HÀ NỘI — Historically, the mostly publicly financed health care system in Việt Nam has only been able to afford to pour resources into a handful of central level hospitals in big cities, forcing patients living in remote areas with serious diseases to go to Hà Nội or HCM City for treatment.

Aside from the additional costs for transportation and living, by the time a patient has reached the central hospital, the ‘golden window’ to best treat their condition might have closed long ago.

But for the last decade, an initiative called Project 1816 has rotated experts and professional medical staff from central-level to local-level hospitals, reducing the overcrowding in hospitals’ higher administrative units and improving the quality of medical service delivery in rural areas.

The so-called ‘satellite hospitals’ project has enabled local hospitals to acquire experience, technology, devices and manpower from central level hospitals. Many more citizens can now enjoy medical advances right in their hometowns.

December 2017 marks 10 years of implementing Project 1816. So far, central-level hospitals have sent some 4,000 medical professionals to train medical staff in local hospitals, while some 4,800 techniques have been transferred and 2.5 million patients have been treated locally instead of traveling to big cities, the Ministry of Health said.

From death’s hand

Patient N.V.P., 85 years old and a resident of rural Cẩm Xuyên Town of the central province of Hà Tĩnh, was admitted to the hospital with severe chest pain, breathing difficulties and headache.

Dr Nguyễn Văn Lợi, from Cẩm Xuyên General Hospital’s intensive care unit, said that since the hospital did not have echocardiography (heart ultrasound) machine or other advanced monitoring techniques, they could only do basic tests and ask the patient to rest. The octogenarian patient later went into coma and her heart stopped beating.

As luck would have it, at the time there was a working group from Hà Nội E Hospital, a 50-year-old central level hospital under the Ministry of Health’s management, visiting Cẩm Xuyên Town, where the local general hospital is considered a satellite facility.

Doctor Đỗ Quốc Phong, from the E hospital’s intensive care unit, immediately performed heart reanimation and injected adrenaline into the patient’s veins. Five minutes later, her heart resumed beating.

Phong said P. would have had little chance of survival unless emergency techniques had been applied in a timely manner.

In just three days (January 8-10), the Hospital E’s group of doctors blessed several patients with their professional expertise.

The heart doctor’s table was always crowded, showing locals’ real need for cardiology care. Meanwhile, both general hospitals of Cẩm Xuyên and Kỳ Anh towns were woefully lacking in doctors and especially in those with an in-depth knowledge of cardiology.

Because of this, 53-year-old patient N.V.T. from Cẩm Xuyên has not had his heart thoroughly checked up in the five years since he had his heart operation carried out in Huế City. Only on this occasion did he have the chance to get his heart tested carefully and receive plenty of helpful answers.

The E Hospital group also noted high demand for treatment of upper respiratory problems or ENT (ear, nose, and throat) disorder in children, and bone and joint issues for the elderly.

E Hospital’s deputy director Lê Quốc Việt said the working group was deployed in order to assess the real condition – both in terms of infrastructure and manpower – in Cẩm Xuyên general hospital and Kỳ Anh general hospital. During this trip, 1,200 patients were treated, including many whose previously unidentified afflictions were finally diagnosed.

Practical benefits

Professor Lê Ngọc Thành, head of Hospital E, said that the hospital has been providing assistance to 10 provincial level hospitals (Thái Bình, Thanh Hoá, Bắc Ninh, Bắc Giang and Hải Dương provinces, and Hải Phòng City), regional general hospitals like Tĩnh Gia and Ngọc Lặc in the central province of Thanh Hoá, and two district-level hospitals (Cẩm Xuyên and Kỳ Anh).

Most of the expertise is focused on cardiology, injury treatment, intensive care and poison control, Thành added.

Thái Bình General Hospital, with the help of Hospital E, will open for the first time a cardiothoracic (heart and chest) surgery faculty in 2018 to perform open heart surgery, lung surgery, mediastinal and thoracic surgery – all of which were impossible before.

Thanh Hoá General Hospital is considered to have mastered most of the techniques it has received. The central province has invested VNĐ34 billion (US$1.5 million) to build new surgery theatres and buy new medical equipment to aid in open heart surgery.

The health ministry said that one of the most significant results of the satellite hospital project is that it motivates provincial-level hospitals to upgrade infrastructure and invest in training medical staff, which in turn brings benefits to patients.

Similarly, the central Bạch Mai Hospital in Hà Nội has trained hundreds of doctors in the remote areas of the northern mountainous province of Yên Bái in many areas of medicine and skills – diagnostic imaging, gastroenterology, cardiology and surgery – since it first co-operated with the province under Project 1816 ten years ago, according to Assoc. Prof. Nguyễn Quốc Anh, Bạch Mai Hospital’s director.

Vũ Mạnh Cường, deputy director of communications and emulation under the health ministry, said that in the coming years, one priority will be an information network where surgeries can be live-streamed, and training and education activities can be done online. The $81 million telemedicine programme, or the remote diagnosis and treatment of patients by means of telecommunications technology, part of the Project 1816, will also receive special attention.

In addition, communication works must be stepped up so that local people are aware of which diseases and conditions can now be handled by local doctors, hopefully improving the visitation rate, Cường added. — VNS