13 September 2015

Photos From Our New Out-Patient Facility

Rehabilitation in Vietnam
A young Vietnamese banker who has suffered a stroke (CVA) works to regain functional use of his hand and arm under the care of American and Vietnamese therapists at the new out-patient facility of the Traditional Medicine Hospital of Da Nang, located at 342 Phan Chau Trinh Street. In addition to neuro-rehab and treatment of chronic and acute pain, this facility also provides effective and affordable treatment of heroin addiction via acupuncture and other traditional remedies.

Stroke Rehab in Vietnam
A motorbike taxi driver rejoices in regaining both the use of his right arm and his ability to balance on a two-wheeled vehicle with the help of Thuy, an American-trained Vietnamese physiotherapist. More info on physical therapy in Vietnam here.

Tea shop with Original Artwork
Tea shop at the new out-patient facility of the Traditional Medicine Hopsital of Da Nang, located at 342 Phan Chau Trinh Street features the art work of disabled artist Nguyen Tan Hien.

14 April 2015

Recipe for Success

I've been a physiotherapist in Vietnam, volunteering in four different hospitals, a school for disabled kids, and out in the community in Da Nang, Hoi An, and rural Quang Nam since 2005. And while my first years here were certainly educational for me and afforded me the opportunity to personally help countless disabled Vietnamese people, I--like every other foreign therapist I have spoken with--was unable to make any significant impact upon the way in which Vietnamese-trained physiotherapists practice physical therapy. As you can see from earlier blog posts, I had in fact given up on trying to change practice here and instead, since 2010, been focused solely on providing hands-on rehab for patients at the Traditional Medicine Hospital of Da Nang, a 140 bed non-acute facility that had an abundance of stroke patients, but not much to offer in terms of physiotherapy.

However, when Dr. Nguyen Van Anh became director of the facility a year ago, everything changed. Not only did he immediately begin renovating the sadly deteriorated hospital and grounds, he also initiated several new projects, including a widely acclaimed drug rehab program. And--of particular interest to me--he brought in a large number of newly graduated Vietnamese therapists on a probationary basis and told them that if they wanted to work in this hospital, they would be required to follow and learn from me. This has made all the difference in the world! Although neuro-rehabilitation is an especially challenging aspect of physical therapy and although their earlier training had left them without the ability to evaluate, plan and implement effective treatment regimes for individual stroke patients, our young therapists have been doing their very best under my guidance. I would not say that they are "world class" therapists at this point, but they are head and shoulders above any other therapists that I've encountered in the ten years I've been volunteering in Vietnam. And they continue to improve with each new patient that they treat. I am so very proud of them!
Young Therapist at Traditional Medicine Hospital
Remarkably, word of mouth has already brought us an ever increasing number of patients from the city of Da Nang itself and also from Hoi An, Quang Nam, Quang Ngai, and Hue, as well as from the mountainous region to the west and the off-shore islands of Cham and Ly Son. In fact, in the days immediately following the Tet holiday this year, 45 stroke patients were admitted to our service while other nearby rehab facilities received but a few. Our patients now include not only those who had been frustrated by ineffective rehab treatment they had received elsewhere, but also new stroke patients, transfered to us directly following their initial acute stay at the General Hospital of Da Nang.
Young Therapists at Traditional Medicine Hospital
Dr. Anh has a new vision, and I'd like to help him achieve that as well. We would like to create an effective Early Intervention program for children with cerebral palsy and developmental delays. Existing child rehab programs in Da Nang attempt to deal piecemeal--with very minimal success--with older children who have already developed contractures and/or maladaptive movement patterns. We want to catch kids early and work together with the child's family to guide them on a developmental path which holds the best potential for their optimal development. Thanks to our open-minded therapists and to our supportive administration, we have a wonderful opportunity to do something great for the disabled children of Da Nang and their families. Now all we need is an experienced foreign paediatric physiotherapist to guide us in our efforts. If you know of anyone who might be interested in such a long-term volunteer opportunity, please send them our way!
Bean and Me

3 April 2014

Slow and Steady Wins the Race

By Thanh Nguyen, Thanh Nien News
Thursday, April 03, 2014 23:06
Photo from Thanh Nien
Virginia Lockett, an American physiotherapist, exams a patient at a hospital in Da Nang/PHOTO COURTESY OF VIRGINIA LOCKETT

An unusual journey from the US to Vietnam took physiotherapist Virginia Lockett and her artist husband David Lockett 11 years, but it is not one that they regret one bit.

