Leprechauns in Vietnam

IHP has a system called POD, Person of the Day. The POD rotation goes by alphabetical order of our last names so that each student is appointed five or six days out of the semester. The POD is responsible for morning announcements, introducing and thanking every guest speaker, and making sure the group stays on schedule throughout the day. And it just so happens that I was designated Person of the Day on the most extraordinary, joyous, and festive day of the year - St. Patrick's Day! I started the day by bringing chocolate gold coins to school in the morning and placing them on everyone's desk (a leprechaun visited the classroom, wink wink!). I had to search high and low to find it in the supermarket the day before, but it was absolutely worth the effort. I couldn't find anything Irish-themed, so instead, I had to settle for gold coins with Ho Chi Minh's face on them...but whatever works! After lunch, Casey and I decided to make March 17th a little extra special for the group. We performed a treble reel and then taught everyone how to do the traditional set, The St. Patrick's Day. It was so much fun bringing Irish festivities to Southeast Asia. We were likely the only people celebrating the occasion, but I didn't care. I decked myself out in all shades of green and had an extra kick in my step throughout the day. Other than these special events, my POD experience was not too strenuous. Later in the day, we split into groups and traveled to either the Reproductive Health clinic or the Obstetric Hospital. And, in complete failure of my POD duties, we accidentally left two students behind in the process...whoops!

At the clinic, the doctors served us tea and took us to a room with Ho Chi Minh's gold-encased bust sitting in the corner. We learned about the types of services provided there and the kinds of patients seen. Our group was particularly intrigued by the "two-child policy" in place in Hanoi. The limitations of the number of births has had interesting effects on the population. For instance, many people seek abortions when their second child is not male. This strong desire for a male child has made sex-selective abortions in Vietnam common and is extremely problematic for a number of reasons. We discussed the issues within our group after the site visit and it appears to me that the best way to fix this through public health is to slowly change the cultural mentality that leads parents to more highly value male children. This might be accomplished by providing microfinance opportunities to women, which would improve their economic power and perhaps adjust cultural norms. If women know that opportunities exist for their female children and that the child could one day provide for herself and the family, then it is my prediction that sex-selective abortions would decrease.

Classes continued as usual for the rest of the week. In Research Methods, we divided into our Vietnam case study groups. I will be looking at the differences in urban and rural health care and health-seeking behaviors. Traditional medicine is much more openly discussed and utilized by the people in Vietnam, as opposed to those in South Africa. My group has already met with members of the Ministry of Health and learned much about the failing health system in Vietnam, so it will be interesting to see where people go to receive care. As Vietnam transitions from a nearly universal healthcare system in the 1970s to a mixed public-private system starting in 1990, oversight and regulation is severely lacking. More money is going into the private care facilities, which are more commonly used by the wealthy populations, creating a skewed version of medical care. Wealthy patients also offer to pay a "hidden fee" that allows them better, higher quality care that is unaffordable for the poor. The system is stuck in a transition in Vietnam and because of it, health is suffering. Our group's working hypothesis for our case study is that high social capital in rural areas, as opposed to lower social capital in urban settings, will result in community healing methods in place of (or in addition to) biomedical care. When the biomedical sphere is failing for the rural poor, their next avenue of support is the networks provided by the community itself. In urban areas, the poor have limited social networks in a more isolated environment. For this reason, when the healthcare system is unable to support them, there will be no safety net in place for their wellbeing.

As our interviews and quantitative measurements come into play for the case study, I will keep you updated on what we discover!