Vietnamese baby factory

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  Pho Nang Ho Chi Minh, Vietnam
Monday, July 14, 2008

Visited Hung Voung Public OB hospital today. Some interesting stats as shared by the hospital director Dr. Thach:
   -800 liscensed beds
   -942 actual beds (extras are in hallways to avoid putting 2 pt/bed)
   ~150-160 MDs on staff
   ~300 midwifes 
   ~600 total midwifes, nurses and technicians in all
   -33,000 babies delivered last year
   -average 80-100 babies/day delivered this year (slower than last year)
   -1/3 of pregnancies are high risk: mainly precclampsia/hypertension
   -30% of deliveries C-section (Saigon as a whole has 35% C-section rate)
   -private hospitals have 70% C-section rate
   -120,000 babies delivered in Saigon annually
   -Ministry of Health does not permit elective C-section in public hospitals, so surgeons must justify each case
   ~100 abortions/day in this hospital (surgical D&C and medical:IV fluid forced into uterus until labor is induced, delivered baby (often around 7 months gestation) is left to die)
   -IUD most common birth control method..usually left in about 4yrs avg

'Parking garage' in middle of hospital

. in cities (longer? in rural)
   -HIV rates slowly increasing
   -Gov't has set up volunteer testing centers for HIV
   -almost all patients at this hospital are HIV tested

Hospital architecture is open design, only necessary areas (delivery rooms, nurseries) are enclosed. Many post-partum patients are in open-air hallways for the 2-3 day stay after delivery. Others are in rooms off the hall with 3 beds/couplets per room. Most of the walls are very dirty, and conditions are very crowded, with family of the mother-baby couplet present to help out. Waiting rooms for family were good sized, often outdoors. Lines of sleeping bats can be seen up in the eaves of the hospital courtyard.

Paying and nonpaying moms have separate antepartum, delivery, and postpartum areas. Delivery rooms have a wall down 70% of the middle with two delivery beds on each side. Each delivery area had about 11 women actively delivering. Women are mostly silent during delivery and are attended by a doctor or midwife and some nurses or technicians. We had to put on long lab coats, face masks, and plastic bag shoe covers before entering delivery room on paying side

Abandoned babies

. Nonpaying side had no face masks and we changed into sandals. Women generally stay 2 hours in delivery room after birth, then go to the crowded postpartum room for 4 hours before being moved to bed where they will stay until discharge. Babies get mom's name written on leg with permanent marker to avoid mixups.

In the neonatal unit some isolettes had 2 babies...one room had a line of abandoned babies. It is common for babies with birth defects such as cerebral palsy to be abandoned...this hospital gets about 15 babies a day. If defects are found during antenatal care it is common to get an abortion.

About 500 women are seen per day at this hospital, only about 100 women a year attend childbirth classes due to lack of instructors and people not wanting to miss work to attend as classes are in the early afternoon. Alot of the teaching materials we saw were "Johnson's baby"...provided by good old Johnson & Johnson.

Our group presented lectures on the "March of Dimes" prenatal education class curriculum (we gave them a copy of the entire curriculum, they will have to translate it), prenatal care in the UK (by our British medical student), late preterm baby care, and OB Stat team implementation to promote faster treatment babies who become acutely ill. Tomorrow we will cover English for the healthcare provider and have a English conversation class.

Must go eat now..btw they fed us at the hospital Can tin (canteen) and they had the most amazing spring rolls that we dipped in a fantastic sauce

Delivery room

. Also had a red-broth beef and potato/vegetable soup into which we dipped awesome french bread. The meat we dipped in little dishes of salt/pepper mix that we squeezed fresh limes over. There was also a seafood soup and angel-hair rice noodles. We stuffed ourselves, then retired to a conference room to nap in reclining lawn chairs for an hour before starting class.

9 pm: PS- had frog stir fry for supper at a nicer restaurant called Hoang Yen. There is nothing exotic about frog! It tastes exactly like chicken and is a pain to eat cuz there's a million little bones to pick the meat off of. It was a good yellow curry dish though. Oh yah, one of the ladies ordered red wine....it came chilled and in a small glass filled to top. They have no idea how to serve wine here. The guave juice was just fine though. There was a waiter standing next to our table at all times, just waiting in case we needed anything. When I picked the mushrooms out of my dish, he leaned over and started helping...just a little weird.

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Newborn nursery

Shared quarters

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