Medical Monday: Disabled in Vietnam

In my Semester at Sea reflections, I return often to Vietnam. I think it was the first country to shock me, well and truly. It was not very easy to make my SAS experience medically-oriented, and I had to do a lot of hard work to learn about medicine in various countries. Vietnam was the country where the medicine came to me without having to be asked (much like the vendors, and the traffic).

We had a field lab for my Illness Narratives class (definitely one of the best classes OF MY LIFE, but more of that later). We visited an orphanage for disabled children and an elderly women’s home.

It looked like a happy orphanage, if there is such a thing. Colourful playgrounds. Kids running up to greet us, hug us, hold our hands. The children we saw initially were mostly children with Trisomy 21 – a little hypotonic, but otherwise probably reasonably healthy.

Then we were taken to two wards that were not healthy.

PicMonkey Collage vietnam

Ward 1: So many grown children in diapers, with the worst flexor contractures I have ever seen (I haven’t seen that many, but still). From what I could tell most of them had Cerebral Palsy or Hypoxic Ischaemic Encephalopathy. The nurses said the children got daily physiotherapy, but if they did… it wasn’t working.

Young boys with stubble on their chins. Young girls with adolescent skin. And a good deal of them were, I believe, not mentally delayed. A good deal of them could have been taught to take care of themselves to some extent, if only someone tried. But it seemed as though all children with similar problems had been grouped into this one umbrella-area.

Ward 2: Just when you think you have seen the worst, you see worse. The hydrocephalus-ward. I would post pictures, but ethically I’m going to refrain. Basically, the largest hydrocephali I have ever seen (and I have seen a lot of those). My hands itched for a tape-measure. I tested their reflexes, and many of the children had none.

I was told that the children had no hope for surgery. Essentially, they were waiting on death.

This was the first time that I realised how fortunate South Africa is. I always thought we were in such a bad place, but no child in South Africa need die from hydrocephalus (if they do, it is a fault in the system and not in availability). In Vietnam, the concept of free healthcare for the poor and desolate does not exist.

So I walked away from the orphanage thinking that maybe I (or someone else, or a team) could organise pro-bono surgery for these children. But I realised that even if we could pull it off – find the surgeons, the aneasthetists, scrub nurses, equipment, operating rooms and who knows what else for “free” – we would not really be solving the problem.

Because the real problem in Vietnam (and many other countries) is not JUST the fact that they have lots of disabled children. The problem is about maternal health care, early childhood care, social welfare, attitudes…

As I walked further away from the orphanage, I felt desolate myself. Here was a problem that I really did not think had a solution.

But as I walked even further, something happened that turned the shock and anguish and uselessness into a fire, and I got angry. Angry that the world allows situations like these to exist. Angry that we think if people in OUR countries are okay, we can stop worrying. In the global society, does not EVERY life affect another? It is juvenile, I know, to expect countries to care about each other’s healthcare or educational problems. What are the odds of situations in Vietnam truly affecting me? I do not know, but that’s not really why I care. I care, and I am angry, because I cannot NOT be affected by what I saw that day.

I still do not have a solution, exactly.

But I do have a fire.

Despite the sadness of this day, Vietnam was a wonderful country. This clip features my voice and reflections, but also the reflections of my fellow SASers. Enjoy.


  1. CyndyNewsome says:

    I can’t even imagine what you’re seeing and feeling.
    It made me think of one of my favorite quotes:
    “Sometimes I’d like to ask God why He allows poverty, famine, and injustice in the world when He could do something about it, but I’m afraid God would ask me the same question.” -Anonymous

    1. I so agree.
      Please also tell us more about the illness narratives class.

  2. Jane says:

    Thanks for linking up today. We are so shielded from the plight of so many in other countries. When good people see things and then do something about them, no matter how small, that is how the world changes.

  3. Visiting from Medical Mondays – what a great blog you have and what an experience you are living. I think what you are doing is amazing and am excited to learn more.

  4. Emma says:

    Oh my goodness! What an experience! I think I would be outraged as well. Love to hear you’re on a Semester at Sea. One of our girls is hoping to do the program as well. It sounds like a life altering event.
    Thank you so much for linking up with us for Medical Monday! 🙂

  5. This post was beautiful. It made me have flashbacks to the time I spent in Haiti. You expressed the injustice and desire to change it so well.

  6. TrishaDM says:

    That is heartbreaking.
    It is true. Sometimes I feel like we miss what things are happening in other countries, what other places are lacking because we just see what is wrong or right at home. I can’t even fathom children dying on a ward with hydrocephalus. I can’t imagine what it was like to see them. And to not be able to do anything but look on and love them.
    I agree with you on the underlying issue. Even if you can fix one problem, it really doesn’t stop the cycle. It doesn’t stop it from happening to other children. Because the problem is a huge systems issue.
    I wish we could just make everyone have good primary care throughout life. It can make such a difference.

  7. B says:

    Thanks for your fire! I hope to get another opportunity to do some outreach in another country… I had a brief experience in Nicaragua a few years ago. Knowing what I know now, it would be a different experience, but just remembering that I may not be able to change the world, but if I can make a difference to even one person- that’s still a solution to that person and their family.

    1. You’re so right! Thank you!

  8. This is a real eye opener for me… I’m definitely guilty of having the “I’m in America, and there’s nothing medicine can’t do” mentality. I can’t even imagine the things that you saw, and honestly, I’d love to do a medical mission someday to help in areas less fortunate than my own. Thanks for linking up this month, and for letting me realize that just because I have it easy in the medical world, doesn’t mean the rest of the world does.

    Much love,

    1. I’m really glad my post meant something to you – thanks for stopping by and commenting!
      I look forward to read more about what’s in store for you.

  9. Nisha says:

    Reading this post makes me realize how lucky I am to live in South Africa living with Cerebral Palsy in other countries seems difficult to say the least. You’re right we only seem to care about our own these days it sucks 😦 I’m sorry you had to witness such hardship.

    1. Thank you Nisha, and I’m glad you could benefit from the post.

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