By Son Nguyen in HCMC
April is now referred to as the ‘Black Month’ for the healthcare sector as numerous deaths involving the obstetric emergency have been reported in local media. From HCMC as the country’s first-rate healthcare hub to other provinces across the country, as many as 14 maternal mortality cases have been reported since April 18, with several deaths of both mothers in delivery and their children. Behind the fatalities are not only the complications beyond the professional skills and ability of physicians and related healthcare agencies, but also their highly-suspicious ethical merits, especially the indifference towards the human life.
The maternal mortality rate in Vietnam, according to Tuoi Tre, has been drastically reduced over the years, from some 330 for every 100,000 deliveries in 1980 to 84 in 2000 and 64 in 2008, not much higher than 42 in Malaysia, 47 in Thailand and 40 in China in the same year. And it is assumed that there is nothing phenomenal in this maternal mortality rate now except that the cases are better covered by local media. However, apart from the falling number of fatalities as an encouraging sign, the real picture is quite heart-rending and abnormal.
Most recently, Tuoi Tre covers an appalling case in Mo Duc Hospital in Quang Ngai Province when both the woman and her child died last Saturday after being admitted into the hospital the previous day. The 34-year-old Huynh Thi Tung came to the polyclinic hospital at 8.30pm, and soon after an initial examination, she suffered great pain. Her relatives asked for help from a nurse named Nga, who coldly said delivery would come around the next morning. When it all turned worse hours later, the nurse still refused to help the poor woman, and she and her babe died one hour later while in labor in the operation theater. It is noted that the hospital’s obstetric doctor was not there at the critical time, and he only came to the clinic ten minutes after the deaths.
In another case, Nguoi Lao Dong reports the death of a lying-in woman in HCMC’s Hoc Mon District Clinic. The hospital’s leaders explain the cause as amniotic fluid embolism, which is quite rare in the world and which is the first case ever in this very clinic since its operation seven years ago. However, among 14 deaths, four or five cases have been attributed to this rare and highly-fatal incidence, said to be at one among 20,000 deliveries in the world. Tuoi Tre ironically says rare incidences in the world are popular in Vietnam.
Nguoi Lao Dong questions whether the indifference towards the prolonged pains suffered by lying-in women has made the normal mortality rate an abnormal thing, as seen in the case of Mo Duc Hospital in Quang Ngai.
Commenting on the recent cases, Doctor Huynh Thi Thu Thuy, deputy director of Tu Du Obstetric Hospital in HCMC, pinpoints not only the poor professional skills of physicians, but also the ethical merits in the healthcare sector. The doctor says on Sai Gon Tiep Thi that quite many physicians are not willing to update knowledge and professional skills on medical issues.
“After monitoring hospitals in different regions, we always organize seminars to help doctors improve their skills and knowledge, but some hospitals do not attend such events, and even those who send representatives are not ready to overcome their own shortcomings when pointed out,” she notes. The doctor, who also serves as head of the Health Ministry’s supervision team for maternal clinics in the central region, criticizes the physician’s indifference and routine performance as one of the reasons behind many recent deaths.
Sai Gon Tiep Thi also publishes in-depth reports on the performance of maternity wards at many district-level and provincial hospitals in the country, ringing a bell of alarm on the shortage of skilled physicians as well as the lack of specialized equipment. Most district-level clinics in HCMC do not have enough obstetric doctors, and there is also one where a surgeon works as head of the maternal ward. Similarly, Tuoi Tre says in Nghe An Province, there are many hospitals with only one obstetric doctor each, meaning the doctor is not always on duty there, especially during the night.
This shows that “the healthcare sector has ignored lower-level clinics,” comments Sai Gon Tiep Thi. The newspaper cites Doctor Huynh Thi Thu Thuy of Tu Du Obstetric Hospital as saying that many provincial health departments are also to blame for the situation.
“During our supervision trips, we always invite the provincial health department to join us so that they can learn about weaknesses and shortcomings and find ways to address such problems. Regrettably, not all heath departments in provinces care about such feedback,” she says.
The doctor refers to the case of Binh Dinh Province, saying not a single official from the Department of Health joined her supervision trip last year. “When we challenged them, they finally sent a low-level staff, who simply sat there and took notes so as to report to the department leaders later. I do not know whether the staff made the report or not, but when we returned, the situation there remained unchanged.”
The people’s hopes are shattered, and the public confidence in the country’s healthcare system has been sapped given the popular occurrence of deaths at maternal clinics these days. The Black April persists, not only for the health care sector but also for the public, as long as the deadly indifference stays unchanged, not only among physicians and healthcare workers, but also among officials in charge of this sector.
The Saigon Times Daily