For a better understanding of VNMAP’s operations and how it has helped shaped young medical minds, check out the reflections of Ryan Brennessel, a medical student and former participant, below.

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Throughout my life, I have had the opportunity to travel to many parts of the world.  As my mother worked for a major airline for nearly three decades, I was exposed to various cultures and lifestyles by the time I had reached the eighth grade.  These incredible experiences allowed me to see all the usual highlights on any traveler’s itinerary, but what made more of an impact on me was witnessing first hand the extreme poverty and deplorable conditions outside usual tourist stops.  Seeing people struggle to survive on so little made me appreciate what I have and what I have been given throughout my life. Being aware of this at such a young age, I vowed that one day I would get involved in giving back.

When I found out that I had been selected to be a medical student team member on the Viet Nam Medical Assistance Program’s 2010 mission trip, I realized that it would be a wonderful opportunity to make a difference.  My trip into the rural regions of the Mekong Delta in Viet Nam further opened my eyes to the healthcare disparities that exist globally.

The team I worked with consisted of physicians, pharmacists, translators, volunteers, physician assistant students and fellow medical students who worked feverishly in oppressive heat and poverty stricken villages over the course of two weeks to examine up to, and sometimes more than, two hundred people per day. Days began early, starting with the loading of a small bus with medicine and medical supplies and a long drive through narrow roads that cut through rice paddies and vegetation. Our final destination changed each day, but we usually ended up at a rundown school house or government building that we would then transform into a makeshift clinic. Goals included providing basic screenings, medication, nutritional supplements, patient education, as well as financial support and follow-through for extreme case referrals to city hospitals. Data was collected for a collaborative study on hypertension—a burdening issue for many Vietnamese—with the goal of better understanding how to treat it. (Hopefully, with this knowledge, the people of rural Viet Nam can be cared for on a more long-term and sustainable basis.)  Surplus medical supplies from clinic days were collected and personally delivered to orphanages, shelters for mentally disabled and blind children, non-profit clinics, and a senior care center.

The impact the mission had on me cannot be described in words. The program did more than just provide for the underserved of Viet Nam; it also gave me the educational experience of a lifetime. It allowed me to increase my awareness of the human condition, and explore particular areas of medicine where I can make a significant contribution.  The trip offered insight into an amazing culture that was both very different, yet principally similar at the same time.  Many of the diseases and ailments I had spent months reading about and studying in text books now had an unforgettable face and story. There were opportunities to work beside Vietnamese and American doctors and watch them care for   patients with the utmost display of compassion. I observed interactions that no textbook can teach an aspiring physician.  It was an honor to be a part of a team that worked tirelessly in less than optimal conditions to help those who are less fortunate. For me, this mission was not just the fulfillment of a desire to travel, but a step in the direction of becoming a competent and caring physician both at home and abroad.

Correction: A previous version of this post misspelled the author’s name as Ryan Bressells.  The correct spelling is Ryan Brennessel, as seen above.

This year (2009), The Vietnam Medical Assistance Program (VNMAP) selected Lam Dong, a province in the Western Highland, as its site for examining and treating patients. Each day our team worked in a different commune: one day in Lam Ha, another day in Gan Reo, then Darahoa, or Gia Lam, etc., but to me (and perhaps to most members of the group) our day of work (June 19, 2009) at Luc Hoa Orphange in Dinh An is the most unforgettable one.

Behind Bi Ngan wooden bridge is Nguyen Khong Pagoda. “Bi Ngan” means “The Other or Different Bank of the River.” The name of the bridge implies that people who visit the pagoda, passing this bridge, will awaken to the Buddha’s teachings and will see a different world, a different “river bank” which is much better and happier than the illusory “river bank” of the world they formerly saw. I don’t know if this was caused by natural erosion from rain and sunshine or whether someone intentionally erased one letter and changed an accent to deface the sign, but the name on the sign over the bridge had somehow been changed to “Bi Nan” (“Got into an Accident”)! Past the pagoda is Luc Hoa Orphanage. When we arrived, patients of all ages from the commune and the nearby neighborhood were waiting in patience and in silence. Buddhist Nun Superior Tam Hanh and her disciples as well as the orphans from three to fifteen years of age here welcomed us with happy expressions and friendly smiles.

The front yard and some rooms of the orphanage were used as our medical site. After arranging medicines and setting up tables and chairs for examinations, we began our work. Our team that day consisted of doctors in our group, Dr. Nguyen Ngoc Lien together with some people from the Lam Dong Red Cross who volunteered to help us, a pharmacist, and medical students and translators. Before patients came to see us, their blood pressure levels were taken by Hoang, Van Anh, or Uyen (people from the Lam Dong Red Cross) and they were asked a few questions to see whether they had diabetes, hypertension, hepatitis B or other chronic diseases. Most patients were ethnic K’Ho, many of whom could not speak Vietnamese very well. One example: the examination of one patient, we found the word “diabetes” was checked on the patient’s form (in Vietnamese we call this disease “tieu duong,” “tieu = urinate” and “duong” = sugar; “duong” is also a homonym of “street”).  With caution, the doctor for whom I was translating that day told me to ask the patient more questions to elicit additional information about the patient’s disease so that he could appropriately prescribe for this patient.