In 2006, they sold their house in America and moved for good to a country they’d only visited twice earlier, the first time in 1995.

During the process of making this momentous decision, they’ve been helped by their ability to change the lives of many disadvantaged Vietnamese people for the better.

After settling down in the central city of Da Nang, Lockett started volunteering as a physiotherapist at several local hospitals.

Meanwhile, Steady Footsteps, a non-profit organization that they’d founded prior to their moving, has worked to provide walkers, canes and pump-action carts for poor patients. Funds for this work have come from their savings and donations from other individuals and charities.

Sometimes they provide more than just a piece of equipment.

For instance, a man who had his legs and part of his arm muscles weakened by a spinal cord tumor was helped to open a small grocery shop at home and given a used three-wheel motorbike.

They have also distributed 3,400 helmets for healthcare workers in Da Nang, winning recognition and praise from the city’s Department of Health.

Fateful encounter

Lockett said they first visited Vietnam to adopt children in 1995.

The trip not only helped them find a daughter and a son but also made her, a professional trained to work with physically impaired people, realize how “hopeless” the situation was for people with disabilities in Vietnam.

Upon learning of her expertise, a man who assisted them with adoption paperwork in the central resort town of Nha Trang took them to meet his 65-year-old father who had been bed-ridden for five years after a traffic accident and a stroke.

The old man’s circumstances would have been much different had he been in the US or Canada, where he would have undergone orthopedic surgery for his injury soon after the accident, and walked again with assisting devices and therapy in a few weeks, she said.

Therapy would have also helped him recover from the stroke, Lockett said.

It struck her then that “there must be thousands and thousands of disabled Vietnamese people, spending their lives on floors and in beds, simply because they lack the medical and rehabilitative care that we take for granted in the west.”

“I didn’t know what I could do about it, but it haunted me.”

Ten years later, in response to a call from a North American non-profit organization, Lockett flew to Da Nang as a volunteer clinical instructor at the Da Nang Orthopedic and Rehabilitation Center.

For the second trip, she packed a variety of devices that she knew was unavailable and unaffordable in Vietnam so that she could give them to her future patients. Many of pieces of equipment were adjusted by her husband, who was also travelling with her, to fit Vietnamese recipients.

Lockett said the trip was long enough for her to realize why physiotherapy in Vietnam was almost ineffective, even with the help of experts from international NGOs.

Instead of being instructed to do functional activities like getting out bed, patients were asked to perform “very simple passive exercises,” she explained, adding assistive devices were also insufficient.

Helping some patients “truly” recover during the time she worked convinced Lockett that she could use her skills and training to improve the lives of many people with disabilities in Vietnam.

Better work

Lockett said in an interview with Vietnam Television that in the US, a physiotherapist can get tied up with lots of administrative tasks including documentation and limitations related to insurance, but here in Vietnam, she is free to do the best she can to help her patients recover.

Her dedication has won her a lot of respect and admiration from her Vietnamese colleagues.

“Rain or shine, she always comes to work on time and is dedicated to treating her patients,” said Nguyen Van Anh, director of Da Nang Traditional Medicine Hospital, where Lockett has worked for over the past three years treated some 300 patients so far.

Dr. Nguyen Kim Dieu of hospital praised her treatment methods, saying that depending on each patient’s condition, she would design suitable exercises that can help the patient regain his or her ability to do particular, practical tasks.

While there is an interpreter to help with the language barrier, Lockett is also admired for her ability to communicate well with patients who suffer speech and brain disorders caused by strokes or traumatic brain injuries sustained in road accidents.

She first establishes eye contact with them, and then directly demonstrates what they should do instead of explaining it verbally.

“I love this work and what I’m doing now is what I wanted to do when I first came out of the physical therapy school,” Lockett said.

She said although it might seem “very noble and selfless” of them to leave an American lifestyle for living and working as volunteers in Vietnam, their life here is “so much less stressful and more meaningful” than it was in the US.

Artistic talents

The Locketts now also run the Da Nang Artists Company, which markets paintings and embroidery works made by people with disabilities that the wife meets during her volunteering work.

Lockett said they were inspired to establish the company after meeting Nguyen Tan Hien at the Da Nang Rehabilitation-Sanatorium Hospital in 2007.

Hien, who hails from the Central Highlands town of Buon Ma Thuot, had been in the hospital for three years then. His legs and part of his arms were paralyzed after he was hit by a bus.

The accident forced him to stop his university studies as a mathematics major, but it did not prevent him from pursuing his dream of getting into an art school and becoming a professional artist.

