Everything all at once

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My second week in Hanoi was filled with so many new and interesting things, it is going to be difficult to fit them all in to one blog post, but for you, I will try. Sorry for my absence.

As always, I must mention the traffic again. I think I am beginning to get used to it, and getting used to being in Hanoi in general, but it’s just impossible to describe. I have spent time in big cities before, and I have a clear picture of what traffic is like in the United States. But here, traffic is a different beast entirely. Imagine being a pedestrian trying to walk home after a long day of class. The two-lane street is filled with perhaps ten lanes worth of motorbikes. Crossing the street is a brave act in which I can do little more than cross my fingers. Walking down the sidewalk gives me no illusion that I am safe from the traffic; when the streets are too busy the motorbikes dominate there too. There are horns blaring, smoke from hot skewers of meat coming from the carts of street vendors, music playing, children shouting. Imagine a father driving his three children home from school on his motorbike, each of them wearing a backpack with a different Disney character. The children here are so unafraid, so used to the chaos of the streets.

The air pollution in Hanoi is terrible, as one can imagine based on all the traffic. I’ve developed a pesky cough. Many motorbike riders wear cloth face masks with all sorts of fun patterns—you can buy them off of street vendors for about 20,000 dong, or less than one US dollar. One can find the air quality index online to get a sense of how bad the pollution is going to be that day. In Hanoi, there are three organizations that run the main towers that report the air quality: the US embassy, United Nations International, and the Vietnamese government. While the US embassy tower and the UN tower generally report similar indexes, the Vietnamese government’s tower consistently reports much lower numbers, meaning better air quality.

This sort of false positive reporting is common throughout Vietnam, and particularly in the healthcare system. One of the biggest diseases actually afflicting Vietnam is “achievement disease,” in which hospitals report having fewer cases of certain diseases or disorders in order to appear as though they are seeing improvement in the health of their area. This leads to outbreaks going unreported, which poses a great public health risk to the community and the country at large. Additionally, Vietnam’s data collection and reporting system is inefficient and incomplete—many areas of Vietnam are still running mainly on a paper system, which makes it difficult to gather data from different areas of the country. Not having enough data on disease statistics makes it hard to implement policy and programs that could improve the health of a region.

There are so many topics I would like to expand upon, but since I seem incapable of updating my blog more than once a week, I am just going to give a brief overview of what else I have been doing in Hanoi.

A few days ago we visited the National Hospital of Traditional Medicine in Hanoi. Traditional medicine has been practiced in Vietnam for thousands of years, and is recognized as an official part of the healthcare system. Most of the practitioners at the National Hospital of Traditional Medicine have medical degrees as well as postdoctoral specialization in traditional medicine. In Vietnamese medical school, students are required to take two semesters worth of classes on traditional medicine. We received a tour of the hospital and visited the pharmacy, where we saw the many drawers in which they keep the herbs for their remedies. We got to try a number of different herbs used to treat different conditions. They have a distillery in the hospital, which they use to make different concentrates and tinctures.

Today, I visited the National Obstetrics Hospital in Hanoi. While the women get individual rooms in which to give birth, as they do in the United States, before and after labor women are in big rooms with anywhere between 2 and 14 beds. On the wall, there was a listing of all the different prices for different sized rooms. Walking around the hospital, there were many open doors, through which we could see rooms with four or five beds, with women caring for newborns. As in the US, it is common for a few family members to come with the women to the hospital when they are going to give birth. There was also a small gym in the hospital with a badminton court, where family could spend time while waiting for a new baby to arrive.

We also had a guest lecture and presentation on the still present effects of Agent Orange in Vietnam. In my experience in the US public school system, the use of Agent Orange during the Vietnam War (or the American War as they call it here) was sort of hush hush, sort of breezed over in the curriculum. It has been roughly three generations since many members of Vietnam’s population were initially exposed to Agent Orange, a defoliant, whose main chemical is dioxin, which was sprayed on the dense jungles of Vietnam to kill the plant life and expose the Northern soldiers. Dioxin is the most toxic chemical that has ever been manufactured and its presence in the food and water in Vietnam has caused birth defects that can be seen even three generations later. While many US veterans who fought in the Vietnam War have received compensation for the negative health effects of Agent Orange, the United States government refuses to accept that there is any evidence linking its use to birth defects and high cancer rates in Vietnam. They claim that all wartime crimes have been settled. The Vietnamese go uncompensated by our government and our chemical manufacturers who are responsible for so much pain and suffering in this country. There are areas of Vietnam known as “hot spots” where there are extremely high amounts of dioxin in the soil. Eating meat from livestock raised here or eating certain types of plants can be extremely detrimental to one’s health and the health of their offspring. Interventions have been staged by several organizations in Vietnam to educate the citizens of these, mostly rural, areas about how dioxin enters the body and how to avoid it. To remove dioxin from the soil in these regions is costly and requires heating the soil to extremely high temperatures for long periods of time. Money from the United States would help this process, but the US has demanded that blood tests for dioxin levels for residents of these areas who are suffering poor health consequences be provided as a form of proof. Every blood test for an individual costs roughly $1000 to $1500—money that Vietnam clearly does not have.

We have also had several discussions surrounding disability and how it is viewed in Vietnam. The city of Hanoi is completely inaccessible to many people with disabilities, and it is interesting to think about what it means to be disabled, and how it is sometimes the built environment that decides who is able and unable to function there. Disability is viewed by many in Vietnam as a form of punishment for atrocities committed by ancestors or relatives. This belief is slowly beginning to shift through globalization and the increased prevalence of biomedicine in Vietnam. We discussed disability also in relation to selective abortion. Movements in the US surrounding abortion and a woman’s right to choose have focused largely on the component of choice. In different cultural contexts, however, choice can mean very different things. When a woman in Vietnam makes the decision on whether or not to abort a fetus based on markers of physical impairments, it is often not her choice alone. The opinions of her husband and their extended family factor heavily into this decision. I am realizing more and more just how individualistic the United States is, and how this differs in many Asian countries, which have much more collectivist societies.

Like I said, I could expand on many of these topics extensively, but for the purpose of this blog post, I will refrain. I am learning so much here. Though the city of Hanoi does sometimes make me anxious with its constant stimulation and hectic traffic, I am truly enjoying my time here. In the alleyways of the city, one can happen upon markets full of fresh fruits and vegetables, many of which are exotic to me. The people are kind and understanding, and architecture is fascinating, particularly in the Old Quarter. Oh, and for those who were wondering, my lovely host family did get me a birthday cake—it was chocolate with strawberries, and they sang me Happy Birthday in English (which apparently they always do). And also, we should all do a little happy dance that I have had zero stomach issues this far, which is nothing short of a miracle. Seven or eight people on my program so far have had to stay home from stomach sickness, and a couple spent the night in the hospital. I’m keeping my fingers crossed.

It’s hard to believe that my time in Vietnam is already half over. Monday, we leave to spend the week in Lac Village, located in Mai Chau Valley. I could not be more excited to get away from the city for a while and finally get a breath of fresh air.

And with that, I need to take a breath. Until next time.

#Vietnam