I asked:
- Do you have diabetes?
He replied (without standard accents, the way the K’Ho pronounce the Vietnamese language)
- Yes!

I continued:
- So what are your blood sugar readings before and after meals?
- I don’t know.
- Did you go to see your doctor?
- No!
- You did not see any doctors, nor do you know your blood sugar levels. So how come you know that you have “diabetes” (“tieu duong”)?
- I did not have a place to urinate at home so I “urinated” in the “street”; that’s how I know I have “tieu duong”!

Oh! This man understood “diabetes” as “urinate in the street”! No wonder this patient and many other ethnic people checked the box on their “Patient Intake Form” saying that they have “tieu duong”!

In another case, I told a patient, “The doctor said you have hypertension.” She seemed not to understand me, so I used more simple words, “Your blood pressure is high.” In Vietnamese both “high” and “tall” are expressed as “cao,” so another way to say “high blood pressure” is “cao mau”; if translated word by word, it might sound like “tall blood.”) She looked at me and the doctor with skeptical eyes; I gave her a friendly look to encourage her to ask us more questions. After some hesitation, she said to us: “I don’t know if the doctor was right to say that I have ‘tall blood’ because I am this short, how can my blood be tall?”

This was the “experience” we “transmitted” to each others’ ears when we asked patients about “diabetes.” Finally we came to a “solution”: We would ask “if they saw any ants coming to their urine” and we would hear an exact answer. We also spent more time on explaining the meaning of “hypertension” and guiding them on their daily diet for their blood pressure to be more stable.

In the afternoon, delicious vegetarian food was served with sweet starfruit (carambola) and jackfruit for dessert. The food was all homemade; even the fruit came from a tree growing in the orphanage yard. It was a lot of fun when on our break some of us climbed the tree; some used a long stick to pick the golden, sweet startfruit! The tree is really high, laden with ripened fruit. The children eagerly brought us plastic bags or baskets to help gather the fresh starfruits. Delight radiated from those little ones’ faces!

That day more than 200 patients were examined, treated for common acute diseases and given medications that our group had brought with us. We finished working quite early that day.

Leader of VNMAP, KhoiNguyen Nguyen, offered a little sum of money to the Buddhist Nun (with the hope we could “compensate” her for the cost of buying food and for cooking for us); nevertheless, she did not accept because “most of you are students who have traveled from the other half of this planet to come here, sacrificing your time, effort and money to come help the sick and the poor. I recorded here your good will but money I could not accept!” KhoiNguyen persisted at length in his efforts to persuade her and finally she accepted the money “to help the people who are poorer and in more urgent need.” Then she showed us around the orphanage. All the furniture here was simple, clean and in neat order. Before saying goodbye to us, she invited us to enjoy the dancing and singing performance of the “little actors and actresses.” They passionately performed one song after another. All the songs were so nice. Let’s “listen” to Hanh Khai (wishes to be a singer when she grows up), who is going to “sing” for us the song “Let’s look at each other in the
eyes!”

“I invite you, my older brothers, older sisters, younger brothers and sisters,
Let’s come here to hold hands.
This is a place there is no more anger or sadness,
This is a place that had room for nothing but smiles,
This is a place that had room for nothing but kindheartedness
Let’s look at each other in the eyes!
We will find overwhelming compassion for humankind,
Now look at each other in the eyes,
You will find sweetness of human love.
Let’s look at each other in the eyes!
Let’s look at each other in the eyes!”

Yes, this was a place where only kindheartedness and overwhelming compassion for humankind could be conceived! Let us open our hearts, sharing with one another the fond gaze and human warmth, to relieve some of the pain in our sick bodies.

Check out the other cool programs you can volunteer with>>
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The Viet Nam Medical Assistance Program (VNMAP) was started by a group of students from the Philadelphia College of Osteopathic Medicine and Johns Hopkins School of Medicine. The pilot mission trip took place in June 2007. During the mission, they found that there is a tremendous need for medical assistance from the poor and the ethnic minority population in the central region of Viet Nam. In addition to providing much needed health care for the people of Viet Nam, they realized that the experience provided a great opportunity for medical students and volunteers to acquire a valuable education ranging from everyday clinical work to learning about the health care system of Viet Nam.

VNMAP is recruiting Volunteers, Pharmacist, Medical Students, and Doctors for the upcoming mission. The application deadline has been extended to Jan 20th, 2010. Please go here for more info or contact Huan Tran at huan.tran@vnmap.org