He asked Ho Viet Phuong, an architecture student who was paralyzed by a spinal cord tumor, to teach him to draw during free time, so that he could pass the school’s entrance tests.

However, to his dismay, Hien discovered that all drawing classes were on the school’s second floor, meaning that he could not access them on his wheelchair.

Lockett said her husband recognized Hien’s talent and told him that he could become a real artist without going to school, because many famous artists in the world were self-taught.

They asked him to draw pictures that they could use for printing postcards and greeting cards for Steady Footsteps. He was offered US$10 for each picture, and in the end he earned $100 for works that he drew with a pencil tied to his fingers with rubber bands.

Hien said that later, Lockett returned after a short visit to the US and told him two stories that he could illustrate for her.

“She kept encouraging me to continue drawing, and buying my paintings to hang them in her house or give as gifts to others,” he said.

With continuous support from the Locketts, Hien was slowly able to grow from drawing with pencils to doing water colors and even acrylic paintings.

The American couple helped market his paintings online and found buyers from different parts of the world like Canada, Hong Kong and Singapore.

Hien’s works have since been displayed at a couple of local and international exhibitions. The appreciation and acceptance that he received for his works have given the artist a lot of self-confidence and belief. He is now happily married and works as a consultant for other people with disabilities.

“Throughout my journey, Ms. Virginia and her husband are always by my side. I respect them and love them as my family,” Hien said.

“We’ve helped and worked with lots of people since we were in Vietnam, but Hien is very special to us,” Lockett told Vietnam Television.

“It’s a rare thing when you can have such a big impact on somebody’s life. It’s an honor.”

13 December 2013

VIỆT NAM TRONG TIM TÔI (Vietnam in my Heart)

1 December 2013

A Little Bit Famous

4 December 2011

Yes, We're Still Here!

Well, it’s been over a year since my last post on the Steady Footsteps blog, though there’s quite a bit of new material on my other blog, A View from Vietnam. We’re still in Da Nang and we’re still busily engaged in trying to make life better for disabled folks in Central Vietnam.

Virginia Gait-Training Stroke Patient

Trang, Huy, and I have been working together at the Traditional Medicine Hospital of Da Nang for more than a year now and hope to continue for the foreseeable future. The majority of our hospital patients have suffered strokes, though many at a younger age than I had been accustomed to seeing in the States. (Our most recent is only 17 years of age!) We’ve also worked with divers from Quang Ngai who sustained spinal cord damage due to decompression sickness (aka: “the bends”) and--of course--victims of traumatic brain injury due to motorbike accidents.

Tiny Ten-Year-Old Nhan Rides a Bike

Our work in the community has continued as well. In Dai Hiep, four year old Phuoc, who has cerebral palsy, has started to speak and continues to try valiantly to perfect his head control and gain functional use of his arms. Tiny ten-year-old Nhon, who has what appears to be a pituitary disorder, has transformed himself, with our help, from a weak and listless waif into a dynamo on wheels! Farther afield in Quy Son, Trang has been traveling an hour each way via motorbike to become, in essence, a Guardian Angel for Hoa, a head-injured young woman with coordination problems that I’ve been following intermittently for the past four years. Under Trang’s care, Hoa has started speaking, doing more and more activities of daily living independently in her home, and even getting out into the community for the first time in four years on the back of Trang’s three-wheeled motor bike.

Trang and Hoa Pickin' Chicken

Finally, our efforts to promote the financial success of disabled artists of our acquaintance have led us to formalize a business called The Da Nang Artists Company. (A Vietnamese language version of the site can be seen here.) Through our efforts, paintings by Nguyen Tan Hien, our quadriplegic artist and friend, are now offered for sale not only by us, but also via another on-line gallery based in the UAE: liborius-xu.com Hien’s proudest, however, of two very different accomplishments this year. He and his wife Ly now have a baby son and a little one-bedroom house of their very own!

Hoa Si Da Nang

17 October 2010

Walking the Walk

I’ve been trying, in every way that I can think of, to share my knowledge and love of physical therapy with young Vietnamese therapists since I first started volunteering in Da Nang more than five years ago. Regretfully, neither I nor any of the other American, Canadian, German, Australian, or New Zealander therapists that I’ve encountered have had any significant success in that regard. Even with our best efforts at demonstrating and explaining, with the assistance of the best translators that we can find, we still have not been able to light a fire under these marginally trained so-called physical therapists. What a pity. And what a puzzle, as well.

