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Dr Toan's endless battle to save road victims

Update: August, 07/2012 - 19:09


Patience is a virtue: Family members wait at Viet-Duc Hospital while their relatives undergo surgical treatment. — VNS Photos Truong Vi
Confirmation: Dr Toan check an x-ray with a colleague to make sure exactly where the bones are broken - and just where to begin manipulating them back into position.
Joining the queue: Patients lined up in the corridor waiting to be moved to treatment clinics. Dozens of road victims arrive at the hospital throughout the day, a reflection on the deadly situation on Viet Nam roads.
Foreign help: An overseas doctor takes part in an operation at one of Viet Nam's busiest hospitals, the Viet-Duc. Some pay their own way.
The horrors on the roads of Viet Nam fill many hospitals, especially Ha Noi's Viet Duc, where one doctor and his team fight endlessly to save the lives of road victims. Ha Nguyen reports.

We met Dr Ngo Toan on a hot Sunday in July. Outside, it was 37oC and humid, and inside the Viet Duc hospital it was barely any cooler. Threading our way through a corridor filled with hundreds of traffic accident victims, we felt like we'd suddenly been transported to the middle of a battlefield. Around us patients screamed in agony, begging doctors for help.

"It was like being on the front during the war, with hundreds of injured soldiers lying on the ground waiting to be rescued by doctors," recalled the equally shaken friend who accompanied me.

As we passed by a bed with three injured patients, a young man cried out to me. "I'm going to die," he sobbed. "I'm in horrible pain. Help me! I will not drink any more while driving a motorbike! I will.... give.... up drinking..."

The patient's name was Nong Van Chu, 22, and he came from the northern province of Hoa Binh (80km west of Ha Noi). Chu was among several dozens of injured people brought to the hospital that day.

I told Chu that I would tell Dr Toan about his case. A professional surgeon who has operated on thousands of patients over the past two decades, Toan knows what he is doing. But even an experienced doctor would feel overwhelmed by Toan's caseload.

After 15 minutes of searching, we found the doctor with his hands full. The room was crowded with patients and their anxious relatives. At first, I didn't see him, so I called out his name. I found him surrounded by dozens of people. They asked him to check their legs, their hands, their heads, the arthroscopie of knee, hip arthroplastie and tendons.

Almost all of Toan's patients are poor. They come from Ha Noi's surrounding areas and northern provinces such as Cao Bang and Ha Giang. Their awareness about obeying traffic rules is still low. Many of them still don't wear a helmet while driving a motorbike, said Toan, who is head of the Viet Duc Hospital's Orthopaedic - Trauma Institute and vice president of the Viet Nam Orthopaedic Association.

Toan said that drunk driving and motorbike racing cause many of the emergency cases he is responsible for. Other patients seek him out for help with foot and ankle deformities and disabilities.

While surgeons at the hospital operate on 150 patients a day, Toan has to operate on several dozen such cases a week. (These figures do not include emergency operations).

Lung Thi Hao, who lives in the northern province of Ha Giang's remote Yen Minh District, said she will never forget how Toan changed her life.

Hao, who has suffered from polio since she was eight months old, could not even walk until she saw Toan 10 years ago.

"My family was very poor, so my parents sent me to a provincial centre for social protection. There I was treated by several local and foreign medical organisations but I couldn't walk until Dr Toan came," said Hao.

The doctor asked the Social Protection Centre in Ha Giang to send Hao to Thai Nguyen so he could operate on her.

"After a year of efforts on both our part, Hao could walk," Toan recalled.

Now, Hao is married with a five-year old son. She runs a stall selling miscellaneous goods near her house.

"Thanks to Dr Toan, now I can walk by myself and earn a stable income to feed my boy and my parents," Hao said.

Dr Toan told Viet Nam News another heartwarming story: Three years ago, during a working trip to Ha Giang's Vi Xuyen District, he had treated a Tay ethnic patient named Dang Thi Thuy, who was paralysed in her right arm from an accident years earlier. Because her family could not afford the treatment, she lived with the injury, growing more miserable and suicidal every year.

"Even though I planned to spend my time in Vi Xuyen District doing check-ups, I found time to operate on Thuy. After several hours, thank God, the operation was successful," said Toan.

Like Hao, Thuy is now married and lives a happy life.


