Postcard from Dien Bien Phu: Dr Kirsty Foster

5 January 2012

Dr Kirsty Foster and Professor Jonathan Morris are working with trainee midwives in Dien Bien Phu, Vietnam to improve child health outcomes.
Dr Kirsty Foster and Professor Jonathan Morris are working with trainee midwives in Dien Bien Phu, Vietnam to improve child health outcomes.

Sydney Medical School's Dr Kirsty Foster will be making frequent visits to the isolated town of Dien Bien Phu in the mountainous northwest of Vietnam over the next two years as part of a program to develop health care skills in the local community and reduce its terrible maternal and child health mortality rates.

Through the University of Sydney's Hoc Mai Foundation Dr Foster, Professor Jonathan Morris and other maternal and child health educators from the University were recently awarded $242,000 from AusAID to implement the two-year community training plan.

Dr Foster recently travelled with Professor Morris to Dien Bien Phu. She describes her experiences here:

Our grant builds on work the Maternal and Child Health team have been doing in Dien Bien Phu since 2004. The Hoc Mai Foundation began life in 1989 as a student exchange organisation between Vietnam and Australia but in the 12 years since has grown to encompass a much broader range of work. The common thread is that everything is done with the aim of improving health and medical education in Vietnam.

Many people from Sydney Medical School were already contributing to Hoc Mai when we were alerted to the poor child and maternal health situation in Dien Bien Province by the Chancellor of the University, Professor Marie Bashir.

The Chancellor is the patron of Hoc Mai but as a passionate advocate of developing world medicine also has a much a longer association with Vietnam and many colleagues there.

The Dien Bien Phu region, situated up in the mountains, not far from the Laos border, is very beautiful. But it is also very poor, literacy levels are low and it is home to more than 20 ethnic minority groups. Transport between Dien Bien Phu and the provincial villages has improved in the past couple of years but it is still a spine-jarring trip to travel to community health centres, a few kilometres from the main district hospital.

All this means that, from a health perspective, there are so many challenges here. In maternal and child health, the Dien Bien statistics are shocking and much worse than the country's national figures.

Some local children in Dien Bien Phu.
Some local children in Dien Bien Phu.

Our funding is to improve the maternal, neo-natal and child health outcomes in Dien Bien province, and the plan is to run six workshops over the next two years.

On this trip we discussed the two major components of the workshops with the heads of the regional health groups - the first being to up-skill and increase the knowledge of local hospital staff in maternal and child health.

We'll be teaching about infection control, nutrition, dealing with post-partum haemorrhage, and other important subjects that many of the community health workers have never had the opportunity to learn. Things that we take for granted, like iron supplements in pregnancy, are not available to women in remote parts of the province.

Previously, we've demonstrated how women can source iron from foods and I have shopped at the local market to make sure that the iron rich foods we use in our teaching are locally available.

The second component of the project is to take a small number of champions from among the medical and midwifery staff and other community leaders, and train them in health promotion and health literacy.

It will be a community development project enhancing what is already in place, absolutely nothing like "here are the clever Australians coming here to tell us what to do". We have expertise in medicine and education, but the local health professionals have achieved a great deal in a very difficult environment, and using their knowledge of the people and local cultural practices is an essential component of the program.

It is also a collaboration between Hoc Mai and Vietnamese colleagues, and on this visit we spent time with Dr Son, Director of the Dien Bien Provincial Hospital, with the Department of Health and with representatives from Hanoi Medical University and the Vietnamese Women's Union.

My visit also included interviews with young Vietnamese doctors and allied health professionals for AusAID Leadership Awards. Hoc Mai has been fortunate to secure funding from the Australian government to bring some of the brightest young Vietnamese to Australia for short periods of intensive training.

Our Hoc Mai alumni increasingly hold senior positions in the health sector in Vietnam and are wonderful ambassadors for the University and the country.

Dr Kirsty Foster is a senior lecturer in medical education at Sydney Medical School and has worked extensively in international health. Jonathan Morris is Professor of Obstetrics, Gynaecology and Neonatology in Sydney Medical School, and Head of Northern Clinical School, based at Royal North Shore Hospital.

Dien Bien Phu is in the mountainous northwest of Vietnam, near the Laos border.
Dien Bien Phu is in the mountainous northwest of Vietnam, near the Laos border.

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