The question I’ve been wrestling with for the past year or so is: what can I do in the face of this seemingly intractable obstacle to providing decent rehabilitative care for the disabled folks that I encounter here in Central Vietnam? The answer that I finally settled upon is to just provide the care myself, with the help of some intelligent, compassionate, bi-lingual young assistants.

So, for the past six months, Trang (a lovely young disabled woman who initially signed on as our cook) and Huy (my trusty translator) have been working directly with disabled kids out in the countryside, along with me and an occasional foreign volunteer. And it’s been great! What a difference to work alongside young people who are open to new ideas and enthusiastic about helping disabled folks and their families have a better life! Instead of merely talking about rehabilitation, we’re doing it. (Following our lead, the Kianh Foundation hired Trang’s little sister, newly graduated from high school, to work alongside Danielle, their Aussie PT, and found her enthusiasm, diligence and openness to new ideas a breath of fresh air after working for seven years with typical Vietnamese therapists.)

Trang Helping Kids in the Countryside

Steady Footsteps has now initiated a new formal relationship with the Traditional Medicine Hospital of Da Nang and an informal one with a brand new school for disabled kids in Da Nang. Trang and Huy are working alongside me with the blessings of the administration of both facilities. What a relief to give up on “Talking the Talk” and finally just focus on “Walking the Walk!”

Huy as PT assistant

16 October 2010

Tao's Story

Tao's Old Cart

When Tao showed up at the rehab hospital where I was volunteering last year, he told me that he fell down frequently because of weakness in his legs. From the doctors, I found out that Tao had an inoperable, but slow growing, spinal cord tumor in his neck. Upon examination, I determined that Tao’s legs were actually quite strong. His problem was that he could not feel them. That’s why he often tripped and fell and it was also why Tao was unable to travel by motorbike as nearly all of us do in Vietnam. Not only could Tao not control a standard motorbike, he was even afraid to ride on the back as he feared that his feet would slip off the pegs and get caught in the rear wheel.

With that insight into Tao’s situation, I worked with him on developing a safe and consistent gait pattern while cautioning him that he would always have to pay close attention to his feet, especially when walking on uneven surfaces. I also bought him a pair of shoes with clearly defined heels and had him practice keeping his feet on the pedals of a stationary bicycle. As a result, Tao was finally able to travel on the back of a motorbike with confidence and so was able to travel home on the weekends to be with his wife and three daughters.

Months later, I encountered Tao as he was vigorously pumping a hand-powered cart up a blazing hot, steep stretch of road in the countryside southwest of Da Nang. I cringed to watch him, covered in sweat and with veins bulging on his forehead, struggle up that hill. I knew that the spinal cord tumor in his neck not only blocked sensation to his legs, also caused unremitting pain in Tao’s right arm. Tao’s Herculean effort was surely exacerbating his arm pain. The sort of cart that Tao was using is actually rather brilliantly designed. It needs no fuel and moves as fast as a bicycle on level pavement. In fact, Steady Footsteps has purchased quite a few of them for impoverished disabled folks in the Nui Thanh district of Quang Nam province. Unfortunately, Tao lives in an exceptionally hilly area and was trying to eke out a living by selling newspapers and lottery tickets at various coffee and noodle shops that hilly region. Things were not going well for him—he was racked by pain and he often did not even break even financially on his daily newspaper sales.

We followed Tao to his home that day and listened to him talk about his dream of having a little shop of his own. And we made that happen: Steady Footsteps not only supplied Tao with initial merchandise and start-up funds, we also provided him with a used three-wheel motor bike and lessons in how to drive it. Tao’s life is still no bed of roses—his arm still gives him fits and he’s nowhere close to middle-class—but he’s got the shop of his dreams and he’s able to provide for his family and that’s not bad.

Tao's New Old Motorbike

3 October 2010

For Better or Worse, Till Death Do Us Part

Dung and Linh at the Prosthetic Shop

We finally got the phone call we’d been anticipating for more than a year and a half. Dung’s wife Linh has been admitted to the General Hospital of Da Nang, having at last reconciled herself to the idea of having a tube surgically placed through the wall of her abdomen to prepare for a life-long regime of peritoneal dialysis in the hope that she will be able to continue to raise her two young sons and care for her husband Dung.

I met Dung and Linh in 2008 at a rehab facility near my home in Da Nang. There, amidst all the stroke and brain-injured patients, Dung was a rarity. He was entirely coherent and independently ambulatory. He had recently survived electrocution on a construction job and had only one major handicap, but it was a big one.

