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Dr Sneh's diary: 376 patients in a day

The first of the temporary health clinics has been set up in the village of Hang Kia, where the local Hamong people rarely have contact with healthcare professionals.

 
Dr Sneh Khemka in one of the temporary health clinics in the Mai Chau valley.

Tarpaulins, candlelights and giant flying bugs signify the warm night as I sit beside a Vietnamese homestay writing this. We’re in the Mai Chau valley, in north-west Vietnam, and have had our first day of treating the local people for various ailments.

Yesterday saw the transfer from Hanoi and we rose through the dense, green velvety hills in vehicles to get us near the remote village of Hang Kia. A three-hour, sun-baked hike took us to the idyllic tranquillity that typifies rural Vietnam and the village of the Hamong people.

The Hamong are descendents of the Chinese, and having been wrongly identified early by society as unwelcome invaders, they soon became outcasts. Unfortunately, the sentiment persists and it is characterised by their lack of contact with traditional services, one of which is  healthcare.

So it was with some surprise that the local villagers, dressed in the their traditional woven garb, observed us as we settled in to the long houses and carried our bulky medical supplies to the local school to set up for the clinic the next day.
 

 

From epilepsy to cosmetic surgery

Woman and child

We segregated the rooms into triage, diagnosis and treatment, and dispensary. We also had an intimate exam room and a separate area for the paediatric dental flouride programme we were running. I was rather surprised at the comprehensiveness of dispensary, with a full range of drugs available to treat conditions, such as helminth infections, trachoma, burns and impetigo.

The four doctors, including me, saw 376 patients in a day, providing a range of services from well-baby checks to minor surgery. The conditions I encountered included newly-diagnosed epilepsy (a fit in front of us in the clinic), cataracts, a fractured forearm, abdominal worms, sexual dysfunction and minor cosmetic surgery.

The most challenging of the cases was what really gave this mission its flavour. We met a young couple in their teens whose children were riddled with lice, scabies and malnutrition – all stemming from poor care and social circumstances in a country that is still maturing and coming to economic stability. And why did it typify the mission? Well, it was not just about the immediate treatment and cleansing of the children, but it was about the extra hour spent between two sets of translators (the Humong don’t speak Vietnamese) providing education on basic hygiene and feeding; the extra time taken to ensure that the work we are doing is not just a one off, but sustainable and enduring.
 

Making a difference

I spent considerable time teaching the local doctors and students techniques in surgery, ophthalmology and medical management of common conditions, an endeavour which was particularly rewarding.

Yes, we are making a difference, and doing so with happy hearts and willing recipients.

Tomorrow sees a big day of hiking to the next village, which is considerably hotter and busier than here, with new medical challenges awaiting us. But for now, a richly deserved ‘Bia Han Noi’ has arrived, along with some tempting looking delicacies.
 

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