conducted in the last half of 2010, to record weight measurements and albumin levels of patients in Bach Mai hospital’s Intensive Care Unit (Hanoi), Cho Ray Hospital’s Department of Surgery (HCMC) and Can Tho Hospital, shows that 40-60% of the patients are underweight.
The Vietnamese have not given adequate attention to their nutritional needs during the treatment and recovery process, says Dr. Nguyen Gia Binh, head of Bach Mai’s Intensive Care Unit.
Little attention paid to nutritional needs
Dr. Binh points out that Vietnamese people often bring their own home-cooked food to the hospital for their family members, without being aware that the food may not be sufficiently nutritious for the patient.
It is essential that a hospital have nutritionists to advise patients on what to eat or how many calories to take in each meal.
“But we have yet to provide patients with nutritionists in Vietnamese hospitals,” says Binh.
To date, Bach Mai Hospital has set up a hundred diet regimens for different types of illnesses. These regimens and menus for certain typical diseases are posted on the canteen door for the patients’ reference.
These meals at Bach Mai hospital, provided on the recommendation of the hospital nutritionists, allow patients to choose what suits their taste and personal conditions.
However, Bach Mai is still a rare hospital that has its own nutrition center. In other hospitals, patients commonly eat food their relatives cooked and brought from home or buy unhygienic food from vendors outside the hospital.
Insurance should cover diet regimens, too
Dr. Dinh Thi Kim Lien, director of Bach Mai Hospital Nutrition Center, says patients with severe illnesses usually lose their appetite and do not want to eat, leading to weight loss and subsequently malnutrition.
“Malnutrition can retard the treatment and recovery progress,” she says.
“Eating much salty food can increase the blood pressure of hypertension patients. Kidney disease patients get worse if they are to eat food with high levels of protein,” Dr. Lien offers some examples.
Dr. Nguyen Quoc Tuan, head of the Planning Section of Bach Mai Hospital suggests that changing the patients’ awareness of the importance of food in medical treatment and recovery is the key factor to improving their nutrition intake.
The food not only has some influence on the illness but also interacts itself with the medicine given, says Dr. Tuan.
One common misconception among many cancer patients is that all the nutrients they get from the food will go to feed the tumors.
“Actually, cancer patients need to have sufficient nutrients to be able to undergo rigorous chemotherapeutic treatments. Patients with malnutrition cannot receive enough dosage of chemicals, bringing no improvement in their condition,” says Dr. Tuan.
Dr. Lien also suggests that the patients’ diet regime be considered as medicine and covered by insurance.
A standardised nutrient diet will cost a patient VND50-60,000 for 3 meals per day, while the money they have to pay for nutrition infusion is in the area of hundreds of thousands.
Since their insurance policy only covers nutrition infusion, a deplorable paradox arises where a patient healthy enough to eat is given nutrition infusion to help reduce the costs for the family.
For many poor patients unable afford anything other than porridge in their daily meal after an operation, recovery takes a long time due to malnutrition
“And there are also a lot of patients who have nothing to eat but bread every day, for all their money have gone to pay for the hospital fees,” said Dr. Lien.