Ha Noi's Bach Mai hospital : Still a war zone

Do Cien Chanh, 79, a lifetime in Viet Nam’s Peoples Army after joining at 16. After complaining of chest pain, he was admitted to Bach Mai hospitals' cardiology ward where he was awaiting his turn to undergo mitral valvuloplasty surgery – the use of a balloon catheter to unblock a major coronary artery. His daughters Do Hong Van 49, and Do Thi Loan, 58, had been waiting with him for three days and two nights. The old soldier vacated a shared bed for one of the few wheelchairs to make way for another patient. Two or three patients to a bed is common throughout the over crowded hospital...See video here

Ha Noi's Back Mai public hospital will be a hundred years old next year and it shows.

The war torn hospital was built by the French in 1911 and looks over the railway line that runs north to the Chinese border and south to what was at the turn of the last century Sai Gon.

Bach Mai Hospital was bombed during an American raid on a nearby airfield at Christmas 1972 and killed 28.

A new French hospital was built beside it and started to admit both Vietnamese and expatriates in 2000.

There are only 65 beds at the new international hospital: Bach Mai hospital adjacent to it has 1340.

But it’s not the lack of beds at the new Hospital that drives about 300,000 Vietnamese to the old hospital every year.

It’s the cost.

Patients are required to pay in advance on admittance at the International Hospital in either cash or international credit card.

A bed costs between 300 and 500 US dollars a day with surgery, x-rays, blood tests, medication and meals as extras added to the five-star-hotel prices.

Both Vietnamese and non Vietnamese who can afford health insurance have a bed and a room to themselves and can buzz for a nurse for help.

The patients have a pillow, clean sheets and the constant smell of antiseptic to remind them of the hospitals hygiene.

Fortunately both public Bach Mai and the private French International hospital maintain the required standard for medical treatment for rich and poor alike.

Physicians at both hospitals are registered with Vietnams Health ministry.

The expertise at both hospitals was tested seven years ago when their physicians and nurses contained the spread of the deadly Severe Acute Respiratory Syndrome (SARS) virus.

But in January this year the Vietnam News Service reported that “Around 20 percent of the patients who use respiratory machines at the Bach Mai hospital get pneumonia.''

Bacteria at the hospital was spread by equipment that has not been sterilized properly and hands that had not been washed regularly.

A 2003 survey showed that only 13 percent of hospital workers washed their hands. In 2007, the figure had risen to 17 percent and last year it was 47 percent.

In 2007 the Vietnam News Service reported that 'Overcrowding was the major contributor to the high rate of transmitted infections at the hospital.

Paediatric ward administrator Le Kien Ngai said: " More than 40 patients a month were infected at the hospital despite the installation of the most modern hospital sanitation systems in Viet Nam'.

There were then 900 patients in the 350 bed paediatric ward.

Rooms in the hospitals Cardiology ward are smaller than a bathroom in a Ha Noi five- star hotel and are meant for two beds. But a third carrying one of the increasing number of patients requiring cardiology treatment is regularly added to the room.

The cardiovascular ward had 300 patients to 150 beds in 2007 and the figure has probably increased.

Cardiologists from America's Mayo clinic who shared their knowledge with the physicians of Bac Mai's cardiology ward last year noted that not only were the Vietnamese surgeons the 'busiest mitral valvuloplasty surgeons in the world' but that the same balloon catheter used for unblocking a major coronary artery was used on seven or eight patients and not one only as in the US.

Vietnamese surgeons perform about 150 operations a year or three times more than surgeons in the developed world.

The Mayo Clinic visitors also noted that patients at the Bach Mai hospital were accompanied by an ‘abundance’ of relatives.

The relatives keep a 24- hour watch on the patient, the respirator and intravenous drips because there are not enough nurses to do the job.

They quickly learn how to read the monitor so as to call for help if the heart stops or when the drip bottle is empty.

Relatives wash the bed bound patient and empty their toilet bowls and they also provide the patient with food.

It is not uncommon to see a rice cooker under the bed and plugged into a power point next to the respirator.

Patients are not provided with any bedding except for a straw mat.

There are no white sheets, pillows or blankets at the Bach Mai hospital.

The relative who can afford to buy the bare necessities including a plastic stool to sit on beside their loved ones can do so from the hospital's mini supermarket.

At night relatives sleep on folded beds and straw mats in the hallways or in the grounds of the hospital because they cannot afford to pay for a hotel room.

Last month Health Minister Nguyen Quoc Trieu opened a special ward at the Bach Mai hospital in an effort to accommodate the relatives of patients who act as substitute nurses.

The new ward will provide 300 bunks that will cost almost US1 a night.

A blanket and a mosquito net is included.
The Southeast Asian Times