He had no arms.

We do have a shop in Da Nang that makes artificial limbs. It’s actually pretty darned good when it comes to making practical low-cost artificial legs--in large measure because of the work done here during the Vietnam/American War by the American Friends Service Committee, a Quaker organization. Unfortunately, no one in Da Nang—or in Hanoi, for that matter—had the expertise or the components needed to make a functional arm for Dung.
Dung soon left the rehab hospital, realizing that no one there was in a position to help him, but we stayed in touch. For the next year, I sought an answer to Dung’s dilemma. Finally, the Limb Center of Wellington, New Zealand, came to Dung’s rescue. They not only donated the necessary components to compensate for the restricted range of motion in Dung’s left elbow (his right stump is too short to accommodate a functional prosthetic arm), but they also sent a technician, Malte, to help the local prosthetic technicians fabricate this unusual prosthesis.

Dung Gets a New Arm

During the following year, Steady Footsteps staff and volunteers worked with Dung to help him become as functionally independent as possible with his new arm. We had a three-wheeled trike designed and fabricated for him so that he could become more mobile. His cousin, who is a welder, designed a cup with a swivel grip made from bullet casings so that he could enjoy drinking coffee with the friends and neighbors who came to the little coffee shop that Dung and Linh opened in the front room of his parents’ house. (Dung’s own house had been demolished in an urban renewal project just before his accident and the compensation money they received was eaten up by medical costs after his accident.) As Dung regained the ability to feed, dress, and bathe himself, he began to pull out the deep depression that had enveloped him ever since his accident. Unfortunately, fate dealt this family yet another cruel blow.

Coffee Time

While Dung was learning to operate his new arm, Linh finally sought medical treatment for the severe abdominal pain that she had been suffering. Not surprisingly, considering the stress she had been under, tests showed that she had a duodenal ulcer, for which she subsequently received treatment. The surprising news, however, was that tests inadvertently revealed that Linh had only one kidney. The devastating news was that that one kidney was failing.

Linh has been wrestling with that news and its implications for over a year. She’s been hospitalized numerous times since then for palliative treatment and each time the doctors advise her to have surgery and get started on regular dialysis, pointing out that, should she wait until her kidney fails completely, she may very well not survive the surgery. The surgery is more than Linh and Dung can afford, so Steady Footsteps is paying for it. The monthly cost of the dialysis regime is also beyond them and I don’t really see how, in good conscience, we could back away from helping them with that as well.

What do you think? Could you help us out with this project? Of all the adaptive devices that we could ever give Dung, what could we do that would ever replace Linh?

Dung and Sons

7 June 2009

Re-Imagining Rehabilitation in Vietnam

While health care technology has rocketed into the 21st century in Vietnam, with cardiac bypass surgery, total hip replacements and in-vitro fertilization available now to those who can afford it, physical rehabilitation remains mired somewhere in the 1950s. I, myself, studied physical therapy a mere thirty-five years ago in the States, but this observation was offered me by a New Zealander who actually did become a therapist in1950:

“The situation you’re describing sounds just like New Zealand when I first became a therapist. Don’t worry,” she said, “the Vietnamese will gradually figure things out, just as we did over the past fifty years.”

That seems a rather depressing prospect for the 86 million people living in Vietnam today, don’t you think?

In America these days, the American Physical Therapy Association advocates that new entrants to the profession of physical therapy be educated at the doctoral level. Yet USAID-funded programs, such as Health Volunteers Overseas (HVO), routinely send American and Canadian volunteers to Vietnam for two to four weeks at a time to offer clinical instruction to graduates of two-year PT tech schools. Even without looking closely at the results of such a program—which I can assure you are abysmal—could any reasonable person suppose that Vietnam will ever “catch up” to the standards of rehabilitation offered elsewhere in the world?

Vietnam and America’s histories are closely intertwined, in ways that many Americans would prefer to overlook. Even as Vietnam emerges from the grinding poverty and isolation of the bleak decades of US-imposed embargo, parts of that shared history bequeath a twisted legacy to the future.

Most significantly, Vietnam is isolated by language. When you consider that most of the fluent English-speakers in Vietnam were associated with the losing side of a long and bitter civil war, it’s not surprising that they would subsequently be excluded from the educational system and the government of Vietnam. Thus, there are very, very few people in Vietnam today who are truly fluent in English—and those who are most assuredly are not Vietnamese physical therapy technicians! Translators--even those who are graduates of university level programs--may have had little or no previous exposure to foreigners. Even if a foreign volunteer should be lucky enough to be assigned a translator who is actually capable of conversational English, the sorts of things that physical therapists need to talk about are not in the normal English language curriculum. Indeed, there is not even Vietnamese vocabulary for much of what we need to say. How is it reasonable to expect that anything productive will come from this doomed attempt at communication?

