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Vietnam PUBLIC HEALTH
In 1945 Vietnam had forty-seven hospitals with a total of
3,000 beds, and it had one physician for every 180,000 persons.
The life expectancy of its citizens averaged thirty-four years.
By 1979 there were 713 hospitals with 205,700 beds, in addition
to more than 10,000 maternity clinics and rural health stations;
the ratio of physicians to potential patients had increased to
one per 1,000 persons, and the average life expectancy was sixtythree years.
Information concerning the health sector in the mid-1980s,
although fragmentary, suggested that the country's unified health
care system had expanded and improved in both preventive and
curative medicine. Medical personnel totaled about 240,000,
including physicians, nurses, midwives, and other paramedics. The
quality of public health care and the level of medical technology
remained inadequate, however, and authorities were increasingly
concerned about such problems as nutritional deficiency, mental
health, and old-age illnesses. Cardiovascular diseases and
cancers were reportedly not widespread but had increased "in
recent years." Information on AIDS was unavailable.
The most common diseases were malaria, tuberculosis,
trachoma, intestinal infections, leprosy, diphtheria, tetanus,
whooping cough, measles, poliomyelitis, chicken pox, typhoid
fever, acute encephalitis, and acute meningitis. Hanoi claimed in
1970 that alcoholic cirrhosis and venereal diseases were "seldom
found in North Vietnam because of the wholesome and temperate
life of the population and the cadres." In November 1984,
however, the government admitted that the incidence of these
diseases had increased "significantly" since 1976, "especially in
the major cities."
Vietnam claimed to have eliminated cholera, smallpox, and
typhoid in the North as early as 1959 and poliomyelitis by 1961.
Malaria, once endemic, was said to have been eradicated in many
provinces of the North by 1965. Much progress was reported also
in the containment of trachoma, tuberculosis, and other diseases,
but an official assessment made public in November 1984
acknowledged that, except for smallpox, contagious and infectious
diseases had yet to be brought under control and that the
mortality rate associated with these diseases remained high. The
high mortality rate associated with malaria was a matter of
particular concern, especially in the provinces along the
Vietnam-Laos border, the Central Highlands, the central region,
and the northern border provinces. Tuberculosis, responsible for
the death of about 1 percent of the national population, or
nearly 600,000 persons annually, remained a major problem
although the rate fell from the 1.7 percent reported in 1976. In
1984 as many as 92 percent of the people examined in many
different localities were found to be afflicted with one or more
diseases. Authorities judged from these results that as few as 48
to 60 percent of the people in the localities sampled were in
good health. Gastroenteritis and such childhood diseases as
diphtheria, and whooping cough accounted for the extremely high
35 percent mortality rate among children, but the annual death
rate for the population as a whole in 1983 was 7.4 per 1000
persons, a decline from 26 per 1000 in 1945.
The prevalence of epidemics of bacterial, viral, and
parasitic diseases was attributed to the unsanitary environment.
For this reason the government introduced programs to improve
hygiene habits. Sanitary stations emphasizing water and
environmental purification were established in every district,
and campaigns such as the Three Cleans movement (clean food,
water, and living conditions) and the Three Exterminations
movement (extermination of flies, mosquitoes, and rats) were
instituted. In addition, officials encouraged district residents
to dig wells and construct septic tanks. They recommended regular
vaccinations and inoculations against diphtheria, tetanus,
whooping cough, polio-myelitis, tuberculosis, and measles.
Although access to health care improved by the mid-1980s, the
shortages of funds, of qualified physicians, and of medicines
prevented the Hanoi government from providing quality health care
for more than a few. Minister of Public Health Dan Hoi Xuan
acknowledged in November 1984 that the inadequacy of the public
health system was responsible for the proliferation of private
health services, the black market in medicines, and the
consequent corruption of a number of doctors and pharmacists.
In 1987 the practice of traditional medicine remained an
important part of the health care system. The Institute of Folk
Medicine in Hanoi, a leading center devoted to the study of
ancient theories and practices, utilized acupuncture and massage
as an integral part of its treatment programs. Official sources
maintained that traditional Vietnamese medicine had given rise to
new therapeutic methods that called for the wider application of
herbal medicine and acupuncture. The cultivation of medicinal
plants and manufacture of drugs derived from these plants
reportedly helped to overcome the shortage of Western medicines,
which had to be imported in large quantities every year. Some of
these traditional drugs were described as "most effective" in
curing dysentery, arthritis, gastritis, stomach ulcers, heart
diseases, influenza, blood clotting, and high blood pressure. In
1985 the Vietnamese press reported that many cooperatives were
using folk medicines to satisfy 50 to 70 percent of their own
needs for common drugs. Earlier in 1985, however, an official
source had disclosed that efforts to develop Vietnamese medical
science by integrating traditional and modern methods had not
been systematic and had achieved minimal success.
In the mid-1980s, there were six medical and pharmaceutical
colleges, one college-level institute for the training of
managerial cadres in the health services, and more than forty
secondary-level schools for mid-level paramedics and pharmacists.
Physicians at "modern scientific and technical installations,"
according to the Vietnamese press, performed "sophisticated"
heart, lung, kidney, and neurological surgery as well as
microscopic eye surgery. Vietnamese doctors also were reported to
be abreast of procedures in a number of other disciplines such as
nuclear medicine and hematology.
Data as of December 1987
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