Picture of calm: Dr Toan in the middle of an operation.
Free of charge

"Apart from operating on these patients, we have worked with several foreign organisations from Australia, France and Canada to operate on many others free of charge - particularly children in troubled parts of the country," Toan said.

He singled out an effective co-operation between the Viet Duc Hospital and the Prosthetic Outreach Foun-dation (POF) and the American Orthopaedic Foot & Ankle Society (AOFAS).

Over the past 11 years AOFAS has been operating free of charge on nearly 800 patients and conducting check-ups on more than 2,100 others in various clinics, said Toan.

Dr Pierce Scranton, who has worked with him for years, said he has been learning Vietnamese to communicate better with local doctors and patients.

"Since I met Dr Ngo Toan in 2002, our surgeries have been successful, and each year we hold a seminar to exchange views with local surgeons.

"I admired the hunger to learn that his Viet Duc Hospital doctors displayed, so I decided to obtain expensive arthroscopy instruments (inspection of the inside of a joint using an endoscope) funded by the AOFAS Outtreach&Education Fund.

"I taught Dr Toan arthroscopic techniques. He, in turn, taught his colleages," Dr Scranton said.

This year Scranton's fellow American surgeons operate free of charge on 80 patients, most of them children with foot deformities and disabilities, as part of a four-week humanitarian outreach project in Viet Nam.

The American surgeons have check-ups to over 200 other patients in clinics in Ha Noi, Vinh, Thai Nguyen and Dien Bien.

The surgeons have been working with the Ortho-paedic Rehabilitation Institute, the Viet Duc Hospital and the Ha Noi orthopaedic surgeons in the programme.

They also share knowledge and teach new techniques on how to care for patients, said Lousanne Lofgren, executive director of the (AOFAS) and Orthopaedic Foot&Ankle Outreach & Education Fund (OEF).

"Many children and adults here suffer from deformities that would otherwise go untreated, so helping them is a special privilege for us," said Naomi Shields, MD of Wichita, Kansas, the team leader.

"At Viet Duc Hospital we were pleased to see a middle-aged woman return to the clinic for her one-year follow-up. She had a tendon transfer surgery last year and now is walking normally, without pain, and seems very pleased with her result."

According to Dr Toan, Dr Shields is a professional surgeon who is excellent in both the theoretical and the practical aspects of medicine. She has devoted much of her life to operating on Vietnamese children, sharing the hardships of her Vietnamese surgeon counterparts at Viet Duc Hospital and in remote hospitals in Thai Nguyen and Dien Bien. "We learn very well from her surgical skills," Toan said.

Dr Paul Juliano of Hershey, Pennsylvania, who came to Viet Nam for the first time as a volunteer, said what most struck him was how crowded the clinics were, and how many patients have deformities that are not common in the US.

The US surgeons paid their own costs to travel to Viet Nam to participate in this outreach project, said Lofgren, adding that AOFAS also sponsored a one-day educational seminar in Ha Noi for 135 Vietnamese orthopaedic surgeons.

Speakers from HCM City, Hue and Viet Duc gave presentations at the seminar along with US foot and ankle surgeons.

Dr Toan said he hoped that the US surgeons will continue coming to Viet Nam to give free operations to poor patients, particularly those in remote and disadvantaged regions.

Asked about whether there is any way for patients not to share beds, Dr Toan said the Ministry of Health has projected that by 2015, patients in major hospitals - including Viet Duc Hospital - will have their own beds.

According to the ministry's draft proposal, international-standard policlinics and hospitals will be built in Ha Noi's districts of Gia Lam, Long Bien, Hoa Lac, Soc Son, Phu Son and Son Tay, said Dr Vuong Anh Duong of the Ministry's Therapy Department.

He said that other localities, hospital and health clinics specialising in cancer, cardiovascular, obstetrics and paediatrics will receive support from the ministry.

The project will cost over VND36.7 trillion (US$1.7 billion), and will be funded by the State budget, Govern-ment bonds, local and foreign organisations and individuals, Duong said.

Dr Toan said thanks to the project, patients will have other hospitals to go to so they will no longer all rush to Viet Duc Hospital, as they currently do.

"We would not have to work on Sunday, although I'm always ready to give a helping hand to those hospitals needing me to operate on an wounded patient," said Dr Toan. — VNS

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