Huffington blog DARE TO BE 100
November 14, 2017
VIET NAM AGAIN
The President’s Asia swing rekindled many memories. I climbed Mount Fuji again. I ran the Beijing marathon again. I walked the Great Wall again. But most poignantly were the memories brought back from my time in Vietnam.
20 years ago Chuck Feeney read my book Dare to be 100, and it spoke to him. He had just completed the acquisition of the billion-dollar duty free shops enterprise, and he was scanning his horizons for what to do next. This bonanza launched a career that the New York Times called the greatest philanthropy since Carnegie. Chuck, now a close friend, has made and given away billions of dollars through his organization the Atlantic Philanthropies to make the world more habitable for all of us. Chuck is a contrarian and has turned his attention to situations where America has dishonored itself. Vietnam and Cuba have emerged as his targets.
He, 25 years ago, inquired as to what I was doing with my life. At age 70 I had just closed down my busy medical practice and was seeking a Schweitzer type redirection for the remaining 30 years of my life. My wife and I were filling out applications for the Peace Corps. As I told this to Chuck he immediately offered “why don’t you come to Vietnam with me?”
Within a week I was headed to Saigon with Chuck’s traveling group that included several Irish university presidents who had recently been gifted major academic support by Chuck.
Our appointed task was to act as an advance party to advise on potential support opportunities.
Chuck’s staff filled each day with worthy candidates. Health and education were prime foci. With much enthusiasm I dove in seeking potential value.
I learned that earlier Chuck had supported a French heart surgeon, Carpentier, who once a year had flown in to town with his retinue to fix the scarred heart valves of the kids who were suffering from rheumatic heart disease. High theater, but what about the several dozen children upstairs in the medical floor suffering from acute rheumatic fever and destined to have scarred valves in the future because of the inadequate care given for their strep throats up country.
They didn’t need heart surgery. They needed better public health at the local level that was absent.
Virtually the entirety of medical care in Vietnam is centered in the cities where the money is . Vietnam however is an agricultural country and people live elsewhere, so there is a major mismatch. Rural healthcare is consigned to basic communal health centers that are meager in resources and morale. The barefoot doctors were earnest but ineffective. I visited a number of these outback clinics. Most had a desk and chairs. Most had running water and electricity, but little else.
I recommended a major investment in improving the public health in Vietnam. In Saigon we convened the directors of the schools of public health and sought their input. We bonded them into a cohesive group complete with medical journal and annual meeting. We upgraded their curricula as most of their texts were still in Russian. Prevention became the mantra.
A new national law was passed that mandated compulsory helmet use. This has had a profound effect on the high incidence of head injury on the crowded streets of Viet Nam.
I was mostly excited about another enterprise that I felt would bring their outdated System to an adequate performance level, and this involved equipping each local healthcare center with a computer. Such a resource would arm the local practitioner with the articles from yesterday’s New England Journal of Medicine, and thereby upgrade competence and prestige. Unfortunately this imaginative proposal was blocked by the government’s paranoid fear of alien influence.
Despite this dereliction the public health Enterprise in Vietnam is alive and well. New schools , more staff, more emphasis on the health of the public. The Atlantic Philanthropies has committed several hundred million dollars to its ascendancy.
Highway safety and improved public health are better exports than bombs.