organized curiosity

Improving health care through research

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Can Nova Scotia health research help Vietnam’s children?

PatVietnamThe last two weeks, my wife and I escaped the ice, snow and cold of Nova Scotia and went to Vietnam for a holiday and for research (we did manage to still get back in time for two storms in one week) .

Vietnam is a great place to visit. The people are warm and helpful. It has thousands of years of culture. The food is amazing and there are incredible sights to be seen. I loved the excitement of the cities and the calm of the countryside. We ate in excellent restaurants and squatted on small stools to eat street food. The only meal we were disappointed in was at an upscale restaurant.

Vietnam has a population of 93 million and is growing at about 1% per year. Hanoi, the capital is a city of 6 million. There are about 26 million children in Vietnam.

The first thing I noticed after we left the new international airport at Hanoi was the motor bikes. Thousands flow down each street and crossing the road is an art. One just has to walk out and bikes flow around you like a school of fish. The two most amazing things are that at intersections they weave between each other and that motorbikes carry everything including chickens, entire families and trees.

We also noticed that everyone is connected via cell phones. Every street has 2 or 3 phone stores and there are 131 cell phone subscriptions per 100 people in Vietnam compared to 81 per 100 people in Canada.

Vietnam is a low income country but is making progress and joining the official ranks of the lower middle income countries of the world. The economy is growing at 5.4%, about two and a half times the rate of Canada’s growth. Poverty, however, is still a huge problem. The Gross National Income per person in Vietnam is about $1740US compared to the $52,200US in Canada.

We found the Vietnamese warm, entrepreneurial, energetic and very proud of their country. At the end of the first millennia, they freed themselves from the Chinese and established their independence. From the 1860’s till the mid 1950’s, France was a colonial occupier. The Japanese were in charge during the Second World War.  In my youth, I protested the Vietnam war.  The American war (as it is called in Vietnam) lasted for a decade before the collapse of Saigon in 1975.  After that the Vietnamese fought another war, a limited regional war with the Chinese.  Vietnam remains a single party country with the only party being the communist party.

I ended up in Vietnam because of a meeting hosted by the Graham Boeckh Foundation in Montreal last year where I gave a talk about Strongest Families. Strongest Families is the distance child mental health program that was begun at the IWK with funding from the Canadian Institutes of Health Research. Eliot Goldner from Simon Fraser University suggested I join the Grand Challenges project he was doing with Dr. Vu Cong Nguyen from the Institute of Population, Health and Development in Hanoi and add a child mental health component.

So, I was in Vietnam to discuss starting a Strongest Families Vietnam program.

There are very few child psychiatrists or child psychologists in Vietnam. The culture has, until now, had a difficult time dealing with child discipline and a recent UNICEF report found that over 90% of children experienced psychological aggression and 65% experienced physical punishment in the previous month.

The group of scientists, NGO and governmental officials that I met were among the most thoughtful and innovative individuals I have ever encountered. Their focus was on improving child behavior problems using the best science, adapted to the Vietnamese culture. Beginning with a small feasibility study, we hope to have funding from Grand Challenges Canada and the Vietnamese government to do a larger study. Perhaps we will have a nation wide Strongest Families Vietnam program. It is a bit ironic that it may be easier to scale up an innovative program in a low income country with few resources than in a developed country such as Canada.

~Dr. Patrick McGrath