Physical therapy in Vietnam is not a high-status occupation, nor is it a highly paid one. Only the top 10% of Vietnamese high school students are admitted to university, and these therapists were NOT in that top 10%! Physical therapy training in Vietnam consists of learning certain well-defined “techniques” and then practicing them under the cursory supervision of similarly trained therapists. Evaluation and treatment planning are NOT part of the curriculum. Neither, for that matter, are transfer and gait training. And yet therapists emerge from this minimal training program convinced that they know absolutely all there is to know about physical therapy. They are invariably polite to visiting foreign volunteer therapists, but foreign therapists who return on subsequent visits to Vietnam are universally disappointed to note that their educational efforts have had no enduring effect whatsoever. It’s important to note that the physical therapy supervisors have had the same minimal training as the rest of the therapists and that they view their role as ensuring that PT continues to be practiced “correctly.” The most promising Vietnamese physical therapy student I ever worked with (the only one who ever “got” the idea of gait training) told me--through a translator--the following:

“You know, I really like what you are trying to teach me. I can see that it is much more effective than what we usually do here. But I have to tell you that if I get a job in a Vietnamese hospital and I attempt to do this, I will be corrected. And, if I continue to use your techniques, I will be fired.”

Gait Training in Hoi An

That statement stunned me, as it is so hard to perceive what is really going on when you stand outside of both the language and the culture of a place. But now, two years later, I know that that physical therapy student was telling me the truth. Even after two years of working continuously at one facility, with one dedicated translator, I cannot honestly say that I have been able to significantly change practice there. On the other hand, I recently had the opportunity to work alongside two volunteer occupational therapists in the rehabilitation department of a different hospital, under the dynamic leadership of two progressive, open-minded physicians and what we were able to accomplish there in a mere two months was simply amazing. Those two physicians had--many years ago--studied about rehabilitation: one in Israel and the other in Philippines. They were ready, willing and able to support and implement new ideas introduced by foreign therapists. Had they actually had full training as therapists, they would have implemented those changes themselves, over ten years ago.

So here’s what those progressive MDs and I want to propose for the future of rehabilitation in Vietnam:

We believe that young, government-employed physicians with a special interest in rehabilitation should be provided the opportunity to study for an entry-level doctorate or masters degree in physical therapy in America. (It goes without saying that they would first need to study English for a year in America to enable them to get the best results from their studies.) Right now, most Vietnamese hospitals are fully staffed with minimally trained PT techs that are going to stay in those positions until they retire, decades from now. It’s actually difficult for new graduates to find a position. Trying to change practice through the existing school system is futile in the short term as new PT technicians would rank below everyone else in seniority and be unable to “buck the system.” Fully trained, Vietnamese physical therapist-physicians, however, would be able to step into any existing physical therapy department in Vietnam with the knowledge, skills and the authority to ensure the delivery of good quality rehabilitation.

There is an idea in America that any Vietnamese person would never return to Vietnam, should they be permitted to enter the US. This is a very simplistic view, which does not begin to take into account how much life has changed for the better in Vietnam recently and how much more comfortable it is to live within the circle formed by one’s own family, culture and language. Government positions in Vietnam are highly sought after, even considering the low salary levels of both Vietnamese PTs and MDs. Employment by the state assures one of job security, health care, four month paid maternity leave, disability pay and a full pension after thirty years (at age 55 for women and at 60 for men). Additionally, therapists and physicians routinely develop private practices to supplement their government salary. I’ve lived in Vietnam for the past three years and I wouldn’t care to live anywhere else. The cost of living is low and the pace of life here is very, very pleasant. It’s simply naïve to assume that any Vietnamese person would willingly abandon such a life.

Kiwi-Designed Prosthesis with Vietnamese-Designed Adaptive Toothbrush
I believe that America owes a special debt to the Vietnamese people. Moreover, I think that sharing knowledge and skills that can ease the suffering of millions of people is simply the decent thing to do. We don’t need to send specialized, high-tech equipment or vast sums of money overseas to implement such a project. In fact, all the money necessary to fund this project would be spent in educational institutions in the US.

Surely, surely we can find a way to fulfill this dream.


More photos

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